Sequential exposures of mammalian cells to low- and high-LET radiations. II. As a function of cell-cycle stages.

The synergistic effects of low- and high-LET radiations were further studied with partially synchronized Chinese hamster V79 cells. Principally, nearly monoenergetic 425 MeV/u neon ions and 570 MeV/u argon ions produced near the Bragg peak were employed as the high-LET radiations and 225 kVp X rays as the low-LET counterpart. It was found that the killing effect due to damage interaction after sequential irradiations with the particle beam and X rays varies throughout the cell cycle. The greatest effect was observed in late-S phase which was most resistant to either of the radiations. The effect was quantitatively less in the G1/S border and in G2. Effects on pure mitotic cells have not been investigated in this study. For all cell stages studied, a dose of high-LET particles modified the shape of the X-ray survival curve in a way similar to the modification predicted by an appropriately selected X-ray dose. This finding suggests that the mechanism for the synergistic effects is similar to that operating for sequential treatments with X rays alone. Experiments with an S population, either incubated at 37 degrees C or room temperature between fractionation of high- and low-LET radiation treatments further verified that the damage involved is a repairable type. At a certain fractionation interval (6 to 8 h) following a dose of high-LET treatment, initially asynchronous cells were found to be very sensitive to X-irradiation. It is noteworthy that the net killing measured at this "radiosensitive window" was as effective as the killing observed by "immediately" sequential treatments with the same doses of high- and low-LET radiations. Such a time window also existed when the order of the treatment sequence was reversed except that the time of occurrence was earlier and the window was broader. This sensitization effect may be explained by radiation-induced G2 arrest together with an increase of radiosensitivity as the previously irradiated cells progress into S phase. Radiotherapy strategies using combined high-LET and low-LET radiations for rapidly proliferative tumors are presented.