Academic literature on the topic 'Individual radiosensitivity'

Abstract Background. Individual radiosensitivity has a crucial impact on radiotherapy related side effects. Our aim was to study a breast cancer collective for its variation of individual radiosensitivity depending on the patients’ age. Materials and methods. Peripheral blood samples were obtained from 129 individuals. Individual radiosensitivity in 67 breast cancer patients and 62 healthy individuals was estimated by 3-color fluorescence in situ hybridization. Results. Breast cancer patients were distinctly more radiosensitive compared to healthy controls. A subgroup of 9 rather radiosensitive and 9 rather radio-resistant patients was identified. A subgroup of patients aged between 40 and 50 was distinctly more radiosensitive than younger or older patients. Conclusions. In the breast cancer collective a distinct resistant and sensitive subgroup is identified, which could be subject for treatment adjustment. Preliminary results indicate that especially in the range of age 40 to 50 patients with an increased radiosensitivity are more frequent and may have an increased risk to suffer from therapy related side effects.

Radiation therapy is widely used for cancer treatment. Medical application of ionizing radiation can cause different responses in human depending on individual radiosensitivity. Therefore, assessment of individual radiosensitivity could be proposed as assistant tool in optimizing radiotherapy. The cytokinesis- block micronucleus and G2 chromosomal radiosensitivity assays were proposed as appropriate methods for assessment of individual radiosensitivity. In current study we carried out a pilot cytokinesis-block micronucleus and G2 chromosomal radiosensitivity assays comparison by evaluating specificity of chromatid breaks yield and micronuclei frequency in peripheral blood lymphocytes as biomarkers of individual radiosensitivity in three cancer patients treated with radiotherapy. Our study revealed positive correlation between higher increase in frequency of micronuclei and chromatid breaks after in vitro irradiation in radiotherapy patients peripheral blood lymphocytes with occurrence of adverse radiation effects in tissue which are not being targeted. G2 assay appeared to be more sensitive than micronuclei assay for assessment of irradiation-induced alterations in individual radiosensitivity during the radiotherapy that could affect development of treatment side effects. Therefore, further investigations involving more radiotherapy patients as well as healthy donors are required to select the most sensitive method and reveal the possible correlation between individual radiosensitivity and adverse effect of radiotherapy.

Radiation protection regulations have been established to reduce exposure of individuals to acceptable safe levels. These limits assume that people have similar responses to ionizing radiation and that there is no variation in individual radiation risk. The purpose of this research was to determine if apoptosis in lymphocytes can be used to assess individual sensitivity to ionizing radiation. Blood samples were taken from 54 males ranging in age from 19–85 years. Apoptosis was measured using modified flow cytometry based Annexin-FITC/7AAD and DiOC6/7AAD assays in different populations of lymphocytes (total mixed lymphocyte population, subset CD4+ or CD8+ lymphocytes) after exposure to in vitro doses of 0, 2, 4 or 8Gy (dose rate 0.1Gy/min). The variation in individual responses to radiation was large. The variation was the largest in the CD4+ lymphocyte subpopulation. Radiation-induced apoptosis decreased with age of donor demonstrating that as people age their lymphocytes may become relatively more resistant to radiation. This research shows that individuals have marked differences in their sensitivity to radiation and protection policies may someday need to be tailored for some individuals.

Воздействие ионизирующего излучения вызывает значительные функциональные изменения в клетках человека, выражающиеся в активации различных сигнальных путей и транскрипционного ответа множества генов. Величина этих изменений вариабельна у разных индивидов, составляя феномен индивидуальной радиочувствительности. В обзоре рассматриваются известные маркеры индивидуальной радиочувствительности человека, начиная от цитогенетических, позволяющих непосредственно оценить эффективность репарации радиационно-индуцированных повреждений ДНК в клетках, до маркеров, выделенных на основании полногеномных и полнотранскриптомных исследований дифференциально экспрессирующихся генов, обусловливающих различные аспекты клеточного и организменного ответа на радиационное воздействие. Exposure to ionizing radiation causes significant functional changes in human cells which lead to activation of various signaling pathways and transcriptional response of many genes. The magnitude of these changes is variable for different individuals, making the phenomenon of individual radiosensitivity. In the review, markers of individual radiosensitivity are described ranging from cytogenetic markers for assessing the efficiency of DNA repair of radiation-induced damage in cells to genome- and transcriptome-wide approaches to identify differentially expressed genes that determine various aspects of response to radiation exposure.

