By International Atomic Energy Agency
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Extra info for Accidental Overexposure of Radiotherapy Patients in San Jose, Costa Rica
There is a high fatality rate, depending on the location of spinal cord irradiation. Mortality from cervical or high thoracic lesions reaches 70%, with death resulting from pneumonia or infection of the urinary tract. About 10% of the total number of patients are at very high risk of spinal cord effects; some are already paralysed. The spinal cord is a relatively radiosensitive structure and overexposure can have disastrous consequences. As with other tissues, the total dose, the number of fractions and the volume (or length) of spinal cord irradiation are all important.
CARDIOVASCULAR SYSTEM Radiation induced changes in the heart have been reported in patients treated for Hodgkin’s disease. Cardiomyopathy rarely occurs with standard fractionation schemes and doses of less than 40 Gy. Above this level, up to half of the patients will experience pericarditis. Patients show a more than 50% incidence of complications when the dose exceeds 60 Gy (standard fractionation). Increasing the dose per fraction has been shown to significantly increase the complications and incidence.
None of those persons in charge at the time of the accident, including the dosimetrist, the radiation therapist from the San Juan de Dios Hospital and the person who performed the initial calculation and calibration, were available for an interview in an effort to reconstruct the charts. The treatment time was transcribed from a purpose written computer program. The name of the person who had made the calculation was also on the computer sheets. There was no documentation on how calculation of the treatment time had been made after the source had been changed: by using a ratio or by using the new measured dose rate.
Accidental Overexposure of Radiotherapy Patients in San Jose, Costa Rica by International Atomic Energy Agency