To summarize the radiobiological properties that distinguish targeted radionuclide therapy (TRT) from external beam radiotherapy (EBRT) and describe their influence on DNA damage and cellular stress responses.
Approach:
Radiobiological Comparison: The review contrasts the characteristics of TRT and EBRT, focusing on differences in radiation delivery, dose rates, and biological responses.
Cellular Outcomes: It discusses key cellular outcomes such as apoptosis, senescence, and alternative cell death pathways in relation to dose rate kinetics and linear energy transfer (LET).
Key Findings:
TRT delivers continuous low dose rate radiation, leading to distinct biological stress profiles compared to EBRT.
The spatial dose distribution in TRT is heterogeneous, affecting DNA damage complexity and cellular responses.
High-LET α-particles produce clustered DNA damage, which is more likely to result in cytotoxic chromosomal aberrations.
Interpretation:
Limitations:
The review primarily focuses on tumor-intrinsic responses, potentially overlooking microenvironmental or systemic effects.
Conclusion:
Advancing the understanding of TRT-induced cellular responses is essential for refining treatment strategies and addressing the mechanistic gaps in current knowledge.
