Mason K A, Withers H R, Chiang C S
University of Texas M.D. Anderson Cancer Center, Dept. of Experimental Radiotherapy, Houston 77030.
Int J Radiat Oncol Biol Phys. 1993 Jul 15;26(4):643-8. doi: 10.1016/0360-3016(93)90282-z.
Using a guinea pig model of lumbar myelopathy, various factors affecting the tolerance of spinal cord to irradiation were assessed: (a) extent of initial injury (b) time interval between priming and test doses (c) animal age at the time of initial radiation treatment.
A 3 cm section of lumbar spinal cord of guinea pigs was irradiated with fractionated doses of 4.5 Gy gamma rays given as 9 fractions per week. Guinea pigs were primed with 9 x 4.5 Gy in 7 days which is 60% of the ED50 for a continuous course of treatment. After 28 or 40 weeks, animals were retreated with 6-14 fractions of 4.5 Gy. Animals were observed for 2 years following the priming dose and both the incidence and latency of myelopathy recorded.
Young adult guinea pigs (8 wk old) showed both a decreased radiation tolerance and latency compared to old individuals (40 wk old). At 28 or 40 wk after 9 x 4.5 Gy, only about 8% of the initial injury was remembered in young adult guinea pigs.
The amount of residual injury was dependent on the initial damage as a proportion of the tolerance dose. The spinal cord shows a greater capacity for long-term recovery than generally appreciated and re-treatment doses clinically prescribed may be lower than necessary.
利用豚鼠腰椎脊髓病模型,评估影响脊髓对辐射耐受性的各种因素:(a)初始损伤程度;(b)预照射剂量与测试剂量之间的时间间隔;(c)初始放射治疗时的动物年龄。
对豚鼠的3厘米腰椎脊髓节段进行分次照射,每周9次,每次4.5 Gyγ射线。豚鼠在7天内接受9×4.5 Gy的预照射,这是连续治疗方案中ED50的60%。28或40周后,动物再次接受6 - 14次4.5 Gy的照射。在给予预照射剂量后观察动物2年,记录脊髓病的发生率和潜伏期。
与老年个体(40周龄)相比,年轻成年豚鼠(8周龄)的辐射耐受性和潜伏期均降低。在9×4.5 Gy照射后28或40周,年轻成年豚鼠仅保留了约8%的初始损伤。
残余损伤量取决于初始损伤占耐受剂量的比例。脊髓显示出比一般认为的更大的长期恢复能力,临床规定的再治疗剂量可能低于必要剂量。