3 Radiation Protection in Brachytherapy

Radiation Protection in Brachytherapy

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THE GEC ESTRO HANDBOOK OF BRACHYTHERAPY | Part I: The basics of Brachytherapy Version 1 - 01/12/2014

3 Radiation Protection in Brachytherapy Panagiotis Papagiannis, Jack Venselaar

1. Summary 3 2. Introduction: The international recommendations for a system of radiological protection 3 3. Design considerations of brachytherapy facilities 5 4. Brachytherapy facility shielding 7

5. Radiation protection issues associated with specific techniques 6. Source storage and transportation

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11 12 14 15

7. Organizational issues

8. Key messages 9. References

1. SUMMARY

effects on human health, i.e.: global / regional radiation expo- sures, evidence of radiation-induced health effects in exposed groups including atomic bomb survivors, and advances in the understanding of biological mechanisms involved in the occur- rence of radiation-induced health effects (21,29,40). Updated general recommendations for a system of radiological protec- tion are prepared by the ICRP. These are further disseminated internationally through the publication of basic safety standards in the IAEA safety series and European Atomic Energy Commu- nity (Euratom) directives, which are based heavily on ICRP rec- ommendations. 1 Ultimately, these recommendations need to be transformed into national regulations and legislation, and they are further particularized by national and international scientific and professional bodies. An example of the dynamic aspect of this process can be seen in Table 3.1. According to ICRP terminology, a brachytherapy program is a source leading to planned exposure situations that involve the deliberate introduction and operation of the program, and are characterized by the ability to predict the magnitude and extent of the exposures and plan the radiological protection. It must be optimization and the application of exposure limits) in the context of brachytherapy. This is followed by an overview of design aspects and equipment prerequisites of brachytherapy departments. Particular focus is given to the calculation of material thickness to meet a set of structural shielding design goals, providing reference to sources of relevant data in the literature as well as the ESTRO website. Besides technique specific aspects of a radiation protection program for low- and high-dose rate applications, including practical infor- mation for source management, storage, and transportation, organizational issues are also discussed. These comprise the elements of a radiation protection program within a com- prehensive quality management system to ensure optimized patient treatments, while minimizing risks of radiation acci- dents as well as staff and general public exposure. The im- portance of written procedures and proper training of the members of the brachytherapy team cannot be overstressed.

This chapter aims to summarize technical and procedural information to aid the process of optimization of protection in brachytherapy, and to highlight some key elements of this process by elaborating on aspects of radiation protection in practice. Although based on the system for radiation protection de- veloped, and periodically re-evaluated, through expert con- sensus at an international level, national legislation may vary. Information in this chapter is therefore informative only and it should be carefully checked against local regulations prior to adoption. The chapter begins by discussing the general principles of the international system for radiation protection (justification,

2. INTRODUCTION: THE INTERNATIONAL RECOMMENDATIONS FOR A SYSTEMOF RADIOLOGICAL PROTECTION

Radiological protection, in general, is based on consensus de- veloped by international committees and organizations to pro- tect the individual from the harmful effects of radiation. This relates to occupational exposure, public exposure, and medical exposure of patients as well as their comforters and caregiv- ers. These independent international bodies have developed recommendations for a comprehensive system of radiologi- cal protection pertinent to all applications of radiation. These recommendations stem mainly from work performed by the International Committee on Radiological Protection (ICRP), and two members of the United Nations family of entities, the Scientific Committee on the Effects of Atomic Radiation (UN- SCEAR) and the International Atomic Energy Agency (IAEA). Such work forms a dynamic process based on the continuous review of studies and publications on ionizing radiation and its

1 At the time of writing, the ICRP Publication 103 (2007) (24) had replaced the previous recommendations (ICRP 1991) (17), which in turn led to the publication of revised IAEA Basic Safety Standards (IAEA 2014 (15) replacing IAEA 1996 (8)) and a new European Union basic safety Directive (Council Directive 2013/59/EURATOM of 5 December 2013 (3) replacing Directive 96/29/Euratom of 13 May 1996 (4)).