Thesis (MTech (Biomedical Technology))--Cape Peninsula University of Technology, 2017.
Apoptosis is the dominant mechanism of cell death induced by radiation and is the key mechanism used to remove cells with significant DNA damage. Previous research investigated the feasibility of using the Leukocyte Apoptosis Assay (LAA) to determine individual sensitivity to radiation and it was found that an apoptotic response could be loosely linked to age, race and gender. Apoptosis is controlled by the Bcl-2 proteins and therefore the balance between Bax and Bcl-2 protein expression is important. With this background it would be relevant to know why certain individuals are more sensitive to radiation than others. The objectives of this study was to evaluate the effect of ionising radiation on apoptotic proteins, Bcl-2 (anti-apoptotic) and Bax (pro-apoptotic) expression and to explore if there is a relationship between radiation induced apoptosis (RIA) and Bcl-2 or Bax expression.

This thesis focuses on how physical and biological factors influence the outcome of exposures to γ/X-rays. That the dose rate changes during real life exposure scenarios is well-known, but radiobiological data from exposures performed at increasing or decreasing dose rates is lacking. In paper I, it was found that an exposure where the dose rate decreases exponentially induces significantly higher levels of micronuclei in TK6 cells than exposures at an increasing or constant dose rate. Paper II describes the construction and validation of novel exposure equipment used to further study this “decreasing dose rate effect”, which is described in paper III. In paper I we also observed a radioprotective effect when cells were exposed on ice. This “temperature effect” (TE) has been known for decades but it is still not fully understood how hypothermia acts in a radioprotective manner. This was investigated in paper IV, where a multiparametric approach was used to investigate the underlying mechanisms. In paper V the aim was to investigate the role of biomarkers and clinical parameters as possible risk factors for late adverse effects to radiotherapy (RT). This was studied in a rare cohort of head-and-neck cancer patients that developed mandibular osteoradionecrosis (ORN) as a severe late adverse effect of RT. Biomarker measurements and clinical factors were then subjected to multivariate analysis in order to identify ORN risk factors. The results suggest that the patient’s oxidative stress response is an important factor in ORN pathogenesis, and support the current view that patient-related factors constitute the largest source of variation seen in the frequency of late adverse effects to RT. In summary, this thesis provides new and important insights into the roles of biological and physical factors in determining the consequences of γ/X-ray exposures.

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Submitted. Paper 5: Manuscript.

