Experiences from a High Dose I-131 Trial at University Health Network
Matthew Bernacci | University Health NetworkEnoch ABC Ballroom
As the largest health research organization in Canada, the University Health Network has attracted many clinical trials in the promising field of targeted Theranostics. One such trial is presented here, highlighting the unique challenges of a high dose I-131 therapy study where administration and inpatient stay occurred in a hospital ward without intended radioisotope design considerations. The study involving an I-131 radiopharmaceutical (mean therapy activity of 600 mCi), required multidisciplinary collaborations between oncologists, nurses, nuclear medicine, radiation safety, trial sponsors, and various other support staff. Due to the administered activity amounts and lack of a dedicated shielded inpatient room, portable lead shields of 1/4” and 1” thickness were implemented. Dose and contamination considerations to caregivers, staff, and other members of the public were evaluated. An inpatient stay of several days was required for medical monitoring, and radioactive isolation to minimize exposures to others. Contamination and access controls were established, and exposures to surrounding areas assessed. Doses received by staff directly involved in patient care were tracked to verify they remained below applicable dose limits. Several training sessions were offered to a large pool of hospital staff, the majority having limited experience with radioactive patients. In addition to licensing the patient room, a small research lab was commissioned as a nuclear medicine hot lab. This presentation will describe the process from licensing of new locations, training of staff, room preparation, administration, patient stay, waste management, and final release/clearance.