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Retreatment skin and oral mucosa
•
Rapid proliferative recovery begins within 2 weeks
•
Full re-irradiation tolerance for early injury is
reached within
2-3 months
•
Re-irradiation tolerance for late damage will be less
(cfr. slides mouse limb)
13
Bone marrow
•
Toxicity of initial treatment must be considered,
independently of blood cell counts that may be misleading!
14
time
relative cell number
high dose/toxicity
peripheral cells
stem cells
stimulated
transit
proliferation
stem cells
time
relative cell number
low dose/toxicity
peripheral cells
stimulated
transit
proliferation
Courtesy W Dörr; Basic Clinical Radiobiology, 4th Ed, page 262
Earlier recovery of peripheral cell number does not reflect recovery of
stem cell population (
i.e.
restoration of radiation tolerance)