Radioprotection 2024 , 59 ( 4 ), 287 – 295 © J . Yan and D . Li , Published by EDP Sciences , 2024 https :// doi . org / 10.1051 / radiopro / 2024032
Available online at : https :// www . radioprotection . org /
ARTICLE
Protection during radiotherapy : selenium
J . Yan and D . Li *
Department of Nuclear Medicine , Sun Yat-sen Memorial Hospital , Sun Yat-sen University , 510289 Guangzhou , People ’ s Republic of China . Received : 16 May 2024 / Accepted : 2 August 2024
Abstract – The multifaceted applications of nuclear technology , especially in cancer treatment through radiotherapy , bring considerable benefits to our daily lives but also necessitate the imperative for effective strategies to effectively mitigate radiation-induced issues . While strict compliance with usage specifications is essential , ensuring proper protection against radiation-induced damages is crucial . Selenium , in its various forms including selenomethionine , Ebselen , and sodium selenite , emerges as a promising radioprotective agent with demonstrated efficacy across diverse radiation-injured organs , highlighting its significance as an effective and potent antioxidant that affordable for most patients . Abundant experiments have exhibited the capacity of selenium-containing compounds and metabolites to function as valuable radioprotective adjuvants , emphasizing their potential in safeguarding against the adverse effects of radiation exposure . To harness the full radioprotective potential of selenium , further research is needed to optimize selenium supplementation strategies , taking into account factors such as timing and dosage , particularly in the context of radiotherapy .
Keywords : Radioprotection / radiotherapy / selenium / Ebselen / sodium selenite
1 Introduction
With the evolution of society , nuclear technology has found applications in various fields including medicine , the military and nuclear power instead of one terminology . This transition from a singular application to a multifaceted usage has spurred significant progress across all walks of life . Despite the strides made and given that nuclear energy itself is still considered risky in condition of inadequate compliance of instructions , we could never underestimate its detriments . Nowadays , with the escalating global incidence of cancer worldwide , radiotherapy ( RT ) is introduced to cancer patients during their treatment more often , thus the likelihood of radiation damage ensue . The problems stemming from radiation have garnered heightened attention , making the prevention and treatment of the radiation-induced damage become a hot topic of discussion ( Arnold , 2022 ).
In addition to being directly acting on DNA , ionizing radiation ( IR ) also leads to superfluous production of reactive oxygen species ( ROS ), such as hydroxyl radicals , singlet oxygen , and hydrogen peroxide , which , in turn , causes damage to pivotal cellular contents including DNA , RNA , proteins and lipids , leading to necrosis and apoptosis , ultimately resulting in cell death . Approximately two-thirds of radiation-induced damage attributes to ROS , which continues to be generated post-irradiation ( Brown et al ., 2010 ).
* Corresponding author : lidan269 @ mail . sysu . edu . cn
Radiotherapy is now commonly used in the realm of cancer treatment , with roughly half of cancer patients undergoing this procedure . Higher doses of radiation within a reasonable range are frequently needed to maximize the eradication of cancer cells in the irradiated area , but high doses of RT may cause severe toxicity in adjacent tissues and organs ( De Ruysscher et al ., 2019 ). Biological effects caused by radiation exposure could be divided into two categories according to the dose of radiation : relatively higher dose of radiation could cause acute radiation syndrome and the following delayed effect of acute radiation exposure , while lower dose of radiation is inclined to chronic radiation injury ( Ray et al ., 2014 ). Receiving highdose (> 2 Gy ) total-body irradiation ( TBI ) in a relatively short time may lead to acute radiation syndrome ( ARS ), which represents a collection of symptoms such as nausea , vomiting , fatigue , fever , diarrhea and seizures . And these symptoms typically manifest with minutes to weeks after the exposure . While the injury lingers , placing survivors of ARS at risk of delayed effect of acute radiation exposure ( DEARE ), which occurs months to years after radiation exposure and may cause a range of chronic illness , such as injury in pulmonary tissue , hepatic tissue , kidney tissue , cardiovascular tissue , reproductive tissue and oral cavity as well as salivary glands , giving rise to corresponding symptoms ( Dainiak et al ., 2011 ; DiCarlo et al ., 2011 ; Gasperetti et al ., 2021 ; Wu and Orschell , 2023 ). Chronic radiation injuries may elevate the risk of cardiac toxicity , cognitive impairment , reproductive disorders , deformity and impairments to bone and teeth growth , hair loss and secondary malignancy , genetic mutations and carcinogenesis .
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