WASHINGTONIn 1997, the Nuclear Regulatory Commission issued new
guidelines for radiation therapy that, for the first time, permitted outpatient
use of radioactive iodine therapy in selected patients (ie, highly compliant
patients discharged to low-occupancy settings). Previously, this therapy had
required inpatient treatment and 3 days of isolation.
High Level of Staff Education
Outpatient care involving
radioimmunotherapy (RIT) is "more
convenient" and "less expensive," but requires a high level of
staff education to be done safely, said Carolyn Hendrix, RN, OCN, manager of
the Cancer Outpatient Treatment Clinic of the Hoag Cancer Center, Hoag
Hospital, Newport Beach, California.
At a poster session of the 27th Annual Congress of the Oncology Nursing
Society (abstract 71), she described a model developed at Hoag for treating
non-Hodgkin’s lymphoma patients with the investigational RIT iodine-131
tositumomab (Bexxar). The successful use of the treatment program, she said,
demonstrates the feasibility of the outpatient approach.
‘Distance, Time, and Shielding’
"Distance, time, and shielding" are the keys to safe RIT
treatment, Ms. Hendrix said. Nurses must be trained to work efficiently so that
contact with patients getting radioactive antibodies is minimized. The
treatment must take place away from highly traveled areas of the hospital (in a
lead-shielded isolation room), and all staff involved with these patients must
wear badges to monitor radiation.
Patients and staff must be educated about the dangers of radiation and the
steps that can lessen them, Ms. Hendrix said.