DOCSLIB.ORG

Radiation Safety for Nurses

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Radiation Safety for Nurses Medical Care Program Southern California Region Radiation Safety for Nurses Rev. 2/01 Nursing RADIATION SAFETY FOR NURSES HOW TO USE THIS HANDOUT This handout is in two parts, and you should use each part differently. The first part, Radiation Safety Review contains essential information for all nurses whose duties may involve radiation and/or radiation sources. Please read all of this section as soon as possible. The second part, Radiation Safety Procedures, contains specific radiation safety rules for the nursing care of patients undergoing each of the major procedures involving radiation and/or radiation sources. Please read the section on each procedure before providing patient care connected with that procedure. If you are already providing care in connection with a procedure, read the appropriate section immediately, to review the safety rules for nurses. Page numbers for these procedures are: Diagnostic X-Ray: page 5 Diagnostic Nuclear Medicine: page 6 Radioiodine Therapy: page 6 Radiophosphorus Therapy: page 7 Brachytherapy: page 7 Radiation Emergencies: page 8 Rev. 4/02 Kaiser Permanente Radiation Safety Training Nursing Page 1 Radiation Safety Review INTRODUCTION X-Rays As an experienced professional in your field, you X-Rays are produced by several types of equipment. may already be familiar with radiation safety; but no The types of x-ray equipment that you encounter matter how much you know, you need to review the depend on your specialty. In general though, nurses key points, for two reasons: most often see mobile radiographic and C-arm fluo- • State regulations and Kaiser Permanente poli- roscopy units. cies both require an annual review of radiation safety procedures in your professional spe- Diagnostic Radionuclides cialty. Diagnostic radionuclides are radioactive materials • Under the pressures of time and work load, used in nuclear medicine departments. They include even experienced nurses can become some- technetium-99m, gallium-67, thallium-201, and oth- ers. Overall, the risk presented by diagnostic radio- what lax about routinely taking proper safety nuclides is minimal. precautions. Therapeutic Radionuclides For people who consistently practice radiation safety, Therapeutic radionuclides are unsealed radioactive the risk is truly negligible. But for people who are materials administered in therapeutic doses to pa- uninformed, forgetful, or just careless, the risk in- tients orally or by injection. They include: creases. So no matter how experienced you are with • Radioiodine (I-131), usually administered radiation, take some time to refresh your memory by orally to treat hyperthyroidism and thyroid reading this review. cancer. • Radiophosphorus (P-32), which is admini- SOURCES OF RADIATION stered by injection to treat certain types of In medical facilities, the five most common sources cancer. of ionizing radiation are: • X-Ray producing equipment, usually found in Therapeutic radionuclides present potential radia- the radiology department, and in surgery, emer- tion hazards. But if proper safety practices are gency, and patient care areas, as well as in followed carefully, the risk here is also minimal. specialized areas such as the cardiac catheteri- zation lab. Brachytherapy Sources • Diagnostic radionuclides, usually found in the Brachytherapy procedures use sealed sources con- nuclear medicine department and in patient taining radioactive material in therapeutic quantities care areas. to treat certain types of cancer. These sources are • Therapeutic radionuclides, usually found in inserted into patients’ bodies, in areas such as the the nuclear medicine department, and in pa- uterus, breast, and naso-pharynx. The most com- tient care areas where therapeutic nuclear monly used radioactive materials include: medicine patients are cared for. • Radioactive cesium (Cs-137). • Brachytherapy sources, usually found in the • Radioactive iridium (Ir-192). same areas as therapeutic radionuclides. • Radioactive iodine (I-125). • Radiation therapy equipment, usually found in the radiation therapy department. Although brachytherapy sources containing radio- active materials are sealed, they do present potential Now let’s look more closely at each source of radiation hazards. Here again, the risks are greatly ionizing radiation. reduced by following sound safety practices. Kaiser Permanente Radiation Safety Training Rev. 4/02 Page 2 Nursing Radiation Therapy Equipment Radioactive contamination can produce significant lev- Radiation therapy equipment uses ionizing radia- els of localized radiation exposure. tion to treat certain forms of cancer and other abnor- mal tissues. This equipment focuses high-energy Sources that DO NOT Produce Ionizing radiation from outside the body, on carefully se- Radiation lected tissues. It is usually administered in therapeu- Remember that the hazards we are discussing are tic doses. The linear accelerator and cobalt (Co-60) produced by