Measurement of Human Normal Tissue and Tumour Responses

  • G. Ross
  • J. R. Yarnold
Conference paper


The scarcity of quantitative measures of normal tissue damage and tumour response in patients undergoing radiotherapy is an obstacle to the clinical evaluation of new treatment strategies. Retrospective studies of complications in critical normal tissues taught important lessons in the past concerning the potential dangers of hypofractionation (Singh 1978). However, it is unethical to use serious complications as planned end-points in prospective studies. One aim of this paper is to review the desirable characteristics of clinical end-points required to compare alternative treatments employing radiotherapy, with emphasis on simple scales applied by clinicians or even the patients themselves.


Tumour Response Human Normal Tissue Moist Desquamation Radiation Myelopathy Normal Tissue Damage 
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  1. Aaronson NK, Bakker W, Stewart AL et al. (1986) A multi-dimensional approach to the measurement of quality of life in lung cancer clinical trials: A joint project of the EORTC Lung Cancer Cooperative Group and Study Group on quality of life. In: Aaronson NK, Beckmann J, Bernheim J, Zittoun R (eds) Aaronson NK, Bakker W, Stewart AL et al, pp 63–82 ( EORTC monograph series )Google Scholar
  2. Ash D, Peckham MJ, Steel GG (1979) The quantitative response of human tumours to radiation and misonidazole. Br J Cancer 40: 883–889PubMedCrossRefGoogle Scholar
  3. Bartelink H (1983) Prognostic value of the regression rate of neck node metastases during radiotherapy. Int J Radiat Oncol Biol Phys 9: 993–996PubMedCrossRefGoogle Scholar
  4. Bloom HJG, Wallace ENK, Henk JM (1969) The treatment and prognosis of medulloblastoma in children: a study of 82 verified cases. Am J Roentgenol 105: 43–62Google Scholar
  5. Dische S, Saunders MI (1980) Tumour regression and prognosis: a clinical study. Br J Cancer 41 [Suppl IV]: 11–13Google Scholar
  6. Fowler JF, Morgan RL, Silvester JA, Bewley DK, Turner BA (1963) Experiments with fractionated X-ray treatment of the skin of pigs. Br J Radiol 36: 188–196PubMedCrossRefGoogle Scholar
  7. Gish JR, Coates EO, Dussault AB, Doub H (1959) Pulmonary radiation reaction: a vital capacity and time-dose study. Radiology 73: 679–683PubMedGoogle Scholar
  8. Glaholm J, Repetto JR, Yarnold JR, Smith IE, Magrini S, Cherryman G. (1987) Carboplatin (JM8), etoposide (VP16) and thoracic irradiation for small cell lung cancer (SCLC): an evaluation of lung toxicity (Submitted)Google Scholar
  9. Glucksmann A (1974) Histological features in the local radiocurability of carcinomas. In: Friedman M (ed) The biological and clinical basis of radiosensitivity. CC Thomas, Springfield, Illinois, pp 203–218Google Scholar
  10. Glucksmann A, Spear FG (1945) The qualitative and quantitative histological examination of biopsy material from patients treated by radiation for carcinoma of the cervix. Br J Radiol 18: 313Google Scholar
  11. Katz HR (1983) The effect of resection on local failure in irradiated non-oat cell carcinoma of the lung. Int J Radiat Oncol Biol Phys 9: 1793–1805PubMedGoogle Scholar
  12. Kramer S, Lee KF (1974) Complications of radiation therapy: the central nervous system. Semin Roentgenol 9: 75–83PubMedCrossRefGoogle Scholar
  13. Libshitz HI, Shuman LS (1984) Radiation induced pulmonary change: CT findings. J Comput Assist Tomogr 8: 15–19PubMedCrossRefGoogle Scholar
  14. Libshitz HI, Southard ME (1974) Complications of radiation therapy: the thorax. Semin Roentgenol 9: 41PubMedCrossRefGoogle Scholar
  15. Mah K, Van Dyk J, Keane T, Poon PY (1987) Acute radiation-induced pulmonary damage: a clinical study on the response to fractionated radiation therapy. Int J Radiat Oncol Biol Phys 13: 179–188PubMedGoogle Scholar
  16. Obetz SW, Smithson WA, Groover RV et al. (1979) Neuropsychologic follow-up study of children with acute lymphocyte leukaemia: a preliminary report. Am J Paediatr Hematol Oncol 1: 207–213CrossRefGoogle Scholar
  17. Orton CG, Ellis F (1973) A simplification in the use of NSD concept in practical radiotherapy. Brit J Radiol 46: 529–537PubMedCrossRefGoogle Scholar
  18. Peters LJ, Brock WA, Johnson T, Meyn RE, Tofilon PJ, Milas L (1986) Potential methods for predicting tumour radiocurability. Int J Radiat Oncol Biol Phys 12: 459–467PubMedCrossRefGoogle Scholar
