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PubMed1996

[The ultrastructural study on radiation injuries of the jaws and soft tissues].

To search for the pathological basis of osteoradionecrosis (ORN), a ultrastructural investigation was performed on some experimental and clinical speciments. The result of this ultrastrcture study shows the nature of ORN is direct injuries of radiation rays to cells; damage of the arterioles are not the main pathologicalbasis, changes of the cytoplasm are more evident than that of nuclei. The changes of blood vessels in soft tissues are more extensive and serious than those of the bone.

Animals↗
PubMed1986

Acute and late radiation injury in rhesus monkey parotid glands. Evidence of interphase cell death.

Acute and chronic salivary gland dysfunction are common sequelae of radiotherapy for head and neck cancer; but the associated morphologic changes, especially of the acute damage, have received relatively little study. For investigation of the morphologic characteristics of acute radiation injury to parotid glands, rhesus monkeys were studied 1-72 hours after parotid irradiation with single doses of 2.5-15.0 Gy. The acute damage from all doses was clearly expressed by 24 hours. Histologically, parotid glands irradiated with 2.5 or 5.0 Gy had random degeneration and necrosis of the serous acinar cells. Doses of 7.5-15.0 Gy produced widespread degeneration along with necrosis of whole acini. Serous cell damage was accompanied by neutrophilic inflammation that subsided after 24 hours to become replaced by plasma cell and lymphocytic infiltrates. Parotid glands receiving 7.5-15.0 Gy were atrophic at 16-22 weeks after irradiation and showed no recovery by 40 weeks. Although parotid acinar cells are well-differentiated nondividing cells, these observations show that they express lethal radiation injury in interphase within hours of receiving a radiation dose as low as 2.5 Gy. This is unlike most mammalian cells that express radiation injury during mitosis. Chronic atrophy is a consequence of this direct, irreversible, and early injury, rather than the result of radiation-induced changes in the vasculature.

Acute Disease↗
PubMed2000

PET in differentiation of recurrent brain tumor from radiation injury.

The annual incidence of primary intracranial tumors is 7 to 19 cases per 100,000 people. The general approach to the treatment of brain neoplasms is surgical resection of solitary lesions or limited disease, followed by radiation therapy with or without chemotherapy. Multiple metastatic lesions are usually treated with whole-brain radiation. Radiation injury occurs in 5% to 37% of cases and can be difficult to differentiate from residual or recurrent malignancy by MRI. PET has been used to differentiate radiation injury from malignancy on the basis of differences in glucose uptake. Recent studies have reported the sensitivity and specificity of PET to be 81% to 86% and 40% to 94%, respectively. This article reviews the classification of primary brain tumors, the histologic changes associated with radiation injury, and the diagnostic and prognostic information provided by PET.

Brain↗
PubMed1989

[Preventive effect of TJ-48 on recovery from radiation injury].

Effects of Juzen-taiho-toh (TJ-48) on the recovery of haemopoietic systems from radiation injury are analyzed. Female C57BL/6 mice (6 to 8 week-old) were irradiated at doses of 0, 1, 2, 3, 5 or 7 Gy from a 60Co source. During the 7 days after irradiation, the mice were given TJ-48 solution (1.25g in 100ml distilled water). Seven days after irradiation, the mice were sacrificed, and cell counts of bone marrow (both femurs), thymus, spleen, and peripheral blood were made. The bone marrow cells were used for CFU-f, CFU-GM, BFU-E, and CFU-E assays. No difference were observed between the experimental and control groups. However, the CFU-S. d14 and CFU-S.d9 counts in the TJ-48-treated groups were greater than the respective values in the control groups, especially in the low-dose range of irradiation (1, 2, 3 Gy). In the assay for CFU-S.d14, the mice injected with TJ-48-treated bone marrow cells showed better general condition, heavier spleens with larger and more numerous colonies than the control mice. There was no difference in the number of CFU-f between TJ-48-treated and control groups. Since the CFU-S.d14 assay is thought to reflect the most primitive progenitor cells in the haemopoietic system, these results strongly suggest that TJ-48 acts on stem cells in the G0 phase to manifest recovery-enhancing effects from radiation injury.

Animals↗
PubMed2002

Prosurvival and antiapoptotic effects of PGE2 in radiation injury are mediated by EP2 receptor in intestine.