ionizing radiation. Occasionally, people teletherapy units are examples of radiation therapy think there may be a radiation hazard in other situ- equipment. ations where there is actually none, because there is no ionizing radiation. RADIATION HAZARDS The potential hazard from radiation is exposure to Selected examples of things that do not produce ionizing rays or particles. Radiation exposure can ionizing radiation include x-ray machines that are occur in three types of situations: not actually making an exposure, patients who have • When you are near an x-ray machine that is had x-rays or external beam radiation therapy treat- actually making an exposure. In this situation, ments, nuclear medicine imaging equipment, iodine x-rays scatter and can expose an unshielded contrast material used in patients for x-ray imaging, body. ultrasound equipment, and microwave ovens. • When you are near or in contact with a patient undergoing brachytherapy or radionuclide State and Kaiser Permanente Standards therapy. In this situation, radiation is emitted Five thousand mrem per year is the maximum expo- from the patient’s body, and/or from objects sure permitted by state regulations for workers con- that have been contaminated by radioactive sidered to be “occupationally exposed.” (Occupa- material. tionally exposed workers are people such as x-ray • When you or your clothing have been con- and nuclear medicine technologists who routinely taminated by radioactive material. and regularly work with and around radiation and radioactive materials.) Radioactive Contamination Normally, potential radiation hazards are evident, because they are associated with specific areas, Kaiser Permanente’s own standards are more con- equipment, and procedures. But radioactive con- servative than the state’s. We set standards to tamination is not. By definition, radioactive con- achieve radiation exposure levels “As Low As Rea- tamination is the presence of radioactive materials sonably Achievable” (ALARA). For example, our anywhere they don’t belong — that is, anywhere maximum permissible exposure per year for occu- they are not appropriately identified, contained, and pationally exposed workers is 1,000 mrem — only controlled. one-fifth of the limits allowed by state regulations. Here is a summary of state and Kaiser Permanente Contamination is especially hazardous because it radiation exposure standards for occupationally ex- can be present without your knowing it. With posed workers: people, contamination may be external (contact with the skin) or it may be internal, due to ingestion, Maximum Permissible Whole Body Dose inhalation, or absorption of radioactive material. Period State Standard Kaiser Standard This can happen with radionuclide therapy, but is Month (no standard) 150 mrem unlikely in brachytherapy, because sealed brachyth- Year 5,000 mrem 1,000 mrem erapy sources are not likely to leak or break. Rev. 4/02 Kaiser Permanente Radiation Safety Training Nursing Page 3 Keep in mind that these are maximum allowable doses • Do not handle material labeled as radioac- for occupationally exposed workers. The amount actu- tive unless you are trained and authorized to do ally received is normally much less. For all workers who so. are not considered to be occupationally exposed, the maximum extra exposure is 100 mrem per year — the Reduce Your Exposure Time same as for the general public. The key to reducing your exposure time is planning. Make sure in advance that you have everything you What this means to you depends on your particular need so that you can complete necessary procedures job responsibilities: near a radiation source as quickly as possible. • If you do not routinely and regularly work with or near radiation sources, you are “non-occu- Increase Your Distance From Radiation pationally exposed.” In this case, you will Radiation levels vary inversely with the square of probably receive no extra radiation whatever. the distance from their source — that is, levels • If you work with patients receiving therapeu- decrease sharply with distance. The farther away you place yourself, the less radiation you are ex- tic doses of radioactivity, you may receive posed to. around 50 extra mrem per year. (You are still not “occupationally exposed”). Shield Yourself from Radiation Shielding will also reduce the level of radiation. Pregnant Personnel Shielding is very effective with x-rays. Wear a lead Kaiser Permanente policies discourage pregnant apron, where provided. If your hands may be in the personnel from caring for patients receiving thera- x-ray beam, wear lead
Load more

Recommended publications
  • Submission to the Nuclear Power Debate Personal Details Kept Confidential
