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Updated: Apr 19, 2026
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Bystander effects and radiotherapy.
Alicia Marín1, Margarita Martín1, Olga Liñán1
1Department of Radiation Oncology, Hospital Universitario de la Princesa, Madrid, Spain.
Summary
Radiation-induced bystander effects occur in cells not directly hit by radiation, impacting DNA and cell cycles. Understanding these effects is crucial for improving radiotherapy and radiation risk assessment.
Area of Science:
- Radiobiology
- Radiation Oncology
Background:
- Radiation-induced bystander effects are biological responses in non-irradiated cells near irradiated ones.
- These effects involve DNA damage, chromosomal instability, and apoptosis, influencing cellular equilibrium.
Purpose of the Study:
- To review the biological impacts of radiation-induced bystander effects relevant to radiotherapy.
- To explore their role in cell cycle, hypoxia, fractionated doses, and combined radio-chemotherapy.
Main Methods:
- Literature review focusing on radiation-induced bystander effects.
- Analysis of their implications in various radiotherapy contexts, including IMRT and proton therapy.
Main Results:
- Bystander signals can alter cell proliferation, apoptosis, and differentiation.
- Genetic variations influence bystander toxicity and normal tissue damage.
- Out-of-field doses from photon scattering in IMRT can induce bystander responses.
Conclusions:
- Understanding bystander effects is vital for accurate radiation risk assessment.
- Further research is needed to optimize radiotherapy protocols and mitigate normal tissue damage.
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