Nationwide Survey on Implementation of 2011 Nuclear Regulatory Commission Policy on Release of Patients After ¹³¹I Therapy for Thyroid Cancer.

Abstract

The objective of this nationwide survey was to evaluate whether there has been a change in the practice regarding hospital release of differentiated thyroid cancer patients treated with ¹³¹I since the publication of Nuclear Regulatory Commission Regulatory Issue Summary 2011-01 addressing patient release. <b>Methods:</b> A survey was emailed to approximately 25,000 members of ThyCa: Thyroid Cancer Survivors' Association, Inc., and was available online from March to August 2018. Responses were included from adult patients regarding their most recent ¹³¹I therapy received between 2011 and 2018 ("after 2011"). Responses to this survey were compared with those of a similar previous survey for ¹³¹I therapies received between 1997 and 2009 ("before 2009"). <b>Results:</b> Of the 2,136 responses, 1,111 met the inclusion criteria. A similar percentage (∼98%) of patients were given oral or written radiation safety instructions (RSIs) after 2011 and before 2009, with a shift away from nuclear medicine physicians providing instructions after 2011 (43%) in comparison with before 2009 (54%; <i>P</i> < 0.001). More patients were able to discuss and individualize the RSIs after 2011 (67%) than before 2009 (29%; <i>P</i> < 0.001). However, 2% of patients do not recall ever receiving RSIs after 2011. After 2011, more patients were treated as outpatients (87%) than before 2009 (66%; <i>P</i> < 0.001). For outpatients, more patients were discharged within 30 min after receiving ¹³¹I therapy after 2011 (78%) than before 2009 (72%; <i>P</i> = 0.002). The same percentage (0.6%) of patients traveled more than 2 h with at least 2 occupants in the vehicle within approximately 1 m of the patient after 2011 and before 2009. Immediately after therapy, a similar percentage of patients stayed in a nonprivate residence after 2011 (4%) and before 2009 (5%; <i>P</i> = 0.28). Of the 27 outpatients released within 30 min to nonprivate residences, 2 patients received 5.55-11.1 GBq (150-299 mCi) of ¹³¹I. <b>Conclusion:</b> This survey suggests that since publication of the Nuclear Regulatory Commission Regulatory Issue Summary 2011-01 on patient release after radioiodine therapy, there have been improvements in some radiation safety practices on release of outpatients, as well as improvements in patient compliance on travel and lodging.