Kummermehr J
Radiobiol Radiother (Berl). 1989;30(3):181-92.
Not only in experiment on animal but also from analysis of clinical data important knowledges could be obtained in the last years, that deal with the course of biological processes in tumor and normal tissue during fractionated irradiation. In centre there are differences in the capacity for recovery from sublethal radiation injury and in repopulation. Chronically reacting normal tissues show a clearly higher repair capacity than tumors, that can be used for hyperfractionation with reduced single doses. With it higher attention must be given to repairing time yet, that the selective benefit is not endangered by incomplete recovery. On the other side clinical analyses have confirmed that the stem cell repopulation--going on in several tumor types, so e.g. in squamous cell carcinomas, during the time of conventional treatment--can make a considerable contribution to radioresistance. The actual level of knowledge justifies further clinical experiments with unconventional fractionation, especially with accelerated hyperfractionation.
在过去几年里,不仅通过动物实验,而且从临床数据分析中都能获得重要知识,这些知识涉及分次照射期间肿瘤和正常组织中生物过程的进程。核心在于亚致死性辐射损伤恢复能力和再增殖方面存在差异。慢性反应性正常组织显示出比肿瘤明显更高的修复能力,这可用于降低单次剂量的超分割放疗。与此同时,仍必须高度重视修复时间,以免选择性益处因恢复不完全而受到威胁。另一方面,临床分析证实,在传统治疗期间,几种肿瘤类型(如鳞状细胞癌)中持续进行的干细胞再增殖会对放射抗性有相当大的影响。目前的知识水平证明有理由进一步开展非常规分割的临床试验,特别是加速超分割放疗。