Treatment with Ca-DTPA of internal contaminations by plutonium and americium: Recommendations for writing protocols in Cea and AREVA centers

The purpose of this document is to provide physicians working in a B.N.F. (Basic Nuclear Facility) with recommendations for the drafting of Ca-DTPA treatment protocols for internal contamination by actinides. These recommendations are based on the results of injections carried out by Cea and AREVA doctors in a working group, with the collaboration of the Army Radiation Protection Service. The study focused on Ca-DTPA IV injection. Other dosage forms, routes of administration as well as adjuvant treatments are also mentioned. For cases of contaminated wounds and inhalation, indicators for treatment with Ca-DTPA, particularly its initialization, the dosage, duration, frequency of administration, the criteria for ending the treatment, then its efficiency and dosimetry gain are covered. A guide for the prescription of the radio toxicological monitoring necessary for the treatment and the dosimetric evaluation is proposed. (authors)