Baker DG, Krochak RJ, et al.
Cancer investigation. Date of publication 1989 Jan 1;volume 7(3):287-94.
1. Cancer Invest. 1989;7(3):287-94.
The response of the microvascular system to radiation: a review.
Baker DG(1), Krochak RJ.
Author information:
(1)Division of Radiation Oncology, University of Virginia Medical Center,
Charlottesville 22908.
The microvasculature is a ubiquitous organ system having a major role in the
pathogenesis of radiation damage to normal tissues. Although the kinetics of
radiation damage to endothelial cells is similar to other tissues (as reflected
by Do and Dq) the late effect is a manifestation of injury, not only to the
endothelial cell population, but also to the basement membrane. Tissue damage is
progressive. The initial expression of radiation injury is an increased
permeability leading to changes in the extracellular milieu. There is an
irregular proliferation of endothelial cells leading to capillaries of irregular
diameter and shape. Fibrous proliferation increases the histohematic barrier and
is ultimately reflected in a loss of parenchymal cells. Replacement fibrosis
progresses until a steady state is reached where the surviving parenchymal cells
can be sustained by the microvasculature. The clinical significance depends on
the role of the organ system involved. For patients who have medical conditions
which adversely effect the stability of the vascular system (hypertension,
diabetes, etc.), the expressions of radiation injury may be more severe and
increase the morbidity associated with these diseases. Angiogenesis in
granulation tissue is less radiosensitive than in steady-state parenchymal
tissues. Wound healing is not significantly affected by commonly used therapeutic
doses of irradiation, 40-50 Gy delivered 4-6 weeks preoperatively or
postoperatively early in the development of the granulation tissue, but may be
complicated where a significant degree of fibrosis has developed. The vascular
responses leading to telangiectasia were discussed.
PMID: 2477120 [Indexed for MEDLINE]
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