Evaluation of DNA damage in radiotherapy-treated cancer patients using the alkaline comet assay

The aim of this study was to evaluate primary DNA damage and the dynamics of the repair of radiotherapy-induced DNA lesions in non-target cells of cancer patients. This study included patients diagnosed with different solid tumors who received radiotherapy. The levels of DNA damage were evaluated using the alkaline comet assay on peripheral blood leukocytes. Altogether four blood samples per patient were collected: before and after receiving the first dose of radiotherapy, in the middle of radiotherapy cycle, and after the last dose of radiotherapy. The results indicate that after the first radiation dose significantly increased levels of DNA damage were recorded in almost all cancer patients compared to their baseline values. Specific patterns of DNA damage were recorded in samples analyzed in the middle of radiotherapy and after receiving the last dose, indicating the possibility of adaptive response in some patients. Our results indicate that persistence of post-irradiation damage in peripheral blood leukocytes (and possibly in other non-target cells) of cancer patients that are strong determinants for the secondary cancer risk. Moreover, the alkaline comet assay was confirmed as a rapid and sensitive assay for the assessment of genome damage after in vivo irradiation.