Journal of Radiation Research最新文献

{"title":"Comparative analysis of kVCT- and MVCT-guided helical tomotherapy for total body irradiation: evaluation of process times and residual setup errors.","authors":"Yuta Omi, Ryuichi Yada, Tatsuya Hasegawa, Ken Shishido, Keita Sakai, Tomotaka Kinoshita, Katsumasa Nakamura, Yoshiyuki Itoh, Arisa Takeuchi","doi":"10.1093/jrr/rraf062","DOIUrl":"https://doi.org/10.1093/jrr/rraf062","url":null,"abstract":"<p><p>Helical tomotherapy-based total body irradiation (TBI) traditionally employs megavoltage computed tomography (MVCT) for image-guided setup; however, its 390 mm field of view (FOV) and long acquisition times constrain workflow efficiency and whole-body alignment. This study evaluated whether a newly implemented whole-body fan-beam kilovoltage CT (kVCT; 500 mm FOV) can streamline this process. In a retrospective study involving 14 patients treated with a Radixact X9 system (September 2021-September 2023), we timed the patient setup, imaging, registration, re-setup, and beam delivery for each upper-body (UB) and lower-body (LB) segment. Residual setup errors were measured along the lateral, longitudinal, and vertical axes. The kVCT shortened the initial setup cycle (setup + imaging + registration) from 25.4 ± 4.6 to 15.9 ± 3.3 min for UB and from 14.5 ± 3.8 to 9.4 ± 2.4 min for LB (P < 0.001 for both). The total fraction time, including delivery time, decreased from 71.8 ± 7.5 to 56.7 ± 5.3 min. When residual errors exceeded 5 mm, the additional time required for a second cycle was nearly halved with kVCT (7.3 vs. 14.3 min for UB; 4.8 vs. 8.2 min for LB). The kVCT maintained mean absolute residual errors below 2 mm in all axes, and every 95th-percentile value remained within the 5 mm tolerance recommended for tomotherapy-based TBI. These time savings are expected to reduce intrafraction motion and staff workload. Overall, whole-body kVCT enables faster, comprehensive image guidance while preserving accuracy, thereby streamlining tomotherapy-based TBI and reducing the burden on patients and clinical staff.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric effect of internal error correction on pubic bones in image-guided passive scattering proton therapy for prostate cancer.","authors":"Kimihiro Takemasa, Takahiro Kato, Sho Sasaki, Yuki Narita, Tomohiro Ikeda, Shuta Ogawa, Sho Oyama, Masao Murakami","doi":"10.1093/jrr/rraf061","DOIUrl":"https://doi.org/10.1093/jrr/rraf061","url":null,"abstract":"<p><p>Image-guided passive scattering proton therapy (PSPT) has been widely adopted in Japan and worldwide, with substantial long-term clinical data supporting its efficacy in treating prostate cancer. However, as hypofractionated protocols become increasingly common, the impact of internal anatomical shifts on surrounding organs at risk (OARs) warrants renewed attention. The pubic bones, situated near the prostate, are often exposed to unintended high doses, especially during internal error correction based on fiducial marker alignment. This study retrospectively analyzed 30 patients with localized prostate cancer treated with PSPT using lateral opposed fields. Simulated isocenter shifts were applied anteriorly and inferiorly in 2-mm increments up to 10 mm to assess dose changes to the pubic bones. Dose-volume histogram metrics including V80%, V90% and V95% were evaluated. Pubic bones dose increased in both shift directions, with a more pronounced effect for anterior shifts, with a 10-mm anterior shift increasing V80% by 14.2 cc on average-2.4 times greater than inferior shifts. Dose elevation correlated strongly with the anatomical proximity between the clinical target volume and pubic bones (r > 0.66, P < 0.001). These results suggest that anterior correction in PSPT can cause substantial dose escalation to the pubic bones, potentially increasing the risk of insufficiency fractures. As extreme hypofractionation becomes more common, careful evaluation of pubic bones dose should be incorporated into treatment planning, alongside traditional OARs such as the rectum and bladder. Early replanning should be considered when persistent anterior displacement is observed to maintain patient safety and quality of life.