Dj. Brenner et al., QUANTITATIVE COMPARISONS OF CONTINUOUS AND PULSED LOW-DOSE RATE REGIMENS IN A MODEL LATE-EFFECT SYSTEM, International journal of radiation oncology, biology, physics, 34(4), 1996, pp. 905-910
Citations number
30
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: There is increasing interest and usage of pulsed low dose rat
e (PDR) brachytherapy, in which a single source is shuttled through th
e catheters of an implant, typically for about 10 min each hour. This
study was designed to compare the late effects produced in various PDR
regimens with those from the corresponding continuous low dose rate (
CLDR) regimens. Methods and Materials: A model late-responding system
was used, namely, cataract induction in the rat lens. This system has
the advantage of being highly quantifiable. The rats eyes were exposed
to a total dose of 15 Gy either continuously over 24 h, or with three
different PDR regimens, all with the same total dose and overall time
. We addressed three questions: (a) are late effects increased when a
CLDR regimen is replaced with 10-min pulses repeated every hour? (b) A
re late effects increased if hourly 10-min pulses are replaced with 10
-min pulses repeated every 4 h? (c) Are late effects increased if 10-m
in pulses are replaced with 100-s pulses? Results: We found that the f
our regimens under test, continuous, 10-min pulses each hour, 10-min p
ulses every 4 h, and 100-s pulses every hour, showed no significant di
fferences in cataractogenic potential, as estimated with the Wilcoxon-
Gehan test. Power tests indicated that the experimental design was ade
quate to detect relatively small differences in cataractogenicity betw
een regimens. Conclusions: The equality of late effects from CLDR and
PDR in these experiments must imply that sublethal damage repair is qu
ite slow in this model late-responding system, in agreement with trend
s observed in the clinic for sublethal damage repair of late sequelae.
Such trends would suggest that PDR is unlikely to produce significant
ly worse late effects than the corresponding CLDR regimen, which is in
agreement with early clinical data using PDR. Caution, however, is st
rongly recommended.