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首页> 外文会议>Congress of the International Radiation Protection Association;IRPA 12 >Evaluation of Bone Marrow Irradiation by Area Under the Curve of Blood Counts Measurements in Hemodialyzed Patients with Differentiated Thyroid Cancer Treated with ~(131)Iodine.
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Evaluation of Bone Marrow Irradiation by Area Under the Curve of Blood Counts Measurements in Hemodialyzed Patients with Differentiated Thyroid Cancer Treated with ~(131)Iodine.

机译：〜（131）碘治疗血液透析的分化型甲状腺癌患者的血细胞计数曲线下按面积评估骨髓照射。

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The administration of ~(131)I is a well established treatment for differentiated thyroid carcinoma (DTC).Uncommon situations, such as DTC in patients on hemodialysis (HD), can generate logistic problems withpersonnel and disposables materials, as well as with suitable calculation of the activity to be administered, in orderto avoid excessive irradiation to critical organs such as bone marrow, due to excretion impairment.Objectives: To estimate the risk of bone marrow irradiation in patients with DTC and end stage renal disease(ESRD) in HD, requiring radioiodine ablation therapy, and to make radiation safety considerations during HD.Methods: 2 patients (p) with ESRD in HD with DTC with indication of post surgical ~(131)I ablation of the thyroidremnant were submitted. An interdisciplinary approach between Nuclear Medicine, Endocrinology andNephrology departments was addressed. Both patients received a 3.7GBq dose of ~(131)I. Extended high flux HDwas performed 24 hours after therapeutic dose (dialysis flow 800ml/min and blood flow 400ml/min during 6hours). External exposition was measured with a portable monitor at 1 meter distance from the p and serial bloodcount teams???? of the inlet and outlet blood lines of the HD blood circuit were obtained; chip monitors were usedby the Nephrology personnel in order to measure their external exposition. At the end of the procedure, residualactivity of the HD machine, dialyser and lines were measured with a portable monitor. In order to evaluate thebone marrow irradiation, the radionuclid clearance, the area under the curve (AUC) was calculated, taking intoaccount the different values of the effective half life described in the literature.Results: In the 2 p, 94 and 90% of the ~(131)I dose had been removed at the end of the first HD session respectively(76% and 66% in the first hour of HD). A parallel reduction was observed in the external dosimetry. The effectiveintradialysis ~(131)I T ? was 1.4 and 1.8 hours.Conclusions: External dosimetry was useful to evaluate the residual activity at the end of the HD. We considerthat strict isolation would only be necessary until the end of the first HD. The most critical question that needs tobe answered is what dose of ~(131)I that should be used to effectively treat the tumor without increasing the risk ofside-effects.
机译：〜（131）I的给药是公认的分化型甲状腺癌（DTC）治疗方法。 罕见的情况，例如接受血液透析（HD）的患者中的DTC，可能会导致以下问题 人员和一次性材料，以及适当计算要管理的活动，以便 避免由于排泄障碍而对关键器官如骨髓过度照射。 目的：评估DTC和终末期肾病患者骨髓照射的风险 HD中需要进行放射碘消融治疗（ESRD），并在HD期间要考虑放射安全性。 方法：2例（p）患有DTC的ESRD伴有HD的患者，提示手术后〜（131）I消融甲状腺 剩余的被提交。核医学，内分泌学和核医学之间的跨学科方法 肾脏科得到了解决。两名患者均接受3.7GBq剂量的〜（131）I。扩展的高通量高清 是在治疗剂量后24小时进行的（6个月期间透析流量800ml / min，血流量400ml / min） 小时）。用便携式监护仪在距p和连续血1米的距离处测量外部暴露 算球队？？？？获得高清血液回路的入口和出口血液线;使用了芯片监视器 由肾脏科人员进行，以衡量他们的外在状况。程序结束时，残留 用便携式监视器测量高清计算机，透析仪和线路的活动。为了评估 计算骨髓照射，放射性核素清除率，曲线下面积（AUC），并考虑 考虑到文献中描述的有效半衰期的不同值。 结果：在第2个HD中，第一次HD疗程结束时已分别去除了〜（131）I剂量的94％和90％ （在高清的第一个小时中分别占76％和66％）。在外部剂量测定中观察到平行减少。有效的 透析内〜（131）I T？是1.4和1.8小时。 结论：外部剂量测定法可用于评估HD结束时的残留活性。我们认为 只有在第一个高清影片结束之前，才需要严格隔离。需要解决的最关键的问题 应回答的是应使用什么剂量的〜（131）I来有效治疗肿瘤，而又不增加 副作用。

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