The radiobiology of human cells and tissues. In vitro radiosensitivity. The picture has changed in the 1980s

Substantial developments have been made during the 1980s in the radiobiology of human tumours, in particular in studies of the radiosensitivity of human tumour cells. It is now clear that tumour cells differ considerably in radiosensitivity, to an extent that by itself is capable of explaining the clinical response of tumours to radiotherapy. There also is evidence that the radiosensitivity of human tumour cell lines to low radiation doses correlates with clinical experience. Irradiation at low dose rate amplifies the differences between cell lines. In conjunction with mathematical modelling, a study of the dose-rate effect also allows a distinction to be drawn between repairable and non-repairable damage. The differences seen between cell lines at low acute doses or low dose rates are associated with the non-repairable component. The most radiosensitive cell lines have a steep component of non-repairable damage and they give the impression of being recovery-deficient; this may, however, be incorrect for when evaluated at constant dose levels recovery is found to increase with increasing radiosensitivity. This leads to the view that recovery from radiation damage may reflect the amount of recoverable damage inflicted rather than the 'capacity' of the cells to recover.