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilize in-vivo offline PET/CT imaging to evaluate range deviations of implanted metal-clips in whole-breast proton radiotherapy.","authors":"Fuquan Zhang, Yongkuan Hao, Yan Lu, Jiayi Guo, Rong Zhou, Yinxiangzi Sheng, Jiangang Zhang, Qing Zhang, Jingfang Zhao, Jingyi Cheng","doi":"10.1093/jrr/rraf041","DOIUrl":"https://doi.org/10.1093/jrr/rraf041","url":null,"abstract":"<p><p>This study presented a quantitative analysis of the differences in the depths of the distal 50% of acquired and estimated positron emission tomography (PET) images for 18 patients who had a total of 109 titanium (Ti) metal-surgical clips implanted after breast-conserving surgery. Offline PET/computed tomography (PET/CT) images were acquired after proton irradiation. Hounsfield Unit modifications were applied to correct for metal artifacts induced by the Ti clips in the planning CT scans of the soft tissues surrounding the clips. The positron-emitting-isotope PET distribution was calculated through Range-Verification scripting. Quantitative analysis was conducted on the depth differences at the distal 50% R50 of the PET and the calculated PET distribution. Using the R50 method, the depth verification results of the clips and the normal tissues were compared. The R50 method calculates the positional difference at the half-maximum value 2 cm from the skin, with clips beyond this position not affecting the results. Analyses of the regions around the Ti clips were conducted. The depth difference for Ti < 2 cm (where the depth of the clips from the skin was <2 cm) was -1.63 ± 1.08 mm, while the corresponding normal tissue (Ticont) showed a depth difference of -1.79 ± 1.15 mm. There was no statistically significant difference in the depth differences between Ti < 2 cm and the corresponding Ticont. This study utilized offline PET verification to demonstrate that applying tissue corrections based on surgical clips and surrounding muscle tissues in clinical practice ensures that the presence of surgical clips does not compromise the precision of proton dose delivery at the surgical site.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxicity and patient-reported outcomes after moderately hypofractionated radiotherapy (60 Gy in 20 fractions) for prostate cancer: prospective observational study.","authors":"Koyo Kikuchi, Takafumi Segawa, Yoshiro Ieko, Hirobumi Oikawa, Ryuji Nakamura, Hisanori Ariga","doi":"10.1093/jrr/rraf059","DOIUrl":"https://doi.org/10.1093/jrr/rraf059","url":null,"abstract":"<p><p>We investigated toxicity and patient-reported outcomes in patients with localized prostate cancer treated with moderately hypofractionated radiotherapy, focusing on clinically meaningful deterioration assessed using the minimum clinically important difference (MCID) at 24 months. Between January 2019 and December 2021, 58 patients were prospectively enrolled at a single institution and received volumetric-modulated arc therapy and image-guided radiotherapy, delivering 60 Gy in 20 fractions. The median follow-up period was 48 months. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 5.0. Health-related quality of life (HR-QOL) was assessed at baseline and at 3, 6, 12, 24 and 36 months using the Short Form-8 Health Survey (SF-8) and the Expanded Prostate Cancer Index Composite (EPIC). Grade 2 acute gastrointestinal (GI) and genitourinary (GU) toxicities occurred in 0% and 5.2% of patients, respectively. Late Grade 2 GI and GU toxicities occurred in 1.7% and 6.9% of patients, respectively. No Grade ≥ 3 toxicities were reported. At 24 months, a ≥ 2 × MCID decline in SF-8 physical and mental component scores was observed in 12.2% (95% confidence interval [CI]: 3.2-21.2%) and 14.3% (95% CI: 4.5-24.1%), respectively. In the EPIC domains, ≥ 2 × MCID declines occurred in 23.8% (95% CI: 10.9-36.7%) for bowel and 8.5% (95% CI: 0.5-16.5%) for urinary summary scores. A 60 Gy regimen delivered in 20 fractions is feasible and well tolerated, with low toxicity and stable HR-QOL, although these preliminary findings are based on a limited observation period and sample size. Longer follow-up and larger studies are warranted.