Cited by 155Effects of Radiation ExposureRadiation Therapy and DosimetryAdvanced Radiotherapy Techniques

Radiation‐induced tissue damage and response

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McBride, William H, Schaue, Dörthe·2020·The Journal of Pathology

Abstract

Normal tissue responses to ionizing radiation have been a major subject for study since the discovery of X-rays at the end of the 19th century. Shortly thereafter, time-dose relationships were established for some normal tissue endpoints that led to investigations into how the size of dose per fraction and the quality of radiation affected outcome. The assessment of the radiosensitivity of bone marrow stem cells using colony-forming assays by Till and McCulloch prompted the establishment of in situ clonogenic assays for other tissues that added to the radiobiology toolbox. These clonogenic and functional endpoints enabled mathematical modeling to be performed that elucidated how tissue structure, and in particular turnover time, impacted clinically relevant fractionated radiation schedules. More recently, lineage tracing technology, advanced imaging and single cell sequencing have shed further light on the behavior of cells within stem, and other, cellular compartments, both in homeostasis and after radiation damage. The discovery of heterogeneity within the stem cell compartment and plasticity in response to injury have added new dimensions to the consideration of radiation-induced tissue damage. Clinically, radiobiology of the 20th century garnered wisdom relevant to photon treatments delivered to a fairly wide field at around 2 Gy per fraction, 5 days per week, for 5-7 weeks. Recently, the scope of radiobiology has been extended by advances in technology, imaging and computing, as well as by the use of charged particles. These allow radiation to be delivered more precisely to tumors while minimizing the amount of normal tissue receiving high doses. One result has been an increase in the use of schedules with higher doses per fraction given in a shorter time frame (hypofractionation). We are unable to cover these new technologies in detail in this review, just as we must omit low-dose stochastic effects, and many aspects of dose, dose rate and radiation quality. We argue that structural diversity and plasticity within tissue compartments provides a general context for discussion of most radiation responses, while acknowledging many omissions. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

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  • In general, tissues that proliferate very slowly are less radiosensitive and will demonstrate radiation-induced damage much later than more rapidly proliferating tissues.

    “In general, tissues that proliferate very slowly are less radiosensitive and will demonstrate radiation induced damage much later than more rapidly proliferating tissues ( 20 ).”

    From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [20]

    The Conclusions state that tissues with slow turnover respond late to irradiation, supporting the timing comparison. The Introduction says the link between reproductive activity and radiosensitivity holds only partly, with many exceptions; greater sparing of slow-responding tissues under dose fractionation does not establish that they are generally less radiosensitive. (LLM, conf=0.82)

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Authors
McBride, W. H., & Schaue, D.
Affiliations
University of California, Los Angeles (US)
Corresponding author
McBride, William H
Venue
The Journal of Pathology
Publisher
Wiley
Published
2020-02-21
Volume
250
Issue
5
Pages
647-655
ISSN
  • 0022-3417 (ISSN-L)
  • 1096-9896
OpenAlex
W3003926400
Cited by
155
References
100
Citations by year
2026: 23 · 2025: 31 · 2024: 33 · 2023: 30 · 2022: 16 · 2021: 17 · 2020: 4 · 2019: 1
FWCI
2.47
Type
journal article
Language
en
Open access
Locations
  • The Journal of Pathology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders
Center for Scientific Review (1R01CA226875‐01, 5R01CA191234‐05, 5U19AI067769‐15)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Effects of Radiation Exposure
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Radiation Therapy and Dosimetry
  • Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
Keywords
radiation-induced tissue damage, normal tissue response, ionizing radiation, radiosensitivity, clonogenic assay, fractionated radiotherapy, hypofractionated radiotherapy, stem cell compartment, tissue turnover, radiation quality, particle therapy, tissue plasticity
MeSH terms
DNA Damage, Dose-Response Relationship, Radiation, Humans, Neoplasms, Radiation Tolerance, Time Factors, Acute Radiation Syndrome

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