title: Tolerance of rat spinal cord to continuous interstitial irradiation.
abstract: OBJECTIVE
  To study the kinetics of repair in rat spinal cord during continuous interstitial irradiation at different dose rates and to investigate the impact of a rapid dose fall off over the spinal cord thickness.
  
  
  METHODS
  Two parallel catheters were inserted on each side of the vertebral bodies from the level of T10 to L4. These catheters were afterloaded with two 192Ir- wires of 4 cm length each (activity 1-10 mCi/cm) or connected to the HDR- microSelectron. Experiments have been carried out to obtain complete dose response curves at 7 different dose rates: 0.53, 0.90, 1.64, 2.56, 4.4, 9.9 and 120 Gy/h. Paralysis of the hindlegs after 5 - 6 months and histopathological examination of the spinal cord of each animal were used as experimental endpoints.
  
  
  RESULTS
  The distribution of the histological damage was a good reflection of the rapid dose fall - off over the spinal cord, with white matter necrosis or demyelination predominantly seen in the dorsal tracts of the spinal cord or dorsal roots. With each reduction of the dose rate, spinal cord tolerance was significantly increased, with a maximum dose rate factor of 4.3 if the dose rate was reduced from 120 Gy/h to 0.53 Gy/h (ED50 of 17.3 Gy and 75.0 Gy, respectively). Estimates of the repair parameters using different types of analysis are presented. For the direct analysis the best fit of the data was obtained if a biexponential function for repair was used. For the 100% dose prescribed at the ventral side of the spinal cord the alpha/beta ratio is 1.8 Gy (0.8 - 2.8) and two components of repair are observed: a slow component of repair of 2.44 h (1.18 - infinity) and a fast component of 0.15 h (0.02 - infinity). The proportion of the damage repaired with the slow component is 0.59 (0.18 - 1). For the maximum of 150% of the prescribed dose at the dorsal side of the spinal cord the alpha/beta ratio is 2.7 Gy (1.5 - 4.4); the two components for the kinetics of repair remain the same.
  
  
  CONCLUSIONS
  Spinal cord radiation tolerance is significantly increased by a reduction in dose rate. Depending on the dose prescription, the alpha/beta ratio is 1.8 or 2.7 Gy for the 100% and 150% of the reference dose (rate), respectively; for the kinetics of repair a biphasic pattern is observed, with a slow component of 2.44 hours and a fast component of 0.15 hours, which is independent of the dose prescription.
authors.affiliation: Institute of Radiotherapy, University of Nijmegen, The Netherlands.
authors.forename: L A
authors.initials: LA
authors.lastname: Pop
authors.forename: M
authors.initials: M
authors.lastname: van der Plas
authors.forename: A C
authors.initials: AC
authors.lastname: Ruifrok
authors.forename: L J
authors.initials: LJ
authors.lastname: Schalkwijk
authors.forename: A E
authors.initials: AE
authors.lastname: Hanssen
authors.forename: A J
authors.initials: AJ
authors.lastname: van der Kogel
mesh_terms: D000818:Animals; D001918:Brachytherapy; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D008297:Male; D011836:Radiation Tolerance / Q000502:physiology*; D051381:Rats; D017208:Rats, Wistar; D013116:Spinal Cord / Q000473:pathology / Q000528:radiation effects*; D014945:Wound Healing / Q000502:physiology*