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Biomedical subjects

A Wambersie

Publications and source records attributed to A Wambersie.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Exposure to ionizing radiation: radiobiological effects and pathogenesis. 1].

The present paper describes the radiobiological effects induced by an exposure to ionizing radiation and their pathogenesis. The different skin reactions are described in detail because of their importance and frequency. Thus the acute skin lesions after high doses and the late effects resulting, either from high doses, or from accumulation of chronic irradiation, are studied. The main early syndromes are then characterized: neurological, gastro-intestinal, bone-marrow and prodromic. As far as the complex problem of radiocarcinogenesis is concerned, the main results derived from studies by international organizations such as the ICRP and the UNSCEAR are reported: risk coefficient of 5% per gray, for lethal radio-induced cancer, after total body irradiation, at low dose of low-LET radiation. The effects of irradiation in utero are then considered: risk of malformation after irradiation during the two first months of pregnancy and risk of mental retardation after irradiation during the third and the fourth months. Finally, the genetic risk is presented as being equal to one fourth of the risk of carcinogenesis at low-doses. The effects of irradiation on the gonads are also described.

Environmental Exposure↗
PubMed1996

Survival and diseases in C57BL mice exposed to X rays or 3.1 MeV neutrons at an age of 7 or 21 days.

Survival and causes of mortality were studied in 7- or 21-day-old male C57BL/Cnb mice exposed to 0.5, 1 or 3 Gy of 250 kVp X rays or 0.125, 0.25, 0.5 or 1 Gy of accelerator neutrons (modal energy 3.1 MeV). A total of 1287 animals were used in the experiments. Survival of irradiated animals was reduced significantly only in the mice receiving the highest doses (1 Gy neutrons, 3 Gy X rays ). Mice exposed to the lowest doses (0.125 Gy neutrons, 0.5 Gy X rays) lived significantly longer than controls, apparently reflecting a reduction in non-neoplastic lung and liver diseases. All malignant tumors increased significantly from (and including) doses of 0.5 Gy neutrons and 1 Gy X rays. Hepatocellular carcinoma was the principal contributor to the increase in tumor incidence, at least after exposure to neutrons. No significant increase in hepatocellular carcinoma was seen in 21-day-old mice exposed to X rays. An increase, especially after 3 Gy X rays, was also observed for all leukemias. Controls in the present study lived significantly longer than those in our earlier studies of irradiated adult mice, making a direct comparison of the radiation-induced effects in adult and infant mice difficult. Based on percentage life shortening, it appears that exposure during infancy does not shorten total survival or survival from cancer much more than exposure of adults, although such exposure, especially to neutrons, causes more hepatocellular carcinoma. Due to the nonlinearity of the dose-effect relationships, it is difficult to calculate the RBE of neutrons. For survival time at higher doses an RBE of about 3 is obtained. When the incidence of all malignant tumors and of hepatocellular cancer is fitted to a linear or a linear-quadratic function, an RBE from 5 to 8 is obtained. No RBE can be estimated for hepatocellular carcinoma in mice of an age of 21 days because exposure to X rays does not seem to cause this tumor at that age.

Age Factors↗
PubMed1995

[Quality control in pediatric radiology].

The authors recall the fundamentals of an adequate use of the X-rays considering to the ALARA (As Low As Reasonably Achievable) principle. The article deals more specifically with radiation protection and quality control in radiopediatrics, as this age group is essentially concerned with stochastic hazards, i.e. cancer induction and genetic injurious effects. The major elements of X-ray equipment are reviewed, including the X-ray generator, device, film-screen, radiogenic tube, automatic exposure device, and so on... The influence of technical parameters on dosimetry in terms of radiation protection as well as dosis variation, according to the type of disorder, are demonstrated. Reference is made to the radiologic techniques proposed by the Lake Starnberg Group.

Child↗
PubMed1995

Effect of neutrons alone or combined with diethylnitrosamine on tumor induction in the livers of infant C57BL mice.

The possible combined effects of the initiator diethylnitrosamine (DEN)+neutrons on the induction of foci, adenomas and carcinomas in the livers of C57BL/Cnb mice were evaluated. Four groups of infant mice were treated as follows: DEN alone, neutrons alone, DEN followed by neutrons and neutrons followed by DEN. Ten mice in each group were killed at 10-week intervals over 70 weeks. The following parameters were measured: body weight, liver weight, number and size of superficial macroscopic liver lesions, and number and total surface area of the different types of microscopic liver lesions. The rate of appearance of foci increased significantly at different times when a dose of 0.125 Gy of neutrons was administered 7 days before or after a dose of 1.25 micrograms of DEN. No significant differences were observed in the total surface area of foci and/or adenomas and carcinomas when increasing doses of neutrons were given 7 days before or after the administration of 1.25 and 2.5 micrograms of DEN.

