RBE values and repair characteristics for colo-rectal injury after caesium 137 gamma-ray and neutron irradiation. II. Fractionation up to ten doses.

Early and late colo-rectal damage in mice have been assessed after 137Cs gamma irradiation and 3 MeV neutrons given as 1,2,5 or 10 fractions. Damage was measured by early changes in body weight, the late production of short faecal pellets and the pattern of lethality after irradiation. The data have been analysed in terms of the time course of expression of damage, fractionation effects and the RBE for neutrons over a wide range of doses per fraction (0.5-12.5 Gy neutrons, 3.5-33.5 Gy gamma rays). An initial epithelial denudation led to an early loss of weight, maximal at 11-17 days after irradiation. A dose-dependent weight reduction persisted over the animals' life-time. Deaths after localised pelvic gamma irradiation were progressive with no sharp demarcation between early or late phases of injury. The time course for lethality was qualitatively similar after neutrons. Beyond six months the rectum became constricted by fibrosis and a higher proportion of small faecal pellets was observed. At 6-15 months relatively shallow dose-response curves were obtained for this change. The sparing effect of fractionation was marked for the gamma-irradiated mice and almost absent after neutrons. A very high repair increment (11 Gy) was seen with two gamma-ray fractions of 20 Gy. At lower doses per fraction the proportion of each gamma-ray fraction recovered was 50-69% for all assays, i.e., similar to that for other normal tissues. There was a slight enhancement in the sparing effect for the late compared with the early assays over the lower dose range. The RBE was strongly dependent on dose per fraction because of the lack of reparable damage after neutrons. The RBE for both early and late effects was 5.0 at a neutron dose per fraction of 1 Gy. Extrapolation of the RBE data to lower doses, using the linear quadratic model, predicts a higher RBE for late (7.4-12.7) than for early damage (5.7-8.5) if gamma-ray doses below 5 Gy are used.