L'exposition aux rayonnements ionisants est une composante inévitable de la vie moderne. Il est bien établi qu'il existe une grande variabilité inter-individuelle de la radiosensibilité chez les individus sains et chez des patients atteints de cancer. Cependant, les mécanismes impliqués dans l'hétérogénéité des réponses biologiques radio-induites ne sont pas encore bien compris, et une approche biologique permettant d’établir de façon fiable le niveau de radiosensibilité reste à développer. Dans cette thèse, nous avons étudié l'ampleur et l'impact de la radiosensibilité individuelle chez les individus sains dans les contextes de dosimétrie d'urgence et de radiothérapie. Nous avons également examiné les différents rôles des télomères dans la prédiction de la radiosensibilité individuelle et des risques pour la santé humaine à long terme (spécifiquement, en ce qui concerne les maladies cardiovasculaires et/ou les cancers) après irradiation. Tout d'abord, dans le contexte de la dosimétrie dans le cas d'une situation d'urgence (lorsqu’il est nécessaire d’estimer rapidement la dose d’irradiation reçu par un individu), nous avons démontré que l'impact de la radiosensibilité individuelle peut être négligeable en utilisant des mesures globales de fluorescence de γH2AX via cytométrie en flux dans des fibroblastes humains et des lymphocytes à 4 heures après exposition ; cette méthode peut être un outil de biodosimétrie efficace et rapide qui peut aider au tri des personnes irradiées dans une situation d'urgence basées sur les niveaux individuels d'exposition. Dans un second temps, nous avons étudié l'ampleur et l'influence de la radiosensibilité individuelle sur l'induction d'aberrations chromosomiques après une irradiation de 2 Gy de rayons γ, correspondant à une fraction de radiothérapie conventionnelle, dans les lymphocytes d'individus sains. Pour ces analyses, nous définissons la radiosensibilité individuelle par rapport à la fréquence des cassures double-brin (CDB) radio-induite, qui ont été calculées à partir de la quantification des aberrations chromosomiques visualisées par hybridation in situ des télomères et centromères (TC-FISH). Ce marquage améliore et simplifie la technique « gold standard » de dosimétrie biologique (la quantification des chromosomes dicentriques). Nous avons également estimé la radiosensibilité individuelle à l’irradiation carbone, ions lourds utilisés en radiothérapie, et l'efficacité biologique relative (EBR) des ions carbone par rapport à une irradiation γ. Nous avons fourni des courbes dose-réponse pour ces deux types d’irradiations en fonction de la fréquence des CDB radio-induite par exposition à une gamme de doses. De plus, nous avons estimé l'EBR d'un troisième type de rayonnement également utilisé en radiothérapie d'ions lourds (protons) par rapport à une irradiation γ, et nous avons comparé la radiosensibilité individuelle de ces trois types d'irradiation avec énergies différentes. Ensuite, nous avons évalué les rôles des télomères et de leur maintien pour la prédiction de la radiosensibilité individuelle. Nous avons constaté que la longueur moyenne des télomères, en combinaison avec leurs modifications radio-induites, peuvent être un bon prédicteur de la radiosensibilité individuelle. Enfin, nous avons montré comment les télomères pourraient être liés à des risques sanitaires à long terme après une irradiation: nous avons démontré que le raccourcissement des télomères pouvait être un nouveau facteur de prédiction de maladies cardiovasculaires après radiothérapie, et nous avons discuté par la suite, les télomères comme des acteurs clés dans le processus de cancérogenèse radio-induite. En conclusion, nous proposons un modèle présentant la façon dont les télomères pourraient jouer un rôle crucial dans ces deux pathologies radio-induite, et nous délibérons des relations entre le maintien des télomères, les effets biologiques radio-induites, et la radiosensibilité individuelle
Exposure to ionizing radiation (IR), from both natural and man-made sources, is an inevitable part of modern life. It is well established that there are considerable inter-individual variations in sensitivity to IR among healthy individuals and cancer patients. However, the mechanisms involved in the heterogeneity of biological responses to IR are not well understood, and a reliable biodosimetric and clinical approach to measure and rank radiosensitivity remains to be established. In this thesis, we study the extent and impact of individual radiosensitivity in healthy individuals in the contexts of emergency dosimetry and radiotherapy, and we explore the roles of telomeres in the prediction of individual radiosensitivity and long-term human health risks following IR exposure (specifically, cardiovascular diseases and/or cancer). First, in the context of dosimetry in the event of an emergency situation (when rapid dose estimates of each individual in an irradiated population are needed), we demonstrate that the impact of individual radiosensitivity can be negligible using global cellular measurements of γH2AX fluorescence via flow cytometry in human fibroblasts and lymphocytes at 4 hours post-irradiation; this method could be an effective and rapid biodosimetry tool that can aid in the medical triage of irradiated individuals in an emergency setting based on individual levels of exposure. Second, we study the extent and influence of individual radiosensitivity on the induction of chromosomal aberrations following a routinely administered dose of 2 Gy during conventional fractionated photon radiotherapy (γ-rays) in lymphocytes of healthy individuals. For these analyses, we define individual radiosensitivity based on the frequency of IR-induced DNA double strand breaks (DSBs), which were calculated from the scoring of chromosomal aberrations visualized with telomere/centromere-fluorescence in situ hybridization (TC-FISH). This TC-FISH staining of metaphasic chromosomes enhances the “gold standard technique” of biodosimetry (the dicentric chromosome assay) with the visualization of telomeres and centromeres and thereby provides improved simplicity and sensitivity to the classical cytogenetic assay. We also compare individual radiosensitivity following γ-irradiation to that following carbon irradiation, an up-and-coming ion species currently being used in heavy ion radiotherapy. We provide dose response curves for both γ- and carbon irradiations based on the calculated frequency of IR-induced DNA DSBs at a range of doses, and estimate the relative biological effectiveness (RBE) of carbon irradiation relative to γ-irradiation. We then estimate the RBE of a third type of IR also frequently used in heavy ion radiotherapy (proton beams) in comparison to γ-irradiation, and compare individual radiosensitivity to each of these three types of IR with different IR energies. Third, we evaluate the roles of telomeres and telomere maintenance in the prediction of individual radiosensitivity; we find that inherent mean telomere length in combination with the IR-induced change in mean telomere length may be a strong predictor of individual radiosensitivity. Finally, we show how telomeres could be linked to long-term health risks following IR exposure: we demonstrate that telomere shortening could be a new prognostic factor for cardiovascular disease following radiotherapy, and discuss how telomeres could be key players in the process of radiation-induced carcinogenesis. In conclusion, we deliberate the relationships between telomere maintenance, radiation effects, and individual radiosensitivity, and propose a model of how telomeres could play crucial roles in the development of cardiovascular diseases and the process of IR-induced carcinogenesis

