Editing Radiation therapy (section)

==== Estimation of dose based on target sensitivity ====
Different cancer types have different radiation sensitivity. While predicting the sensitivity based on genomic or proteomic analyses of biopsy samples has proven challenging,<ref>{{cite journal | vauthors = Scott JG, Berglund A, Schell MJ, Mihaylov I, Fulp WJ, Yue B, Welsh E, Caudell JJ, Ahmed K, Strom TS, Mellon E, Venkat P, Johnstone P, Foekens J, Lee J, Moros E, Dalton WS, Eschrich SA, McLeod H, Harrison LB, Torres-Roca JF | display-authors = 6 | title = A genome-based model for adjusting radiotherapy dose (GARD): a retrospective, cohort-based study | journal = The Lancet. Oncology | volume = 18 | issue = 2 | pages = 202–211 | date = February 2017 | pmid = 27993569 | pmc = 7771305 | doi = 10.1016/S1470-2045(16)30648-9 }}</ref><ref>{{cite journal | vauthors = Lacombe J, Azria D, Mange A, Solassol J | title = Proteomic approaches to identify biomarkers predictive of radiotherapy outcomes | journal = Expert Review of Proteomics | volume = 10 | issue = 1 | pages = 33–42 | date = February 2013 | pmid = 23414358 | doi = 10.1586/epr.12.68 | s2cid = 39888421 }}</ref> the predictions of radiation effect on individual patients from genomic signatures of intrinsic cellular radiosensitivity have been shown to associate with clinical outcome.<ref>{{cite journal | vauthors = Scott JG, Sedor G, Ellsworth P, Scarborough JA, Ahmed KA, Oliver DE, Eschrich SA, Kattan MW, Torres-Roca JF | display-authors = 6 | title = Pan-cancer prediction of radiotherapy benefit using genomic-adjusted radiation dose (GARD): a cohort-based pooled analysis | journal = The Lancet. Oncology | volume = 22 | issue = 9 | pages = 1221–1229 | date = September 2021 | pmid = 34363761 | doi = 10.1016/S1470-2045(21)00347-8 }}</ref> An alternative approach to genomics and proteomics was offered by the discovery that [[History of Radiation Protection|radiation protection]] in microbes is offered by non-enzymatic complexes of [[manganese]] and small organic metabolites.<ref>{{cite journal | vauthors = Daly MJ | title = A new perspective on radiation resistance based on Deinococcus radiodurans | journal = Nature Reviews. Microbiology | volume = 7 | issue = 3 | pages = 237–245 | date = March 2009 | pmid = 19172147 | doi = 10.1038/nrmicro2073 | s2cid = 17787568 }}</ref> The content and variation of manganese (measurable by electron paramagnetic resonance) were found to be good predictors of [[radiosensitivity]], and this finding extends also to human cells.<ref>{{cite journal | vauthors = Sharma A, Gaidamakova EK, Grichenko O, Matrosova VY, Hoeke V, Klimenkova P, Conze IH, Volpe RP, Tkavc R, Gostinčar C, Gunde-Cimerman N, DiRuggiero J, Shuryak I, Ozarowski A, Hoffman BM, Daly MJ | display-authors = 6 | title = Across the tree of life, radiation resistance is governed by antioxidant Mn<sup>2+</sup>, gauged by paramagnetic resonance | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 114 | issue = 44 | pages = E9253–E9260 | date = October 2017 | pmid = 29042516 | pmc = 5676931 | doi = 10.1073/pnas.1713608114 | bibcode = 2017PNAS..114E9253S | doi-access = free }}</ref> An association was confirmed between total cellular manganese contents and their variation, and clinically inferred radioresponsiveness in different tumor cells, a finding that may be useful for more precise radiodosages and improved treatment of cancer patients.<ref>{{cite journal | vauthors = Doble PA, Miklos GL | title = Distributions of manganese in diverse human cancers provide insights into tumour radioresistance | journal = Metallomics | volume = 10 | issue = 9 | pages = 1191–1210 | date = September 2018 | pmid = 30027971 | doi = 10.1039/c8mt00110c | doi-access = free | hdl = 10453/128630 | hdl-access = free }}</ref>