^(177)Lu-DOTATATE治疗对病房内工作人员及公众的辐射影响  

Impact of ^(177)Lu-DOTATATE therapy on radiation exposure of ward healthcare staff and accompanying persons

作　　者：苏雪松 张锦明[2] 耿建华 陈英茂[2] 李高峰 王雪鹃 SU Xuesong;ZHANG Jinming;GENG Jianhua;CHEN Yingmao;LI Gaofeng;WANG Xuejuan(Department of Nuclear Medicine,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021 China;Department of Nuclear Medicine,First Medical Center of Chinese PLA General Hospital,Beijing 100853 China;Beijing Explore Times Technology Co.Ltd,Beijing 102600 China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院核医学科,北京100021 [2]解放军总医院第一医学中心核医学科,北京100853 [3]北京格物时代科技发展有限公司,北京102600

出　　处：《中国辐射卫生》2024年第5期510-516,共7页Chinese Journal of Radiological Health

基　　金：中国癌症基金会北京希望马拉松专项基金(LC2021A19)。

摘　　要：目的研究在^(177)Lu-DOTATATE治疗过程中,治疗场所的放射性空气污染、表面污染、周围剂量当量率以及受照人员的照射剂量。方法选取某综合医院核医学科^(177)Lu-DOTATATE治疗病房,在4名患者治疗前后分别对病房内气体和表面污染情况进行采样。在开始^(177)Lu-DOTATATE治疗后测量4名患者周围剂量当量率,测量位置分别为距离患者躯干中部右外侧0.1、0.3、0.5 m以及1~4 m(间隔0.5 m)处,测量时间点分别为给药中5、15、30 min、给药后0~4 h(间隔1h)以及24和48h。计算受照人员在各个时间段内与患者保持不同距离的接触受到的照射剂量。结果4名患者在^(177)Lu-DOTATATE给药中与给药后的放射性气溶胶检测结果均与给药前相近。除2号患者外,其他患者的测量位置均未测量到表面污染。在^(177)Lu-DOTATATE给药过程中,周围剂量当量率随药物注射剂量的增加而增加,药物注射完成后1h内周围辐射剂量明显降低。给药结束时刻距离患者1 m处4名患者平均周围剂量当量率为42.931μSv/h。在给药开始至给药后4 h内,受照人员与患者始终保持1 m接触受到的总照射剂量为167.64μSv。结论^(177)LuDOTATATE治疗不会对空气造成放射性污染,应在治疗开始前做好针对潜在表面放射性污染的应对措施。在治疗过程中陪护人员与医护人员受到的照射剂量均小于照射剂量约束值,应采取相应措施尽可能降低医护人员的照射剂量。Objective To investigate air radioactivity contamination,surface contamination,ambient dose equivalent rates,and radiation doses to individuals in the treatment room during ^(177)Lu-DOTATATE therapy.Methods A ward for ^(177)Lu-DOTATATE therapy was selected in the nuclear medicine department of a general hospital.Air and surface radioactivity samples were collected before and after therapy for four patients.Ambient dose equivalent rates were measured around the four patients following the initiation of ^(177)Lu-DOTATATE therapy.Measurements were taken at distances of 0.1,0.3,0.5,and 1−4 m(with 0.5 m intervals)from the right lateral midsection of the patient’s torso.The measurement time points in-cluded 5,15,and 30 min after initiation of administration,as well as 0−4 h(with 1 h intervals),24 h,and 48 h post-adminis-tration.Radiation exposure doses for personnel at different distances from the patients were calculated for each time interval.Results The results of radioactive aerosol detection for all four patients during and after the administration of ^(177)Lu-DOTATATE were similar to those before administration.Surface contamination was not detected at the measurement locations except for patient number 2.The ambient dose equivalent rates increased with increasing injection dose during the administration.However,the ambient dose equivalent rates decreased significantly within one hour after administration.At the end of the administration,the average ambient dose equivalent rate at a distance of one meter for the four patients was 42.931μSv/h.From the start of administration to four hours post-administration,personnel maintaining a distance of one meter from the patient received a total radiation dose of 167.64μSv.Conclusion Air radioactivity contamination does not occur during ^(177)Lu-DOTATATE therapy.However,measures should be taken before the commencement of therapy to ad-dress potential surface contamination.Both accompanying persons and healthcare staff receive radiation doses below the stipulated do

关 键 词：^(177)Lu-DOTATATE 治疗 放射性气溶胶 表面污染 周围剂量当量率 

分 类 号：X591[环境科学与工程—环境工程]