5 à 15% des 175 000 patients traités par radiothérapie (RT) chaque année sont exposés à une toxicité considérée comme « inhabituelle » pouvant entraîner des séquelles parfois graves. Les techniques innovantes de photonthérapie apportent une solution balistique pertinente mais inappropriée pour certaines tumeurs ou certains patients. Deux approches permettent d'entrevoir des solutions à ces situations. 1- Contribution au développement de l'hadronthérapie par ions carbone : Ces particules possèdent une masse et une charge qui leur confèrent un avantage balistique et biologique particulièrement intéressant. Le caractère rare des tumeurs éligibles et le très faible nombre de centres n'ont pas permis, ou justifié, à ce jour la réalisation d'études comparatives randomisées afin d'en évaluer le service rendu. Via le projet FP7 ULICE, nous avons intégré et animé plusieurs groupes à l'échelle nationale et internationale. Nous avons directement produit des procédures unifiées en terme d'immobilisation, de recueil des données élémentaires, de structuration protocolaire et de transformation des données en métadonnées échangeables. Nous avons proposé des concepts originaux permettant de décrire la dose prescrite et les volumes d'intérêt, au-delà du concept réducteur d'EBR. 2- Un nouveau biomarqueur de radiosensibilité individuelle (RSI). L'identification des patients les plus à risque de développer les réactions les plus sévères reste un enjeu majeur. Aucun test de RSI ne s'impose comme gold standard. A partir de primocultures fibroblastiques issues de patients ayant présenté un profil de toxicité inhabituel à la RT, le taux de cassures double brins résiduelles à 24h estimé par immunofluorescence indirecte (marqueur γH2AX) a permis de définir 3 groupes de RSI. Toutefois ce seul marqueur n'est pas assez robuste. Le délai de transit cyto-nucléaire de la protéine ATM semble affiner notre classification. Un nouveau modèle mécanistique a ainsi pu être développé
5 to 15% of the 175,000 patients treated with radiation therapy (RT) annually are exposed to toxicity considered "unusual" that can lead to serious sequelae. Innovative photon RT techniques provide relevant but inappropriate ballistic solution for certain tumors or certain patients. Two approaches guide solutions to these situations.1- Contribution to the development of carbon ion RT. These particles possess a mass and a charge that give them particularly interesting ballistics and biological properties. The rarity of eligible tumors and the low care offer have failed conducting randomized controlled trials to evaluate its cost-effectiveness. Throughout the FP7-ULICE project, we directly produced standard operating procedures in terms of basic data collection, protocol structuring and processing of metadata. We proposed original concepts to describe and report the dose and volume of interest, beyond the restricted concept of RBE. 2- A novel biomarker of individual radiosensitivity (IRS). The identification of the patients the most at risk of developing the most severe reactions remains a major challenge. There is no gold standard in the field of IRS assays.From fibroblasts primocultures sampled from patients with an unusual toxicity, the number of residual DNA double-stand breaks 24h after radiation and estimated by indirect immunofluorescence (marker γH2AX) allows to identify three groups of IRS. However this single marker is not robust enough. The delay of ATM nucleoshuttling appears to refine our classification. A new mechanistic model has been developed

