1.Water intake volume and its effect to the radiation level and length of hospital stay among Differentiated Thyroid Cancer (DTC) patients undergoing High Dose Radioactive Iodine (RAI) Therapy
Elgie JF. Gregorio ; Marcelino A. Tanquilut ; Wenceslao S. Llauderes ; Emelito O. Valdez-Tan
The Philippine Journal of Nuclear Medicine 2020;15(2):20-34
Introduction:
Radioactive Iodine therapy is an established therapeutic application of well-differentiated thyroid cancer.
However, the proven benefits of ionizing radiation of Iodine-131 also carry potential toxicities to other normal exposed
tissues. Good water hydration during the course of RAI therapy is one of the radiation protection measures to
minimize toxicities, directed to increase excretion of unbound iodine from the body. Apparently, a number of
recognized medical societies had different recommendations on the amount of water intake during radioactive iodine
therapy.
Objective:
To determine if there is a significant difference in the decrease of exposure rate, total effective dose
equivalent, and length of stay of differentiated thyroid cancer patients undergoing high dose RAI when comparing
between different amounts of water intake per day (<3L/day vs > 3 L/day).
Methods:
This study employed a prospective cohort design. Patients with differentiated thyroid cancer (DTC) admitted
for high-dose RAI therapy at Jose R. Reyes Memorial Medical Center were included in the study. Dose rate and water
intake volume were measured and total effective dose equivalent was computed every 24-hrs until discharged.
Student t test was used to compare two water intake levels on quantitative variables while fisher exact test for
categorical data.
Results:
A total of 47 participants were included in the study with 28 patients under > 3L/day group and 19 patients
under < 3L/day with a mean consumption of 4.9 L/day and 2.3 L/day, respectively. There was no significant difference
on the mean exposure rate between those who consumed at least 3L (15.3 mR/hr) against those who consumed less
than 3L (17.3 mR/hr) during the time of intake, after the 24 hours (p=.9935) and 48 hours (p=.7523). Likewise, there is
no significant difference on their mean total effective dose equivalent [in per day during intake (p=.9678), 24 hours
(p=.4141) and 48 hours (p=.6706)]. The mean length of hospital stay is also the same for both groups with 1.7 days.
Conclusion
The study concludes that consuming different volume of water per day (> 3 L/day vs < 3L/ day) have the
same rate of decreased in exposure rate, total effective dose equivalent (TEDE) as well as the same length of hospital
Thyroid Neoplasms
;
Adenocarcinoma
;
Iodine Radioisotopes