SU‐E‐J‐131: Safety of 131I‐Rituximab Outpatient Radioimmunotherapy of Non‐Hodgkin Lymphoma

Purpose: Establish the safety of outpatient 131I‐rituximab radioimmunotherapy (RIT) by determining prospective individual radiation absorbed dose to critical normal organs in patients and by calculating the radiation exposure to hospital staff, carers, and members of the public. Determine environmen...

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Published in:Medical Physics 2011-06, Vol.38 (6), p.3472-3472
Main Authors: Calais, P.J., Turner, J.H.
Format: Article
Language:English
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Anatomy
Diseases and conditions
Dosimetry
Environmental impacts
Environmental safety
Radiation safety
Radiation treatment
Therapeutics
Thermoluminescent dosimeters
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description Purpose: Establish the safety of outpatient 131I‐rituximab radioimmunotherapy (RIT) by determining prospective individual radiation absorbed dose to critical normal organs in patients and by calculating the radiation exposure to hospital staff, carers, and members of the public. Determine environmental impact of radioactive urine. Methods: Two hundred consecutive outpatients treated with 131I‐rituximab radioimmunotherapy for non‐Hodgkin Lymphoma with therapeutic activities between 1000 and 4500 MBq (mean 2290 MBq), predicated upon whole body radiation absorbed dose of 0.75 Gy, were studied. Their 292 family members/carers and 432 visitors wore TLD badges for the week during which the patients were confined to their home and contact with children and pregnant women was avoided. The entire urine output of the first 100 patients was collected for that week and measured. Results: All patients received 131I‐rituximab activities according to the prescribed dose of 0.75 Gy to whole body. Toxicity was limited to hematological grade 4 neutropenia in 10% of patients and thrombocytopenia in 10%. There were no episodes of bleeding or infection. The objective response rate (ORR) of 50 first‐line RIT was 98% with complete remission (CR) in 78%. The ORR for 142 consecutive patients with relapsed, refractory disease was 67% with CR in 50%. From 200 consecutive patients, radiation exposure to adult carers ranged from
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Determine environmental impact of radioactive urine. Methods: Two hundred consecutive outpatients treated with 131I‐rituximab radioimmunotherapy for non‐Hodgkin Lymphoma with therapeutic activities between 1000 and 4500 MBq (mean 2290 MBq), predicated upon whole body radiation absorbed dose of 0.75 Gy, were studied. Their 292 family members/carers and 432 visitors wore TLD badges for the week during which the patients were confined to their home and contact with children and pregnant women was avoided. The entire urine output of the first 100 patients was collected for that week and measured. Results: All patients received 131I‐rituximab activities according to the prescribed dose of 0.75 Gy to whole body. Toxicity was limited to hematological grade 4 neutropenia in 10% of patients and thrombocytopenia in 10%. There were no episodes of bleeding or infection. The objective response rate (ORR) of 50 first‐line RIT was 98% with complete remission (CR) in 78%. The ORR for 142 consecutive patients with relapsed, refractory disease was 67% with CR in 50%. From 200 consecutive patients, radiation exposure to adult carers ranged from &lt;0.01 mSv to 3.67 mSv (mean 0.48 mSv), to other co‐residing family members was &lt;0.01 mSv to 1.2 mSv (mean 0.23 mSv), and to visitors sharing badges was &lt;0.01 to 0.73 mSv (mean 0.17 mSv). Excreted urinary activity was typically &lt;25% of administered activity. Conclusions: Outpatient 131I‐rituximab radioimmunotherapy of non‐ Hodgkin Lymphoma is safe and effective. The median radiation exposure of carers is within the range permitted by international guidelines. Release dose rates of less than 25 uSv/h at 1 m were attained within one week of therapy.