  19. Pezner RD, Archambeau JO (1981) Brain tolerance unit: a method to estimate risk of radiation brain injury for various dose schedules. Int J Radiat Oncol Biol Phys 3: 397–402Google Scholar
  20. Prato FS, Kurdyak R, Saibil E, Rider W, Aspin N (1977) Regional and total body lung function in patients following pulmonary irradiation. Invest Radiol 12: 224–237PubMedCrossRefGoogle Scholar
  21. Riccardi R, Brouwers P, Di Chiro G, Poplack DG (1985) Abnormal computed tomography brain scans in children with acute lymphoblastic leukaemia: serial long-term follow-up. J Clin Oncol 3: 12–18PubMedGoogle Scholar
  22. Rowland JH, Glide well OJ, Sibley RF et al. (1984) Effects of different forms of central nervous system prophylaxis on neuropsychologic function in childhood leukaemias. J Clin Oncol 2: 1327–1335PubMedGoogle Scholar
  23. Saunders MI, Anderson P, Dische S, Craig Martin WM (1982) A controlled clinical trial of misonidazole in the radiotherapy of patients with carcinoma of the bronchus. Int J Radiat Oncol Biol Phys 8:347–350Google Scholar
  24. Schultheiss TE, Higgins EM, El-Mahdi AM (1984) The latent period in clinical radiation myelopathy. Int J Radiat Oncol Biol Phys 10: 1109–1115PubMedCrossRefGoogle Scholar
  25. Sheline GE (1975) Radiation therapy of primary tumours. Semin Oncol 2: 29–42PubMedGoogle Scholar
  26. Singh K (1978) Two regimes with the same TDF but differing morbidity used in the treatment of stage III carcinoma of the cervix. Br J Radiol 51: 357–362PubMedCrossRefGoogle Scholar
  27. Suit HD, Walker AM (1980) Assessment of the response of tumours to radiation: clinical and experimental studies. Br J Cancer 41 [Suppl IV]: 1–10Google Scholar
  28. Suit H, Lindberg R, Fletcher GH (1965) Prognostic significance of extent of tumour regression at completion of radiation therapy. Radiology 84: 1100–1107PubMedGoogle Scholar
  29. Thomlinson RH (1982) Measurement and management of carcinoma of the breast. Clin Radiol 33: 481–493PubMedCrossRefGoogle Scholar
  30. Thomlinson RH, Dische S, Gray AJ, Errington LM (1976) Clinical testing of the radiosensitiser Ro-07-0582. 3. Response of tumours. Clin Radiol 27: 167PubMedCrossRefGoogle Scholar
  31. Turesson I, Notter G (1984a) The influence of fraction size in radiotherapy on the late normal tissue reaction. 2. Comparison of the effects of daily and twice a week fractionation on human skin. Int J Radiat Oncol Biol Phys 10: 599–606PubMedCrossRefGoogle Scholar
  32. Turesson I, Notter G (1984b) The influence of fraction size in radiotherapy on the late normal tissue reaction. 1. Comparison of the effects of daily and once a week fractionation on human skin. Int J Radiat Oncol Biol Phys 10: 593–598PubMedCrossRefGoogle Scholar
  33. Turesson I, Notter G (1986) The predictive value of skin telangiectasia for late radiation effects in different normal tissues. Int J Radiat Oncol Biol Phys 12: 603–609PubMedCrossRefGoogle Scholar
  34. Van der Kogel AJ (1986) Radiation-induced in the CNS: an interpretation of target cell responses. Br J Cancer 53 [Suppl VII]: 207–217Google Scholar
  35. Van der Schueren E, Van den Bogaert W, Kian Ang K (1983) Radiotherapy with multiple fractions per day. In: Steel GG, Adams GE, Peckham MJ (eds) The biological basis of radiotherapy. Elsevier, Amsterdam, pp 195–210Google Scholar
  36. Van Dyk J, Hill RP (1983) Post-irradiation lung density changes measured by computerized tomography. Int J Radiat Oncol Biol Phys 9: 847–852PubMedCrossRefGoogle Scholar
  37. Wheldon TE, Michalowski AS, Kirk J (1982) The effect of irradiation on function in self-renewing normal tissues with differing proliferative organisation. Br J Radiol 55: 759–766PubMedCrossRefGoogle Scholar
  38. Williams MV, Denekamp J, Fowler JF (1984) Dose-response relationships for human tumours: implications for clinical trials of dose modifying agents. Int J Radiat Oncol Biol Phys 10: 1703–1707PubMedCrossRefGoogle Scholar
  39. Yarnold JR, Horwich A, Duchesne G, Westbrook K, Gibbs JE, Peckham MJ (1983) Chemotherapy and radiotherapy for advanced testicular non-seminoma. 1. The influence of sequence and timing of drugs and radiation on the appearance of normal tissue damage. Radiother Oncol 1: 91–99Google Scholar
  40. Yarnold JR, Bamber, JC, Gibbs J (1986) Tumour growth delay as a clinical endpoint for the measurement of radiation response. Radiother Oncol 5: 207–214PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • G. Ross
  • J. R. Yarnold

There are no affiliations available

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