title: Dose rate-dependent sparing of the gastrointestinal tract by fractionated total body irradiation in dogs given marrow autografts.
abstract: OBJECTIVE
  We compared gastrointestinal toxicity of single vs. fractionated total body irradiation (TBI) administered at dose rates ranging from 0.021 to 0.75 Gy/min in a canine model of marrow transplantation.
  
  
  METHODS
  Dogs were given otherwise marrow-lethal single or fractionated TBI from dual 60Co sources at total doses ranging from 8-18 Gy and delivered at dose rates of 0.021, 0.05, 0.10, 0.20, 0.40, and 0.75 Gy/min, respectively. They were protected from marrow death by infusion of previously stored autologous marrow cells and they were given intensive supportive care posttransplant. The study endpoint was 10-day mortality from gastrointestinal toxicity. Logistic regression analyses were used to jointly evaluate the effects of dose rate, total dose, and delivery regimen on toxicity.
  
  
  CONCLUSIONS
  With increasing dose rates, mortality increased for either mode of delivery of TBI. With dose rates through 0.10 Gy/min, mortality among dogs given single vs. fractionated TBI appeared comparable. Beginning at 0.20 Gy/min, fractionation appeared protective for the gastrointestinal tract. Results in dogs given TBI at 0.40 and 0.75 Gy/min, respectively, were comparable, and dose fractionation permitted the administration of considerably higher total doses of TBI than were possible after single doses, an increment that was on the order of 4.00 Gy. The data indicate that the impact of fractionating the total dose at high dose rates differs from the effect of fractionation at low dose rates.
authors.affiliation: Fred Hutchinson Cancer Research Center, Department of Medicine, the University of Washington School of Medicine, Seattle 98104, USA.
authors.forename: R
authors.initials: R
authors.lastname: Storb
authors.forename: R
authors.initials: R
authors.lastname: Raff
authors.forename: H J
authors.initials: HJ
authors.lastname: Deeg
authors.forename: T
authors.initials: T
authors.lastname: Graham
authors.forename: F R
authors.initials: FR
authors.lastname: Appelbaum
authors.forename: F G
authors.initials: FG
authors.lastname: Schuening
authors.forename: H
authors.initials: H
authors.lastname: Shulman
authors.forename: K
authors.initials: K
authors.lastname: Seidel
authors.forename: W
authors.initials: W
authors.lastname: Leisenring
mesh_terms: D000818:Animals; D016026:Bone Marrow Transplantation; D004064:Digestive System / Q000528:radiation effects*; D004285:Dogs; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation / Q000401:mortality