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Background and purpose To investigate the cytogenetic damage in blood lymphocytes of patients treated for prostate cancer with different radiation qualities and target volumes. Materials and methods Twenty patients receiving carbon-ion boost irradiation followed by IMRT or IMRT alone for the treatment of prostate cancer entered the study. Cytogenetic damage induced in peripheral blood lymphocytes of these patients was investigated at different times during the radiotherapy course using Giemsa staining and mFISH. A blood sample from each patient was taken before initiation of radiation therapy and irradiated in vitro to test for individual radiosensitivity. In addition, in vitro dose–effect curves for the induction of chromosomal exchanges by X-rays and carbon ions of different energies were measured. Results The yield of chromosome aberrations increased during the therapy course, and the frequency was lower in patients irradiated with carbon ions as compared to patients treated with IMRT with similar target volumes. A higher frequency of aberrations was measured by increasing the target volume. In vitro , high-LET carbon ions were more effective than X-rays in inducing aberrations and yielded a higher fraction of complex exchanges. The yield of complex aberrations observed in vivo was very low. Conclusion The investigation showed no higher aberration yield induced by treatment with a carbon-ion boost. In contrast, the reduced integral dose to the normal tissue is reflected in a lower chromosomal aberration yield when a carbon-ion boost is used instead of IMRT alone. No cytogenetic "signature" of exposure to densely ionizing carbon ions could be detected in vivo .

Summary The premature chromosome condensation (PCC) technique has been used to compare chromatin breakage and repair in non-cycling CHO-K1 cells following high LET (C ions) and low LET (X-rays) irradiation. For both radiation qualities the average initial number of excess PCC fragments increases linearly with dose. However, the frequency of chromatin breaks follows the pattern of energy deposition and at higher LET values reveals clustering due to the large number of ionizing events being concentrated in a small volume of the cell nucleus. In consequence, the distribution of PCC chromosomes plus excess fragments among cells has followed Poisson statistics after X-ray irradiation while the overdispersion of the frequencies has been observed after C-irradiation indicating that a single particle traversal through a cell nucleus can produce multiple chromatin lesions.