    Submission to the Nuclear power debate Personal details kept confidential __________________________________________________________________________________________ Firstly I wish to say I have very little experience in nuclear energy but am well versed in the renewable energy one. What we need is a sound rational debate on the future energy requirements of Australia. The calls for cessation of nuclear investigations even before a debate begins clearly shows that emotion rather than facts are playing a part in trying to stop the debate. Future energy needs must be compliant to a sound strategy of consistent, persistent energy supply. This cannot come from wind or solar. Lets say for example a large blocking high pressure weather system sits over the Victorian, NSW land masses in late summer- autumn season. We will see low winds for anything up to a week, can the energy market from the other states support the energy needs of these states without coal or gas? I think not. France has a large investment in nuclear energy and charges their citizens around half as much for it than Germany. Sceptics complain about the costs of storage of waste, they do not suggest what is going to happen to all the costs to the environment when renewing of derelict solar panels and wind turbine infrastructure which is already reaching its use by dates. Sceptics also talk about the dangers of nuclear energy using Chernobyl, Three Mile Island and Fuklushima as examples. My goodness given that same rationale then we should have banned flight after the first plane accident or cars after the first car accident.
    [Show full text]
  • NUREG-1350, Vol. 31, Information
    NRC Figure 31. Moisture Density Guage Bioshield Gauge Surface Detectors Depth Radiation Source GLOSSARY 159 GLOSSARY Glossary (Abbreviations, Definitions, and Illustrations) Advanced reactors Reactors that differ from today’s reactors primarily by their use of inert gases, molten salt mixtures, or liquid metals to cool the reactor core. Advanced reactors can also consider fuel materials and designs that differ radically from today’s enriched-uranium dioxide pellets within zirconium cladding. Agreement State A U.S. State that has signed an agreement with the U.S. Nuclear Regulatory Commission (NRC) authorizing the State to regulate certain uses of radioactive materials within the State. Atomic energy The energy that is released through a nuclear reaction or radioactive decay process. One kind of nuclear reaction is fission, which occurs in a nuclear reactor and releases energy, usually in the form of heat and radiation. In a nuclear power plant, this heat is used to boil water to produce steam that can be used to drive large turbines. The turbines drive generators to produce electrical power. NUCLEUS FRAGMENT Nuclear Reaction NUCLEUS NEW NEUTRON NEUTRON Background radiation The natural radiation that is always present in the environment. It includes cosmic radiation that comes from the sun and stars, terrestrial radiation that comes from the Earth, and internal radiation that exists in all living things and enters organisms by ingestion or inhalation. The typical average individual exposure in the United States from natural background sources is about 310 millirem (3.1 millisievert) per year. 160 8 GLOSSARY 8 Boiling-water reactor (BWR) A nuclear reactor in which water is boiled using heat released from fission.
    [Show full text]
  • Review of Outpatient Brachytherapy Medicare Payments to Carolinas Medical Center
    DEPARTMENT OF HEALTH & HUMAN SERVICES OFFICE OF INSPECTOR GENERAL Office of Audit Services, Region IV 61 Forsyth Street, SW, Suite 3T41 Atlanta, GA 30303 February 6, 2012 Report Number: A-04-11-06135 Ms. Suzanne Freeman Divisional President Carolinas Medical Center P.O. Box 32861 Charlotte, NC 28232-2861 Dear Ms. Freeman: Enclosed is the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), final report entitled Review of Outpatient Brachytherapy Medicare Payments to Carolinas Medical Center. We will forward a copy of this report to the HHS action official noted on the following page for review and any action deemed necessary. The HHS action official will make final determination as to actions taken on all matters reported. We request that you respond to this official within 30 days from the date of this letter. Your response should present any comments or additional information that you believe may have a bearing on the final determination. Section 8L of the Inspector General Act, 5 U.S.C. App., requires that OIG post its publicly available reports on the OIG Web site. Accordingly, this report will be posted at http://oig.hhs.gov. If you have any questions or comments about this report, please do not hesitate to call me, or contact Andrew Funtal, Audit Manager, at (404) 562-7762 or through email at [email protected]. Please refer to report number A-04-11-06135 in all correspondence. Sincerely, /Lori S. Pilcher/ Regional Inspector General for Audit Services Enclosure Page 2 – Ms. Suzanne Freeman Direct Reply to HHS Action Official: Nanette Foster Reilly Consortium Administrator Consortium for Financial Management & Fee for Service Operations Centers for Medicare & Medicaid Services 601 East 12th Street, Room 235 Kansas City, Missouri 64106 Department of Health and Human Services OFFICE OF INSPECTOR GENERAL REVIEW OF OUTPATIENT BRACHYTHERAPY MEDICARE PAYMENTS TO CAROLINAS MEDICAL CENTER Daniel R.
