Compromized DNA repair as a basis for identification of cancer radiotherapy patients with extreme radiosensitivity

作者：Lobachevsky, Pavel; Leong, Trevor; Daly, Patricia; Smith, Jai; Best, Nickala; Tomaszewski, Jonathan; Thompson, Ella R.; Li, Na; Campbell, Ian G.; Martin, Roger F.; Martin, Olga A.^*

来源：Cancer Letters, 2016, 383(2): 212-219.

DOI：10.1016/j.canlet.2016.09.010

• Radiation therapy
• Radiosensitivity
• Predictive assays
• DNA repair
• gamma-H2AX
• Statistical criteria

A small percentage of cancer radiotherapy patients develop abnormally severe side effects as a consequence of intrinsic radiosensitivity. We analysed the gamma-H2AX response to ex-vivo irradiation of peripheral blood lymphocytes (PBL) and plucked eyebrow hair follicles from 16 patients who developed severe late radiation toxicity following radiotherapy, and 12 matched control patients. Longer retention of the gamma-H2AX signal and lower colocalization efficiency of repair factors in over-responding patients confirmed that DNA repair in these individuals was compromised. Five of the radiosensitive patients harboured LoF mutations in DNA repair genes. An extensive range of quantitative parameters of the gamma-H2AX response were studied with the objective to establish a predictor for radiosensitivity status. The most powerful predictor was the combination of the fraction of the unrepairable component of gamma-H2AX foci and repair rate in PBL, both derived from non-linear regression analysis of foci repair kinetics. We introduce a visual representation of radiosensitivity status that allocates a position for each patient on a two-dimensional "radiosensitivity map". This analytical approach provides the basis for larger prospective studies to further refine the algorithm, ultimately to triage capability.

• 出版日期2016-12-28
• 单位华中科技大学