Issn Print: 0143-3636

Publication Date: 2000/02/01


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Initial experiences with 153Sm-EDTMP therapy: Practical aspects and radiation protection considerations

J K Roberts; S E Owens; E Allan

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Excerpt

153Sm-EDTMP is the most recent therapy agent to be licensed for palliation of bone pain arising from osteoblastic skeletal metastases. Some of the practical aspects and early experiences of introducing this new technique are described, with particular reference to the radiation protection issues associated with patients returning home.
Eight patients, all with primary breast carcinoma and multiple skeletal metastases, have been treated to date. In agreement with published data, images of the therapy uptake 3 h after intravenous injection showed good concordance with 99Tcm-MDP bone scans. The early clinical results appear promising. From a technical point of view, the set-up of the dose calibrator and accurate dispensing of the therapy dose are discussed, with summaries of the variations in measured activity found with source configuration and volume changes.
Under current regulations, most patients may be treated as outpatients. Data from the patients treated to date are presented, including administered activity, retained activity upon release and corresponding MBq·MeV products. Dose rates at 1 m reached a maximum of 20 μSv·h−1 immediately post-injection and 11 μSv·h−1 4-6 h later. The average time to reach no restriction (10 MBq·MeV) was 4.3 days. This is discussed in light of recent BIR recommendations on advice for patients which could lead to longer restrictions than appear necessary (21 days for dose rates >4.6 μSv·h−1) (BIR Working Party, Br J Radiol 1999; 72: 121-125). Alternative calculations based on BIR data and time-distance modelling suggest that a maximum of 14 days is sufficient.
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