    [Show full text]
  • Radiation Quick Reference Guide Recommend Contacting Your State Fusion Center
    Domestic Nuclear Detection Office If you encounter something suspicious follow your specific local protocols. Radiation Quick Reference Guide Recommend contacting your state fusion center. DNDO is available 24/7 to assist at 1-877-DNDO-JAC / 1-877-363-6522 JAC Information Line 202-254-7179 Email: [email protected] Nuclear Concerns/ Threats 1. Nuclear Weapon - a device that releases nuclear energy in an ex- Isotopes of Concern for use in RDDs - with common uses plosive manner. Uses Highly Enriched Uranium (HEU) and/or 1. Cobalt-60 – cancer treatment, level/ Plutonium. density gauge, teletherapy, radiography, 2. Improvised Nuclear Device (IND) - a nuclear weapon fabricated food sterilization/irradiation, by a terrorist organization or rogue nation. brachytherapy 2. Iridium-192 – Radiography/non- destructive testing, flaw detection, brachy- therapy “cancer seed”, skin cancer Cobalt 60 sources Uranium “superficial” brachytherapy Plutonium 3. Uranium a. Uranium exists naturally in the earth’s crust. Of the different “isotopes” of uranium, U-235 is the one required to produce a Iridium sentinel and nuclear weapon. gamma camera b. Natural uranium contains a small amount of U-235 (<1%) which Cesium Seeds must be separated in complex extraction processes to create HEU. The predominant uranium isotope is U-238. 3. Cesium-137 - Gauge/level gauge, industrial radiography, brachyther- c. Highly Enriched Uranium (HEU) refers to uranium usable in weap- apy/teletherapy, well logging/density gauges ons due to its enrichment in U-235. 4. Strontium-90 – Radioisotope thermoelectric generator (RTG), fis- d. Approximately 25 kg of HEU is required for a nuclear weapon. sion product, industrial gauges, medical treatment e.
    [Show full text]
  • HISTORY Nuclear Medicine Begins with a Boa Constrictor
    HISTORY Nuclear Medicine Begins with a Boa Constrictor Marshal! Brucer J Nucl Med 19: 581-598, 1978 In the beginning, a boa constrictor defecated in and then analyzed the insoluble precipitate. Just as London and the subsequent development of nuclear he suspected, it was almost pure (90.16%) uric medicine was inevitable. It took a little time, but the acid. As a thorough scientist he also determined the 139-yr chain of cause and effect that followed was "proportional number" of 37.5 for urea. ("Propor­ inexorable (7). tional" or "equivalent" weight was the current termi­ One June week in 1815 an exotic animal exhibi­ nology for what we now call "atomic weight.") This tion was held on the Strand in London. A young 37.5 would be used by Friedrich Woehler in his "animal chemist" named William Prout (we would famous 1828 paper on the synthesis of urea. Thus now call him a clinical pathologist) attended this Prout, already the father of clinical pathology, be­ scientific event of the year. While he was viewing a came the grandfather of organic chemistry. boa constrictor recently captured in South America, [Prout was also the first man to use iodine (2 yr the animal defecated and Prout was amazed by what after its discovery in 1814) in the treatment of thy­ he saw. The physiological incident was common­ roid goiter. He considered his greatest success the place, but he was the only person alive who could discovery of muriatic acid, inorganic HC1, in human recognize the material. Just a year earlier he had gastric juice.
