Enhancement of Radiosensitivity of Skin of Patients by High Pressure Oxygen

Brenk, H.A.S. van den; Kerr, R. C.; Richter, W; Papworth, M. P.

doi:10.1259/0007-1285-38-455-857

Cited by 23 publications

(2 citation statements)

References 8 publications

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“…In this situation, hyperbaric oxygen can sensitise skin to radiation. Human skin was reported to be sensitised by up to 40% in terms of dose reduction for equivalent reactions using hyperbaric oxygen ( Van den Brenk et al, 1965). In rodents, DMFs of 1.6-2.2 have been reported for leg skin reactions, and 1.2 for skin colonies.…”

Section: Hyperbaric Oxygenmentioning

confidence: 99%

ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context

Stewart¹,

Akleyev²,

et al. 2012

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This report provides a review of early and late effects of radiation in normal tissues and organs with respect to radiation protection. It was instigated following a recommendation in Publication 103 (ICRP, 2007), and it provides updated estimates of 'practical' threshold doses for tissue injury defined at the level of 1% incidence. Estimates are given for morbidity and mortality endpoints in all organ systems following acute, fractionated, or chronic exposure. The organ systems comprise the haematopoietic, immune, reproductive, circulatory, respiratory, musculoskeletal, endocrine, and nervous systems; the digestive and urinary tracts; the skin; and the eye. Particular attention is paid to circulatory disease and cataracts because of recent evidence of higher incidences of injury than expected after lower doses; hence, threshold doses appear to be lower than previously considered. This is largely because of the increasing incidences with increasing times after exposure. In the context of protection, it is the threshold doses for very long follow-up times that are the most relevant for workers and the public; for example, the atomic bomb survivors with 40-50years of follow-up. Radiotherapy data generally apply for shorter follow-up times because of competing causes of death in cancer patients, and hence the risks of radiation-induced circulatory disease at those earlier times are lower. A variety of biological response modifiers have been used to help reduce late reactions in many tissues. These include antioxidants, radical scavengers, inhibitors of apoptosis, anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, growth factors, and cytokines. In many cases, these give dose modification factors of 1.1-1.2, and in a few cases 1.5-2, indicating the potential for increasing threshold doses in known exposure cases. In contrast, there are agents that enhance radiation responses, notably other cytotoxic agents such as antimetabolites, alkylating agents, anti-angiogenic drugs, and antibiotics, as well as genetic and comorbidity factors. Most tissues show a sparing effect of dose fractionation, so that total doses for a given endpoint are higher if the dose is fractionated rather than when given as a single dose. However, for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease, it appears that the rate of dose delivery does not modify the low incidence. This implies that the injury in these cases and at these low dose levels is caused by single-hit irreparable-type events. For these two tissues, a threshold dose of 0.5Gy is proposed herein for practical purposes, irrespective of the rate of dose delivery, and future studies may elucidate this judgement further.

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Section: Hyperbaric Oxygenmentioning

confidence: 99%

ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context

Stewart¹,

Akleyev²,

et al. 2012

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“…Examples of this in man, which necessitated reductions in dose when the oxygenation status of the tissue was increased, are the skin (van den Brenk et al, 1965), the spinal cord (Coy & Dolman, 1971) and laryngeal cartilage (Churchill-Davidson, 1968;Henk et al, 1977). The expected effect of oxygenation status on fractionation sensitivity has not yet been considered in detail.…”

mentioning

confidence: 99%

Fractionation sensitivity and the oxygen effect

Hendry¹,

Thames²

1990

The British Journal of Radiology

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Many normal tissues in natural conditions exhibit slight radiobiological hypoxia (Hendry, 1979). Examples of this in man, which necessitated reductions in dose when the oxygenation status of the tissue was increased, are the skin (van den Brenk et al, 1965), the spinal cord (Coy & Dolman, 1971) and laryngeal cartilage (Churchill-Davidson, 1968; Henk et al, 1977). The expected effect of oxygenation status on fractionation sensitivity has not yet been considered in detail. Fractionation sensitivity can be quantified by the ratio of the parameters α and β in the following equation, which describes the probability (P) of a given level of radiation injury in a tissue following a schedule of doses (x) delivered to a total dose (D). where K is the number of tissue-rescuing units (TRU) (Hendry & Thames, 1986).

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Hyperbaric oxygen in radiation therapy

Glassburn¹,

Brady²,

Plenk³

1977

Cancer

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The importance of oxygen with low LET radiations has been established beyond any doubt in many different systems, both plant and animal. While some studies, especially head and neck tumors, are impressive, it has not been demonstrated unequivocally that radiation under hyperbaric conditions is superior to well fractionated, well conceived, conventional radiotherapy. Any resulting gain in survival from the addition of hyperbaric oxygen will be limited, especially with more advanced stages of disease. Well controlled studies, especially with earlier stage disease, are still necessary. It would be worthwhile to undertake such trials, especially with tumors of the head and neck constituting the most promising site of study, as others have noted, since even a 5% to 10% improvement in survival would mean many lives saved. Continued trials with hyperbaric oxygen, oxygen in other forms, neutrons and other particles, and radiation sensitizing drugs are all justified in an attempt to overcome the oxygen effect on human tumors.

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Enhancement of Radiosensitivity of Skin of Patients by High Pressure Oxygen

Cited by 23 publications

References 8 publications

ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context

ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context

Fractionation sensitivity and the oxygen effect

Hyperbaric oxygen in radiation therapy

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