Cristiane J Gomes-Lima1,2, Di Wu1,3, Pejman H Kharazi3, Gauri J Khojekar4, Matthew D Ringel5, Richard J Vetter6, Gary Bloom7, Kenneth D Burman2, Leonard Wartofsky2, Douglas Van Nostrand1,3. 1. 1 MedStar Health Research Institute , Washington, DC. 2. 2 Division of Endocrinology, MedStar Washington Hospital Center , Washington, DC. 3. 3 Division of Nuclear Medicine, MedStar Washington Hospital Center , Washington, DC. 4. 4 Department of Radiology, George Washington University. 5. 5 Division of Endocrinology, Diabetes and Metabolism, Wexner Medical Center, The Ohio State University , Columbus, Ohio. 6. 6 Biophysics, Mayo Clinic and Medical School , Rochester, Minnesota. 7. 7 ThyCa: Thyroid Cancer Survivors Association, Inc. , Olney, Maryland.
Abstract
BACKGROUND: Whether radioactive iodine (131I) treatments for differentiated thyroid cancer should be performed as an outpatient or inpatient remains controversial. The objective of this study was to survey selected aspects of radiation safety of patients treated with 131I for differentiated thyroid cancer as an outpatient. METHODS: An e-mail invitation was sent to over 15,000 members of ThyCa: Thyroid Cancer Survivors' Association, Inc. to complete a web-based survey on selected aspects of radiation safety regarding their last outpatient 131I treatment. RESULTS: A total of 1549 patients completed the survey. Forty-five percent (699/1541) of the respondents reported no discussion on the choice of an inpatient or outpatient treatment. Moreover, 5% (79/1541) of the respondents reported that their insurance company made the decision. Survey respondents recalled receiving oral and written radiation safety instructions 97% (1459/1504) and 93% (1351/1447) of the time, respectively. Nuclear medicine physicians delivered oral and written instructions to 54% (807/1504) and 41% (602/1462) of the respondents, respectively. Eighty-eight percent (1208/1370) of the respondents were discharged within 1 hour after receiving their 131I treatment, and 97% (1334/1373) traveled in their own car after being released from the treating facility. Immediately post-therapy, 94% (1398/1488) of the respondents stayed at their own home or a relative's home, while 5% (76/1488) resided in a public lodging. The specific recommendations received by patients about radiation precautions varied widely among the respondents. Ninety-nine percent (1451/1467) of the respondents believed they were compliant with the instructions. CONCLUSION: This is the largest, patient-based survey published regarding selected radiation safety aspects of outpatient 131I treatment. This survey suggests several concerns about radiation safety, such as the decision process regarding inpatient versus outpatient treatment, instructions about radiation safety, transportation, and lodging after radioiodine therapy. These concerns warrant further discussion, guidelines, and/or policies.
BACKGROUND: Whether radioactive iodine (131I) treatments for differentiated thyroid cancer should be performed as an outpatient or inpatient remains controversial. The objective of this study was to survey selected aspects of radiation safety of patients treated with 131I for differentiated thyroid cancer as an outpatient. METHODS: An e-mail invitation was sent to over 15,000 members of ThyCa: Thyroid Cancer Survivors' Association, Inc. to complete a web-based survey on selected aspects of radiation safety regarding their last outpatient131I treatment. RESULTS: A total of 1549 patients completed the survey. Forty-five percent (699/1541) of the respondents reported no discussion on the choice of an inpatient or outpatient treatment. Moreover, 5% (79/1541) of the respondents reported that their insurance company made the decision. Survey respondents recalled receiving oral and written radiation safety instructions 97% (1459/1504) and 93% (1351/1447) of the time, respectively. Nuclear medicine physicians delivered oral and written instructions to 54% (807/1504) and 41% (602/1462) of the respondents, respectively. Eighty-eight percent (1208/1370) of the respondents were discharged within 1 hour after receiving their 131I treatment, and 97% (1334/1373) traveled in their own car after being released from the treating facility. Immediately post-therapy, 94% (1398/1488) of the respondents stayed at their own home or a relative's home, while 5% (76/1488) resided in a public lodging. The specific recommendations received by patients about radiation precautions varied widely among the respondents. Ninety-nine percent (1451/1467) of the respondents believed they were compliant with the instructions. CONCLUSION: This is the largest, patient-based survey published regarding selected radiation safety aspects of outpatient131I treatment. This survey suggests several concerns about radiation safety, such as the decision process regarding inpatient versus outpatient treatment, instructions about radiation safety, transportation, and lodging after radioiodine therapy. These concerns warrant further discussion, guidelines, and/or policies.
Authors: Carol Greenlee; Lynn A Burmeister; Robert S Butler; Charlotte H Edinboro; Shannon McIntyre Morrison; Mira Milas Journal: Thyroid Date: 2011-02 Impact factor: 6.568
Authors: Edward B Silberstein; Abass Alavi; Helena R Balon; Susan E M Clarke; Chaitanya Divgi; Michael J Gelfand; Stanley J Goldsmith; Hossein Jadvar; Carol S Marcus; William H Martin; J Anthony Parker; Henry D Royal; Salil D Sarkar; Michael Stabin; Alan D Waxman Journal: J Nucl Med Date: 2012-07-11 Impact factor: 10.057
Authors: James C Sisson; John Freitas; Iain Ross McDougall; Lawrence T Dauer; James R Hurley; James D Brierley; Charlotte H Edinboro; David Rosenthal; Michael J Thomas; Jason A Wexler; Ernest Asamoah; Anca M Avram; Mira Milas; Carol Greenlee Journal: Thyroid Date: 2011-03-18 Impact factor: 6.568
Authors: José Willegaignon; Marcelo Sapienza; Carla Ono; Tomoco Watanabe; Maria Inês Guimarães; Ricardo Gutterres; Maria Helena Marechal; Carlos Buchpiguel Journal: Clin Nucl Med Date: 2011-06 Impact factor: 7.794