Therapy

Phosphorus-32 Therapy

This treatment may be given to patients with myeloproliferative disease such as thrombocythaemia or  Polycythaemia.This radionuclide poses no external radiation hazard because it emits pure Beta particles. However, special care must be taken to prevent contamination and possible gastro-intestinal absorption.

• The dose is administered intravenously.
• All personnel involved in the procedure are to be adequately protected with gloves and gowns.
• The patient will only require hospitalisation if a dose of greater than 1110MBq is to be given.

This Radionuclide is used for the relief of bone pain in patients suffering painful osteoblastic skeletal metastases.

The Half-life of Samarium-153 is 46.7 hours.

As Samarium is a gamma-emitting isotope, the patient can undergo conventional whole-body imaging 24 hours after administration. Scanning is done similar to a Bone scan.

• To reduce radiation exposure to the general public, the patient is to remain in the department for up to 4 hours post injection or they should void twice before leaving. They should be instructed to flush the toilet twice.
• All personnel should be adequately protected with gloves and gowns
• Aseptic technique should be used.

N.B. Adverse Reactions: Flare reactions (worsening of pain shortly after Therapy) may occur within 3 days of therapy.

Strontium - 89 Therapy (Metastron)

To relieve bone pain, Strontium -89, commercially known as Metastron may be prescribed to the patient. Metastron is chemically very similar to calcium. Most of its radio-activity is absorbed locally at the sites of concentration. Because the effects of Metastron within the body are limited to the sites where it concentrates, it should not cause any harm to other people through body contact.

During the first week after the injection, Metastron will be present in the blood and urine. Certain precautions are necessary to be taken.

• Where a normal toilet is available it should be used instead of urinal. The toilet should be flushed twice after each use.

• Any spilled urine should be wiped off with a tissue and flushed away.

• Ensure that hands are always washed after using the toilet.

• Immediately wash linen or clothes when contaminated with blood or urine. These should be washed separately from other clothes and rinsed thoroughly.

• Any spilled blood should be washed away.

Yttrium- 90 Silicate Therapy

This Radionuclide is used primarily in the treatment of chronic proliferative synovitis and effusions of various large joints. It achieves partial synovectomy due to irradiation and is less traumatic than a surgical synovectomy.

It is valuable in the treatment of conditions of the knee such as Rheumatoid arthritis, chronic pyrophosphate arthropathy, psoriatic arthritis and ankylosing spondylitis. It may also be used in the treatment of neoplastic conditions by intrapleural, intraperitoneal and intra-arterial injection.

Half Life of Yttrium-90 is 64.1 hours

Procedure: Injected into synovial cavity of the joint.

The joint should be immobilised in a light splint for 24 hours.

 

Radio-Iodine(I-131) therapy

I-131 therapy is a treatment modality for patients with Graves disease and thyroid cancer. Larger activities of I-131 (more than 4 GBq) are used to ablate thyroid remnants or to treat metastases. These patients require hospitalisation following treatment until radiation level decreases to a safe level. The period of hospitalisation usually varies between 2 to 3 days.

Four steps are involved in the therapy procedure.

Consultation: Detailed information about the treatment and information on radiation safety are given to the patient. Informed consent is obtained. Pregnancy state is ascertained where appropriate. Interpreters are used whenever neccessary.

I-131 administration: This includes administration of radioisotope followed by hospitalisation. Nuclear medicine physician and technologists handle the administration of I-131. The treatment room is prepared by nursing staff with assistance from the technologists staff.

Inpatient stay: Monitoring of the patient radiation level is handled by medical physicist. The patient is discharged, when the radiation level decreases to a safe level.

Decontamination: The treatment room needs to be decontaminated before it is used for other patients. This procedure is carried by the physicist or by the technologist staff.

Hospital staff who are involved in caring for the hospitalised patients need to follow simple guidelines to reduce their exposure to radiation.  

• Minimise the time spend with the patient,
• Maximise the distance from the patient.

consistent with the delivery of good clinical care.

Radiation Safety Instructions for patients after therapy

• Avoid prolonged contact with other people.

• Avoid contact with pregnant women and young children.

• Sleep in separate bed for 2 nights.

• If sexually active, men and women should avoid pregnancy for up to 12 months.

• Wash hands well after using toilet. If any urine is seen outside the toilet, clean it up with a tissue and flush the tissue down the toilet. Flush the toilet twice after for each use.

• Drink 10 glasses of fluid each day.

• Rinse undergarments in a sink or tub before placing them in the washing machine with other laundry.

• Use separate eating utensils and cups should be used.

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