Animals↗
PubMed1995

Dose-effect relationship for in vivo and in vitro induction of dicentric aberrations in blood lymphocytes of children.

Chromosome aberrations induced in vivo were studied in nine children 5-12 years old treated with total-body high-energy photon irradiation (pulsed exposure from a LINAC) for different types of malignant diseases. Dose-effect relationships were obtained for each child by taking blood at different times during exposure. In vitro dose-effect relationships for chromosome aberrations in children and adults were obtained by exposing blood under the same conditions as the children. Exposure in vivo and in vitro yielded similar linear-quadratic dose-effect relationships for dicentric aberrations. The response in vitro was slightly greater than in vivo, but the difference was not very large. It is concluded that the dose-effect relationship for dicentric chromosome aberrations obtained in vitro for adults can be used for biological dosimetry in irradiated children. Some of the children displayed a high number of "rogue cells" before exposure; this may be due to the malignant disease as it was not found in the healthy controls.

Adolescent↗
PubMed1995

[Emergency measures in accidental exposure to ionizing radiation].

The present paper is intended to provide any physician with a basic information and recommendations on how to behave with individuals who have been irradiated and/or contaminated (or believed to have been exposed), either in the case of a broad nuclear accident or a limited accidental exposure (e.g. occupational). Emphasis is put on the emergency measures to be taken as well as on their relative priority. Information is also provided in order to allow any physician to assess the magnitude and the severity of the exposure on the basis of early clinical symptoms and reactions. This would enable him to sort out the patients and to orientate them towards the appropriate specialized centre, or on the other hand, to reassure the patients. The information and recommendations are presented, purposely, in a concise and schematic way in order to facilitate, when needed, a quick and easy reading.

Clinical Protocols↗
PubMed1994

Dose prescription in boron neutron capture therapy.

PURPOSE: The purpose of this paper is to address some aspects of the many considerations that need to go into a dose prescription in boron neutron capture therapy (BNCT) for brain tumors; and to describe some methods to incorporate knowledge from animal studies and other experiments into the process of dose prescription. MATERIALS AND METHODS: Previously, an algorithm to estimate the normal tissue tolerance to mixed high and low linear energy transfer (LET) radiations in BNCT was proposed. We have developed mathematical formulations and computational methods to represent this algorithm. Generalized models to fit the central axis dose rate components for an epithermal neutron field were also developed. These formulations and beam fitting models were programmed into spreadsheets to simulate two treatment techniques which are expected to be used in BCNT: a two-field bilateral scheme and a single-field treatment scheme. Parameters in these spreadsheets can be varied to represent the fractionation scheme used, the 10B microdistribution in normal tissue, and the ratio of 10B in tumor to normal tissue. Most of these factors have to be determined for a given neutron field and 10B compound combination from large animal studies. The spreadsheets have been programmed to integrate all of the treatment-related information and calculate the location along the central axis where the normal tissue tolerance is exceeded first. This information is then used to compute the maximum treatment time allowable and the maximum tumor dose that may be delivered for a given BNCT treatment. RESULTS AND CONCLUSION: The effect of different treatment variables on the treatment time and tumor dose has been shown to be very significant. It has also been shown that the location of Dmax shifts significantly, depending on some of the treatment variables--mainly the fractionation scheme used. These results further emphasize the fact that dose prescription in BNCT is very complicated and nonintuitive. The physician prescribing the dose would need to rely on some method, like the one developed here, to come up with an appropriate dose prescription.

Boron Neutron Capture Therapy↗
PubMed1994

The clinical RBE and microdosimetric characterization of radiation quality in fast neutron therapy.

High-LET radiation therapy using fast neutrons is being applied regularly at several centres worldwide and in the future, other types of radiation qualities, such as protons and heavier ions and boron neutron capture therapy (BNCT) are likely to be used. The neutron beams used are of considerably varying energy and thus considerable variations in the relative biological effectiveness (RBE) have been found. At present, no generally accepted method exists for the quantitative specification of these differences in radiation quality for clinical purposes. This is in clear discrepancy with the accuracy requirements in clinical dosimetry. An approach is presented which is based on a single parameter radiation quality characterization determined in combined microdosimetric and radiobiological experiments. It is shown that the method can meet the accuracy requirements of clinical dosimetry and that it is applicable within a concept of formalized procedure of clinical practice and experience ('clinical RBE').

