51
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Lambin P, Lawton P. Radiosensitivity testing of normal tissues: a way to optimise radiotherapy? Eur J Cancer 1994; 30A:576-7. [PMID: 8080667 DOI: 10.1016/0959-8049(94)90520-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- P Lambin
- University Hospital St. Rafaël, Department of Radiotherapy, Leuven, Belgium
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52
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Rosemann M, Schulze B, Abel H. DNA Supercoiling and Repair in Peripheral Lymphocytes as a Measure of Acute Radiation Response After Radiotherapy. RADIATION ONCOLOGY INVESTIGATIONS 1994; 2:126-133. [PMID: 22962540 PMCID: PMC3436605 DOI: 10.1002/roi.2970020304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
DNA supercoiling density and incision kinetics during ultraviolet (UV) excision repair hav been measured in lymphocytes from 20 cancer patients and 17 healthy donors. Nucleoid sedimentation was used, which allows the sensitive detection of both DNA damage and alterations in chromatin structure. The release of DNA supercoiling after ethidium bromide intercalation and the kinetics of the incision step following UV irradiation were compared in lymphocytes derived from cancer patients and those from normal donors. The classification into lymphocytes with normal or reduced repair and normal or altered supercoiling, respectively, revealed that reduced repair as well as altered chromatin structure occurred more frequently in lymphocytes derived from patients (40% and 85%, respectively) than in those from healthy donors (35% and 23%, respectively). Even more striking was the simultaneous occurrence of both characteristics in tumor patients: in 34% of all cases reduced repair was associated with altered supercoiling density, whereas among healthy donors this association occurred in only 18% of all cases. Supercoiling density may be related to functional integrity of lymphocytes and repair capacity to recovery after radiation damage. Since both parameters are important for the radiation response of normal tissue, we consider these measurements a potential prognostic assay aimed at reducing acute reaction of the normal tissue.
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Affiliation(s)
- Michael Rosemann
- Department for Experimental Radiation Biology, Robert Roessle Clinic/Central Institute for Cancer Research, Berlin, Germany (M.R., B.S., H.A.); Institute of Cancer Research, Radiotherapy Research Unit, Sutton, Surrey, Great Britain (M.R.)
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53
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Hendry JH, West CM, Moore JV, Potten CS. Tumour stem cells: the relevance of predictive assays for tumour control after radiotherapy. Radiother Oncol 1994; 30:11-6. [PMID: 8153375 DOI: 10.1016/0167-8140(94)90004-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- J H Hendry
- Department of Experimental Radiation Oncology, Paterson Institute for Cancer Research, Christie Hospital (NHS) Trust, Manchester, UK
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54
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Ling CC, Burman C, Chui CS, Jackson A, Kutcher GJ, Leibel S, LoSasso T, Mageras G, Mohan R, Yorke E. Perspectives of multidimensional conformal radiation treatment. Radiother Oncol 1993; 29:129-39. [PMID: 8310138 DOI: 10.1016/0167-8140(93)90238-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We consider the present technological advancement that underlies the implementation of computer-controlled conformal radiotherapy. We also consider the developments in modern biology that may provide input to therapy planning. The concept of multidimensional conformal radiotherapy is advanced, which integrates geometrical precision and biological conformality, to optimize the treatment planning for individual patients, with a view to improve the overall success of radiotherapy.
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Affiliation(s)
- C C Ling
- Memorial Sloan Kettering Cancer Center, New York, NY 10021
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55
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Elyan SA, West CM, Roberts SA, Hunter RD. Use of an internal standard in comparative measurements of the intrinsic radiosensitivities of human T-lymphocytes. Int J Radiat Biol 1993; 64:385-91. [PMID: 7901300 DOI: 10.1080/09553009314551571] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A study has been made of the intrinsic radiosensitivity of peripheral blood lymphocytes from normal individuals. Cell survival following in vitro high (1.55 Gy min-1) and low (0.0098 Gy min-1) dose-rate irradiation was obtained for single lymphocyte samples from three individuals in six experiments. Despite wide interexperimental variability the ranking of intrinsic radiosensitivity for these individuals was reproducible. Further studies were carried out using low dose-rate irradiation only, on: (1) single lymphocyte samples from 18 people; (2) 14 samples taken on different occasions from one of these donors over a period of 5 months; and (3) a large store of lymphocytes from another individual. The latter was assayed in every experiment and served as an internal standard to which results could be normalized. In comparison with uncorrected values, the normalized results for the 14 samples from the single individual showed a reduction in the spread of data while those for the 18 different donors were unchanged. An analysis of variance was carried out on a larger data set of 38 measurements which included repeat assays on several of the samples (two samples from the multiply-sampled individual and five samples from other donors were assayed twice). In comparison with the uncorrected values, the normalized results showed a reduction in experimental variability such that the coefficient of variation (CV) for surviving fraction at 4 Gy for the multiple samples from a single individual decreased from 41 to 19%. In contrast, there was little change in the variation between 18 individuals with CVs of 56 and 62%, respectively, for uncorrected and normalized results. These data suggest that the use of an internal standard for the determination of the intrinsic radiosensitivity of individuals using peripheral blood lymphocytes should aid the development and evaluation of predictive tests for the radiotherapy of cancer.