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of radiation-induced DNA damage repair-related genes as diagnostic biomarkers for radiation.","authors":"Qi Zhang, Yi Yu","doi":"10.1093/jrr/rraf057","DOIUrl":"https://doi.org/10.1093/jrr/rraf057","url":null,"abstract":"<p><p>Radiation exposure is a significant risk factor for various tumors and illnesses, with early-stage radiation dose closely linked to disease progression. Accurate assessment of radiation exposure is critical for effective treatment. This study aimed to identify radiation-induced DNA damage repair-related genes using weighted gene co-expression network analysis on datasets GSE90909 and GSE102971, supplemented by literature. A protein-protein interaction network was constructed to identify key genes, and their expression levels were compared between irradiated and control groups to evaluate diagnostic efficacy. Immune-related scores were calculated, and correlations between diagnostic genes and immune cells were analyzed. Regulatory networks involving transcription factors (TFs), microRNAs (miRNAs) and key genes were established, alongside gene interaction networks using GeneMANIA. A gene-drug interaction network was also developed. Five key genes-PCNA, REV3L, POLH, LIG1 and XPC-were identified, all significantly overexpressed in irradiated populations. These genes demonstrated strong diagnostic capability for radiation exposure and were positively correlated with radiation dose. Their expression levels were also closely associated with immune cell infiltration, including natural killer cells, plasma cell-like dendritic cells and regulatory T cells. Key regulatory interactions involved TFs (E2F1, TP53) and miRNAs (miR-145, miR-143), while associated genes included FEN1, REV1 and CDKN1A. Drugs linked to these genes included Quercetin and Hydroxyurea. In conclusion, the study identified five key genes with diagnostic potential for radiation exposure, positively correlated with radiation dose. These findings provide a foundation for radiation diagnosis and dose assessment, particularly in populations with later-stage diseases.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External radiation dose reconstruction for settlements near the Semipalatinsk nuclear test site, Kazakhstan, in the international multicenter study: a detailed review and comparative analysis of the initial data.","authors":"Valeriy Stepanenko, Sergey Shinkarev, Alexandra Lipikhina, Kazbek Apsalikov, Andrey Kaprin, Sergey Ivanov, Peter Shegay, Evgenia Ostroumova, Viktoria Bogacheva, Yuliya Brait, Kassym Zhumadilov, Masayoshi Yamamoto, Aya Sakaguchi, Satoru Endo, Nariaki Fujimoto, Bernd Grosche, Vladimir Iatsenko, Alla Androsova, Noriyuki Kawano, Masaharu Hoshi","doi":"10.1093/jrr/rraf049","DOIUrl":"10.1093/jrr/rraf049","url":null,"abstract":"<p><p>Studies on health effects of radiation exposure to residents around the Semipalatinsk nuclear test site (SNTS), Kazakhstan, are necessary for epidemiological assessment of radiation-related health risks after low-dose irradiation. Radiation dose estimates are the principal point for radiation epidemiological studies. These estimates should be based on the most reliable initial data, used for dose estimations. The comparative critical analysis of various available archival and published initial data, namely values of historical exposure dose rates and values of soil contamination by 137Cs in considered settlements, including information about dates, times and locations of measurements, was performed with the aim to select most reliable and realistic initial data necessary for estimation of settlement-average accumulated external doses for some settlements located in the vicinity of radioactive clouds' trajectories related to the most significant tests at the SNTS. Results of estimation of accumulated external radiation dose to air, based on these selected initial data, are presented for 18 settlements. Calculated accumulated external doses were compared with retrospective instrumental dose estimates for settlements, where data on TL/OSL luminescence retrospective dosimetry with quartz-containing samples or electron spin resonance (ESR) dosimetry with tooth enamel were available. Estimation of settlement-average external radiation dose to air is the first important step necessary for the next step-individualized radiation dose estimations among different age, professional and ethnic-specific groups of population lived in the study settlements considering behavior, shielding, location and relocation factors in each population group. This is a subject of future work.