Can DNA repair cause enhanced cell killing following treatment with ionizing radiation?

Production of DNA damage is the basis of cancer treatments, such as chemotherapy and radiotherapy. The limitation of the treatment dose tends to be how well the normal cells within the body can tolerate the therapy. Although it is possible, to some extent, to localize the treatment area during radiotherapy by targeting the beam of ionizing radiation, chemotherapy usually involves a whole body treatment. In order to improve the effectiveness of treatments, it is important to understand how cells repair the DNA damage. This review will attempt to explain how DNA repair, which would be expected to always enhance cell survival, actually may result in increased cell killing following certain types of cancer treatments, such as ionizing radiation and bleomycin sulfate. Work is underway in many laboratories to unravel how the repair systems handle specific types of DNA damage. Such information will pave the way in designing adjuvant therapies that alter a tumor cell's DNA repair capacity and increase tumor cell killing.