Cellular Repair Flashcards
Parameters of radiation exposure
- total dose absorbed
- rate at which dose delivered
- quality of the radiation
Acute radiation sickness syndrome
4-24 hrs after exposures
what determines whether subjects live or die after TBI
hematopoietic system
Lethal damage (LD)
irreversible and irreparable
Sublethal Damage (SLD)
repairable in hours unless additional SLD added
Potential Lethal Damage (PLD)
component of radiation damage that can be modified by post irradiation environmental conditions.
LD 50 for radiation
4.5 Gy
CNS syndrome time frame
hours
GI syndrome time frame
3-10 days
Hematopoietic syndrome time frame
30 days
PLD environmental conditions
incubate cells in salt solution. delay mitosis through suboptimal growth conditions –gives DNA chance for repair
PLDR
Potential Lethal Damage Repair - usually occurs in G0 - G1 cells
Culture conditions that facilitate PLDR
- post radiation maintenance
- culture conditions suboptimal for cell cycle progression
- isotonic media or chemicals that inhibit DNA synthesis
SLDR
Sublethal Damage Repair - repair of radiation lesions progresses as a time dependent function
Elkin and Sutton concept
shoulder of the dose-survival curve reflects the ability of the cell to accumulate sublethal radiation damage.
SLD recover time
6 hours
Fractionation
- normal cells recover while tumor cells have less time to repair.
- tumor cells in radioresistant phase in one treatment will be sensitive in next
- re-oxygenation b/w fractions
hyper-fractionation
- small fractions (<2 Gy)
- bronchus, cervix, uteri, head, neck
- less sensitive than late-responding healthy tissues to fraction size
hypo-fractionation
- fewer fractions more than 2 Gy
- similar fractionation sensitivity to healthy tissue
Therapeutic doses
curative cases:
epithelial 60-80 Gy
lymphoma 20-40 Gy
Preventative doses
(aka adjuvant dose)
-45-60 Gy in 1.8 - 2 Gy fractions
Typical Fractionation schedule
1.8-2 Gy per day 5 days per week
Child fractionation dose
1.5-1.8 Gy per day
concomitant boost regimen
two fractions in a single day (used near end of course of treatment)
alpha/beta value
quantifies sensitivity to fraction size
linear-quadratic clinical response function
alpha x D + B x D^2
D in linear quadratic clinical response function
fraction size
low alpha/beta
increased responses for fractions sizes greater than 2 Gy
BED2
Biologically effective Dose - in 2 Gy fractions
4 R’s of radiobiology
Repair
Reassortment
Repopulation
Reoxygenation
SLDR mechanism
dsDNA break rejoining before second dose occurs
Dose Rate Effect
lower the dose = reduced biologic effect
Inverse dose rate effect
decrease dose rate = increased cell killing
continuous low dose means cells trapped in G2
Very low dose rates
- steady state cell population
- cells accumulate in G2
- species specific
Reoxygenation
fractionation give cells time to re-oxygenate
OER
Oxygen enhancement ratio - ratio of doses administered hypoxic to aerated conditions
chronic hypoxia
due to limited diffusion range of oxygen in tissue
acute hypoxia
temporary closing of tumor blood vessels
Principal factor leading to development of necrotic area in tumors
oxygen depletion