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"496-508"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of cardiac toxicity after definitive radiation therapy for thoracic esophageal cancer in Japanese patients.","authors":"Keita Tsukahara, Takanori Abe, Satoshi Saito, Takumi Sakaguchi, Jun Watanabe, Misaki Iino, Tomomi Aoshika, Yasuhiro Ryuno, Genta Michimata, Tomohiro Ohta, Mitsunobu Igari, Ryuta Hirai, Yu Kumazaki, Shin-Ei Noda, Shingo Kato, Yutaka Miyawaki, Hiroshi Sato","doi":"10.1093/jrr/rraf056","DOIUrl":"https://doi.org/10.1093/jrr/rraf056","url":null,"abstract":"<p><p>In recent years, there has been growing interest in cardiac toxicity following radiation therapy (RT) for esophageal cancer; however, detailed incidence and risk factors in Japanese patients remain unclear. The purpose of this study was to clarify the incidence, timing, risk factors, and dose-volume relationships of multiple cardiac toxicities, including pericardial effusion, heart failure, arrhythmia, cardiac valve disease and acute coronary syndrome. We retrospectively analyzed patients of thoracic esophageal cancer without distant metastasis who were treated with curative RT at our hospital between 2007 and 2020. Cardiac toxicity events were graded according to common terminology criteria for adverse events v5.0. Association between cardiac dose-volume parameters and grade 2 or higher toxicity was analyzed using logistic regression analysis. The analysis included 250 patients, with a median follow-up period of 21 months. The 2-year cumulative incidence of grade 2 or higher pericardial effusion, heart failure, arrhythmia, and acute coronary syndrome were 36.6%, 0.4%, 1.4%, and 1.3%, respectively. Logistic regression analysis identified the volume of the whole heart receiving 30Gy as a significant risk factor for grade 2 pericardial effusion (OR, 1.03; 95% confidence interval [CI], 1.01-1.04; P < 0.01) and grade 2 arrhythmia (OR, 1.10; 95%CI, 1.02-1.18; P = 0.01). We reported detailed profile of cardiac toxicity in Japanese patients who received curative RT for esophageal cancer. Reducing cardiac radiation dose may reduce the risk of pericardial effusion and arrhythmia.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prior exposure to microplastics heightened the susceptibility of small intestine to radiation-induced injury in C57BL/6 mice.","authors":"Jing Xu, Zhixing He","doi":"10.1093/jrr/rraf046","DOIUrl":"10.1093/jrr/rraf046","url":null,"abstract":"<p><p>Microplastics (MPs) have been detected in multiple human organs, raising concerns about their potential health risks. The intestinal tract is particularly vulnerable to MPs exposure and accumulation. Radiotherapy often causes side effects such as radiation-induced intestinal injury (RIII). Although previous studies have shown that MPs exacerbate RIII by altering gut microbiota, their effect on the small intestine's intrinsic sensitivity to radiation remains unclear. In this study, C57BL/6 mice were preexposed to MPs for a short period and then irradiated with 4 or 10 Gy to evaluate intestinal injury. Proteomic analysis of small intestine was performed to identify changes in protein expression. Short-term MPs exposure alone caused minimal intestinal damage. While 4 Gy irradiation did not cause significant intestinal injury, 10 Gy irradiation induced pronounced inflammation, increased epithelial apoptosis, and disrupted villus and lamina propria architecture. Importantly, the mice preexposed to MPs exhibited significantly increased sensitivity to RIII. Furthermore, prior MPs exposure significantly exacerbated RIII at 4 Gy but had no obvious influence on RIII at 10 Gy in C57BL/6 mice. The reason might be that the severe radiation-induced injury caused by 10 Gy could obscure the additional effects of prior MPs exposure. Proteomic analysis implicated the 'PI3K-Akt signaling' pathway as a key mediator of this effect. Indeed, treatment with a PI3K inhibitor could attenuate the MPs-driven susceptibility of small intestine to radiation. These findings underscore the need to minimize MPs exposure in patients undergoing radiotherapy.