</description><identifier>ISSN: 0094-2405</identifier><identifier>EISSN: 2473-4209</identifier><identifier>DOI: 10.1118/1.3611898</identifier><identifier>CODEN: MPHYA6</identifier><language>eng</language><publisher>American Association of Physicists in Medicine</publisher><subject>Anatomy ; Diseases and conditions ; Dosimetry ; Environmental impacts ; Environmental safety ; Radiation safety ; Radiation treatment ; Therapeutics ; Thermoluminescent dosimeters</subject><ispartof>Medical Physics, 2011-06, Vol.38 (6), p.3472-3472</ispartof><rights>American Association of Physicists in Medicine</rights><rights>2011 American Association of Physicists in Medicine</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,776,780,785,786,23911,23912,25120,27903,27904</link.rule.ids></links><search><creatorcontrib>Calais, P.J.</creatorcontrib><creatorcontrib>Turner, J.H.</creatorcontrib><title>SU‐E‐J‐131: Safety of 131I‐Rituximab Outpatient Radioimmunotherapy of Non‐Hodgkin Lymphoma</title><title>Medical Physics</title><description>Purpose: Establish the safety of outpatient 131I‐rituximab radioimmunotherapy (RIT) by determining prospective individual radiation absorbed dose to critical normal organs in patients and by calculating the radiation exposure to hospital staff, carers, and members of the public. Determine environmental impact of radioactive urine. Methods: Two hundred consecutive outpatients treated with 131I‐rituximab radioimmunotherapy for non‐Hodgkin Lymphoma with therapeutic activities between 1000 and 4500 MBq (mean 2290 MBq), predicated upon whole body radiation absorbed dose of 0.75 Gy, were studied. Their 292 family members/carers and 432 visitors wore TLD badges for the week during which the patients were confined to their home and contact with children and pregnant women was avoided. The entire urine output of the first 100 patients was collected for that week and measured. Results: All patients received 131I‐rituximab activities according to the prescribed dose of 0.75 Gy to whole body. Toxicity was limited to hematological grade 4 neutropenia in 10% of patients and thrombocytopenia in 10%. There were no episodes of bleeding or infection. The objective response rate (ORR) of 50 first‐line RIT was 98% with complete remission (CR) in 78%. The ORR for 142 consecutive patients with relapsed, refractory disease was 67% with CR in 50%. From 200 consecutive patients, radiation exposure to adult carers ranged from &lt;0.01 mSv to 3.67 mSv (mean 0.48 mSv), to other co‐residing family members was &lt;0.01 mSv to 1.2 mSv (mean 0.23 mSv), and to visitors sharing badges was &lt;0.01 to 0.73 mSv (mean 0.17 mSv). Excreted urinary activity was typically &lt;25% of administered activity. Conclusions: Outpatient 131I‐rituximab radioimmunotherapy of non‐ Hodgkin Lymphoma is safe and effective. The median radiation exposure of carers is within the range permitted by international guidelines. Release dose rates of less than 25 uSv/h at 1 m were attained within one week of therapy.</description><subject>Anatomy</subject><subject>Diseases and conditions</subject><subject>Dosimetry</subject><subject>Environmental impacts</subject><subject>Environmental safety</subject><subject>Radiation safety</subject><subject>Radiation treatment</subject><subject>Therapeutics</subject><subject>Thermoluminescent dosimeters</subject><issn>0094-2405</issn><issn>2473-4209</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNp9kEFOwzAQRS0EEqWw4AbZgpQyjp04ZoeqlhYVilq6jpzYpoYmjhJXkB1H4IycBEO7hcXoa0bvf40-QucYBhjj9AoPSOKVpweoF1FGQhoBP0Q9AE7DiEJ8jE7a9gUAEhJDD8nl6uvjc-Tnzg8m-DpYCq1cF1gd-HXqrwvjtu-mFHkw37paOKMqFyyENNaU5baybq0aUf86HmzlDRMrn19NFcy6sl7bUpyiIy02rTrbax-txqOn4SSczW-nw5tZWGDG0jAhaSxjzZlMmIikYJwJmlMepZrksuCEcpAQc5JroIQLKSRLYogJo5QqQkgfXexyi8a2baN0Vjf-76bLMGQ_9WQ429fj2XDHvpmN6v4Gs_vHPX-549vCON-Brf4J_waWnXWk</recordid><startdate>201106</startdate><enddate>201106</enddate><creator>Calais, P.J.