Thesis (MScMedSc)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Background: The assignment of radiation weighting factors to high energy neutron sources is important as there is reason to believe that neutron relative biological effectiveness (RBE) may be related to the inherent radiosensitivity of different individuals. A study was undertaken to quantify the inherent radiosensitivities of lymphocytes obtained from different donors to 60Co y-rays and p(66)/Be neutrons. For this a novel semi-automated image analysis process has been employed. In addition the responses of lymphocytes with different inherent radiosensitivities have also been tested using Auger electrons emitted by 123I. Methods: The RBE of neutrons was determined from dose-response curves for lymphocytes from different donors. Isolated T-lymphocytes irradiated in vitro were cultured to induce micronuclei in binucleated cells and micronuclei (MN) formations numerated using a semi-automated Metafer microscope system. The accuracy in obtaining dose response curves with this method has been tested by evaluating dispersion parameters of MN formations in the response to the different treatment modalities. Differences in the inherent radiosensitivities of cells from different donors were ascertained using 95 % confidence ellipses. [123I]Iododeoxyuridine was prepared in a formulation that allows incorporation of 123I into the DNA of lymphocytes. Micronucleus formations to this treatment were evaluated in lymphocytes with established differences in inherent radiosensitivities. Results: The image analysis system proved to be consistent in detecting micronuclei frequencies in binucleated lymphocytes. As a result, differences in the inherent radiosensitivities of different individuals were distinctive and could be stated at the 95% confidence level. The inter-individual radiosensitivity variations were considerably smaller for blood cells exposed to high energy neutrons compared to 60Co y-rays. Relative biological effectiveness (RBEM) values between 2 and 13 were determined that are highly correlated with the inherent radioresistance of lymphocytes obtained from different individuals. As such radiation weighting factors for high energy neutrons cannot be based on cytogenetic damage determined in lymphocytes from a single donor. Dispersion parameters for micronuclei formations proved to vary according to ionization density. The variation in RBE with neutron dose changed according to theoretical considerations and automated image analysis detection of MN is thus a suitable method to quantify radiation weighting factors. A clear reduction in the variation in radiosensitivity is noted for lymphocytes exposed to Auger electrons compared to 60Co y-rays. The effectiveness of Auger electrons from [123I]IUdR to induce biological damage is demonstrated as the number of disintegrations needed to yield micronuclei formations was found to be more than two orders of magnitude less than that of other compounds. An increase in the RBE of Auger electrons with radioresistance can be inferred from these findings and constitutes a basis for therapeutic gain in treating cells compared to using radioisotopes emitting low-LET radiation.
AFRIKAANSE OPSOMMING: Agtergrond: Die bepaling van straling gewigsfaktore vir hoë energie neutron bronne is belangrik, aangesien daar rede is om te glo dat die relatiewe biologiese effektiwiteit (RBE) kan verband hou met die inherente stralings sensitiwiteit van verskillende individue. Hierdie studie is onderneem om die inherente radiosensitiwiteit van limfosiete verkry vanaf verskillende skenkers te kwantifiseer na blootstelling aan 60Co y -strale en p(66)/Be neutrone. Vir hierdie doel is daar van 'n semi-outomatiese beeldontleding metode gebruik gemaak. Daarbenewens is die reaksie van limfosiete met vooraf bepaalde inherente radiosensitiwiteite ook getoets aan die hand van Auger elektrone wat uitgestraal word deur 123I. Metodiek: Die RBE van neutrone was bepaal uit dosis mikrokerne frekwensie verwantskappe verkry vir limfosiete. Geïsoleerde T-limfosiete was in vitro bestraal en gekweek om mikrokerne te vorm in dubbelkernige selle. Die mikrokerne was gekwantifiseer deur die gebruik van 'n semi-outomatiese Metafer mikroskoop stelsel. Die akkuraatheid in die verkryging van dosis-effek krommes met hierdie metode is getoets deur die ontleding van verspreidings parameters van MN vorming in reaksie op behandeling met die verskillende stralings modaliteite. Verskille in die inherente stralingsensitiwiteite van die selle van verskillende skenkers was vasgestel deur die konstruksie van 95 % betroubaarheidsinterval ellipse. [123I]Iododeoxyuridine was ook berei om 123I in die DNA van limfosiete in te bou. Die mikrokerne vorming op die behandeling is beoordeel in limfosiete met gevestigde verskille in inherent radiosensitiwiteite. Resultate: Die beeld analise stelsel bewys om konsekwent te wees in die opsporing van mikrokerne wat vorm in dubbelkernige limfosiete. Verskille in die inherente radiosensitiwiteite van verskillende skenkers kon vasgestel word op die 95 % betroubaarheidsvlak. Die skommeling in inter-individuele stralings sensitiwiteite was kleiner vir bloed selle blootgestel aan hoë-energie neutrone in vergelyking met 60Co y-strale. Relatiewe biologiese effektiwiteit (RBEM) waardes tussen 2 en 13 is bepaal wat sterk verband hou met die inherente radioweerstandbiedendheid van limfosiete verkry vanaf verskillende persone. As sodanig kan straling gewigsfaktore vir hoë energie neutrone nie gebaseer word op sitogenetiese skade in limfosiete van 'n enkele skenker nie. Verspreidings parameters vir mikrokern vorming het gewissel as ‘n funksie van ionisasiedigtheid van die straling. Die verandering in RBE met neutron dosis verloop volgens teoretiese oorwegings en die semi-outomatiese beeldontledings metode om mikrokerne op te spoor is dus geskik om stralings gewigsfaktore te kwantifiseer. 'n Duidelike afname in die verandering in die stralingsensitiwiteite is waargeneem vir limfosiete blootgestel aan Auger elektrone in vergelyking met 60Co y-strale. Die hoë doeltreffendheid van Auger elektrone afkomstig van [123I]IUdR om biologiese skade te veroorsaak, word weerspieël deur die feit dat die getal disintegrasies wat nodig is om mikrokerne te vorm meer as twee ordes grootte minder is as dié van ander verbindings. 'n Toename in die RBE van Auger elektrone in selle wat radioweerstandbiedend is kan afgelei word uit hierdie bevindinge. Dit vorm 'n basis vir terapeutiese wins in die behandeling van selle in vergelyking met die gebruik van radio-isotope wat lae ionisasie digthede tot stand bring.

