Radiation exposure to family and household members after prostate brachytherapy.
OBJECTIVE
Patients with localized prostate cancer frequently seek alternatives to radical surgery and external beam radiation therapy. Permanent prostate brachytherapy is an acceptable option. However, fears of radiation exposure to family members may deter some individuals from choosing this treatment option. A direct measurement was performed to determine the expected lifetime exposure from the patient with a brachytherapy prostate implant to family members and the household.


METHODS
After a permanent brachytherapy implant with (125)I or (103)Pd, patients and their family members were provided radiation monitors to measure direct radiation exposure at home. Each patient was given two monitors to wear, and each member of the household, including the spouse, children, and pets, was given a single monitor. In addition, four rooms in the house frequently occupied by the patient were monitored. Based on the reading from the dosimeters measured at the first follow-up visit, the lifetime exposure to each individual or room was calculated. Forty-four patients, along with their families, agreed to participate and complied with the use of the dosimeters. Twenty-nine patients received a (125)I implant and 15 a (103)Pd implant. Assays were obtained on 272 monitors: 78 worn by patients, 52 worn by household members, and 142 posted in rooms.


RESULTS
Exposures measured by patient dosimeters were within the expected range for the type of implant received. Exposures to family members were low. Based on dosimeter readings, the calculated mean lifetime dose to a spouse from her husband was 0.1 (range: 0.04-0.55) mSv for a (125)I implant and 0.02 (range: 0.015-0.074) mSv for a (103)Pd implant. Other family or household members had 0.07 (range: 0.04-0.32) mSv or 0.02 (range: 0.015-0.044) mSv for (125)I and (103)Pd implants, respectively. The calculated lifetime exposure did not exceed the annual limit set by the U.S. Nuclear Regulatory Commission in any of the cases. The majority of room dosimeters (94%) had no detectable radiation exposure.


CONCLUSIONS
Radiation exposure to family members from a patient receiving a permanent prostate brachytherapy implant with radioactive (125)I or (103)Pd is very low and well below the limits recommended by the U.S. Nuclear Regulatory Commission. Radiation exposure to members of a patient's family or to the public should not be a deterrent to undergoing this procedure.
Michalski
Jeff
J
Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA. michalski@radonc.wustl.edu
Mutic
Sasa
S
Eichling
John
J
Ahmed
S Nisar
SN
D001918:Brachytherapy; D005190:Family; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D010165:Palladium / Q000627:therapeutic use*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000295:instrumentation / Q000379:methods*; D011868:Radioisotopes / Q000627:therapeutic use*; D018454:Spouses
D007457:Iodine Radioisotopes; D011868:Radioisotopes; D010165:Palladium