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Large tumours are in general more difficult to cure by radiation treatment than small tumours. Several factors may be responsible for this phenomenon which evolves during tumour growth. In an earlier study using squamous cell carcinoma cell line HN-1, we have shown in split-dose recovery experiments that the amount of sublethal damage repair is equal in spheroids of different diameters. To elucidate this repair capacity further, we have employed other radiation regimens, calculated with the LQ-equation to be iso-effective, in spheroids of different sessions. Using specific growth delay to quantify radiation response after two to five fractions, it was shown that repair capacity was equal in spheroids of different sizes. For small spheroids the specific growth delay was smaller in once daily fractionation regimens than when radiation was administered in twice daily sessions. In large spheroids this advantage of accelerated fractionation was not observed. If spheroids from this squamous cell carcinoma cell line may be regarded as a relevant model system for their in vivo counterparts, then the results from the present study may indicate that accelerated fractionation of treatment is advantageous for small lesions, but not for larger tumours.

Induction of radioresistant tumor cells by previous irradiations may be a problem because the chance to treat a patient presenting with a recurrence with radiotherapy may be lost if a resistant subpopulation was induced by the initial treatment. We here report on experiments with two squamous carcinoma cell lines where cultures were initially irradiated with graded single doses (2-6 Gy) and were re-irradiated after 4 days with single and split doses (2-6 Gy). Both cell lines showed no alteration in radiosensitivity. Also, the split-dose recovery was not changed by the previous irradiations. Flow cytometric analysis showed no significant differences in cell cycle distribution, so that a possible influence of cell cycle redistribution could be excluded. Although preliminary, the results from this study give no indication that previously irradiated cells become more resistant to radiation. In view of the clinical importance of radioresistant clones in tumours, it seems important to perform similar experiments to those reported upon in this study with several radiation fractions as pre-irradiation treatment, to impose a stronger selection pressure on the surviving cells.

Cells from two human cell lines were irradiated both as multicellular tumor spheroids (MTS) and in monolayer culture. Radiation response of MTS was quantified in terms of specific growth delay and proportion cured, and as clonogenic cell survival for monolayer cells. Radiation was applied either as a single or as a split dose with time intervals of 1, 2, and 4 h to determine the rate of sublethal damage repair. Using as endpoint the fraction of MTS cured at an iso-effect level, in MTS of NB-100 neuroblastoma cells repair of sublethal damage was complete within 1 h, whereas in MTS of HN-1 squamous cell carcinoma cells there was still some unrepaired damage left. At a larger dose for NB-100 MTS the repair curve showed a similar shape as for HN-1 spheroids. Using as endpoint specific growth delay, no difference in repair between the various time intervals was observed. In monolayer cells from both cell lines sublethal damage was not fully repaired in the time intervals used. Polarographic microelectrode measurements of oxygen tension inside MTS showed a marked difference in steepness of oxygen tension profiles between MTS from both cell lines. In HN-1 squamous cell carcinoma MTS with diameters up to 500 microns the central pO2 amounted to about 100 Torr, whereas in NB-100 neuroblastoma MTS with the same diameters central pO2-values lower than 30 Torr were observed. NB-100 MTS were irradiated with doses of 5 and 10 Gy gamma rays and subsequently the oxygen tension was measured 1 and 5 h after irradiation. A reoxygenation effect could not be observed, either after single dose or after split dose irradiation. If spheroids may be regarded as a suitable model for tumor responses in vivo, the results from these experiments indicate that reoxygenation is a process eluding polarographic measurements, or that no dramatic changes in oxygen tension are to be expected shortly after high single doses or early in a fractionation scheme.

We compared cis-platin (DDP) and its analogue, carboplatin (JM8, CBDCA) in their ability to inhibit spheroid growth. The activities of DDP and JM8 were also compared in an antimetabolic assay for their ability to inhibit (3H)-thymidine incorporation in multicellular tumor spheroids. The spheroids were derived from a squamous cell carcinoma cell line HN-1, originally derived from a tumor of the tongue. To produce equal levels of growth delay in spheroids, carboplatin was required at concentrations approximately 16 times that of DDP. Carboplatin also required much longer incubation periods than DDP to produce equivalent growth delay and proportions of cured spheroids. Reflecting the initial response to chemotherapy, the antimetabolic assay showed that carboplatin was required at higher concentrations and longer exposure times to produce equal inhibition of the nucleotide precursor thymidine. These findings may have implications for the clinical use of these drugs and in particular would support a role for carboplatin in the treatment of squamous cell carcinoma of the head and neck, since total free-drug exposure of patients to carboplatin may be up to 16-fold greater than with DDP, and the clinical side effects of carboplatin have been shown to be well tolerated. However, one must be cautious about applying in vitro data to clinical situations.

Aggregates of human tumor cells are widely used in experimental studies on tumor responses to treatment. Only a limited number of human tumor cell lines are capable of forming spheroids. In this study cellular characteristics of 7 lung cancer and 4 bladder cancer cell lines are described with respect to their spheroid forming capacity. Comparisons were made with four reference lines known for their propensity to form growing aggregates. In the absence of vimentin expression no spherical aggregates were formed. Spherical aggregates were formed by one bladder and one lung cancer cell line, of which only the latter exhibited growth. Cellular factors influencing the ability of spheroids to increase in volume after spherical aggregation are not yet defined. Viability and clonogenicity of cells in aggregates are not the determinant of growth capacity. The growth rate of cell lines that exhibited growth is determined by tissue culture conditions and additives. Type of medium, percentage of foetal bovine serum and glucose concentration influenced the growth rate of spheroids. Since the response to radiation may be influenced by the growth rate of the tumors, manipulation of tissue culture medium composition offers the possibility of testing the influence of growth rate on the radiation response of one type of spheroids.