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Dissertacao (Mestrado)
IPEN/D
Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Radioactive iodine has been used successfully for almost 70 years since the first treatment took place at the Massachusetts General Hospital in Boston in 1941. However, it was not until after the Second World War that ¹³¹I became generally available for clinical applications (1). The radioactive iodine isotope is chemically identical to ‘stable’ iodine (¹²⁷I) and thus becomes a part of the intrathyroidal metabolism. Its principle of action is based on the emission of β‎-rays with a range of 0.5–2 mm in the tissue leading to high local radiation absorbed doses while sparing surrounding structures. The additional γ‎-ray component of ¹³¹I allows for scintigraphic imaging of the distribution in the gland and can also be used for pre- and post-therapeutic individual dosimetry (see below). Several therapeutic options are available for the treatment of benign thyroid disorders, namely hyperthyroidism: surgical resection (hemithyroidectomy, near-total, or total thyroidectomy), long-term antithyroid drug medication (ATD), and radio-iodine therapy (RAIT) (2, 3). These different treatment modalities are used in varying frequencies depending on geographical location, e.g. iodine supply, availability and logistics, cultural background, and patient-specific features, e.g. goitre size, presence of local symptoms, age, and hormonal status. The diversity of approaches on an international scale still remains impressive and is reflected by a great heterogeneity throughout Europe and also when compared to the USA where radio-iodine therapy is still being applied more frequently than in most European countries (4–8). Radio-iodine therapy was originally aimed at eliminating hyperthyroidism and thus leaving the patient euthyroid. Up-to-date strategies, however, established postradio-iodine induction of hypothyroidism as the treatment objective and, thus, it is included in the category of ‘cure’. This definition holds especially true for the management of Graves’ disease when long-term hypothyroidism was the rule and stabilization of euthyroidism failed in the majority of cases. In fact, the term ‘ablation’, meaning removal or destruction, has been increasingly used to characterize radio-iodine therapy and administration of larger amounts of radio-iodine have tended to make this a self-fulfilling prophecy. Although many clinicians prefer that the end result of treatment be the more easily managed hypothyroidism, others are still reluctant to give up the therapeutic ideal of euthyroidism as the preferred result of radio-iodine therapy and continue their efforts to solve the enigma of thyroid radiosensitivity.