Radiation safety considerations with yttrium 90 ibritumomab tiuxetan (Zevalin)

Radioimmunotherapy is a recently approved treatment modality for non-Hodgkin's lymphoma that enables physicians to target cytotoxic localized radiation to tumor sites without using external-beam sources. Because it uses a pure beta emitter for therapy, (90)Y ibritumomab tiuxetan can be safely and routinely administered in an outpatient procedure, with few discharge instructions, and minimal risk of radiation exposure to a patient's family and acquaintances. Safety precautions for medical professionals administering (90)Y ibritumomab tiuxetan are universal precautions, with the addition of acrylic shielding for the administration of radiolabeled doses. The risk of radiation exposure to healthcare workers and family members is minimal. The primary route for biologic elimination of (90)Y ibritumomab tiuxetan is through the urine. While radiation safety instructions are not required according to the relevant patient release criteria, basic instructions to the patient and family may be valuable to further minimize the risk of radiation exposure and help alleviate patient and family concerns.