MicroRNA changes in advanced radiotherapy techniques and its effect to secondary cancers

MicroRNAs (miRNAs) are a kind of RNA, produced copies of endogenous hairpin-shaped, are 21-25 nucleotide length, small, and single chain. Recent studies have revealed that hundreds of miRNAs are found in the human genome and are responsible for diverse cellular processes including the control of developmental timing, cell proliferation, apoptosis and tumorigenesis. miRNAs can activate the initiation of apoptosis, cessation of the cell cycle and aging in case of DNA damage by stimulating the tumor suppressor target gene p53 directly and indirectly. DNA damage is composed by multiple stress factors including ionizing radiation, reactive oxygen species, UV exposure and drugs like doxorubicin and camptothecin. Radiation is used widely in health, academic area, and industry for producing electricity. As a result of using radiation widely in different fields, environmental radiation exposure is increasing as well. Whereas high dose radiation exposure causes DNA damage and gives rise to ionization to molecules of living cells by accelerating malignant tumor formation. Fields receiving high dose radiation are evaluated in terms of adverse effects, therapeutic efficacy and secondary malignancies in radiotherapy applications. Dose distributions are re-created when it is required. On the other hand, fields received low dose and the doses that the patient is exposure in simulation and/or portal imaging are often overlooked. The changes in miRNA levels arising in low dose radiation field and its effect to neoplastic process in cell will be pathfinder in terms of secondary cancers or second primary cancers. It is shown that there are differences between the level changes of miRNA in low dose fields which are overlooked in daily practical applications because of not resulting with acute or chronic side effect and the level changes of miRNA in high dose fields. With the help of verifying so-called differences in low dose fields which are seen in advanced radiation techniques, radiation oncologists must be careful when using these techniques in childhood cancers and the patient group which have long overall survival period. Additionally, demonstrating the pathway which is influenced by miRNA changes can provide us the opportunity to focus on the exact cancer type which has to be followed. So that we can detect the secondary cancers earlier and can treat them with long expected survival period.