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Nationwide survey of implementation of 2011 Nuclear Regulatory Commission policy on release of patients after 131I therapy.
J Nucl Med 2019JN

Abstract

The objective of this nationwide survey was to evaluate whether there has been a change in the practice regarding hospital release of differentiated thyroid cancer patients treated with 131I since the publication of Nuclear Regulatory Commission Regulatory Issue Summary 2011-01 addressing patient release.

Methods:

A survey was emailed to ~25,000 members of ThyCa: Thyroid Cancer Survivors' Association, Inc. and was available online from March-August 2018. Responses were included from adult patients regarding their most recent 131I therapy received between 2011-2018 (post2011). Responses to this survey were compared to those of a similar previous survey for 131I therapies received between 1997-2009 (pre2009).

Results:

Of the 2,136 responses, 1,111 met the inclusion criteria. A similar percentage (~98%) of patients were given oral and/or written radiation safety instructions (RSI) post2011 and pre2009 with a shift away from nuclear medicine physicians providing instructions post2011 (43%) than pre2009 (54%; p<0.001). More patients were able to discuss and individualize the RSI post2011 (67%) than pre2009 (29%; p<0.001). However, 2% of patients do not recall ever receiving RSI post2011. Since 2011, more patients were treated as outpatients (87%) than before 2009 (66%; P<0.001). For outpatients, more patients were discharged within 30 minutes after receiving 131I therapy post2011 (78%) than pre2009 (72%; P = 0.002). The same percentage (0.6%) of patients travelled >2 hours with ≥2 occupants in the vehicle within approximately one meter of the patient post2011 and pre2009. Immediately post-therapy, a similar percentage of patients stayed in a non-private residence post2011 (4%) and pre2009 (5%; P = 0.28). Of the 27 outpatients released within 30 minutes to non-private residences, two patients received 5.55-11.1 GBq (150-299 mCi) of 131I.

Conclusion:

This survey suggests that since publication of the Nuclear Regulatory Commission Regulatory Issue Summary 2011-01 regarding patient release after radioiodine therapy, there has been improvements in some radiation safety practices on release of outpatients, and in patient compliance on travel and lodging.

Authors+Show Affiliations

MedStar Health Research Institute, United States.MedStar Health Research Institute, United States.ThyCa: Thyroid Cancer Survivors' Association, Inc., United States.MedStar Washington Hospital Center, United States.MedStar Health Research Institute, United States.MedStar Washington Hospital Center, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31451488

Citation

Wu, Di, et al. "Nationwide Survey of Implementation of 2011 Nuclear Regulatory Commission Policy On Release of Patients After 131I Therapy." Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, 2019.
Wu D, Gomes-Lima CJ, Bloom G, et al. Nationwide survey of implementation of 2011 Nuclear Regulatory Commission policy on release of patients after 131I therapy. J Nucl Med. 2019.
Wu, D., Gomes-Lima, C. J., Bloom, G., Burman, K. D., Wartofsky, L., & Van Nostrand, D. (2019). Nationwide survey of implementation of 2011 Nuclear Regulatory Commission policy on release of patients after 131I therapy. Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine, doi:10.2967/jnumed.119.230730.
Wu D, et al. Nationwide Survey of Implementation of 2011 Nuclear Regulatory Commission Policy On Release of Patients After 131I Therapy. J Nucl Med. 2019 Aug 26; PubMed PMID: 31451488.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nationwide survey of implementation of 2011 Nuclear Regulatory Commission policy on release of patients after 131I therapy. AU - Wu,Di, AU - Gomes-Lima,Cristiane J, AU - Bloom,Gary, AU - Burman,Kenneth D, AU - Wartofsky,Leonard, AU - Van Nostrand,Douglas, Y1 - 2019/08/26/ PY - 2019/05/02/received PY - 2019/08/05/accepted PY - 2019/8/28/entrez KW - 131I therapy KW - Oncology: Endocrine KW - Oncology: Head and neck KW - Radiation Safety KW - Radiation Therapy Planning KW - Radionuclide Therapy KW - Radiopharmaceuticals KW - Research Methods KW - Statistical Analysis KW - differentiated thyroid cancer KW - non-private residence KW - radiation safety JF - Journal of nuclear medicine : official publication, Society of Nuclear Medicine JO - J. Nucl. Med. N2 - The objective of this nationwide survey was to evaluate whether there has been a change in the practice regarding hospital release of differentiated thyroid cancer patients treated with 131I since the publication of Nuclear Regulatory Commission Regulatory Issue Summary 2011-01 addressing patient release. Methods: A survey was emailed to ~25,000 members of ThyCa: Thyroid Cancer Survivors' Association, Inc. and was available online from March-August 2018. Responses were included from adult patients regarding their most recent 131I therapy received between 2011-2018 (post2011). Responses to this survey were compared to those of a similar previous survey for 131I therapies received between 1997-2009 (pre2009). Results: Of the 2,136 responses, 1,111 met the inclusion criteria. A similar percentage (~98%) of patients were given oral and/or written radiation safety instructions (RSI) post2011 and pre2009 with a shift away from nuclear medicine physicians providing instructions post2011 (43%) than pre2009 (54%; p<0.001). More patients were able to discuss and individualize the RSI post2011 (67%) than pre2009 (29%; p<0.001). However, 2% of patients do not recall ever receiving RSI post2011. Since 2011, more patients were treated as outpatients (87%) than before 2009 (66%; P<0.001). For outpatients, more patients were discharged within 30 minutes after receiving 131I therapy post2011 (78%) than pre2009 (72%; P = 0.002). The same percentage (0.6%) of patients travelled >2 hours with ≥2 occupants in the vehicle within approximately one meter of the patient post2011 and pre2009. Immediately post-therapy, a similar percentage of patients stayed in a non-private residence post2011 (4%) and pre2009 (5%; P = 0.28). Of the 27 outpatients released within 30 minutes to non-private residences, two patients received 5.55-11.1 GBq (150-299 mCi) of 131I. Conclusion: This survey suggests that since publication of the Nuclear Regulatory Commission Regulatory Issue Summary 2011-01 regarding patient release after radioiodine therapy, there has been improvements in some radiation safety practices on release of outpatients, and in patient compliance on travel and lodging. SN - 1535-5667 UR - https://www.unboundmedicine.com/medline/citation/31451488/Nationwide_survey_of_implementation_of_2011_Nuclear_Regulatory_Commission_policy_on_release_of_patients_after_131I_therapy L2 - http://jnm.snmjournals.org/cgi/pmidlookup?view=long&amp;pmid=31451488 DB - PRIME DP - Unbound Medicine ER -