Mucosal regeneration during radiotherapy

Denham, James W., Walker, Quenten J., Lamb, David S., Hamilton, Christopher S., OBrien, Peter C., Spry, Nigel A., Hindley, Andrew, Poulsen, Michael, OBrien, Maree and Tripcony, Lee (1996) Mucosal regeneration during radiotherapy. Radiotherapy and Oncology, 41 2: 109-118. doi:10.1016/S0167-8140(96)01830-0

Author Denham, James W.
Walker, Quenten J.
Lamb, David S.
Hamilton, Christopher S.
OBrien, Peter C.
Spry, Nigel A.
Hindley, Andrew
Poulsen, Michael
OBrien, Maree
Tripcony, Lee
Title Mucosal regeneration during radiotherapy
Journal name Radiotherapy and Oncology   Check publisher's open access policy
ISSN 0167-8140
Publication date 1996-11
Sub-type Article (original research)
DOI 10.1016/S0167-8140(96)01830-0
Volume 41
Issue 2
Start page 109
End page 118
Total pages 10
Place of publication Shannon, Co. Clare Ireland
Publisher Elsevier
Language eng
Formatted abstract
Background and purpose:
Regeneration of the aerodigestive mucosa is known to occur during conventionally fractionated radiotherapy. The circumstances surrounding its time of onset and magnitude are not well understood, however.

Material and methods:
Mucosal reactions were observed in 100 patients undergoing conventionally fractionated treatment at 2 Gy/day over 7 weeks and 88 receiving accelerated treatment at 1.8 Gy twice daily over 3 1/4 weeks on the Trans Tasman Radiation Oncology Group head and neck cancer trials. Similar observations in 61 patients treated palliatively at dose rates between 0.8 and 240 Gy/h using ten 3.0-4.2 Gy fractions over 2 weeks are compared.


Several findings emerged from these studies: 1. Reactions evolved more quickly at oropharyngeal sites than in the hypopharynx. 2. Reactions at both sites evolved more rapidly at greater rates of dose accumulation. 3. The timing of reactions suggested the presence of a strong regenerative mucosal response that started before the manifestation of 'patchy' (grade II) mucosal reactions. 4. The regenerative response was strong enough to 'make good' damage accumulated at a rate of 2 Gy/day in over a third of cases. 5. The linear quadratic model without time correction failed to provide an adequate prediction of the frequency or intensity of mucosal reactions produced by any of the regimes. A simple model of the regenerative response is presented.


This study suggests that the timing and magnitude of the regenerative response vary between sites and individuals but are linked to the amount of epithelial cellular depletion occurring during treatment.
Keyword Head and neck cancer
Acute mucosal radiation reactions
Mucosal regeneration
Fractionation studies
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 52 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 23 Nov 2010, 14:46:10 EST