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A Direction for Clinical Radiation Pathology

Rubin, P., Casarett, G.·2015·Frontiers of radiation therapy and oncology

DOI 10.1159/000392794

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Tolerance of normal tissue to therapeutic irradiation
Emami, B., Lyman, J., Brown, A., Cola, L., Goitein, M., Munzenrider, J. E., Shank, B., Solin, L. J., & Wesson, M. (1991) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/0360-3016(91)90171-y · Cited by 4,488
“From the pioneering work of Rubin and Cassarett, to the monumental work by Emami et al. and now the exhaustive review by QUANTEC, great progress has been made in the field of normal tissue tolerance to therapeutic radiation.”
BackgroundInfluential
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
Stewart, F. A., Akleyev, A. V., Hauer-Jensen, M., Hendry, J. H., Kleiman, N. J., MacVittie, T. J., Aleman, B. M., Edgar, A. B., Mabuchi, K., Muirhead, C. R., et al. (2012) · Annals of the ICRP · doi:10.1016/j.icrp.2012.02.001 · Cited by 1,604
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“The number ‘1–5%’ appears to originate from the proposal by Rubin and Casarett [24], who defined a clinically acceptable minimum injurious tolerance dose, as a dose that causes severe complications in ‘1–5%’ of patients within 5 years post-radiotherapy.”
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Long-term effects of radiotherapy on taste and salivary function in man
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Analytical approach to estimate normal tissue complication probability using best fit of normal tissue tolerance doses into the NTCP equation of the linear quadratic model.
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Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns
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“These resources present normaltissue dose limits in terms of TD5/5 and TD50/5, the total doses associated with a complication rate of 5% and 50% within 5 y, respectively, as introduced by Rubin and Cassarett in 1972 (27).”
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Late effects of radiation therapy in pediatric patients and survivorship
Palmer, J. D., Tsang, D. S., Tinkle, C. L., Olch, A. J., Kremer, L. C. M., Ronckers, C. M., Gibbs, I. C., & Constine, L. S. (2021) · Pediatric Blood & Cancer · doi:10.1002/pbc.28349 · Cited by 92
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Increase in mast cells and hyaluronic acid correlates to radiation-induced damage and loss of serous acinar cells in salivary glands: the parotid and submandibular glands differ in radiation sensitivity
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“8–2 Gy.(8) Data were collected of the predicted TD, which was related to a 5% rate of complications within 5 years (TD5/5) of the maximum TD, TD50/5, which caused a 50% complication rate by 5 years.”
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Radiation-Induced Lesions of the Brachial Plexus Correlated to the Dose-Time-Fraction Schedule
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“The late side-effects occur months or even years after treatment and depend mainly on disturbances of the microvasculature and connective tissues and can even be irreversible (5).”
Background
The Principles and Practice of Re-irradiation in Clinical Oncology: An Overview
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Radiation tolerance of the pig kidney: A model for determining overall time and fraction factors for preserving renal function
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Relative Radiosensitivities of the Small and Large Intestine
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Maxillo-facial Aspects of Radiation Protection, Focused on Recent Research regarding Critical Organs
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Oral findings in irradiated edentulous patients
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“cause an effect in “at least 1–5%” of exposed individuals (11) where “1–5%” may stem from the clinical tolerance dose concept (19).”
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Animal models of radiation retinopathy – From teletherapy to brachytherapy
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“[15] stated the tolerance dose of the spinal cord to be 50 Gy/25 fractions /5 weeks for minimal injurious dose (TD5/5) and less than 60 Gy/30 fractions/6 weeks for maximal injurious dose (TD50/5) using 1–6 MeV supervoltage therapy.”
Method
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“The decrease in flow rate then continues throughout the treatment period, and if all salivary glands are irradiated to a total dose over 50 Gy, persistent xerostomia may occur (Makkonen et al. 1986a; Makkonen et al. 1986b; Mossman et al. 1982; Rubin and Casarett 1972; Wescott et al. 1981).”
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“…Rubin and Casarett proposed a clinically acceptable minimum injurious tolerance dose, defined as a dose that causes severe normal tissue complications in ‘1–5%’ and ‘25–50%’ of patients within 5 years after radiotherapy (abbreviated as TD5/5 and TD50/5, respectively) (Rubin and Casarett 1972).”
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Authors: Rubin, P., & Casarett, G.
Affiliations: Strong Memorial Hospital (US)
Corresponding author: Rubin, P.
Venue: Frontiers of radiation therapy and oncology
Publisher: S. Karger AG
Published: 2015-04-15
Pages: 1-16
ISSN: 0071-9676 (ISSN-L)
1662-3789
DOI: 10.1159/000392794
OpenAlex: W2242799666
Cited by: 132
References: 0
Citations by year: 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 3 · 2015: 1
FWCI: 11.36
Type: book chapter
Language: en
Open access: closed
Licence: www.karger.com/Services/SiteLicenses (vor)
www.karger.com/Services/SiteLicenses (tdm)
Locations: Frontiers of radiation therapy and oncology (publishedVersion)
Topics: Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advances in Oncology and Radiotherapy
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Effects of Radiation Exposure
Keywords: radiation-induced pathology, radiation injury, radiotherapy

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A Direction for Clinical Radiation Pathology

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