title: Proton RBE for early intestinal tolerance in mice after fractionated irradiation.
abstract: OBJECTIVE
  To determine the influence of the number of fractions (or the dose per fraction) on the proton relative biological effectiveness (RBE).
  
  
  METHODS
  Intestinal crypt regeneration in mice was used as the biological endpoint. RBE was determined relative to cobalt-60 gamma rays for irradiations in one, three and ten fractions separated by a time interval of 3.5h. Proton irradiations were performed at the middle of a 7-cm Spread Out Bragg Peak (SOBP).
  
  
  RESULTS
  Proton RBEs (and corresponding gamma dose per fraction) at the level of 20 regenerated crypts per circumference were found equal to 1.15+/-0.04 (10.0 Gy), 1.15+/-0.05 (4.8 Gy) and 1.14+/-0.07 (1.7 Gy) for irradiations in one, three and ten fractions, respectively. Alpha/beta ratios as derived from direct analysis of the 'quantal radiation response data' were found to be 7.6 Gy for gamma rays and 8.2 Gy for protons. Additional proton irradiations in ten fractions at the end of the SOBP were found to be more effective than at the middle of the SOBP by a factor of 1.14 (1.05-1.23).
  
  
  CONCLUSIONS
  Proton RBE for crypt regeneration was found to be independent of fractionation up to ten fractions. One can expect that it remains unchanged for higher number of fractions as the lethalities for doses smaller than 3 Gy are exclusively due to direct lethal events. As a tendency for increased effectiveness at the end of the SOBP is reported in the majority of the studies, for clinical applications it would be advisable to allow for by arranging a sloping depth dose curve in the deeper part of the target volume. Finally, it must be noticed that most of in vitro and in vivo RBE values for protons are larger than the current clinical RBE (RBE=1.10).
authors.affiliation: Université Catholique de Louvain, Cliniques Universitares St-Luc, 54 Avenue Hippocrate, 1200 Brussels, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Gueulette
authors.forename: J P
authors.initials: JP
authors.lastname: Slabbert
authors.forename: L
authors.initials: L
authors.lastname: Böhm
authors.forename: B M
authors.initials: BM
authors.lastname: De Coster
authors.forename: J F
authors.initials: JF
authors.lastname: Rosier
authors.forename: M
authors.initials: M
authors.lastname: Octave-Prignot
authors.forename: A
authors.initials: A
authors.lastname: Ruifrok
authors.forename: A N
authors.initials: AN
authors.lastname: Schreuder
authors.forename: A
authors.initials: A
authors.lastname: Wambersie
authors.forename: P
authors.initials: P
authors.lastname: Scalliet
authors.forename: D T
authors.initials: DT
authors.lastname: Jones
mesh_terms: D000818:Animals; D019583:Dose Fractionation, Radiation; D005260:Female; D005720:Gamma Rays; D007422:Intestines / Q000473:pathology / Q000502:physiology / Q000528:radiation effects*; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D011522:Protons; D011836:Radiation Tolerance; D011882:Radiotherapy, High-Energy; D011897:Random Allocation; D012038:Regeneration; D014916:Whole-Body Irradiation
chemical_list: D011522:Protons