Modelling oxygen effects on the in- and out-of-field radiosensitivity of cells exposed to intensity-modulated radiation fields

Matsuya, Yusuke  ; McMahon, S. J.*; Butterworth, K. T.*; Yachi, Yoshie*; Saga, Ryo*; Sato, Tatsuhiko   ; Prise, K. M.*

Hypoxia induces radioresistance in tumors, leading to malignant progression in intensity-modulated radiation therapy. To date, it has been shown that intercellular signalling between cells positioned inside and outside radiation field impacts on cellular radiosensitivity under hypoxia and normoxia. However, the mechanistic role of intercellular communication in hypoxia remains to be fully understood. In this study, we modelled the cell-killing effects of intercellular signalling in hypoxia to better understand the underlying mechanisms of response. We used the oxygen enhancement ratio (OER) given from early DSB yields and modelled the in- and out-of-field radiosensitivity. As a result, the model analysis provides an mechanistical interpretation that the probability of hits for releasing cell-killing signals is dependent on oxygen. Our data also suggested that the field-type independent OER value, which can be given by uniform-field exposure, can be applied when predicting both in- and out-of-field radiosensitivity. These results would contribute to more precise understanding of intercellular signalling under heterogeneous exposure to intensity-modulated radiation fields.