Energy Transfer↗
PubMed1994

Development of fast neutron therapy worldwide. Radiobiological, clinical and technical aspects.

Radiobiological data indicate that fast neutrons could bring a benefit in the treatment of some tumour types, and suggest mechanisms through which this benefit could be achieved. However, radiobiology also clearly indicates that there is a need for patient selection as well as for a high-physical selectivity. The main difficulty when interpreting the results of neutron therapy are the poor technical conditions in which the first treatments were applied. This explains why the value and the place of neutron therapy are not universally recognized, although more than 15,000 patients have been treated so far worldwide. There are, however, clinical indications of fast neutrons bringing a benefit for the following tumour sites: salivary glands, paranasal sinuses, soft tissue sarcomas, prostatic adenocarcinomas, palliative treatment of melanoma and rectum. These tumours represent about 10-15% of all patients currently referred to the radiation therapy departments.

Academies and Institutes↗
PubMed1993

Influence of cisplatinum on intestinal tolerance to photon and neutron irradiation in mice.

The hypothesis that cisplatinum (c-DDP) interacts with radiation by inhibiting the cellular repair capacities, was tested by comparing the interaction of c-DDP with low-LET (60Co gamma-rays) and high-LET radiation (d(50) + Be neutrons) in mice. The biological endpoint was lethality, 6 days after total body irradiation (early intestinal tolerance). The dose modifying factor was 1.80 +/- 0.25 for c-DDP plus 60Co gamma-rays, and 1.97 +/- 0.3 for c-DDP plus neutrons. As less repairable damage is induced by fast neutrons than by photons, this suggests that, in this system, the interaction between radiation and c-DDP is not explained by repair inhibition but is purely additive.

Animals↗
PubMed1993

Is it possible to verify directly a proton-treatment plan using positron emission tomography?

A PET camera is used to visualize the positron activity induced during protonbeam therapy in order to verify directly the proton-treatment plans. The positron emitters created are predominantly the 15O and 11C, whose total activity amounts to 12 MBq after an irradiation with 85 MeV protons, delivering 3 Gy in a volume of approximately 300 cm3. Although this method is a useful verification of patient set-up, care must be taken when deriving dose distributions from activity distributions. Correlation between both quantities is difficult, moreover at the last millimeters of their range, protons will no longer activate tissue. Due to the short half-lives the PET camera must be located close to the treatment facility.

Humans↗
PubMed1993

Neutron therapy of bladder carcinoma: can a high rate of severe complications be avoided in neutron therapy?

We reviewed retrospectively a series of 58 patients with deeply invasive bladder cancer treated with fast neutron therapy (p(65) + Be) in order to evaluate its tolerance and side effects. Patients were divided into three groups according to treatment technique. Patients of group A received whole pelvis irradiation up to 50 Gy photon equivalent followed by a boost to the bladder up to 57-66 Gy photon equivalent (40-56 days). Group B patients were treated by a split course regimen of 30 Gy photon equivalent on the whole pelvis at 3-4 weeks interval (66-108 days). Group C patients, not suitable for radical treatment, received only 40-54 Gy photon equivalent (26-70 days). The overall 5-year actuarial survival rate was 30% (SE 8%). As expected, T stage was a statistically significant prognostic factor. The overall local control rate reached 21% at 4 years. Acute and late side effects were minimal to moderate. These results suggest that high-energy neutron beam treatment is at least as effective as photon beam treatment for bladder carcinoma, without a higher incidence of major side effects.

Adenocarcinoma↗
PubMed1993

[Radioprotection in radiology, a controversial practice: how to wear the individual dosimeters?].

After a short recall of the Belgian legislation in the field of radiation protection, the practical organization of individual dosimetry is described. The workers occupationally exposed to radiation shall always wear an individual dosimeter at the level of the chest. When a high irradiation of the hands is suspected, it is necessary to wear a second dosimeter at the level of the wrist or the fingers. When a lead apron is used, due to the important resulting dose heterogeneity, two dosimeters have to be worn, the first one permanently at the level of the chest (behind the lead apron), the second one at the level of the non-protected parts of the body (e.g. neck, shoulders). The effective dose is then calculated by adding the dose received by the first dosimeter and the dose received by the second dosimeter (not shielded by the lead apron) divided by a weighting factor of 10. This evaluation of the effective dose is fully conservative.

