2022
DOI: 10.1017/erm.2022.6
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Key biological mechanisms involved in high-LET radiation therapies with a focus on DNA damage and repair

Abstract: DNA damage and repair studies are at the core of the radiation biology field and represent also the fundamental principles informing radiation therapy (RT). DNA damage levels are a function of radiation dose, whereas the type of damage and biological effects such as DNA damage complexity, depend on radiation quality that is linear energy transfer (LET). Both levels and types of DNA damage determine cell fate, which can include necrosis, apoptosis, senescence or autophagy. Herein, we present an overview of curr… Show more

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Cited by 36 publications
(39 citation statements)
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References 187 publications
(196 reference statements)
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“…Carbon ions kill cells twice or three times more effectively than protons and conventional radiation modalities [ 11 ]. In general, high-LET types induce more DSBs per dose unit, and more complex and dense lesions than low-LET types because they deposit large amounts of energy within a small distance [ 12 ]. The type of initial DNA damage largely determines the repair pathway that is subsequently activated.…”
Section: Introductionmentioning
confidence: 99%
“…Carbon ions kill cells twice or three times more effectively than protons and conventional radiation modalities [ 11 ]. In general, high-LET types induce more DSBs per dose unit, and more complex and dense lesions than low-LET types because they deposit large amounts of energy within a small distance [ 12 ]. The type of initial DNA damage largely determines the repair pathway that is subsequently activated.…”
Section: Introductionmentioning
confidence: 99%
“…protons, carbon ions, α -particle-emitting radionuclides) can differentially affect cell fate ( 317 ). For example, protons mainly induce apoptosis not necrosis which may reduce the leakage of nucleic acids into the cytoplasm to serve as danger signals, hence impacting on the innate immune response ( 317 ). The effects of radiotherapy were previously thought to be mainly due to nuclear DNA damage and their repair mechanisms.…”
Section: Discussionmentioning
confidence: 99%
“…The biological effects of ionizing radiation vary hugely with radiation quality, from sparsely ionizing photons and electrons to protons and densely ionizing heavier ions such as carbon or iron ions. This has been addressed in dedicated radiobiological studies investigating endpoints such as DNA damage induction, its repair, induction of chromosomal aberrations, mutations or cell killing; reviewed, for example, by [ 1 , 2 , 3 , 4 , 5 ]. Modelling and simulation tools, especially Monte Carlo track structure simulations, have succeeded in explaining the observed trends and linking them to the initial physical processes that lead to distinct track structures, as well as subsequent chemical processes of radical formation, reactions, and attack on cellular DNA [ 6 , 7 ].…”
Section: Introductionmentioning
confidence: 99%