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Immunofluorescence was performed at 6 hours for \u03b3\u2010H2AX (DNA damage marker), RAD51 (DNA repair protein), and p21 (cell cycle arrest protein). Viability assays were performed at 96 hours, and capillary Western blotting was utilized to determine RAD51 expression in na\u00efve VS tumors (n = 5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>VS tumors expressed RAD51. In cultured VS cells, radiation initiated dose\u2010dependent increases in \u03b3\u2010H2AX and p21 expression. VS cells upregulated RAD51 to repair DNA damage following radiation. Addition of RI\u20101 reduced RAD51 expression in a dose\u2010dependent manner and was associated with increased \u03b3\u2010H2AX levels and decreased viability in a majority of cultured VS tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VS may evade radiation injury by entering cell cycle arrest and upregulating RAD51\u2010dependent repair of radiation\u2010induced double\u2010stranded breaks in DNA. Although there was variability in responses among individual primary VS cells, RAD51\u00a0inhibition with RI\u20101 reduced RAD51\u2010dependent DNA repair to enhance radiation toxicity in VS cells. Further investigations are warranted to understand the mechanisms of radiation resistance in VS and determine whether RI\u20101 is an effective radiosensitizer in patients with VS.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998221083506","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T12:04:27Z","timestamp":1646136267000},"page":"860-868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["RAD51 Inhibitor and Radiation Toxicity in Vestibular Schwannoma"],"prefix":"10.1002","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1205-2209","authenticated-orcid":false,"given":"Torin P.","family":"Thielhelm","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Miller School of Medicine University of Miami Miami Florida 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