Belgium↗
PubMed1993

Alteration of the blood-brain barrier after irradiation: implication in boron neutron capture therapy.

The radiobiological and clinical data concerning the alteration of the blood-brain barrier (BBB) after cerebral irradiation are reviewed. Several boron neutron capture therapy (BNCT) programs are at present under study in Europe and in the USA. In these programs, irradiation is considered to be delivered in several fractions, and one could also imagine, in principle, delivering BNCT after a full course of external radiotherapy of the brain. These options raise the question of the alteration of the normal BBB by previous irradiation. Before starting clinical applications, it then becomes necessary to assess the integrity of the BBB after different dose ranges and fractionation schemes, and after different time intervals following irradiation. Extrapolation of the available radiobiological and clinical data suggests that for rather small hydrophilic compounds, such as BSH or L-BPA, an early increase in transport through the BBB may be foreseen after single photon dose larger than 10 Gy or after a full standard radiotherapy regimen. However, there is no evidence that the first fractions of a BNCT application (typically 2 to 4 Gy equivalent per fraction) would increase the permeability of the BBB sufficiently to permit transport of large boronated compounds such as porphyrins or antibodies, or even of smaller hydrophilic compounds such as BSH and L-BPA. It can be concluded that the dose selectivity of BNCT is unlikely to be compromised by early alteration of the BBB due to the first fractions of a typical BNCT fractionated regimen.

Animals↗
PubMed1993

Radiobiological intercomparison of p(45)+Be and p(65)+Be neutron beams for lung tolerance in mice after single and fractionated irradiation.

The lung tolerance in mice after single and fractionated irradiations with p(45)+Be and p(65)+Be neutrons produced at the isochronous cyclotron "CYCLONE" of Louvain-la-Neuve (Belgium) was studied. Cobalt-60 gamma rays were used for control irradiations. The end point was the dose which was lethal to 50% of the mice by 180 days (LD50/180). On a log-log plot, the slope (+/- SE) of the relationship between total isoeffect dose and fraction number decreases from 0.34 +/- 0.01 for gamma rays to 0.19 +/- 0.01 for p(65)+Be and 0.12 +/- 0.01 for p(45)+Be neutrons. The data have been analyzed using the linear-quadratic (LQ) model. The alpha/beta ratio (+95% confidence interval) increases from 5.3 (4.3-6.4) for gamma rays to 20.7 (16.7-24.9) for p(65)+Be and 37.9 (25.8-65.8) for p(45)+Be. The RBEs of neutrons relative to gamma rays were estimated from the LQ parameters, to 1.15 and 1.19 for a dose of 14 Gy gamma rays and 2.02 and 2.47 for a dose of 2 Gy gamma rays for p(65)+Be and p(45)+Be neutrons, respectively. The neutron RBE of the p(45)+Be relative to the p(65)+Be calculated from the ratio of their respective RBEs relative to gamma rays reaches 1.03 and 1.23 for doses of 14 and 2 Gy gamma-ray equivalent, respectively. These data are compared with other published data on lung tolerance after irradiation with lower-energy neutrons and with data obtained previously in our laboratory on mouse jejunum and Vicia faba.

Animals↗
PubMed1993

RBE in fast neutron therapy and in boron neutron capture therapy. A useful concept or a misuse?

In high-LET radiation therapy, radiation quality and radiation quality differences have to be taken into account and specified. In fast neutron therapy, an operational approach has been adopted which is based on the concept of "clinical RBE". The paper discusses the quantities of RBE (relative biological effectiveness), reference RBE and clinical RBE and their relationship and significance in radiation therapy. In particular, the difference between the well defined RBE in radiation biology and the clinical RBE which is based on the judgement of radiotherapists is elucidated and emphasized. The clinical RBE is based on the reference RBE and implicitly includes differences in physical selectivity of the irradiation beams and clinical experience. The particular aspects of radiation quality in boron neutron capture therapy (BNCT) are due to the poor penetration of the primary beam, the inhomogeneity of the spatial distribution of 10B nuclides in the irradiated tissue and the short range of the alpha-particles emitted after neutron capture in 10B. The related problems in accounting for radiation quality in BNCT and in the applicability of the clinical RBE concept are discussed.

Boron Neutron Capture Therapy↗