    [Show full text]
  • The Supply of Medical Isotopes
    The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS This work is published under the responsibility of the Secretary-General of the OECD. The opinions expressed and arguments employed herein do not necessarily reflect the official views of OECD member countries. This document, as well as any data and any map included herein, are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Please cite this publication as: OECD/NEA (2019), The Supply of Medical Isotopes: An Economic Diagnosis and Possible Solutions, OECD Publishing, Paris, https://doi.org/10.1787/9b326195-en. ISBN 978-92-64-94550-0 (print) ISBN 978-92-64-62509-9 (pdf) The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. Photo credits: Cover © Yok_onepiece/Shutterstock.com. Corrigenda to OECD publications may be found on line at: www.oecd.org/about/publishing/corrigenda.htm. © OECD 2019 You can copy, download or print OECD content for your own use, and you can include excerpts from OECD publications, databases and multimedia products in your own documents, presentations, blogs, websites and teaching materials, provided that suitable acknowledgement of OECD as source and copyright owner is given.
    [Show full text]
  • Radiation and Risk: Expert Perspectives Radiation and Risk: Expert Perspectives SP001-1
    Radiation and Risk: Expert Perspectives Radiation and Risk: Expert Perspectives SP001-1 Published by Health Physics Society 1313 Dolley Madison Blvd. Suite 402 McLean, VA 22101 Disclaimer Statements and opinions expressed in publications of the Health Physics Society or in presentations given during its regular meetings are those of the author(s) and do not necessarily reflect the official position of the Health Physics Society, the editors, or the organizations with which the authors are affiliated. The editor(s), publisher, and Society disclaim any responsibility or liability for such material and do not guarantee, warrant, or endorse any product or service mentioned. Official positions of the Society are established only by its Board of Directors. Copyright © 2017 by the Health Physics Society All rights reserved. No part of this publication may be reproduced or distributed in any form, in an electronic retrieval system or otherwise, without prior written permission of the publisher. Printed in the United States of America SP001-1, revised 2017 Radiation and Risk: Expert Perspectives Table of Contents Foreword……………………………………………………………………………………………………………... 2 A Primer on Ionizing Radiation……………………………………………………………………………... 6 Growing Importance of Nuclear Technology in Medicine……………………………………….. 16 Distinguishing Risk: Use and Overuse of Radiation in Medicine………………………………. 22 Nuclear Energy: The Environmental Context…………………………………………………………. 27 Nuclear Power in the United States: Safety, Emergency Response Planning, and Continuous Learning…………………………………………………………………………………………….. 33 Radiation Risk: Used Nuclear Fuel and Radioactive Waste Disposal………………………... 42 Radiation Risk: Communicating to the Public………………………………………………………… 45 After Fukushima: Implications for Public Policy and Communications……………………. 51 Appendix 1: Radiation Units and Measurements……………………………………………………. 57 Appendix 2: Half-Life of Some Radionuclides…………………………………………………………. 58 Bernard L.
    [Show full text]
  • Radioactive Waste
    Radioactive Waste 07/05/2011 1 Regulations 2 Regulations 1. Nuclear Regulatory Commission (NRC) 10 CFR 20 Subpart K. Various approved options for radioactive waste disposal. (See also Appendix F) 10 CFR 35.92. Decay in storage of medically used byproduct material. 10 CFR 60. Disposal of high-level wastes in geologic repositories. 10 CFR 61. Shallow land disposal of low level waste. 10 CFR 62. Criteria and procedures for emergency access to non-Federal and regional low-level waste disposal facilities. 10 CFR 63. Disposal of high-level rad waste at Yucca Mountain, NV 10 CFR 71 Subpart H. Quality assurance for waste packaging and transportation. 10 CFR 72. High level waste storage at an MRS 3 Regulations 2. Department of Energy (DOE) DOE Order 435.1 Radioactive Waste Management. General Requirements regarding radioactive waste. 10 CFR 960. General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. Site selection guidelines for a waste repository. The following are not regulations but they provide guidance regarding the implementation of DOE Order 435.1: DOE Manual 435.1-1. Radioactive Waste Management Manual. Describes the requirements and establishes specific responsibilities for implementing DOE O 435.1. DOE Guide 435.1-1. Suggestions and acceptable ways of implementing DOE M 435.1-1 4 Regulations 3. Environmental Protection Agency 40 CFR 191. Environmental Standards for the Disposal of Spent Nuclear Fuel, High-level and Transuranic Radioactive Wastes. Protection for the public over the next 10,000 years from the disposal of high-level and transuranic wastes. 4. Department of Transportation 49 CFR Parts 171 to 177.
