Current Status of Treatment of Radiation Injury in the United States
Abstract
A radiation or nuclear incident would likely result in vast numbers of patients, many of whom would require novel therapy. Although the number of radiation victims in the United States (USA) has been limited, we base our doctrine for treating radiation injuries on i) historical data, ii) animal research, and iii) human results derived from present medical treatment such as the care provided to cancer patients undergoing radiation therapy or chemotherapy. The medical management of radiation injury is complex. Radiation injury may include the acute radiation syndrome (ARS), external and internal contamination, and cutaneous injury. Human and animal data have shown that optimal medical care can raise the nominal lethal dose of radiation by 50% or more. The currently recommended treatment of the ARS in the USA involves supportive care, early use of cytokines, and judicious use of antibiotics. Supportive care for any significant radiation injury also would require the use of intravenous fluids, antiemetics, antidiarrheals, pain medications, and blood product support. The role for cytokines will be described in some detail. The role for stem cell transplantation is controversial as no survival benefit has been demonstrated for this modality. The U.S. Food and Drug Administration (FDA) has published clear guidelines for the use of potassium iodide (KI) to block uptake of radioactive iodine. Treatment of internal contamination requires identification of the radioactive isotope and then appropriate individual programs of treatment. The FDA recently has approved the use of diethylenetriaminepentaacetate (DTPA) for the treatment of internal contamination with plutonium, americium and curium. The FDA also recently approved the use of ferric ferrocyanide (Prussian Blue) for the treatment of internal contamination by radioactive cesium or thallium.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2005
- Accession Number
- ADA438731
Entities
People
- Dean G. Jarrett
- R. G. Sedlak
- W. E. Dickerson
Organizations
- Armed Forces Radiobiology Research Institute