Molecular Radiobiology of Protons Compared to Other Low Linear Energy Transfer (LET) Radiation

Topic Information

Dear Colleagues,

Advanced radiation delivery systems offer significant benefits in cancer treatment; however, there is potential for harm to normal tissue. There is strong and growing interest in proton radiation due to its use in cancer treatment, its prominent role in space radiation exposure, and its ability to inflict a substantial portion of the biological damage caused by neutrons. Protons are a type of low linear energy transfer (LET) radiation, such as X-rays or electrons, that covers a wide energy range. However, at low energies near the Bragg peak (<5 MeV), they become high LET. High-energy protons (>50 MeV) generate copious amounts of secondary radiation, including neutrons and high-LET charged particles. In addition, there is growing interest in advanced radiation modalities, including ultra-high dose rate (FLASH) proton irradiation. There is significant overlap in the approaches used to elucidate molecular mechanisms in the areas of radiation cancer treatment as well as the risks in the diagnostic use of radiation and to radiation workers on Earth and in space. Research in these areas has seen substantial progress in recent years, and this Special Issue aims to provide a comprehensive overview of the biomolecular changes caused by proton radiation and comparisons with X-rays and other low LET radiation. We encourage the submission of original full research papers as well as review articles that present novel mechanistic insights, new techniques, experimental models, predictive theoretical models, and datasets.

Topics include, but are not limited to, the following:

• Comparisons of protons to X-rays and electrons of varying energies in cancer therapy and normal tissue damage;
• Initial and persistent DNA and reactive oxygen species (ROS) damage, damage processing, and aberrant signaling in cells and tissue;
• Creation of omics databases of proton effects;
• Use of artificial intelligence and machine learning in describing and comparing protons with other low LET radiation molecular changes related to health risks;
• Immune-proton therapy;
• Molecular changes causative of non-cancer effects such as cognitive impairments, cataracts, and circulatory disease risks following proton radiation exposure;
• FLASH proton irradiation;
• Molecular changes leading to health risks from solar particle events and cosmic rays.

Prof. Dr. Francis Cucinotta
Prof. Dr. Jacob Raber
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Biophysica biophysica	1.4	2.6	2021	15.7 Days	CHF 1200
Current Issues in Molecular Biology cimb	3.0	5.0	1999	16.3 Days	CHF 2200
Diagnostics diagnostics	3.3	6.9	2011	21.6 Days	CHF 2600
International Journal of Molecular Sciences ijms	4.9	10.0	2000	17.8 Days	CHF 2900
International Journal of Translational Medicine ijtm	-	2.8	2021	28.2 Days	CHF 1200

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22 pages, 3028 KB  

Open AccessArticle

Radiobiology-Guided VMAT Radiotherapy Optimization for Locally Advanced Cervical Cancer

by Ahlam Azalmad, Mehdi El Ouartiti, Mohamed Abour and Mohamed Hilal

Biophysica 2026, 6(1), 15; https://doi.org/10.3390/biophysica6010015 - 23 Feb 2026

Viewed by 626

Abstract

This retrospective planning study evaluated how arc number (AN) and control-point density (CP) affect VMAT quality, radiobiological endpoints, and workflow efficiency for locally advanced cervical cancer in a resource-conscious setting. Twenty-one patients (FIGO IIB–IIIB) were replanned in Monaco v5.51 (Monte Carlo) for 46 [...] Read more.

This retrospective planning study evaluated how arc number (AN) and control-point density (CP) affect VMAT quality, radiobiological endpoints, and workflow efficiency for locally advanced cervical cancer in a resource-conscious setting. Twenty-one patients (FIGO IIB–IIIB) were replanned in Monaco v5.51 (Monte Carlo) for 46 Gy using 6-MV beams (Elekta) with 1–4 coplanar arcs, and dual-arc plans were further analyzed using ≈250, 300, 350, and 400 CP per arc. Target coverage (D98/D95/V95/V98), conformity and homogeneity (CI, HI), and organs-at-risk (OARs) DVH metrics (including D2cc and Vx) were compared alongside monitor units, planning time, and delivery time. Increasing AN improved dose conformity and OAR sparing relative to single-arc plans, whereas increasing CP produced only modest dosimetric changes but substantially increased planning and treatment times. Radiobiological modeling using BED/EQD2 and EUD-based LKB NTCP indicated negligible bladder risk (<0.01%) and low rectal risk (<0.2%), but a higher small-bowel NTCP (~26%) driven by hotspot-sensitive descriptors; Niemierko TCP estimates were similar between leading dual-arc CP settings. Overall, a dual-arc strategy with ~250 CP per arc provided the most practical balance between plan quality, estimated biological effect, and deliverability. Full article

(This article belongs to the Topic Molecular Radiobiology of Protons Compared to Other Low Linear Energy Transfer (LET) Radiation)

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