    [Show full text]
  • Brachytherapy with Miniature Electronic X-Ray Sources
    Brachytherapy with Miniature Electronic X-ray Sources Mark J. Rivard, Larry A. DeWerd, and Heather D. Zinkin Tufts-New England Medical Center, Boston, MA University of Wisconsin, Madison, WI DISCLOSURE Dr. Rivard serves as a consultant and Dr. DeWerd receives research support from Xoft, Inc. HISTORY Electronic brachytherapy (eBx) applies interstitial irradiation without radionuclides A miniature x-ray tube is commonly employed eBx conceived in the 1980s by Alan Sliski of PhotoElectron Corp. in collaboration with MIT Dosimetric properties and source characteristics first published in 1993 (Biggs et al., Gall et al., Smith et al.) in Medical Physics ~ 10 other companies pursued eBx since then RATIONALE Bx Source Advantages Disadvantages radionuclide Well established therapeutic use Fixed dosimetry properties Well established calibration procedures Radioactive waste concerns Fixed photon spectrum and half-life Regular source shipments due to decay High specific activity, small size electronic User-adjustable dose rate (on/off) Unproven clinical application User-adjustable dosimetric properties No NIST calibration protocol Lessened radiological exposure to staff Output variability amongst sources Typically larger in size No statements may be made at this time regarding cost differences or clinical results VENDOR SCOPE 1. Advanced X-ray Technologies Inc. Birmingham, MI 2. Carl Zeiss Ltd. Oberkochen, Germany 3. Xoft Inc. Fremont, CA Advanced X-ray Technologies Use of a primary and secondary targeting system with substantial polar and azimuthal
    [Show full text]
  • Fission-Produced 99Mo Without a Nuclear Reactor
    BRIEF COMMUNICATIONS Fission-Produced 99Mo Without a Nuclear Reactor Amanda J. Youker, Sergey D. Chemerisov, Peter Tkac, Michael Kalensky, Thad A. Heltemes, David A. Rotsch, George F. Vandegrift, John F. Krebs, Vakho Makarashvili, and Dominique C. Stepinski Argonne National Laboratory, Nuclear Engineering Division, Argonne, Illinois halted in the past due to inclement weather, natural phenomena, 99Mo, the parent of the widely used medical isotope 99mTc, is cur- flight delays, and terrorist threats (6). rently produced by irradiation of enriched uranium in nuclear reac- The predominant global 99Mo production route is irradiation of tors. The supply of this isotope is encumbered by the aging of these highly enriched uranium (HEU, $20% 235U) solid targets in nuclear reactors and concerns about international transportation and nu- reactors fueled by uranium (2). Other potential 99Mo production Methods: clear proliferation. We report results for the production paths include (n,g)98Mo and (g,n)100Mo; however, both routes re- of 99Mo from the accelerator-driven subcritical fission of an aqueous quire enriched molybdenum material and produce low-specific- solution containing low enriched uranium. The predominately fast 99 neutrons generated by impinging high-energy electrons onto a tan- activity Mo, which cannot be loaded directly on a commercial 99m talum convertor are moderated to thermal energies to increase fission Tc generator. The U.S. National Nuclear Security Administra- processes. The separation, recovery, and purification of 99Mo were tion implements the long-standing U.S. policy to minimize and demonstrated using a recycled uranyl sulfate solution. Conclusion: eliminate HEU in civilian applications by working to convert re- The 99Mo yield and purity were found to be unaffected by reuse of the search reactors and medical isotope production facilities to low previously irradiated and processed uranyl sulfate solution.