The biological activities of PGE(2) are mediated through EP receptors (EP(1)-EP(4)), plasma membrane G protein-coupled receptors that differ in ligand binding and signal-transduction pathways. We investigated gastrointestinal EP(2) receptor expression in adult mice before and after radiation injury and evaluated intestinal stem cell survival and crypt epithelial apoptosis after radiation injury in EP(2) null mice. EP(2) was expressed throughout the gut. Intestinal EP(2) mRNA increased fivefold after gamma-irradiation. Crypt survival was diminished in EP(2)-/- mice (4.06 crypts/cross section) compared with wild-type littermates (8.15 crypts/cross section). Radiation-induced apoptosis was significantly increased in EP(2)-/- mice compared with wild-type littermates. Apoptosis was 1.6-fold higher in EP(2) (-/-) mice (5.9 apoptotic cells/crypt) than in wild-type mice (3.5 apoptotic cells/crypt). The EP(2) receptor is expressed in mouse gastrointestinal epithelial cells and is upregulated following radiation injury. The effects of PGE(2) on both crypt epithelial apoptosis and intestinal crypt stem cell survival are mediated through the EP(2) receptor.

Animals↗
PubMed2006

Boron neutron capture therapy using mixed epithermal and thermal neutron beams in patients with malignant glioma-correlation between radiation dose and radiation injury and clinical outcome.

PURPOSE: To clarify the correlation between the radiation dose and clinical outcome of sodium borocaptate-based intraoperative boron neutron capture therapy in patients with malignant glioma. METHODS AND MATERIALS: The first protocol (P1998, n = 8) prescribed a maximal gross tumor volume (GTV) dose of 15 Gy. In 2001, a dose-escalated protocol was introduced (P2001, n = 11), which prescribed a maximal vascular volume dose of 15 Gy or, alternatively, a clinical target volume (CTV) dose of 18 Gy. RESULTS: The GTV and CTV doses in P2001 were 1.1-1.3 times greater than those in P1998. The maximal vascular volume dose of those with acute radiation injury was 15.8 Gy. The mean GTV and CTV dose in long-term survivors with glioblastoma was 26.4 and 16.5 Gy, respectively. A statistically significant correlation between the GTV dose and median survival time was found. In the 11 glioblastoma patients in P2001, the median survival time was 19.5 months and 1- and 2-year survival rate was 60.6% and 37.9%, respectively. CONCLUSION: Dose escalation contributed to the improvement in clinical outcome. To avoid radiation injury, the maximal vascular volume dose should be <12 Gy. For long-term survival in patients with glioblastoma after boron neutron capture therapy, the optimal mean dose of the GTV and CTV was 26 and 16 Gy, respectively.

Adolescent↗
PubMed1988

Effects of accelerated fractionation on radiation injury of the small intestine: a new rat model.

The present study assessed the influence of shortening the overall treatment time (accelerated fractionation) on radiation injury of the small intestine. A rat model which allowed repeated irradiation of a localized segment of small intestine was developed. Young adult male Sprague-Dawley rats were orchiectomized, and a loop of the distal ileum was transposed to the left part of the scrotum. The intestinal segment was irradiated with a total dose of 56 Gy, given in 20 fractions, the total treatment time being either 26, 12, or 7 days (i.e. 1, 2, or 3 fractions per day). Radiation injury was assessed by histopathologic examination at 6 hr and at 2 weeks after the last irradiation. The surgical procedure was without complications. Shortening the overall treatment time by giving more than one radiation dose per day resulted in markedly increased injury both at 6 hr and at 2 weeks. It is concluded that accelerated fractionation results in increased radiation injury of the intestine when compared with standard fractionation. Because there may be a relationship between early and late effects in the intestine, our results also indicate that increased late radiation enteropathy may result from accelerated fractionation.

Animals↗
PubMed1987

Three-phase radionuclide bone scanning in evaluation of local radiation injury. A case report.

The management of local radiation injuries is influenced by the degree of vascular compromise within the skin and underlying tissues. Other authors have used thermography and angiography in assessing the blood flow to radiation damaged tissues. This report describes the use of radionuclide imaging in the evaluation of a patient who developed necrosis of his distal digits following a radiation accident. In addition to determining the vascular status of the hands, imaging helped indicate an appropriate level for amputation.

