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Cancers 2017, 9(6), 66; doi:10.3390/cancers9060066

Carbon Ion Radiotherapy: A Review of Clinical Experiences and Preclinical Research, with an Emphasis on DNA Damage/Repair

Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
These authors contributed equally to this work.
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Author to whom correspondence should be addressed.
Academic Editor: Eddy Yang
Received: 8 April 2017 / Revised: 21 May 2017 / Accepted: 6 June 2017 / Published: 9 June 2017
(This article belongs to the Special Issue DNA Repair Pathways in Cancer)
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Abstract

Compared to conventional photon-based external beam radiation (PhXRT), carbon ion radiotherapy (CIRT) has superior dose distribution, higher linear energy transfer (LET), and a higher relative biological effectiveness (RBE). This enhanced RBE is driven by a unique DNA damage signature characterized by clustered lesions that overwhelm the DNA repair capacity of malignant cells. These physical and radiobiological characteristics imbue heavy ions with potent tumoricidal capacity, while having the potential for simultaneously maximally sparing normal tissues. Thus, CIRT could potentially be used to treat some of the most difficult to treat tumors, including those that are hypoxic, radio-resistant, or deep-seated. Clinical data, mostly from Japan and Germany, are promising, with favorable oncologic outcomes and acceptable toxicity. In this manuscript, we review the physical and biological rationales for CIRT, with an emphasis on DNA damage and repair, as well as providing a comprehensive overview of the translational and clinical data using CIRT. View Full-Text
Keywords: hadron therapy; radiation oncology; DNA repair; proton therapy; complex DNA damage; carbon therapy hadron therapy; radiation oncology; DNA repair; proton therapy; complex DNA damage; carbon therapy
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MDPI and ACS Style

Mohamad, O.; Sishc, B.J.; Saha, J.; Pompos, A.; Rahimi, A.; Story, M.D.; Davis, A.J.; Kim, D.N. Carbon Ion Radiotherapy: A Review of Clinical Experiences and Preclinical Research, with an Emphasis on DNA Damage/Repair. Cancers 2017, 9, 66.

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