Progressive development of radiation damage in mouse kidneys and the consequences for reirradiation tolerance.

The aim of this study was to investigate the influence of protracted overall treatment times on the development and repair of renal irradiation injury in mice. Functional kidney damage was measured, from the proportion of 51CrEDTA remaining in the plasma at 30 min after injection of the tracer. Damage was assessed at monthly intervals for up to 14 months after two equal doses of X-rays given in 1 day, 1 month or 6 months. There was no difference between the time of onset or rate of development of damage after two fractions in 1 day or 1 month, but there was a time lag of 7-15 weeks (depending on dose) before the development of damage after 2F given in 6 months. After this time lag the rate of progression of damage was the same for 2F/6 months as for 2F in the shorter intervals. There was therefore no indication of any increase in total tolerated dose for the kidney when the treatment time was protracted, although the time scales for onset of this damage differed. Tolerance of mouse kidneys to reirradiation at 6 months after single doses of 6-12 Gy was also assessed. All of the previously irradiated animals developed a more severe renal impairment after reirradiation than did the age-matched control mice. The most severe damage occurred in mice which received the highest initial radiation doses, but doses of only 6 Gy were sufficient to markedly reduce the tolerance to reirradiation. It was concluded from these studies that no additional dose-sparing (tissue recovery) took place in the kidneys during a 6-month interval. This was true even when the initial radiation dose alone was insufficient to cause measurable renal dysfunction.