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Affiliation(s)
- S A Elyan
- Cancer Research Campaign Department of Experimental Radiation Oncology, Paterson Institute for Cancer Research, Manchester, UK
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56
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Busch DB. Radiation and chemotherapy injury: pathophysiology, diagnosis, and treatment. Crit Rev Oncol Hematol 1993; 15:49-89. [PMID: 8240706 DOI: 10.1016/1040-8428(93)90020-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The text in general is not meant to represent the participants' entire presentations. The lecture presenters in general are not responsible for the summaries, and cannot necessarily be assumed to agree with all that is stated, but they deserve credit for providing the lecture and handout material on which the summaries are based, and in most cases have contributed far more to the summaries than I have.
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Affiliation(s)
- D B Busch
- Department of Environmental and Toxicologic Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000
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57
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Baumann M, Taghian A, Budach W. Radiosensivity of Tumor Cells: The Predictive Value of SF2. MEDICAL RADIOLOGY 1993. [DOI: 10.1007/978-3-642-84918-3_8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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58
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Suit H, Skates S, Taghian A, Okunieff P, Efird JT. Clinical implications of heterogeneity of tumor response to radiation therapy. Radiother Oncol 1992; 25:251-60. [PMID: 1480770 DOI: 10.1016/0167-8140(92)90244-o] [Citation(s) in RCA: 117] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Heterogeneity of response of tumor tissue to radiation clearly exists. Major parameters include histopathologic type, size (number of tumor rescue units (TRUs)), hemoglobin concentration, cell proliferation kinetics and immune rejection reaction by host. Further, normal and presumably tumor tissue response is altered in certain genetic diseases, e.g. ataxia telangiectasia. Any assessment of response of tumor tissue to a new treatment method or the testing of a new clinical response predictor is optimally based upon a narrow strata, viz., uniform with respect to known parameters of response, e.g. size, histological type. Even among tumors of such a clinically defined narrow strata, there will be residual heterogeneity with respect to inherent cellular radiation sensitivity, distributions of pO2, (SH), cell proliferation etc. The value of a response predictor of an individual tumor will be determined by the heterogeneity of values for these and or other characteristics and by the coefficient of variation (CV) of the measured values of the individual parameters. Heterogeneity of one or more parameters of response is reflected in the slope of the dose response curve for local control, viz. the greater the heterogeneity the less steep the slope. To examine for this effect, the slope of dose response curves for control of model tumors of 10(8) tumor rescue units (TRU) and the SF2 = 0.5 (survival fraction after a single dose of 2 Gy) has been used to assess the impact of inter- and intra-tumoral variation of SF2 on slope, defined as gamma 50 values. The gamma 50 is the increase in local control expressed in percent points for a one percentage increment in dose, at the mid-point on the dose-response curve. The gamma 50 was 6.5 for CV = 0.0. For inter-tumoral CVs of 10%, 20% and 40%, the gamma 50 rapidly decreased to 2.4, 1.3 and 0.7. Intra-tumoral variation was less important, viz., for CVs of 10%, 20%, and 40% the gamma 50 values were reduced to 5.3, 3.8 and 2.2. Combining inter- and intra-tumoral variation reduced the gamma 50 only slightly below that for inter-tumoral variation alone. For example, were the CV 10% for inter- and intra-tumoral variation, the gamma 50 would be 2.1 as compared to 2.4 for inter-tumoral variation alone. The number of TRUs also affects slope, viz. gamma 50 increased from 1 to 9.7 as the TRU number increased from 10(1) to 10(12).(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- H Suit
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston 02114
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59
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Commentary 2 to Schull and Weiss: Human Cellular Radiosensitivity–The Search for the Diagnostic Holy Grail or a Poisoned Chalice. ACTA ACUST UNITED AC 1992. [DOI: 10.1016/b978-0-12-035416-0.50017-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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60
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Green MH, Arlett CF, Cole J, Harcourt SA, Priestley A, Waugh AP, Stephens G, Beare DM, Brown NA, Shun-Shin GA. Comparative human cellular radiosensitivity: III. Gamma-radiation survival of cultured skin fibroblasts and resting T-lymphocytes from the peripheral blood of the same individual. Int J Radiat Biol 1991; 59:749-65. [PMID: 1672363 DOI: 10.1080/09553009114550661] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Skin and blood samples were obtained from 34 donors, for whom there was no indication of abnormal radiosensitivity. From these, in 33 cases both fibroblast and T-lymphocyte cultures were obtained and in 26 cases at least three fibroblast and at least two G0 (resting) T-lymphocyte survival assays were possible. Within this set of results, differences in radiosensitivity between donors were significant for fibroblasts but not T-lymphocytes, although the range of radiosensitivity was similar for the two cell types (D 0.90-1.68 Gy for fibroblasts; 1.26-2.15 Gy for T-lymphocytes). Furthermore, there was little evidence for a correlation in radiosensitivity between the two cell types. These results suggest limitations in the predictive value of conventional measurement of cell survival.
