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Lymphocyte radiosensitivity correlated with pelvic radiotherapy morbidity
Tung-Kwang Lee1, Ron R Allison, Kevin F O'Brien
1Department of Radiation Oncology, Leo W. Jenkins Cancer Center, East Carolina University Brody School of Medicine, Greenville, NC 27858, USA. leet@mail.ecu.edu
International Journal of Radiation Oncology, Biology, Physics
|August 12, 2003
Summary
Prostate cancer patients with high radiation-induced micronucleus (MN) yield before treatment show increased risk of radiotherapy morbidity. This MN assay can predict gastrointestinal or genitourinary side effects from pelvic radiation therapy.
Area of Science:
- Oncology
- Radiation Oncology
- Genetics
Background:
- Radiotherapy (RT) is a cornerstone treatment for prostate cancer.
- Predicting RT-related morbidity is crucial for personalized treatment planning.
- Micronucleus (MN) formation in lymphocytes reflects DNA damage sensitivity.
Purpose of the Study:
- To investigate if ex vivo radiation-induced micronucleus (MN) yield in G(0) lymphocytes predicts radiotherapy (RT)-related morbidity in prostate cancer patients.
- To test the hypothesis that a high MN yield indicates a greater risk of developing RT-related morbidity.
Main Methods:
- Prospective study of 38 prostate cancer patients undergoing pelvic RT.
- Cytokinesis-block micronucleus (MN) assay performed on peripheral blood lymphocytes (PBLs) before RT.
- PBLs irradiated ex vivo (1-4 Gy) to determine MN yield.
- Gastrointestinal (GI) or Genitourinary (GU) morbidity assessed post-RT using Radiation Therapy Oncology Group criteria.
Main Results:
- Significant differences in ex vivo MN yield were observed between patients with low (Grade 1 or less) and high (Grade 2 or greater) RT-related morbidity, particularly at radiation doses >= 2 Gy.
- Pre-treatment MN yield in PBLs strongly correlated with the development of RT-related morbidity.
- No correlation was found between RT-related morbidity and patient clinical variables (age, stage, PSA).
Conclusions:
- The pre-RT ex vivo radiation dose-response relationship of MN yield in PBLs is a significant predictive factor for GI or GU morbidity.
- This MN assay may aid in identifying prostate cancer patients at higher risk for RT-related side effects.
- Personalized RT strategies can be informed by pre-treatment MN yield assessment.