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Article Dans Une Revue International Journal of Radiation Biology Année : 2020

Establishing mechanisms affecting the individual response to ionising radiation

Résumé

Purpose: Humans are increasingly exposed to ionising radiation (IR). Both low (<100 mGy) and high doses can cause stochastic effects, including cancer; whereas doses above 100 mGy are needed to promote tissue or cell damage. 10-15% of radiotherapy (RT) patients suffer adverse reactions, described as displaying radiosensitivity (RS). Sensitivity to IR's stochastic effects is termed radiosusceptibility (RSu). To optimise radiation protection we need to understand the range of individual variability and underlying mechanisms. We review the potential mechanisms contributing to RS/RSu focusing on RS following RT, the most tractable RS group.Conclusions: The IR-induced DNA damage response (DDR) has been well characterised. Patients with mutations in the DDR have been identified and display marked RS but they represent only a small percentage of the RT patients with adverse reactions. We review the impacting mechanisms and additional factors influencing RS/RSu. We discuss whether RS/RSu might be genetically determined. As a recommendation, we propose that a prospective study be established to assess RS following RT. The study should detail tumour site and encompass a well-defined grading system. Predictive assays should be independently validated. Detailed analysis of the inflammatory, stress and immune responses, mitochondrial function and life style factors should be included. Existing cohorts should also be optimally exploited.
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Dates et versions

hal-02431625 , version 1 (25-11-2021)

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Dietrich Averbeck, Serge M. Candéias, Sudhir Chandna, Nicolas Foray, Anna Friedl, et al.. Establishing mechanisms affecting the individual response to ionising radiation. International Journal of Radiation Biology, 2020, 96 (3), pp.297-323. ⟨10.1080/09553002.2019.1704908⟩. ⟨hal-02431625⟩
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