</creator><creator>Turner, J.H.</creator><general>American Association of Physicists in Medicine</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201106</creationdate><title>SU‐E‐J‐131: Safety of 131I‐Rituximab Outpatient Radioimmunotherapy of Non‐Hodgkin Lymphoma</title><author>Calais, P.J. ; Turner, J.H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1778-6385d5f97d67a2da797a4b4928f3bdc93490d0593bf0439adad7650537444e333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Anatomy</topic><topic>Diseases and conditions</topic><topic>Dosimetry</topic><topic>Environmental impacts</topic><topic>Environmental safety</topic><topic>Radiation safety</topic><topic>Radiation treatment</topic><topic>Therapeutics</topic><topic>Thermoluminescent dosimeters</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Calais, P.J.</creatorcontrib><creatorcontrib>Turner, J.H.</creatorcontrib><collection>CrossRef</collection><jtitle>Medical Physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Calais, P.J.</au><au>Turner, J.H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SU‐E‐J‐131: Safety of 131I‐Rituximab Outpatient Radioimmunotherapy of Non‐Hodgkin Lymphoma</atitle><jtitle>Medical Physics</jtitle><date>2011-06</date><risdate>2011</risdate><volume>38</volume><issue>6</issue><spage>3472</spage><epage>3472</epage><pages>3472-3472</pages><issn>0094-2405</issn><eissn>2473-4209</eissn><coden>MPHYA6</coden><abstract>Purpose: Establish the safety of outpatient 131I‐rituximab radioimmunotherapy (RIT) by determining prospective individual radiation absorbed dose to critical normal organs in patients and by calculating the radiation exposure to hospital staff, carers, and members of the public. Determine environmental impact of radioactive urine. Methods: Two hundred consecutive outpatients treated with 131I‐rituximab radioimmunotherapy for non‐Hodgkin Lymphoma with therapeutic activities between 1000 and 4500 MBq (mean 2290 MBq), predicated upon whole body radiation absorbed dose of 0.75 Gy, were studied. Their 292 family members/carers and 432 visitors wore TLD badges for the week during which the patients were confined to their home and contact with children and pregnant women was avoided. The entire urine output of the first 100 patients was collected for that week and measured. Results: All patients received 131I‐rituximab activities according to the prescribed dose of 0.75 Gy to whole body. Toxicity was limited to hematological grade 4 neutropenia in 10% of patients and thrombocytopenia in 10%. There were no episodes of bleeding or infection. The objective response rate (ORR) of 50 first‐line RIT was 98% with complete remission (CR) in 78%. The ORR for 142 consecutive patients with relapsed, refractory disease was 67% with CR in 50%. From 200 consecutive patients, radiation exposure to adult carers ranged from &lt;0.01 mSv to 3.67 mSv (mean 0.48 mSv), to other co‐residing family members was &lt;0.01 mSv to 1.2 mSv (mean 0.23 mSv), and to visitors sharing badges was &lt;0.01 to 0.73 mSv (mean 0.17 mSv). Excreted urinary activity was typically &lt;25% of administered activity. Conclusions: Outpatient 131I‐rituximab radioimmunotherapy of non‐ Hodgkin Lymphoma is safe and effective. The median radiation exposure of carers is within the range permitted by international guidelines. Release dose rates of less than 25 uSv/h at 1 m were attained within one week of therapy.</abstract><pub>American Association of Physicists in Medicine</pub><doi>10.1118/1.3611898</doi><tpages>1</tpages></addata></record>
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subjects Anatomy
Diseases and conditions
Dosimetry
Environmental impacts
Environmental safety
Radiation safety
Radiation treatment
Therapeutics
Thermoluminescent dosimeters
title SU‐E‐J‐131: Safety of 131I‐Rituximab Outpatient Radioimmunotherapy of Non‐Hodgkin Lymphoma
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