Biological Effects of 224Ra: Benefit and Risk of Therapeutic Application Proceedings of the Second Symposium at Neuherberg/München, September 20–21, 1976

243 Pages·1978·5.58 MB·English

by  Professor Dr. H. G. Ebert, Professor Dr. W. A. Müller (auth.), W. A. Müller, H. G. Ebert (eds.)

Biological Effects of 224Ra
This symposium was organized by the
Commission of the European Communities,
Directorate-General Research, Science and Education,
Biology, Radiation Protection and Medical Research,
Brussels, Belgium
and the
Gesellschaft fiir Strahlen- und Umweltforschung mbH,
Neuherberg/Miinchen, Federal Republic of Germany
Programme Committee:
W. Gossner, Neuherberg/Miinchen
O. Hug, Neuherberg/Miinchen
C. W. Mays, Salt Lake City, Utah
R. Mole, Harwell
F. Schales t, Frankfurt
Scientific Secretary:
W. A. Miiller, N euherberg/Miinchen
Local Committee:
E. Parchwitz, Neuherberg/Miinchen
Neuherberg/Miinchen, September 20-21, 1976
Publication date: January 1978
Biological Effects of 224Ra
Benefit and Risk of Therapeutic Application
Proceedings of the Second Symposium at
Neuherberg/Miinchen, September 20-21, 1976
Editors
W.A. Muller
Institut fUr Biologie,
Gesellschaft fUr Strahlen- und Umweltforschung m.b.H.,
Neuherberg/Miinchen, Federal Republic of Germany
and
H.G. Ebert
Commission of the European Communities,
Directorate-General Research, Science and Education
Biology, Radiation Protection and Medical Research.
Martinus Nijhoff Medical Division - The Hague/Boston 1978
for
The Commission of the European Communities
Publication arranged hy
Commission of the European Communities,
Directorate-General Scientific and Technical Information
and Information Management, Luxembourg
EUR 5867e
© ECSC, EEC, EAEC, Brussels-Luxembourg, 1978
Softcover reprint of the hardcover 1st edition 1978
Publication date: January 1978
LEGAL NOTICE
Neither the Commission of the European Communities nor any person acting on behalf of the
Commission is responsible for the use which might be made of the following information.
ISBN-13:978-94-009-9730-1 e-ISBN-13:978-94-009-9728-8
DOl: 10.1007/978-94-009-9728-8
Abstract
The Second Symposium on the Biological Effects of 224Ra,
held at Neuherberg, was focused on two topical aspects of
radiation protection. One aspect was the long-term effects
of high-LET ionizing radiations on man and the quantitative
data involved in risk assessment at low doses. The evaluation
of epidemiological studies and experimental research was
discussed in order to provide facts and figures contributing
to an objective assessment of the radiation hazard from
incorporated radionuclides.
The other aspect was that of radiation protection in
medicine. In the case of 224Ra treatment of ankylosing
spondylitis the questions of benefit and risk of this thera-
peutic use of ionizing radiations were discussed, the aim
being to achieve the therapeutic effect while reducing
radiation exposure - and therefore the hazard - to a minimum.
The proceedings contain the complete texts of 23 papers as
well as the final round table discussions.
Table of contents
page
H.G. Ebert Preface 1
W.A. Muller
C.W. Mays On the scientific work of
Fritz Schales 5
W. Gossner Opening adress 7
Session I Chairman: W. Gossner
F.W. Hartl Zur Klinik der ankylosierenden
Spondylitis (Morbus Bechterew) 11
F. Schilling Pathology and raoiology of ankylosing
spondylitis 19
Session II Chairmen: -A. Bertrand, B. ~]indeyer
W. Koch Indication for 22 4Ra-therapy in
ankylosing spondylitis 21
F. Schales Problems and results of a new follow-
up study - 22 4Ra in adult ankylosing
spondylitis patients 30
C.W. lo1ays Addendum to the previous paper: Risk
to bone from present 224 Ra therapy 37
O. Delikan Quality control in the production
process and purity of 224Ra for
injection 44
E. Schmitt Therapeutical results in a follow-up
study 22 4Ra-therapy of ankylosing
spondylitis 50
B. vlindeyer X-ray therapy in the treatment of
ankylosing spondylitis 60
Session III Chairmen: J. Martin, C. Winkler
I. Bahous Radiosynoviorthesis: Local treatment
of rheunatoid arthritis 71
A. Bertrand Comparison of the efficacy of 224Ra
J. Martin and other radio-isotopes in the treat-
C. Hocquard ment of rheuraatoid arthritis 79
B. Wallner Experimental data on the injection of
W.A. Mi.iller 224Ra into the knee-joint of rats and
rabbits 87
W. Koch Intravenous injection of 224Ra in
Morbus Paget 95
Session IV Chairman: H. Spiess
H. Spiess Clinical experiences concerning late
effects and risks of 22 4Ra 102
V. Dvorak Osteogenic sarcomas in mice after
et al. 224Ra or 226Ra adrainistrations 109
V. Kofranek Biological effects of 224Ra and 226Ra
et al. and their relative radiotoxicity in
mice 120
A. Luz The dependence of late effects in
W.A. Muller mice on the temporal distribution of
W. Gessner skeletal a-doses from 224Ra and
