Answer to Question #8606 Submitted to "Ask the Experts"

Category: Nuclear Medicine Patient Issues — Therapeutic Nuclear Medicine

The following question was answered by an expert in the appropriate field:


How many times can a dose of 131I be given to a person? Are there limits as to how much and the number of times a dose may be given, both for persons with and without their thyroid?


This morning I gave a lecture about thyroid therapy with 131I at the University of California, Los Angeles, and amongst other things addressed your very question. Many years ago, I think in the 1950s, someone wrote a paper about two patients who received more than 37 GBq 131I and who got leukemia. For decades after that, the urban myth was that you couldn't safely give more than 37 Gbq (it didn't matter how many doses were given—just the total GBq mattered). But as years went by, physicians occasionally went beyond the 37 GBq limit, and no leukemia was seen. So, at present, I think that if there is thyroid tissue present that takes up 131I, it pays to give 131I to burn out the thyroid and any other thyroid cancer cells in the body. This is true even if the total dose is over 37 GBq. I think that treating the cancer that you have is more important than worrying about one you might create.

Chemotherapy agents and standard external beam radiation therapy can also produce cancer, but they successfully treat many, many more cancers than they cause. While it is conceivable that very high dose totals of 131I could produce a cancer, treating a real cancer is much more important.

Carol S. Marcus, PhD, MD
Professor of Radiation Oncology and of Radiological Sciences, UCLA

Ask the Experts is posting answers using only SI (the International System of Units) in accordance with international practice. To convert these to traditional units we have prepared a conversion table. You can also view a diagram to help put the radiation information presented in this question and answer in perspective. Explanations of radiation terms can be found here.
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