{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:15:26Z","timestamp":1790284526989,"version":"4.1.0"},"reference-count":49,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["Indian J Med Res"],"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Radiotherapy for advanced cervical cancer (CaCx) often results in unintended genitourinary toxicities, notably bladder damage. Predicting such radiation-induced toxicity remains challenging. \u03b3-H2AX, a marker of DNA double-strand breaks (DSBs), offers promise as a predictive biomarker for radiosensitivity. This study aimed to evaluate \u03b3-H2AX foci kinetics in peripheral blood lymphocytes (PBLs) as a surrogate for DNA damage response and a predictor of bladder toxicity in CaCx patients undergoing pelvic radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, 43 FIGO stage IIIB CaCx patients were enrolled. Stage I (n=31) assessed \u03b3-H2AX induction post-CT simulation (2\u20136 mGy); Stage II (n=34) evaluated \u03b3-H2AX kinetics across three radiotherapy fractions (FR1, FR13, FR25) during external beam radiotherapy (50 Gy in 25 fractions \u00b1 cisplatin). Blood samples were collected at baseline, 1-, 4-, and 24-h post-irradiation. \u03b3-H2AX foci were quantified via flow cytometry. Bladder toxicity was graded usingRadiation Therapy Oncology Group (RTOG) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CT and radiotherapy both induced significant \u03b3-H2AX foci, peaking at 1 h. Patients without bladder toxicity showed higher foci induction and faster decay (1\u21924h: 48.9%\n                      <jats:italic>vs<\/jats:italic>\n                      . 39.4%; 1\u219224h: 43.6%\n                      <jats:italic>vs<\/jats:italic>\n                      . 12.8%) across all fractions. Persistent foci at 24 h correlated with increased toxicity risk, indicating deficient DNA repair capacity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation and conclusions<\/jats:title>\n                    <jats:p>\u03b3-H2AX foci kinetics effectively reflect in vivo DNA repair efficiency and predict radiation-induced bladder toxicity. This minimally invasive biomarker may guide personalized radiotherapy, enabling early identification of high-risk patients and potential use of radioprotectors or treatment modifications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/ijmr_1602_2025","type":"journal-article","created":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T16:26:07Z","timestamp":1772382367000},"page":"11-18","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dynamic \u03b3-H2AX response in blood lymphocytes for prediction of radiotherapy induced bladder toxicity in cervical cancer patients"],"prefix":"10.25259","volume":"163","author":[{"given":"Geofrey","family":"John","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, Maharashtra, 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