Research Seeks to Evaluate Radiation Safety for Radioactive Iodine Treatment

Female clinician using syringe to pull from upside-down bottle

A milestone research survey investigated aspects of radiation safety regarding outpatient radiation treatment. The study focused on radioactive iodine treatments for patients with differentiated thyroid cancer (DTC).

More than 15,000 thyroid cancer patients were invited to participate, with more than 1,500 choosing to do so. “This is the largest, patient-based survey published regarding selected radiation safety aspects of outpatient radioactive iodine treatment,” stated the study.

There is still controversy whether radioiodine treatments for DTC should be performed as an inpatient or as an outpatient. “Selected Radiation Safety Aspects Including Transportation and Lodging After Outpatient 131I Therapy for Differentiated Thyroid Cancer” sought to evaluate radiation safety aspects of patients treated with radioactive iodine for differentiated thyroid cancer as an outpatient procedure.

This study was published in Thyroid. The lead author on this was Cristiane J. Gomes-Lima. The study team included Di Wu; Pejman H. Kharazi, MD; Gauri J. Khojekar, MD; Matthew D. Ringel, MD; Richard J. Vetter, Ph.D.; Gary Bloom; Kenneth D. Burman, MD; Leonard Wartofsky, MD; and Douglas Van Nostrand, MD, FACP, FACNP. Gomes-Lima, Wu, Kharazi, Burman, Wartofsky, and Van Nostrand are all part of MedStar Health.

Radioactive iodine therapy is a safe and effective way to treat issues of the thyroid including cancer. Over time, the thyroid will be destroyed by the treatment, removing cancerous cells. One of the concerns with radioactive iodine treatment for patients with DTC is that the following treatment, the patient’s body will give off radiation. The amount of secondary radiation is dependent on the dose and treatment method.  Adherence to radiation safety practices in patients treated with radioactive iodine is important to minimize exposure to family members and the public, and the American Thyroid Association (ATA) released practice recommendations for radiation safety in the treatment of patients with thyroid diseases.

 The study found that in 75.4% of respondents, their physician determined that the procedure should be done as an outpatient. Over 45% of respondents reported that there was no discussion of options of being treated as an inpatient versus an outpatient, with 5% reporting that their insurance made the decision. Ninety-four percent of the respondents stayed at their own home or a relative’s home, while 5% had to reside in public lodging.

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. This large epidemiological study can be used as a baseline for evaluating future changes in radiation safety management.

Thyroid, 2017. DOI: 10.1089/thy.2017.0124