title: Effect of subsequent acute-dose irradiation on cell survival in vitro following low dose-rate exposures.
abstract: OBJECTIVE
  Following acute irradiation, excess radiosensitivity is generally seen at doses <1 Gy, a phenomenon termed "low-dose hyper-radiosensitivity" (HRS). A very strong, HRS-like inverse dose-rate effect has also been described following continuous low dose-rate (LDR) irradiation at <30 cGy h(-1). We report on the sequential irradiation of a cell line by such LDR exposures followed by low acute doses, where either treatment individually would elicit a hypersensitive response. The aim was to determine if a prior LDR exposure would remove the HRS normally seen in response to very small acute radiation doses.
  
  
  METHODS
  T98G human glioma cells were given single continuous LDR exposures of 5-60 cGy h(-1) using a (60)Co gamma-source. At intervals of 0 or 4 h following LDR irradiation, cells were further irradiated with a range of acute doses using 240-kVp X-rays. The response to the combined treatment was assessed using high-precision clonogenic cell survival assays, and the amount of HRS at acute doses <1 Gy was determined.
  
  
  RESULTS
  LDR at > or = 60 cGy h(-1) to total doses up to 5 Gy in asynchronously growing cells did not remove HRS in the subsequent acute-dose survival curve. In confluent cultures, subsequent acute-dose HRS was not present after an LDR dose of 5 Gy at either 60 or 30 cGy h(-1), but returned if a 4-h interval was left between LDR and acute-dose irradiation. In confluent cultures, acute-dose HRS remained for LDR treatments at 5 or 10 cGy h(-1) or if the total dose was 2 Gy. Taking all cultures and dose-rates together, the "degree" of acute-dose HRS, as measured by alpha(s), was significantly greater in cells irradiated at LDR to a total dose of 2 than of 5Gy.
  
  
  CONCLUSIONS
  Initial LDR exposure can affect a subsequent HRS response. HRS is reduced after LDR exposures at greater dose intensity, but can recover again within 4 h of completion of LDR exposure. This suggests that processes determining increased resistance to small acute doses (removal of HRS) might be governed by the level of repairable DNA lesions.
authors.affiliation: Gray Cancer Institute, Mount Vernon Hospital, Northwood, UK.
authors.forename: C R
authors.initials: CR
authors.lastname: Mitchell
authors.forename: M C
authors.initials: MC
authors.lastname: Joiner
mesh_terms: D002470:Cell Survival / Q000528:radiation effects; D004307:Dose-Response Relationship, Radiation; D005720:Gamma Rays; D005910:Glioma / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D011829:Radiation Dosage; D011836:Radiation Tolerance / Q000528:radiation effects*; D013997:Time Factors; D014407:Tumor Cells, Cultured / Q000528:radiation effects; D014965:X-Rays