O. Hug 227Th 135
K.B. Marquart Histopathology of early effects of
W. Gessner 22 4Ra on bone tissue 149
V. Erfle Expression of type C roTA virus
K.H. Marquart particles in 224Ra-induced osteo-
sarcomas 158
Session V Chairman: G.H. Dolphin
C.W. Mays Bone sarcoma risks to man from 224Ra,
H. Spiess 226Ra and 239pu 168
G.W. Dolphin Problems in radiological protection
involving a-emitters in bone 182
P.G. Groer A model for the induction of bone
J.H. Marshall cancer by 224Ra 201
J. Martin Methodological aspect of epidemio-
A. Bertrand logical inquiries in clinical radio-
biology 210
H. Roux Notre experience du 2 24 Ra dans Ie
et al. traitement de la spondylarthrite
ankylosante 212
Round Table Discussion I Moderator: C.W. Mays
Risk evaluation of ankylosing spondylitis therapy 215
Round Table Discussion II Moderator: W. Koch
Clinical results of ankylosing spondylitis therapy 223
R.B. !!!ole Concluding remarks 230
List of participants 233
Preface
Under an association contract linking the Co~ission of
the European Communities and the Gesellschaft fUr Strahlen-
und Umweltforschung mbH, a research programme on the patho-
genesis of somatic radiation damage has been under way for
a number of years. Experimental research on long-term
radiation effects following the incorporation of bone-seeking
radionuclides and an epidemiological study of the conse-
quences for patients treated with 224Ra for therapeutical
reasons have been among the main features of the work. The
research carried out on tumor induction in the low dose
range and for low dose rates is particularly important as
regards assessing the radiation hazard to man.
The second Symposium on the biological effects of 224Ra,
held at Neuherberg, provided a welcome opportunity to take
stock of what has been achieved so far and to discuss the
own research efforts in an international setting. The dis-
cussions focussed on two topical aspects of radiation
protection.
One aspect was the long-term effects of high-LET ionizing
radiations on man and the quantitative data involved in
risk assessment at low doses. The epidemiological studies
and experimental research carried out under the association
contract should provide facts and figures for an objective
assessment of the radiation hazards from incorporated radio-
nuclides, which is one of the fundamental and controversial
problems of the nuclear energy debate.
The other aspect was that of radiation protection in
medicine. In the case of 22 4Ra treatment of ankylosing
spondylitis the question about benefit and risk of this
therapeutic use of ionizing radiations was discussed. In
the light of the results presented, it should be possible,
1
when the appropriate indications are met, to achieve the
therapeutic effect while reducing radiation exposure - and
therefore the hazard - to a minimum.
These two topics are closely related and it was a 'bonus'
of the Synposium that both clinical experiences and radio-
biological research results were presented and discussed
with a view to clarifying the questions involved.
H.G. EBERT W.A. MuLLER
2
Vorwort
Die Kommission der Europaischen Gemeinschaften und die
Gesellschaft flir Strahlen- und Umweltforschung mbH flihren
seit mehreren Jahren im Rahmen eines Assoziationsvertrages
ein Forschungsprogramm liber die Pathogenese der somatischen
Strahlenschaden durch. Experimentelle Untersuchungen liber
die Spatschaden nach Inkorporation osteotroper Radionuklide
und epidemiologische Studien liber die Folgen einer 2 24 Ra_
Behandlung von Patienten gehoren mit zu den Schwerpunkten
der Arbeiten der Assoziation. Von besonderer Bedeutung im
Hinblick auf die Strahlengefahrdung des Menschen ist dabei
das Studium der Tumorinduktion im Bereich niedriger Dosen
und Dosisleistungen.
Es war somit eine willkommene Gelegenheit, das 2. Symposium
liber die biologischen Effekte von 224Ra in Neuherberg zu
organisieren, urn gemeinsam Bilanz des bisher Erreichten
zu ziehen und urn die eigenen Arbeiten im internationalen
Kreis zu diskutieren. Zwei aktuelle Aspekte des Strahlen-
schutzes standen im Mittelpunkt der Erorterungen auf dem
Symposium.
Zum einen stellte sich die Frage nach den Langzeiteffekten
von ionisierenden Strahlungen hoher LET beim Menschen und
damit nach quantitativen Daten flir eine Risikoabschatzung
bei niedrigen Dosen. Hier konnen die durchgeflihrten epidemio-
logischen Studien und experimentellen Untersuchungen zur
objektiven Beurteilung des Strahlenrisikos von inkorporierten
Radionukliden beitragen, das eines der grundlegenden und
kontroversen Probleme in der Diskussion des Kernenergierisi-
kos ist.
Der zweite Aspekt betrifft den Strahlenschutz in der
Medizin. Es wurde im Fall der Therapie der ankylosierenden
Spondylitis mit 224Ra die Frage nach Nutzen und Risiko dieser
3