4.8 Article

Orthovoltage X-Rays Exhibit Increased Efficacy Compared with ?-Rays in Preclinical Irradiation

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CANCER RESEARCH
卷 82, 期 15, 页码 2678-2691

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AMER ASSOC CANCER RESEARCH
DOI: 10.1158/0008-5472.CAN-22-0656

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This study compared the effects of orthovoltage X-rays and Cs-137 gamma-rays on mouse models of acute radiation syndrome. The results showed that orthovoltage X-rays caused more severe damage to bone marrow, spleen, and intestinal tissue, requiring dose reduction to achieve similar biological effects.
Radionuclide irradiators (Cs-137 and Co-60) are commonly used in preclinical studies ranging from cancer therapy to stem cell biology. Amidst concerns of radiological terrorism, there are institutional initiatives to replace radionuclide sources with lower energy X-ray sources. As researchers transition, questions remain regarding whether the biological effects of gamma-rays may be recapitulated with orthovoltage X-rays because different energies may induce divergent biological effects. We therefore sought to compare the effects of orthovoltage X-rays with 1-mm Cu or Thoraeus filtration and Cs-137 gamma-rays using mouse models of acute radiation syndrome. Following whole-body irradiation, 30-day overall survival was assessed, and the lethal dose to provoke 50% mortality within 30-days (LD50) was calculated by logistic regression. LD50 doses were 6.7 Gy, 7.4 Gy, and 8.1 Gy with 1-mm Cu-filtered X-rays, Thoraeus-filtered X-rays, and Cs-137 gamma-rays, respectively. Comparison of bone marrow, spleen, and intestinal tissue from mice irradiated with equivalent doses indicated that injury was most severe with 1-mm Cu-filtered X-rays, which resulted in the greatest reduction in bone marrow cellularity, hematopoietic stem and progenitor populations, intestinal crypts, and OLFM4+ intestinal stem cells. Thoraeus-filtered X-rays provoked an intermediate phenotype, with Cs-137 showing the least damage. This study reveals a dichotomy between physical dose and biological effect as researchers transition to orthovoltage X-rays. With decreasing energy, there is increasing hematopoietic and intestinal injury, necessitating dose reduction to achieve comparable biological effects. Significance: Understanding the significance of physical dosedelivered using energetically different methods of radiation treatment will aid the transition from radionuclide gamma-irradiators toorthovoltage X-irradiators.

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