title: Response of Fingernail Growth to Out-of-Field Low-Dose X ray in Cancer Patients Receiving Radiotherapy.
abstract: The entire body of a patient with cancer is exposed to low-dose levels of radiation (mGy) during radiation therapy. The safety and biological impact of such exposure to low-dose radiation on the human body are largely unknown. The fingernail is a highly proliferative tissue, and its growth can be monitored during radiation treatment to analyze early effects of low-dose radiation. The fingernails of 30 patients who received external beam radiotherapy (EBRT) were used in this study to investigate the change in nail growth during fractionated radiotherapy. Lead shields were applied to some fingers to create dose variance within individual patients. The absorbed dose was measured, and the relationship between the dose and change in nail growth rate was analyzed. Other factors, including serum albumin, hemoglobin level, body weight index, age, gender and chemotherapy, were also subjected to multivariate analysis. Fingernails from patients received an average of 0.96 mGy per treatment fraction. We observed a surprising decline in fingernail growth rate during radiotherapy, which was more prominent in the nonshielded fingernails with a relatively high-absorbed dose. Such growth delay could be observed as early as one week postirradiation and lasted the entire treatment course. Using fingernail growth as a novel marker for radioresponse, the current study showed that exposure to very low-dose ionizing radiation has previously unrecognized early effects on human tissue.
authors.affiliation: Department of a Radiation Oncology, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Shichuan
authors.initials: S
authors.lastname: Zhang
authors.affiliation: b Department of Intensive Care Unit, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Peng
authors.affiliation: e Sichuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Ling
authors.initials: L
authors.lastname: He
authors.affiliation: c Department of GCP Center, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Xudong
authors.initials: X
authors.lastname: Zhang
authors.affiliation: e Sichuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Yiying
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of a Radiation Oncology, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of a Radiation Oncology, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Jiabao
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of a Radiation Oncology, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of a Radiation Oncology, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of a Radiation Oncology, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wen
authors.affiliation: Department of a Radiation Oncology, University of Electronic Science and Technology of China, Chengdu, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
authors.affiliation: d Head and Neck Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; and.
authors.forename: Jinchuan
authors.initials: J
authors.lastname: Fan
mesh_terms: D065638:Absorption, Radiation; D000293:Adolescent; D000328:Adult; D000368:Aged; D001681:Biological Assay / Q000379:methods; D002648:Child; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000254:growth & development* / Q000528:radiation effects*; D009369:Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D000069079:Radiation Exposure / Q000032:analysis*; D011834:Radiation Monitoring / Q000379:methods; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D014965:X-Rays; D055815:Young Adult