title: Radiation Exposure and Safety Precautions Following 131Cs Brachytherapy in Patients with Brain Tumors.
abstract: Cesium-131 (Cs) brachytherapy is a safe and convenient treatment option for patients with resected brain tumors. This study prospectively analyzes radiation exposure in the patient population who were treated with a maximally safe neurosurgical resection and Cs brachytherapy. Following implantation, radiation dose rate measurements were taken at the surface, 35 cm, and 100 cm distances. Using the half-life of Cs (9.69 d), the dose rates were extrapolated at these distances over a period of time (t = 30 d). Data from dosimetry badges and rings worn by surgeons and radiation oncologists were collected and analyzed. Postoperatively, median dose rate was 0.2475 mSv h, 0.01 mSv h, and 0.001 mSv h and at 30 d post-implant, 0.0298 mSv h, 0.0012 mSv h, and 0.0001 mSv h at the surface, 35 cm, and 100 cm, respectively. All but one badge and ring measured a dose equivalent corresponding to ~0 mSv h, while 1 badge measured 0.02/0.02/0.02 mSv h. There was a significant correlation between the number of seeds implanted and dose rate at the surface (p = 0.0169). When stratified by the number of seeds: 4-15 seeds (n = 14) and 20-50 seeds (n = 4) had median dose rates of 0.1475 mSv h and 0.5565 mSv h, respectively (p = 0.0015). Using National Council on Radiation Protection guidelines, this study shows that dose equivalent from permanent Cs brachytherapy for the treatment of brain tumors is limited, and it maintains safe levels of exposure to family and medical personnel. Such information is critical knowledge for the neurosurgeons, radiation oncologists, nurses, hospital staff, and family as this method is gaining nationwide popularity.
authors.affiliation: *Stich Radiation Oncology, Weill Medical College of Cornell University, New York, NY; †Department of Neurosurgery, Weill Medical College of Cornell University, New York, NY.
authors.forename: Menachem Z
authors.initials: MZ
authors.lastname: Yondorf
authors.forename: Theodore H
authors.initials: TH
authors.lastname: Schwartz
authors.forename: John A
authors.initials: JA
authors.lastname: Boockvar
authors.forename: Susan
authors.initials: S
authors.lastname: Pannullo
authors.forename: Philip
authors.initials: P
authors.lastname: Stieg
authors.forename: Albert
authors.initials: A
authors.lastname: Sabbas
authors.forename: Albert
authors.initials: A
authors.lastname: Pavese
authors.forename: Samuel
authors.initials: S
authors.lastname: Trichter
authors.forename: Lucy
authors.initials: L
authors.lastname: Nedialkova
authors.forename: Bhupesh
authors.initials: B
authors.lastname: Parashar
authors.forename: Dattatreyudu
authors.initials: D
authors.lastname: Nori
authors.forename: K S Clifford
authors.initials: KS
authors.lastname: Chao
authors.forename: A Gabriella
authors.initials: AG
authors.lastname: Wernicke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D001932:Brain Neoplasms / Q000532:radiotherapy*; D002588:Cesium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D000069079:Radiation Exposure / Q000009:adverse effects / Q000032:analysis*; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control; D011835:Radiation Protection / Q000379:methods*; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D017751:Safety Management / Q000379:methods
chemical_list: D002588:Cesium Radioisotopes; D019275:Radiopharmaceuticals