Accidents, Occupational↗
PubMed1995

Efficacy of radioprotective agents in preventing small and large bowel radiation injury.

PURPOSE: A variety of adjuvant treatments and cytoprotective agents have been proposed to lessen the toxicity of radiation therapy. The following study was designed to evaluate the benefit of six agents or combinations using anastomotic bursting strength as a measure of transmural radiation injury. METHODS: The 40-Gy study consisted of the following. Seventy-two male Sprague-Dawley rats were divided into eight equal groups: nonradiated control, radiated untreated control, and six radiated treated groups. The radioprotective treatments included ribose-cysteine (Rib-Cys), WR-2721, glutamine, vitamin E, MgCl2/adenosine triphosphate, and RibCys/glutamine in combination. Radiated animals received 40 Gy to the abdomen. Two weeks after radiation, all animals underwent small bowel and colonic resection with primary anastomosis. Animals were sacrificed one week postoperatively, at which time anastomoses were evaluated and bursting strengths determined. The 70-Gy study consisted of the following. The same protocol was repeated for five groups of nine rats divided into nonradiated, radiated untreated, and three radiated treated groups receiving RibCys (8 mmol/kg), RibCys (20 mmol/kg), and WR-2721. All radiated animals received 70-Gy doses. RESULTS: In the 40-Gy group, there were 10 radiation-related deaths and 6 anastomotic leaks among 70 rats studied. None of the differences between groups were significant. Nonradiated control group small bowel and large bowel anastomotic bursting pressures were significantly elevated compared with all radiated groups. Compared with radiated controls, there were significant improvements in small bowel bursting strength in the RibCys, WR-2721, RibCys-glutamine, and vitamin E groups and significant improvement in colonic bursting strength in MgCl2/adenosine triphosphate, WR-2721, and RibCys groups. In the 70-Gy group, all nine nonradiated control rats survived. All eight untreated radiated control rats died, four of eight WR-2721 animals died (P = 0.03), all RibCys (8 mmol/kg) animals died (P = 0.03), and three of nine treated with RibCys (20 mmol/kg) survived (P = 0.08). CONCLUSIONS: WR-2721 and RibCys gave consistent protection against large and small bowel radiation injury. The lower incidence of treatment-related toxicity and potentially equal or greater radioprotective effects may make RibCys more clinically useful than WR-2721.

Adenosine Triphosphate↗
PubMed1986

Clinical study of the radioprotective effects of Amifostine (YM-08310, WR-2721) on chronic radiation injury.

We have previously reported that Amifostine, a radioprotective agent, was effective in treating acute radiation mucositis in the head and neck region. We found that when a considerable amount of Amifostine accumulates in the salivary glands, it may be useful in preventing chronic disturbances of salivary secretion. We have observed an increase in the uptake of Ga-67-citrate to the salivary glands when they were irradiated. In this paper, the radioprotective effects of Amifostine, in treating chronic radiation injury of the salivary glands, were studied, using the cessation of an increase in uptake of Ga-67-citrate after radiotherapy as the criterion. The subjects were 105 patients, (280 salivary glands in Ga-scintigrams) with malignancy of the head and neck region treated by irradiation from 1978 to 1984. Ga-negative glands were recognized in 97%, that is, 36 out of 37 glands, before irradiation, and the figure decreased to 19%, seven out of 37, within 1 to 2 weeks (10Gy less than or equal to) after the start of radiotherapy. In patients who were irradiated with more than 30 Gy and in whom scintigraphy was performed at 6 months or more after radiotherapy, Ga-negative glands were recognized in 18 out of 41 glands, 44%, with Amifostine, compared with 13%, four out of 32 glands, without Amifostine. A difference was recognized between these two groups in the negative change in Ga-67 uptake after radiotherapy (p less than 0.05). These facts suggest that Amifostine may have a radioprotective effect on chronic radiation injury.

Amifostine↗
PubMedDate not supplied

[Morphological types of radiation-induced hematopoietic tissue cell death, its biological essence and significance at various stages of developing acute radiation injury].

The results of morphologic investigation of radiation-induced cell death types in human and animal (dogs) hematopoietic tissue within an acute radiation injury are presented. It has been shown that early and late necrobiosis of myelokaryocytes occurs via apoptosis. An attempt to designate the pathogenic role of apoptosis in hematologic syndrome of acute radiation sickness was performed.

