Radiobiological effects of flattening filter and flattening filter free radiotherapy x-ray on inflammatory and apoptotic pathways in cardiac and pulmonary tissues in an MCF-7 xenograft breast cancer model

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ID: 320081
2026
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Abstract
This study investigated early inflammatory and apoptotic molecular responses in heart and lung tissues following flattening filter (FF) and flattening filter-free (FFF) radiotherapy in a murine MCF-7 xenograft breast cancer model. Mice received a single 20 Gy fraction in FF (400 MU/min) or FFF (1820 MU/min) mode, and cardiopulmonary tissues were analyzed 48 h post-irradiation. Gene expression of Tnf, Il1b, Nfkb and p53 was assessed by RT-qPCR, while NF-κB p65 activation and caspase-3-mediated apoptosis were evaluated by western blot. Both irradiation modalities significantly increased inflammatory cytokine expression and NF-κB signaling compared with controls (P < 0.05), with consistently stronger responses following FFF irradiation. Lung p53 expression increased progressively across tumor-bearing and irradiated groups, indicating enhanced DNA damage signaling, while elevated cleaved caspase-3 levels reflected apoptotic activation, particularly in irradiated groups. Overall, high-dose-rate FFF radiotherapy elicits more pronounced early inflammatory and apoptotic responses in non-target heart and lung tissues than conventional FF delivery, highlighting the importance of incorporating normal tissue radiobiological effects into high-dose-rate radiotherapy strategies.
Reference Key
openalex_W7167643965 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Fatih Hacimustafaoğlu, Serhat Aras, Yalçın Erzurumlu, Burcu Çaykara
Journal journal of radiation research
Year 2026
DOI
10.1093/jrr/rrag046
URL
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