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Affiliation(s)
- M H Green
- MRC Cell Mutation Unit, Sussex University, Brighton, UK
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61
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Gatti RA. Localizing the genes for ataxia-telangiectasia: a human model for inherited cancer susceptibility. Adv Cancer Res 1991; 56:77-104. [PMID: 2028843 DOI: 10.1016/s0065-230x(08)60478-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- R A Gatti
- Department of Pathology, University of California, Los Angeles School of Medicine 90024
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62
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Agren A, Brahme A, Turesson I. Optimization of uncomplicated control for head and neck tumors. Int J Radiat Oncol Biol Phys 1990; 19:1077-85. [PMID: 2211246 DOI: 10.1016/0360-3016(90)90037-k] [Citation(s) in RCA: 118] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Almost 200 patients have been treated for head and neck tumors at two different dose levels. Based on the clinically observed probabilities for tumor control and fatal normal tissue complications at the two dose levels, the dose giving maximum uncomplicated control has retrospectively been calculated and compared with the clinical data. A Poisson statistical model for control and complications has been used including a correlation parameter, delta, to describe the fraction of patients where control and complications are statistically independent. The clinically observed probability of uncomplicated tumor control, P+, is consistent with only a small fraction of the patients treated being statistically independent (delta = 0.2 or 20%). Customarily, 100% of the patients are assumed to be statistically independent with regard to tumor control and normal tissue complications. More precisely, the clinical data are consistent, with almost 20% of the patients being significantly more sensitive to radiation since they gain local tumor control but simultaneously suffer fatal complications. An even larger fraction of the patients (almost 30%) seemed to be more resistant to radiation, showing neither serious treatment complications nor control of the local tumor growth. It is suggested that if these patient groups could be identified by a predictive assay for the radiation sensitivity of their normal tissues and preferably also for their tumors, the uncomplicated tumor control could be increased by about 20%. This figure is based on the actuarial survival of the patients and has been corrected for the inevitable uncertainty in dose delivery. It is also pointed out that about 20% of the patients can never be saved by a predictive assay because of the considerable statistical variance associated with the Poisson process and the eradication of the last clonogenic tumor cell. Finally, note that the possible existence of radiation sensitive and resistant patient groups is consistent with known genetic deficiencies such as ataxia telangiectasia for the sensitive patients and the existence of repair efficient head and neck tumors that are unusually efficient in repairing double strand breaks. If such sensitive and resistant patient groups do exist, it should be sufficient to perform a predictive assay on normal tissues alone avoiding the often impossible task of sampling the most radiation resistant tumor cell line.
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Affiliation(s)
- A Agren
- Dept. of Radiation Physics, Karolinska Institutet, Stockholm, Sweden
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63
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Peters LJ. The ESTRO Regaud lecture. Inherent radiosensitivity of tumor and normal tissue cells as a predictor of human tumor response. Radiother Oncol 1990; 17:177-90. [PMID: 2181561 DOI: 10.1016/0167-8140(90)90202-8] [Citation(s) in RCA: 98] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This lecture reviews the history and current status of attempts to correlate the outcome of radiation therapy with estimates of tumor cell radiosensitivity, made by either histologic assessment of tumors irradiated in vivo or by assays for the survival of tumor cells irradiated in vitro. Genetically determined variability in the radiosensitivity of normal tissue cells from different individuals is also discussed in terms of its effect on the determination of "tolerance" doses and the possible correlation between tumor cell and normal tissue cell radiosensitivity in a given patient. It is concluded that measurement of both tumor cell and normal tissue cell radiosensitivities, along with other radiobiologically-based assays, will improve our ability to predict treatment outcome and provide the basis for further therapeutic advances in radiation oncology.
