RESUMEN
Background: Radioactive solid and liquid waste generated by patients after high-dose iodine therapy may lead to significant radiation exposure if not properly handled. Aims and Objectives: This study was conducted to monitor the radiation exposure along the sewerage drainage system of the high-dose iodine therapy ward and to rule out leakage if any, that might pose a potential radiation hazard to the general public (sewerage workers) and radiation health professional. Materials and Methods: The sewerage drainage system from isolation wards has multiple gate valves to regulate sewerage flow from the high-dose iodine therapy ward into delay and decay tanks (DDT) built, especially for the purpose. Radiation surveillance was done using a Geiger-Muller counter-based survey meter at 11 different locations on a weekly basis for 12 weeks. Results: A total of 26 patients underwent high-dose iodine ablation therapy during the study period in our department, with the highest recorded radiation exposure rate in the sewerage draining system in the 9th week of patient admission. This was at the common gate valve junction (location B) that directed sewerage waste from all four isolation rooms into the common pipeline leading to DDT. Minimal radiation exposure was recorded within Atomic Energy Regulatory Board -prescribed limits with no evidence of leakage. Conclusion: A routine radiation survey is an important component of overall radiation safety in the nuclear medicine department, including sewerage delay tank facilities, which helps keep the radiation exposure to acceptable levels by identifying timely leakage.
RESUMEN
Context: Patients with head-and-neck cancers can develop salivary gland hypofunction after radiotherapy. Oral pilocarpine has been shown to be effective treatment for radiation-induced xerostomia, although its usefulness is being discussed. Aims: We aimed to evaluate the efficacy and safety profile of oral pilocarpine in radiation-induced xerostomia. Materials and Methods: Sixty patients with oropharyngeal carcinoma were planned for radiotherapy and divided into two arms randomly: Arm A (30 patients) received oral pilocarpine and Arm B (30 patients) received placebo tablets for 12 weeks after 3 months of completion of radiotherapy. Salivary gland scintigraphy and xerostomia questionnaire (XQ) were obtained from each patient at baseline and at 3 and 6 months of completion of radiotherapy. Results: There was a marked decrease in uptake ratio (UR) and excretion fraction (EF) after 3 months of completion of radiotherapy. There was a statistically significant difference between both the arms in relation to UR, but no significant difference was observed between the two arms in relation to EF after 6 months of completion of radiotherapy. A statistically significant difference was found comparing the XQ results in both the arms. The XQ results did not correlate with salivary gland dysfunction observed by means of salivary scintigraphy. Adverse effects due to xerostomia were generally mild and occasionally of moderate severity. Conclusion: The use of oral pilocarpine did not significantly improve salivary gland excretory function, despite better results on salivary uptake at 6 months. However, oral pilocarpine significantly improved symptoms of xerostomia with minor side effects that were predominantly limited to sweating.
