Predicting radiocurability.

Several predictors of tumor radiocurability are already integrated into clinical practice, e.g., tumor size, gross morphologic features (i.e., infiltrative or exophytic), histologic type, and grade. These are relatively imprecise, however, and none is specific. The aim of research into predictive assays is not only to refine the discrimination of existing predictors but also to suggest specific experimental approaches for overcoming tumor radioresistance in individual patients. Two broad categories of predictive assays can be defined: direct and indirect measurements of tumor cell survival and/or repair capability following irradiation and measurement of cellular and extracellular parameters affecting radiosensitivity. Examples from ongoing research at the University of Texas M. D. Anderson Hospital using one technique from each category (the micronucleus assay and flow cytometric analysis of tumor cell proliferation kinetics and ploidy) are used to illustrate potential methods of selecting patients for fast neutron radiotherapy.