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Radiological Protection of Patients |
The use of permanent radioactive implants (I-125 or Pd-103 seeds) to treat selected localised prostate cancer patients has been increasing rapidly all over the world for the last 15 years. It is estimated that more than 50,000 patients are treated this way every year in the world, and this number is anticipated to increase in the near future.
Although no accidents or adverse effects involving medical staff and/or members of the patient's family have been reported to date, this brachytherapy technique raises a number of radiation safety issues that need specific recommendations from the ICRP.
All data concerning the dose received by people approaching patients after implantation have been reviewed. Those doses have either been measured directly or calculated. The available data show that, in the vast majority of cases, the dose to comforters and carers remains well below the recommended limit of 1mSv/year. Only the (rare) case where the patient's partner is pregnant at the time of implantation may need specific precautions.
Expulsion of sources through urine, semen, or the gastro-intestinal tract is rare. Specific recommendations should be given to patients to allow them to deal adequately with this event. Of note, due to the low activity of an isolated seed and its low photon energy, no incident/accident linked to seed loss has ever been recorded.