Animals↗
PubMed1992

Adenosine triphosphate-magnesium chloride in radiation injury.

Although adenosine triphosphate-magnesium chloride (ATP-MgCl2) has demonstrated cytoprotective effects in a variety of adverse pathophysiologic conditions, its ability to alter radiation injury is unknown. The purpose of this study, therefore, was to assess the effects of ATP-MgCl2 on colorectal radiation injury after preoperative pelvic radiotherapy. Mixed-breed pigs (n = 36) received 4250 cGy preoperative external-beam pelvic radiotherapy (350 cGy fractions three times per week for 4 weeks). During radiotherapy, animals were randomly assigned to one of three treatment groups: (1) intravenous infusions of normal saline during radiotherapy, (2) intravenous ATP-MgCl2 (30 mumol/kg) during radiotherapy, or (3) intravenous ATP-MgCl2 (60 mumol/kg) during each radiotherapy session. After completion of radiotherapy and a 4-week rest period, animals underwent colorectal resection by either the two-layer hand-sewn (n = 18) or stapled end-to-end anastomosis technique (n = 18). Laser Doppler velocimetric readings were obtained to assess mural colonic blood flow after completion of anastomosis. A second laparotomy on postoperative day 5 or 11 was done to examine the following anastomotic parameters: (1) repeat laser Doppler velocimetry, (2) gross inflammatory scoring, (3) bursting pressure, (4) preoperative barium enema to identify leak or stenosis, (5) analysis of anastomotic hydroxyproline content, and (6) incidence of cutaneous injury in the radiation portals. ATP-MgCl2 administered intravenously at 60 mumol/kg led to (1) diminished colorectal seromuscular ischemia evidenced by laser Doppler velocimetric readings, (2) decreased skin and subcutaneous tissue injury in the treatment portals, (3) significantly decreased perianastomotic inflammatory reaction, and (4) increased early hydroxyproline content. There was no significant difference in the incidence of leakage or stenosis between the study groups, nor was the anastomotic bursting strength significantly different between the treatment groups. Therefore the administration of ATP-MgCl2 (60 mumol/kg) appears to offer significant cytoprotection from preoperative pelvic radiation therapy.

Adenosine Triphosphate↗
PubMed2005

Radiation injury to the liver after intensity-modulated radiation therapy in patients with mesothelioma: an unusual CT appearance.

OBJECTIVE: We sought to report the unusual distribution of radiation-induced injury to the liver in patients with mesothelioma after extrapleural pneumonectomy and intensity-modulated radiation therapy (IMRT). CONCLUSION: Abnormal hepatic enhancement after extrapleural pneumonectomy and IMRT is common in patients with mesothelioma. Knowledge of the early occurrence and typical location and appearance of IMRT-induced injury can be useful in preventing misinterpretation as metastatic disease or recurrent tumor.

Aged↗
PubMed1988

[Radiation injuries of the vertebrae].

The results of examination of 12 patients with vertebral radiation injuries were analyzed. The authors considered clinical and x-ray signs of radiation osteoporosis (5), radiation osteonecrosis (7 patients), and complications in the form of pathological fractures of vertebral bodies. Vertebral radiation injuries were most frequently detected 6-12 yrs. after the discontinuation of radiotherapy.

Adult↗
PubMed1982

[Factors determining the probability of the development of late radiation injuries to adjacent organs in cervical cancer].

Main factors of development of late-onset lesions of the urinary bladder and rectum caused by irradiation of cervical carcinoma are discussed. The results of radiation therapy of 616 patients with cancer of uterine cervix are analysed, and the rates of incidence of late-onset radiation injuries to adjacent organs are considered in relation to dosage, methods of irradiation and early-onset radiation reactions. It was found that the frequency of late-onset radiation injuries of the urinary bladder and rectum increases in proportion to absorbed dosage of radiation and as a result of remote irradiation of the small pelvis with open fields. The time that elapses before early-onset reactions of neighboring organs appear in the course of irradiation proved to be of primary importance in the development of late-onset lesions. It is suggested that the time of early-onset reaction development is characteristic of individual tolerance of normal tissues.

Female↗