Trends in radiation practices for female ocular oncologists in North America

Abstract

Purpose : Ocular oncologists who perform plaque brachytherapy are exposed to radiation. This exposure may be more worrisome for female surgeons, particularly during pregnancy. We conducted a survey study to examine the exposure of female ocular oncologists to radiation, consequent levels of concern, and precautionary risk modifications.

Methods : Twelve female ocular oncologists regularly performing plaque brachytherapy in North America were identified by their registration in the International Society of Ocular Oncology. Ten completed the anonymous Qualtrics survey of 17 questions regarding safety training at their institutions, radiation exposure, and precautions during pregnancy. They also ranked their consequent anxiety levels regarding fertility.

Results : Demographics and responses are shown in Table 1. Eight participants (80%) report monitoring their yearly radiation exposure; four report doses ranging from <1 to 20 mSv, while the other four had exposure reports of ‘minimal’ per their institution. Two participants (20%) report their radiation exposure was not being monitored. Nine report using a non-active plaque to prepare for plaque implantation. Five (50%) report using no lead protection during surgery.
Of the 7 women who experienced pregnancy, six continued to perform plaque brachytherapy treatments while pregnant; one stopped. Five increased their protective practices during pregnancy. Participants rated their anxiety regarding fertility on a scale from zero to ten; the average reported anxiety was 2.7 (SD, 2.2).

Conclusions : This survey study corroborates prior oncology literature that radiation exposure to surgeons during plaque brachytherapy is minimal. Nonetheless there remains some anxiety regarding exposure risk. Many women continued to perform brachytherapy during pregnancy with appropriately increased precautions. The NCRP sets the maximum total body radiation exposure at 50mSv/year, with more stringent rates for pregnant women. The female ocular oncologists who completed the survey all reported exposure rates less than 20mSv. We additionally found high variability in routine exposure monitoring, utilized protective measures, and required training amongst this group of ocular oncologists. Improved education and clearer pregnancy guidelines regarding radiation exposure may help equip female surgeons with optimal understanding of needed precautions.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Table 1. Demographics and Responses of Survey Participants