Purpose: The present review summarizes radiobiological models of norma
l tissue responses to radiation and their consequences for potential t
herapeutic interventions. Material and Methods: Common radiobiological
principles and pathogenetic models can be established for classes of
tissues. These models may support the development of general modalitie
s, both therapeutic and supportive, for the modulation of these respon
ses. Results: The stem cell concept, based on studies in standard tiss
ue culture, describes the clonogenic survival after radiation treatmen
t. The factors affecting cell survival are summarized as the 4 Rs of r
adiotherapy. Based on the stem cell concept, the reactions of normal t
issue to ionising radiation were considered a consequence exclusively
of the proliferative sterilisation of cells of a given target cell pop
ulation. Once stem cells are inactivated, responses develop in a passi
ve manner. However, recent studies into the pathogenesis of radiation
tissue injury have clearly shown that numerous postirradiation events
occur during the symptom-free latent time in irradiated cells and tiss
ues, which modulate the manifestation of damage. These are summarized
by models of tissue radiation pathology. Conclusions: Cellular radiobi
ology and the tissue models based on the stem cell concept assume that
exclusively the sterilisation of target cells is the radiation effect
which results in both acute and late tissue responses. As a consequen
ce, the radiation sensitivity can only be modulated by modification of
radiobiological parameters at the time of irradiation, while at later
time points only symptomatic treatment can be applied. Tissue radiati
on pathology, in contrast, allows for post-irradiation modification of
the manifestation of radiation sequelae in tissues.