Introduction: Ionizing radiation is present in nature and is widely used in medicine, industry, and research. Its primary target in the cell is deoxyribonucleic acid, where it can
induce various types of damage, most commonly single- and double-strand breaks. The extent of damage depends on the type of radiation, dose and dose rate. Understanding these
processes is essential for explaining the biological effects of radiation and ensuring its safe use in medicine, especially in radiotherapy. Purpose: The purpose of this thesis was to investigate, through a systematic literature review, the effects of ionizing radiation on deoxyribonucleic acid and to analyze the mechanisms of damage formation and the cellular response to it. Particular emphasis was placed on the influence of different radiation types, dose and dose rate, as well as differences in response between healthy and tumor cells. Methods: The methodological approach was based on a descriptive method using a systematic literature review. The literature was obtained from the databases PubMed, ScienceDirect, SAGE Journals, and Google Scholar. Primarily, articles published in English after 2021 and available in full text were included. After stepwise filtering and reviewing titles, abstracts, and full texts, a total of 18 scientific articles were included in the final analysis. Results: The results show that different types of ionizing radiation significantly influence the extent and complexity of damage to deoxyribonucleic acid, with high linear energy transfer radiation causing more complex and less repairable damage compared to low linear energy transfer radiation. Dose and dose rate also play an important role, as they affect the frequency of damage and the efficiency of repair mechanisms. Differences were also observed between healthy and tumor cells, with tumor cells often exhibiting altered repair
pathways and increased genomic instability. Discussion and conclusion: The findings emphasize the importance of understanding the mechanisms of deoxyribonucleic acid damage formation and repair for the safe and effective use of ionizing radiation in medicine. Knowledge of differences in the response of healthy and tumor cells may contribute to the improvement of radiotherapy approaches and the reduction of damage to healthy tissues. Further research is needed to gain a deeper understanding of cellular responses to radiation and to optimize therapeutic strategies.
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