ICRP Publication 98: Radiation safety aspects of brachytherapy for prostate cancer

It is now well known that radiation sources are implanted in the body to treat localized cancers such as prostate cancers. The radioactive sources used are Iodine-125 or Palladium-103. The application of the technique, known as brachytherapy, has been rapidly increasing all over the world in the last fifteen years. To date, it is estimated that globally more than 50,000 patients are treated this way every year. Although no accident or adverse effects involving the medical staff and/or members of the patient family have been reported so far, the brachytherapy technique raises a number of radiation safety issues which need specific recommendations from the expert body, International Commission on Radiological Protection (ICRP).

The available data show that, in the vast majority of cases, the dose to comforters and carers remains well below the 1 mSv/year limit. Only in rare case where the patient's partner is pregnant at the time of implantation may need specific precautions. Other related issues are: rare possibility of expulsion of the sources through the urine, the semen or the gastro-intestinal tract; incident/accident linked to the radioactive seed loss; cremation of bodies containing the sources; guidelines for the surgery of pelvic or abdominal regions of the patient; possible modifications of the semen due to the radiation exposure; a limited risk of genetic effects for the child fathered by the patient with the implantation; the possibility of triggering certain types of security radiation monitors; induction of the radiation-induced secondary tumors, etc.

The ICRP publication 93 (2006) provides specific recommendations on the above issues.