DİFERANSİYE TİROİD KARSİNOMUNDA 131I TEDAVİSİ ALAN HASTALARDA KISA MESAFEDE UZUN DÖNEM EKSTERNAL DOZUN DEĞERLENDİRİLMESİ

Yıl 2024, , 227 - 234, 19.07.2024

Bilal Kovan , Dilşat Fırat Arslan , Caner Civan , Emine Göknur Işık , Bayram Demir , Serkan Kuyumcu , Yasemin Şanlı

https://doi.org/10.26650/IUITFD.1458390

Öz

Amaç: İyot-131 (131I) tedavisi, yüksek enerjili gama radyasyonu yayması nedeniyle görüntüleme avantajları sunmakla birlikte, radyasyon güvenliğine ilişkin endişeleri de artırmaktadır. Radyasyondan korunmaya yönelik uluslararası ve ulusal düzeyde çeşitli kurallar ve standartlar oluşturulmuştur. Bu tedaviyi gören hastalar, etraflarındaki kişilerin dışarıdan radyasyona maruz kalma riski oluşturabilir. Bu çalışmanın amacı tedavi gören hastaların yakınındaki radyasyon doz oranlarını ölçmek ve maruz kalanların aldığı kümülatif dozları değerlendirmektir.
Gereç ve Yöntem: Diferansiye tiroid kanseri nedeniyle radyoaktif iyot (RAI) tedavisi gören toplam 44 hasta çalışmaya dahil edildi. Tiroid uyarıcı hormon (TSH) düzeyleri ve 24 saatlik radyoiyot alımları ölçüldü. Hastalara uygulanan RAI dozları kaydedildi. Tedaviyi takiben 131I tedavisinden sonraki 0, 4, 24, 48, 72, 144 ve 240. saatlerde hastalardan 30 cm ve 1 m mesafeden eksternal doz oranları (EDR) ölçüldü. Hastaya eşlik edenlerin radyasyon maruziyetleri üç senaryo dikkate alınarak hesaplandı.
Bulgular: 44 hastanın ortanca TSH değeri 81,74±41,98 mlU/L olarak hesaplanırken, 24 saatlik alım değerlerinin ortancası %6,39±8,42 olarak belirlendi. Ortalama uygulanan tedavi dozu 5,28 GBq (±1,3) idi. İlk 24 saatlik ölçümler ile uygulanan doz arasında korelasyon gözlendi. Ayrıca 24. saatten sonra alınan ölçümler ile 24. saatteki alım değeri arasında korelasyon bulundu. Eşlik eden kişilerin radyasyona maruz kalma oranının üç senaryoda 0,4 ila 1,62 mSv arasında olduğu tahmin edildi.
Sonuç: RAI tedavisi gören hastalara tedavi sonrasında radyasyondan korunmanın önemi ve izolasyon sırasında alınması gereken önlemler konusunda kapsamlı bilgi verilmelidir.

Anahtar Kelimeler

Radyasyon güvenliği, diferansiye tiroid karsinomu, 131I, harici doz hızı, radyasyon koruması

EVALUATING LONG-TERM EXTERNAL DOSES AT SHORT RANGE IN PATIENTS RECEIVING 131I TREATMENT FOR DIFFERENTIATED THYROID CARCINOMA

Öz

Objective: Iodine-131 (131I) treatment offers imaging advantages due to its emission of high-energy gamma radiation, despite concerns being raised regarding radiation safety. Various rules and standards for radiation protection have been established internationally and nationally. Patients undergoing this treatment can present a risk of external radiation exposure to the people around them. The purpose of this study is to measure the radiation dose rates around patients who have undergone treatment and to assess the effects of cumulative doses received by those who have been exposed.
Material and Method: The study includes a total of 44 patients who had undergone radioactive iodine therapy for differentiated thyroid cancer and measures their thyroid stimulating hormone (TSH) levels and 24-hour radioiodine uptake. The 131I doses administered to the patients were recorded. Following treatment, external dose rates (EDR) were measured at distances of 30 cm and 1 m from the patients at 0, 4, 24, 48, 72, 144, and 240 h post 131I treatment. Radiation exposure was calculated by considering three scenarios for those accompanying the patient.
Result: The study calculated the median TSH values of the 44 patients as 81.74±41.98 mlU/L, while the median of their 24- hour uptake values was determined as 6.39±8.42%. The mean administered treatment dose was 5.28 GBq (±1.3). A correlation was observed between the initial 24-hour measurements and the administered dose. Furthermore, another correlation was found between the measurements taken after the 24th hour and the 24-hour uptake value. The radiation exposure for accompanying individuals was estimated to range between 0.4-1.62 mSv across three scenarios.
Conclusion: Patients receiving 131I treatment should be given comprehensive information about the importance of radiation protection after treatment and the precautions to be taken during isolation.

Anahtar Kelimeler

Radiation safety, differentiated thyroid carcinoma, 131I, external dose rate, radiation protectio

Kaynakça

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