title: Radiation tolerance of the rat spinal cord after 6 and 18 fractions of photons and carbon ions: experimental results and clinical implications.
abstract: OBJECTIVE
  The tolerance of the rat spinal cord to photon and carbon ion irradiations was investigated to determine the relative biologic effectiveness (RBE) of carbon ions ((12)C) in the plateau region and in a 1 cm spread-out Bragg-peak.
  
  
  METHODS
  The cranial part of the cervical and thoracic spinal cord of 336 rats was irradiated with 6 or 18 fractions (Fx) of photons or (12)C-ions, respectively. Animals were followed up for 300 days for the onset of paresis grade II and dose-response curves were calculated.
  
  
  RESULTS
  The D(50)-values (dose at 50% complication probability) were 42.9 +/- 0.5 Gy, 62.2 +/- 0.9 Gy (6 and 18 Fx, (12)C-plateau) and 19.2 +/- 0.2 Gy, 17.6 +/- 0.2 Gy (6 and 18 Fx (12)C-peak), respectively. For photons, the D(50)-values were 57.0 +/- 0.7 Gy for 6 and 88.6 +/- 0.7 Gy for 18 Fx. The corresponding RBE-values were 1.33 +/- 0.02, 1.42 +/- 0.02 (6 and 18 Fx, (12)C-plateau) and 2.97 +/- 0.05, 5.04 +/- 0.08 (6 and 18 Fx (12)C-peak), respectively. Including data of a previously performed experiment for 1 and 2 Fx (1) the parameter alpha/beta of the LQ-model was found to be 2.8 +/- 0.4 Gy, 2.1 +/- 0.4 Gy and 37.0 +/- 5.3 Gy for photon-, (12)C-plateau- and (12)C-peak irradiations, respectively.
  
  
  CONCLUSIONS
  Carbon ion irradiations of the spinal cord are significantly more effective in the peak than in the plateau region. The alpha/beta-values indicate a significant fractionation effect only for the plateau irradiations. In the Bragg-peak, the applied RBE-model correctly describes the main features although it generally underestimates the RBE by 25%. In the plateau region, maximum deviations of up to 20% were found. The acquired data contribute significantly to the validation of the applied RBE-model.
authors.affiliation: Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany. c.karger@dkfz.de
authors.forename: Christian P
authors.initials: CP
authors.lastname: Karger
authors.forename: Peter
authors.initials: P
authors.lastname: Peschke
authors.forename: Rita
authors.initials: R
authors.lastname: Sanchez-Brandelik
authors.forename: Michael
authors.initials: M
authors.lastname: Scholz
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
mesh_terms: D000465:Algorithms; D000818:Animals; D002244:Carbon; D002574:Cervical Vertebrae; D004307:Dose-Response Relationship, Radiation; D005260:Female; D017785:Photons; D011829:Radiation Dosage; D011836:Radiation Tolerance; D051381:Rats; D017207:Rats, Sprague-Dawley; D012062:Relative Biological Effectiveness; D013116:Spinal Cord / Q000528:radiation effects*
chemical_list: D002244:Carbon