T. Kisnanto et al.: Radioprotection 2025, 60( 3), 285 – 292 287 Fig. 1. PRISMA visualization for the current systematic review.
publications were screened using the PICO method( participants / patient, intervention, comparison, and outcome). PICO is a structured approach to formulating a clinical or research question. Experiments were conducted after taking into consideration the DNA damage response( DDR) evidenced by the rise in gamma-H2AX foci( C) in cancer patients( P) receiving radiopharmaceutical treatment( I) to measure individual radiosensitivity( O).
2.2 Eligibility and data analysis
This review implemented the PRISMA( Preferred Reporting Items for Systematic Reviews and Meta-Analyses) disclosure items flowchart, as shown in Figure 1. According to searches utilizing specified keywords, 43, 11, and 27 articles were found in each database( PMC, ScienceDirect, and Scopus). The Mendeley reference manager was then used to search for duplicate articles; when the duplicates were deleted, 81 articles existed. The title and abstract were then used to pick 49 appropriate articles, while 32 were rejected. Articles containing full text were examined for eligibility, resulting in six articles that could be continued in the final assessment. According to the inclusion criteria( Tab. 2), only two articles were worthy of processing and are described in Table 3.
2.3 AI tools usage statement
The author uses Assistive AI tools( Grammarly) to correct grammatical errors in this manuscript. In addition, Generative AI tools( QuillBot Premium) are employed to assist in paraphrasing and plagiarism detection.
3 Result and discussion
The PRISMA approach identified two suitable articles that matched the inclusion requirements. The research articles were Widjaja et al.( 2022), and Derlin et al.( 2021). These articles will be thoroughly explained utilizing the PICO method, outlined in Table 3.
Widjaja et al.( 2022) investigated 20 men, aged 72.1 ± 8.6, with metastatic castration-resistant prostate cancer( mCRPC) treated with 177Lu-prostate-specific membrane antigen( 177Lu-PSMA) radiopharmaceutical therapy. A DDR investigation was carried out on the patient’ s peripheral blood lymphocytes using immunocytofluorescence analysis. Blood samples were collected before, an hour after, and 24 hours after 177Lu-PSMA therapy. Before the first cycle of 177Lu-PSMA therapy, all patients had positron emission tomography( PET / CT scans) for measuring tumor PSMA expression( assessing the maximum standardized uptake value( SUVmax) of all tumor lesions). Following the second cycle, DDR markers( gamma-H2AX and 53BP1) were tested for prediction performance against clinical and PET-based indicators for prostate-specific antigen-progressing disease( PSA-PD). The predictive value for progression-free survival( PSA-PFS, expressed as median and 95 % confidence interval [ CI ]) was also investigated. The amount of DDR markers determined individual radiosensitivity in lymphocyte cells before and after the injection of 177Lu-PSMA therapy( Widjaja et al., 2022).
Furthermore, Derlin et al.( 2021) studied 21 patients with advanced gastroenteropancreatic neuroendocrine tumors( ten males and eleven females), with an average age of 64.3 ± 11.6 and a range of 41.0 – 84.9 years. The patients underwent PRRT with 7.4 GBq 177Lu-DOTA-TATE per cycle every 8 – 16