    [Show full text]
  • Nuclear Fusion Enhances Cancer Cell Killing Efficacy in a Protontherapy Model
    Nuclear fusion enhances cancer cell killing efficacy in a protontherapy model GAP Cirrone*, L Manti, D Margarone, L Giuffrida, A. Picciotto, G. Cuttone, G. Korn, V. Marchese, G. Milluzzo, G. Petringa, F. Perozziello, F. Romano, V. Scuderi * Corresponding author Abstract Protontherapy is hadrontherapy’s fastest-growing modality and a pillar in the battle against cancer. Hadrontherapy’s superiority lies in its inverted depth-dose profile, hence tumour-confined irradiation. Protons, however, lack distinct radiobiological advantages over photons or electrons. Higher LET (Linear Energy Transfer) 12C-ions can overcome cancer radioresistance: DNA lesion complexity increases with LET, resulting in efficient cell killing, i.e. higher Relative Biological Effectiveness (RBE). However, economic and radiobiological issues hamper 12C-ion clinical amenability. Thus, enhancing proton RBE is desirable. To this end, we exploited the p + 11Bà3a reaction to generate high-LET alpha particles with a clinical proton beam. To maximize the reaction rate, we used sodium borocaptate (BSH) with natural boron content. Boron-Neutron Capture Therapy (BNCT) uses 10B-enriched BSH for neutron irradiation-triggered alpha-particles. We recorded significantly increased cellular lethality and chromosome aberration complexity. A strategy combining protontherapy’s ballistic precision with the higher RBE promised by BNCT and 12C-ion therapy is thus demonstrated. 1 The urgent need for radical radiotherapy research to achieve improved tumour control in the context of reducing the risk of normal tissue toxicity and late-occurring sequelae, has driven the fast- growing development of cancer treatment by accelerated beams of charged particles (hadrontherapy) in recent decades (1). This appears to be particularly true for protontherapy, which has emerged as the most-rapidly expanding hadrontherapy approach, totalling over 100,000 patients treated thus far worldwide (2).
    [Show full text]
  • Review White Paper (Pdf)
    Brachytherapy: high precision, targeted radiotherapy Because life is for living Table of contents Executive summary 3 Introduction 4 Radiotherapy: present and future goals 5 Overview of brachytherapy 6 • Brachytherapy: high precision, targeted radiotherapy 6 Types of brachytherapy 7 Brachytherapy dosing 7 Brachytherapy efficacy and safety outcomes; patient benefits 8 • Brachytherapy in gynecological cancer 8 • Brachytherapy in prostate cancer 9 • Brachytherapy in breast cancer 12 • Brachytherapy in other cancers 14 • Brachytherapy in palliative care 15 Brachytherapy: setting benchmarks in radiation technology 15 • Advantages: technical and cost base 15 • Ongoing advances in brachytherapy result in improved outcomes and efficiency 16 Cost effectiveness: making efficient use of healthcare resources 17 Conclusions 19 Glossary 20 References 21 2 Brachytherapy: high precision, targeted radiotherapy Executive summary Radiotherapy is a key cornerstone of cancer care: this • The ability of brachytherapy to deliver high radiation White Paper reviews the role of brachytherapy – high doses over a short time period means patients can precision, targeted radiotherapy – in cancer treatment, complete treatment in days rather than the and discusses how it offers an effective, well tolerated weeks required for EBRT. For example, high dose rate radiation treatment option, tailored to the needs and (HDR) brachytherapy treatment for prostate cancer preferences of the individual patient. can be delivered in two treatment sessions, compared to several weeks with EBRT. This has important Brachytherapy combines two fundamental aims potential implications for patient compliance with of radiotherapy: an effective tumor dose with their radiotherapy treatment, as well as minimizing sparing of the surrounding tissue. Brachytherapy is impact on patients’ lives at the forefront of innovation in radiotherapy.
    [Show full text]