REVIEW article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1618270
This article is part of the Research TopicAdvancing Radioprotection: Mechanisms, Interventions, and Therapeutic StrategiesView all articles
Potential Effect of FLASH Radiotherapy on Testicular Damage: A Review of Current Evidence
Provisionally accepted
- People's Liberation Army General Hospital, Beijing, China
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Radiotherapy is a major source of ionizing radiation that adversely affects the male reproductive system. FLASH radiotherapy (FLASH-RT), a novel technique delivering ultra-high dose rate (UHDR) radiation, has shown promise in reducing normal tissue damage while maintaining antitumor efficacy—a phenomenon known as the "FLASH effect". Male fertility depends on the coordinated function of spermatogenic, Sertoli, and Leydig cells in the testes, which display differential sensitivity to radiation exposure. Due to ethical limitations in human studies, rodent models are indispensable for exploring radiation-induced testicular injury. This review summarizes current evidence of the FLASH effect across rodent organs and the impact of ionizing radiation at different dose rates on testicular cells. Given the current lack of direct evidence for the FLASH effect in testicular tissue, it also reviews mechanisms observed in other organs that may contribute to its potential protective role in the testes. A deeper understanding of these mechanisms could inform fertility-preserving strategies in male cancer patients receiving radiotherapy.
Keywords: FLASH irradiation, Ultra-high dose rate, radiation damage, Testicular tissue, Reproductive cells
Received: 25 Apr 2025; Accepted: 09 Sep 2025.
Copyright: © 2025 Zhi, Du, Han, Li, Zhang, Xingdong, Wang, Ma, Lei and Baolin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiao Lei, People's Liberation Army General Hospital, Beijing, China
Qu Baolin, People's Liberation Army General Hospital, Beijing, China
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