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This exploratory study was designed to investigate the representations of radiotherapists in relation to personalized medicine. On the basis of current?>' available radiotherapy predictive tests, we tried to understand how these tests could be used in routine radiotherapy practice and in what way this possible change of practices could affect the role of radiotherapists in treatment protocols. In the absence of any available data allowing the construction of a quantitative tool, qualitative data were recorded by individual interviews with radiotherapists. Based on textual data analysis, a second national quantitative phase was conducted using a self-administered questionnaire. Crossover analysis of the two datasets highlighted the interest of radiotherapists in personalized medicine and the use of predictive tests, while indicating certain limitations and concerns in relation to ethical issues related to personalized medicine in oncology and the physician's position.

From Hiroshima bomb explosion data, the risk of radiation-induced cancer is significant from 100 mSv for a population considered as uniform and radioresistant. However, the recent radiobiological data bring some new elements that highlight some features that were not taken into account: the individual factor, the dose rate and the repeated dose effect. The objective evaluation of the cancer risk due to doses lower than 100 mSv is conditioned by high levels of measurability and statistical significance. However, it appears that methodological rigor is not systematically applied in all the papers. Furthermore, unclear communication in press often leads to some announcement effects, which does not improve the readability of the issue. This papers aims to better understand the complexity of the low-dose-specific phenomena as a whole, by confronting the recent biological data with epidemiological data., (Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

What more natural than a stress response that would vary among individuals? The individual factor has been pointed out in numerous medical research areas, was alluded to in the antiquity under the term "idiosyncrasy" and used by Claude Bernard in the 19th century. The idea that each individual shows a specific response to radiation, as he does for any stress, is well-accepted. However, the history of radiobiology shows that this idea has been neglected. Today, it comes back in the debates of personalized medicine and in the evaluation of the risks of adverse reactions post-radiotherapy and of developing cancers linked to medical exposures., (© 2013 médecine/sciences – Inserm / SRMS.)

To study the biological mechanisms of the repair of the radiation-induced DNA damage leads to two major medical applications: (1) the identification of the radiosensitive patients by using appropriate predictive assays in order to avoid toxicity due to radiation therapy and sometimes to chemotherapy; (2) the decrease of the radioresistance of tumour cells to obtain a better local control. To transpose fundamental biological knowledge from experimental in vitro clinic is delicate and sometimes too hasty, though necessary. In mechanistic terms, clinical features are once again a very rich and under-exploited approach to identify the molecular mechanisms of the DNA repair function. An exhaustive survey of the clinical cases of radiosensitivity with biological samples and with long course surveillance is an inverse approach, probably promising but still difficult to apply. Unlike classical reviews, this article attempts to identify the major genetic syndromes associated with radiosensitivity and cancer predisposition in order to deduce the different stages of major mechanisms of DNA double-strand breaks repair. Emphasis is placed on the importance of studying this repair at the functional level. Surprisingly, among the genetic syndromes associated to radiosensitivity there are some anomalies, not linked to DNA repair itself but to the intracellular trafficking. The repair function but therefore also the signalling are then logically therapeutic targets applicable in radiotherapy but with a very accurate ballistic sparing of the healthy tissues.

Individual response to ionizing radiation is an important information required to apply an efficient radiotherapy treatment against tumour and to avoid any adverse effects in normal tissues. In 1981, Fertil and Malaise have demonstrated that the post-irradiation local tumor control determined in vivo is correlated with clonogenic cell survival assessed in vitro. Furthermore, these authors have reminded the relevance of the concept of intrinsic radiosensitivity that is specific to each individual organ (Fertil and Malaise, 1981) [1]. To date, since clonogenicity assays are too time-consuming and do not provide any other molecular information, a plethora of research groups have attempted to determine the molecular bases of intrinsic radiosensitivity in order to propose reliable and faster predictive assays. To this aim, several approaches have been developed. Notably, the recent revolution in genomic and proteomic technologies is providing a considerable number of data but their link with radiosensitivity still remains to be elucidated. On another hand, the systematic screening of some candidate genes potentially involved in the radiation response is highlighting the complexity of the molecular and cellular mechanisms of DNA damage sensoring and signalling and shows that an abnormal radiation response is not necessarily due to the impairment of one single protein. Finally, more modest approaches consisting in focusing some specific functions of DNA repair seem to provide more reliable clues to predict over-acute reactions caused by radiotherapy. In this review, we endeavoured to analyse the contributions of these major approaches to predict human radiosensitivity., (Copyright © 2011 Académie des sciences. Published by Elsevier SAS. All rights reserved.)