Chemical approaches to radiation protection in mammals.
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A financial assessment is made of the detriment from ionising radiation in diagnostic radiography. The possible dose reductions available with different techniques of radiation protection are assessed and expressed both as a percentage and as actual value. The cost is calculated of these methods of protection. The use of carbon fibre materials is shown to be particularly advantageous. It is stressed that government policy in the United Kingdom is advocating cost-effective methods of health promotion, and these applications are attractive from this viewpoint.
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The profession of health physics has as its goal the protection of workers and the public from the harmful effects of ionizing radiation. On-the-job training used to be the major part of the young health physicist's professional development, and we can all name many respected pioneers still practicing radiation protection in its purest form. Health physicists of the future, however, will be required to build on that stable platform and move into a different arena--one in which their motives, programs and qualifications are constantly questioned in a much broader context. They will be required to defend their actions and themselves in the courtroom as well as the laboratory and the field. The need for certified health physicists will certainly increase dramatically in relation to the total number required just to get the job done. This comes at a time when colleges and universities are finding it increasingly difficult to obtain funding for their degree programs. Members of the profession must become aware of the changing times and expanding potential for litigation, because many health physicists will be involved in this new arena in one way or another.
PURPOSE: The development of a technique to provide sufficient radiation protection to previously irradiated spinal cord in such a manner that interstitial brachytherapy can be conducted after resection of a recurrent tumor and decompression of the cord. METHODS AND MATERIALS: A technique was developed that uses multiple layers of gold foil that are applied around the thecal sac and nerve root sleeves to produce an enveloping radiation shield after resection of recurrent tumor. Once the layers of gold foil are in place, interstitial I125 seeds are permanently placed in the bed of the tumor resection to prevent any recurrence from microcellular disease. The technique is described and its application in the case of a 28-year-old with a third recurrence of chondrosarcoma after external fractionated radiation therapy at the second to the fourth thoracic segments is reviewed. RESULTS: This technique has been used in this first patient. An additional tumor dose of 120.0 Gy was delivered to the tumor bed while the spinal cord was calculated to receive only 1% of the dose over the life span of the implant. To date, this dose of radiation has prevented tumor recurrence for more than 18 months of follow-up. CONCLUSION: This technique of multiple layers of gold foil shielding over the spinal cord and nerve roots has the potential to be a useful tool for the shielding of a previously irradiated spinal cord in the setting of resection of recurrent tumor. It may also have a wider application to a number of other radiosensitive tumors where interstitial brachytherapy may be useful to provide additional treatment after external fractionated radiation therapy.
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