RBE, LET & OER Flashcards
What is the OER ratio?
- The ratio of hypoxic to aerated doses needed to achieve the same effect.
- It always takes more dose to achieve cell killing under hypoxia. Thus, OER is never < 1.
Which radiation energy has the highest OER?
The one with the highest energy
What is the usual range of OER?
2.5-3.0
What’s the usual range of the dose reduction factor (DRF) for a radioprotector?
2.5-3.0
How do neutrons deposit their dose?
They are indirectly ionizing, leading to the production of:
- recoil protons (main mechanism)
- heavier nuclei fragments
- α particles
What is the OER for high LET radiation?
- It is the lowest for α particles (OER = 1)
- It is intermediate for neutrons (OER ~ 1.5)
Does OER require O2 to be present during radiation?
No. It requires O2 be present for 4 ms right after
What is the OER for radiation predisposed to killing cells by a single-hit mechanism?
It is usually lower.
What is the OER for rapidly growing cells?
It is generally lower (~2)
Does OER vary with dose?
Yes!
Why is high LET radiation not affected by oxygen/hypoxia?
It causes DNA damage via direct action.
There is no free radical intermediary.
At what oxygen concentration do tumor cells reach full radiosensitization?
20-40 mmHg; 2%
This is the concentration of O2 in venous blood (2-5%)
O2 concentration in arterial blood is much higher (8-13%)
O2 in room air (20%)
At what partial pressure of O2 do radiated cells exhibit radiosensitivity halfway between their fully aerobic and fully hypoxic responses?
- 4 mmHg
- 0.5% O2
Mnemonic: half-way → 0.5%
What is the conversion between mmHg and Torr?
1 mmHg = 1 Torr
What is the graphical relationship b/w O2 tension and radiosensitivity?
Graph:
Where do hypoxic cells in a tumor reside?
They lie between necrotic cells and aerobic tumor cells (actively dividing).
What are tumor cords?
Tumor forming cylindrical structures around blood vessels
At what tumor radius does a tumor not have a necrotic core?
≤ 160 microns
At what tumor radius does a tumor start to develop a necrotic core?
≥ 200 microns
Do tumors with 160 microns ≤ radius ≤ 200 microns have a necrotic core?
They may or may not.
Why is hypoxia relevant to tumor treatment?
- Hypoxia selects cells with decreased apoptotic potential (harder to kill)
- increased metastatic potential
- more mutations compared to oxic cells
- pH is decreased (6.2)
- Tumor-associated macrophages localize to hypoxic regions
How far can O2 diffuse at the arterial end of the capillary network?
150 microns (radius)
What is chronic hypoxia?
Hypoxia due to diffusion limit of O2 within the tumor
Causes necrosis and formation of a necrotic core
What is acute hypoxia?
Intermittent hypoxia that results from temporary blood vessel closure