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"473-485"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical report on the first clinical use of a bioabsorbable PGA spacer in HDR brachytherapy for recurrent cervical cancer.","authors":"Kae Okuma, Tomomichi Kiyomatsu, Hirotoshi Takiyama, Akane Yoshiba, Koji Inaba, Tairo Kashihara, Kana Takahashi, Madoka Sakuramachi, Ayaka Nagao, Hiroshi Igaki","doi":"10.1093/jrr/rraf053","DOIUrl":"10.1093/jrr/rraf053","url":null,"abstract":"<p><p>In recurrent gynecologic malignancies following prior pelvic irradiation, definitive radiation therapy is often precluded by cumulative dose constraints to adjacent organs at risk (OARs), and patients may be left with only highly invasive surgical options such as total pelvic exenteration. While some institutions have explored displacement techniques such as artificial ascites or hyaluronic acid gel injection, these approaches are not widely adopted and frequently fail to ensure consistent and stable separation of OARs. We report the first clinical use of Neskeep®, a bioabsorbable polyglycolic acid (PGA) spacer, in high-dose-rate (HDR) brachytherapy for recurrent cervical cancer after prior pelvic radiation. A woman in her 40s with prior hysterectomy and HDR brachytherapy for cervical intraepithelial neoplasia grade III developed vaginal stump recurrence 4 years later. Laparoscopic placement of the PGA spacer was performed to achieve durable displacement of the small bowel, followed by eight fractions of HDR brachytherapy. Hyaluronic acid gel was also injected during each fraction to displace the bladder and rectum. The spacer maintained position and volume throughout treatment without complications. Dose-volume analysis showed a marked reduction in small bowel D₂cc (mean equivalent dose in 2 Gy fractions (EQD₂): 121.6 cGy) compared to the initial treatment (606.0 cGy), while the spacer itself received a mean D₂cc of 690.3 cGy. MRI confirmed complete response at 2 months, with no adverse events observed at that time point. The PGA spacer enabled safe, curative reirradiation in a case that would otherwise be unsuitable for further radiation therapy.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"570-577"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in understanding of radiation-induced skin tissue reactions with respect to acute tissue injury and late adverse effect.","authors":"Keiko Iwashita, Keiji Suzuki, Mitsuaki Ojima","doi":"10.1093/jrr/rraf052","DOIUrl":"10.1093/jrr/rraf052","url":null,"abstract":"<p><p>Skin is a tissue vulnerable to radiation exposure, which causes acute tissue reactions, including erythema, edema, desquamation, ulceration and late effects, such as skin cancers. As the effects of radiation exposure on the skin tissue are easily evaluated by visual examination, much information on radiation-induced skin reactions has been available from the clinical observation of people exposed to ionizing radiation, such as cancer patients receiving radiotherapy, although the mechanisms underlying skin reactions have not yet been fully understood. Recent advances in tissue biology at the molecular level have provided insights into the mechanisms of skin tissue reactions from the stem cell points of view. For example, our understanding of epidermal regeneration by epidermal stem cells as well as cells from the bulge in humans and the sebaceous gland in mouse, descriptions of the role of skin immune cells on inflammatory response and maintenance of genome integrity by epidermal stem cell competition, have greatly improved in the last decade with the identification of several key molecules. Thus, this review will provide an overview of the current status toward the comprehensive understanding of the mechanisms of adverse skin tissue reactions, with respect to mitigation of acute skin injuries as well as late carcinogenesis in response to ionizing radiation. In particular, the pleiotropic features of various types of cells consisting of skin tissue and their roles in securing skin functional homeostasis will be discussed.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"437-450"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}