接受^(177)Lu-奥曲肽治疗患者体外辐射水平的检测及其所致周围人员剂量的初步估算

Measurement of external radiation levels around patients treated with ^(177)Lu-DOTA-TATE and preliminary estimation of doses to the surrounding personnel

目的通过测量接受^(177)Lu-奥曲肽(^(177)Lu-DOTA-TATE)治疗神经内分泌肿瘤的患者所产生的辐射,探讨其衰变规律以及对周围人员的辐射剂量。方法使用手持式核辐射监测剂量仪实测接受^(177)Lu-DOTA-TATE治疗后的患者在不同时间点对周围环境的辐射剂量率,分析辐射剂量率随时间和距离的衰变规律,估算距患者不同距离处的辐射水平和患者对周围人员的照射剂量。结果患者体外辐射剂量率随时间成指数形式衰减,前期衰减迅速,后期逐渐减慢,快速衰减阶段的有效半衰期为(1.41±0.25)h(0.9~1.8)h,较慢衰减阶段的有效半衰期为(40.18±6.0)h(32.7~54.73 h);在注射完0 h,距离患者0.25、0.5、1、2、3 m处,归一化平均辐射剂量率分别为(41.7±6.3)、(20.0±3.0)、(7.2±3.8)、(3.4±0.9)、(1.9±0.4)μSv·h^(-1)·GBq^(-1);医生、护士、物理师、摆位技师的受照剂量分别为2.0、10.24、1.08、4.05μSv/患者。结论接受^(177)Lu-DOTA-TATE治疗的患者体外辐射剂量率随时间和距离迅速下降,患者对周围人员造成的辐射水平在国家标准允许的范围内,出院后患者应减少与周围人员近距离长时间接触。

Objective To investigate the decay law of ^(177)Lu-DOTA-TATE in the treatment of neuroendocrine tumors in patients with external radiation and the radiation dose to the surrounding persons.Methods The radiation dose rate from patients to the surrounding environment after ^(177)Lu-DOTA-TATE treatment was measured using a handheld radiation dosimeter at different times.The decay law of the radiation dose rate with time and distance was analyzed,and the radiation levels at different distances from the patients and the radiation dose of the patients to the surrounding persons were estimated.Results The external radiation dose rate from the patients decayed exponentially with time rapidly in the early stage and gradually slowly in the later stage.The effective half-life was(1.41±0.25)h(0.9-1.8)h in the rapid decay stage and(40.18±6.0)h(32.7-54.73 h)in the slower decay stage.At 0 h after injection,the normalized mean radiation dose rates at 0.25,0.5,1,2,and 3 m away from the patient were 41.7±6.3,20.0±3.0,7.2±3.8,3.4±0.9,and 1.9±0.4μSv·h^(-1)·GBq^(-1),respectively.The radiation doses to doctors,nurses,physicists,and positioning technicians were 2.0,10.24,1.08,and 4.05μSv/patient,respectively.Conclusions The external radiation dose rate from patients receiving ^(177)Lu-DOTA-TATE treatment rapidly decreases over time and distance.The radiation levels that patients may cause to the surrounding workers are within the allowable range of national standards.After discharge,patients should reduce close and long-term contact with the surrounding persons.