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Affiliation(s)
- L J Peters
- Division of Radiotherapy, University of Texas M.D. Anderson Cancer Center, Houston 77030
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64
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Maciejewski B, Withers HR, Taylor JM, Hliniak A. Dose fractionation and regeneration in radiotherapy for cancer of the oral cavity and oropharynx. Part 2. Normal tissue responses: acute and late effects. Int J Radiat Oncol Biol Phys 1990; 18:101-11. [PMID: 2298613 DOI: 10.1016/0360-3016(90)90273-m] [Citation(s) in RCA: 92] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The early responses of normal tissues of the oral cavity and oropharynx in 498 patients, and the slowly-developing responses in 268 patients who survived a minimum of 18 months after radiotherapy for squamous cell carcinoma were analyzed. The severity of acute responses correlated with dose intensity. The incidence of severe late responses increased with increase in dose per fraction and was characterized by a low alpha/beta ratio. Severe late responses were significantly associated with severe acute responses independently of dose per fraction and total dose, and were also ameliorated slightly by protraction of treatment time suggesting that some late effects were, at least partly, a consequence of acute injury. Probability of local tumor control correlated with severity of acute response, suggesting that excessive protraction of overall treatment time to minimize acute toxicity may compromise local control of the tumor. There was no demonstrable correlation between the volume of tissue irradiated and the severity of acute or late response.
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Affiliation(s)
- B Maciejewski
- Department of Radiation Oncology, UCLA Medical Center 90024-1714
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65
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Suit HD, Baumann M, Skates S, Convery K. Clinical interest in determinations of cellular radiation sensitivity. Int J Radiat Biol 1989; 56:725-37. [PMID: 2573670 DOI: 10.1080/09553008914551971] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Determinations of cell sensitivity in terms of survival fraction after doses employed in clinical radiation therapy, say 1-3 Gy, are of increasing interest to clinicians as they provide direct experimental data which can be employed without reference to models of cell inactivation. SF2 values are expected ultimately to prove valuable as response predictors. Even so, SF2 values would surely be combined with other predictors also under development to give the best feasible estimate of response of tumor and normal tissue. There are, however, several concerns with the SF2 data currently available. These include: SF2 depends upon the cell system employed (established cell lines vs primary cultures) and the method of assaying survival fraction (colony formation vs population growth); dose-response curves for inactivation of tumors characterized by the reported distribution of SF2 values are, in many instances, not close to those judged to obtain in clinical practice; the broad distribution of SF2 values indicates a rather flatter dose-response curve for tumor control or normal tissue than seems true from clinical experience. There appears to be a potential for clinical gain by determination of sensitivity of normal tissues in order to identify patients who are of increased sensitivity (for example heterozygotes for AT, 5-oxoprolinuria, etc.). Although the absolute SF2 values obtained by current technologies of culturing human cells often appear to be poorly related to values expected from observed radiation response in patients, intensive research on cell viability assays will almost certainly yield more realistic results.
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Affiliation(s)
- H D Suit
- Department of Radiation Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston 02114
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66
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Gatti RA, Berkel I, Boder E, Braedt G, Charmley P, Concannon P, Ersoy F, Foroud T, Jaspers NG, Lange K. Localization of an ataxia-telangiectasia gene to chromosome 11q22-23. Nature 1988; 336:577-80. [PMID: 3200306 DOI: 10.1038/336577a0] [Citation(s) in RCA: 508] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Ataxia-telangiectasia (AT) is a human autosomal recessive disorder of childhood characterized by: (1) progressive cerebellar ataxia with degeneration of Purkinje cells; (2) hypersensitivity of fibroblasts and lymphocytes to ionizing radiation; (3) a 61-fold and 184-fold increased cancer incidence in white and black patients, respectively; (4) non-random chromosomal rearrangements in lymphocytes; (5) thymic hypoplasia with cellular and humoral (IgA and IgG2) immunodeficiencies; (6) elevated serum level of alphafetoprotein; (7) premature ageing; and (8) endocrine disorders, such as insulin-resistant diabetes mellitus. A DNA processing or repair protein is the suspected common denominator in this pathology. Heterozygotes are generally healthy; however, the sensitivity of their cultured cells to ionizing radiation is intermediate between normal individuals and that of affected homozygotes. Furthermore, heterozygous females are at an increased risk of breast cancer. These findings, when coupled with an estimated carrier frequency of 0.5-5.0%, suggest that (1) as many as one in five women with breast cancer may carry the AT gene and that (2) the increased radiation sensitivity of AT heterozygotes may be causing radiation therapists to reduce the doses of radiation used for treating cancer in all patients. To identify the genetic defect responsible for this multifaceted disorder, and to provide effective carrier detection, we performed a genetic linkage analysis of 31 families with AT-affected members. This has allowed us to localize a gene for AT to chromosomal region 11q22-23.
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Affiliation(s)
- R A Gatti
- Department of Pathology, UCLA School of Medicine 90024
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