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Increase in dislocation loop density was shown to provide the dominant contribution to radiation hardening at the late irradiation stages (after reaching double the design end-of-life neutron fluence of ∼4 × 1024 n m−2).
However, of the 9 patients who received inguinal radiotherapy with a follow-up of 5 years there was no incidence of late irradiation toxicity.
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Radiation-induced sarcoma is a rare late complication of irradiation, which develops after a latency period of about 10 years in the previous irradiation field.
Also, preoperative irradiation seems to offer lesser late radiation morbidity by diminished fibrosis, joint stiffness and edema [ 41].
In contrast, death receptor genes (FAS and TNFRSF10B), as well as Bcl-2 family proapoptosis genes (BAX and MAGED1, as inhibitors of the IAP family members), were upregulated early or late after irradiation.
When analyzing miRNA expression, we found 177 miRNAs that were significantly regulated in the late post-irradiation phase.
Otherwise in a study on 223 patients treated with chemoradiation sparing inguinal fields, Papillon and Montbarbon (1987) found metachronous inguinal MTS in only 7.4% of cases over a follow-up period of >3 years; and in a more recent study on 270 patients treated without elective inguinal irradiation, late inguinal MTS were diagnosed in 7.8% of patients (Gerard et al, 2001).
Furthermore, reduced single doses of treatment might contribute to protect androgen-producing Leydig cells from late sequelae of irradiation.
In summary, we can conclude that NHEJ is responsible for the misrejoining of DSBs in pluripotent stem cells at the late G2 after irradiation.
The aims of our study were to quantify acute side effects as well as late toxicity of irradiation, and to identify the pattern of recurrences after treatment in order to optimise radiotherapy portal definition.
Based on cohort studies of long-term mortality and risk estimation models for the induction of secondary cancers following radiotherapy at least 15 20 years follow-up will be required to fully assess whether there is an increased long-term treatment induced cancer risk (Dasu et al, 2005; Darby et al, 2005) and subtle late toxicity from irradiation in BRCA1 mutation carriers.
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