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Radiotherapy in Li-Fraumeni Syndrome: From Biological Concern to Personalized Clinical Decision-Making.
Reyzane El Mjabber1,2, Rim Alami1,2, Nada Filali3,4
1Radiation Oncology, Mohammed VI University of Health Sciences, Casablanca, MAR.
Cureus
|February 9, 2026
Summary
Li-Fraumeni syndrome (LFS) patients with TP53 variants face cancer risks. Radiotherapy use in LFS requires careful consideration due to potential risks and variable outcomes, but is not an absolute contraindication.
Area of Science:
- Oncology
- Genetics
- Radiation Oncology
Background:
- Li-Fraumeni syndrome (LFS) is an inherited cancer predisposition syndrome.
- Germline pathogenic variants in TP53 are the cause of LFS.
- TP53 mutations confer a high lifetime risk of malignancies, often at early ages.
Purpose of the Study:
- To review biological considerations of radiation exposure in TP53 mutation carriers.
- To summarize clinical experience with radiotherapy in Li-Fraumeni syndrome patients.
- To inform clinical decision-making regarding radiotherapy in LFS.
Main Methods:
- Narrative review of biological and clinical literature.
- Analysis of published retrospective clinical reports on radiotherapy in LFS.
- Synthesis of data on patient outcomes and potential late effects.
Main Results:
- Altered p53 function in LFS may affect cellular response to ionizing radiation.
- Clinical outcomes of radiotherapy in LFS patients are variable and largely retrospective.
- Reported outcomes include secondary malignancies and cases without complications.
Conclusions:
- Radiotherapy in Li-Fraumeni syndrome is not an absolute contraindication.
- Consider radiotherapy in selected cases after multidisciplinary discussion, balancing benefits and risks.
- Careful treatment planning and long-term follow-up are crucial when using radiotherapy in LFS.
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