Abstract
BACKGROUND: Targeted radionuclide therapy (TRT) has emerged as a unique and effective treatment modality for cancer. Monte Carlo simulations have greatly advanced investigations into radiation-caused DNA damage, including the complexity of this damage. PURPOSE: This study aimed to evaluate DNA damage induced by high-linear energy transfer therapeutic radionuclides used in TRT, specifically (225)Ac, (177)Lu, and (212)Pb, using Geant4-DNA Monte Carlo simulations. METHODS: The Geant4-DNA toolkit, incorporating the "molecularDNA" example, was employed to simulate radiation interactions within a human fibroblast cell model featuring a fractal chromatin fiber geometry within an ellipsoidal nucleus. Three source geometries (membrane, cytoplasm, nucleus) were modeled to assess the impact of radionuclide localization. Key metrics, including absorbed dose, double-strand break (DSB) yield, single-strand break/DSB ratio, and DSB/Gbp/decay, were calculated for (225)Ac (alpha emitter), (177)Lu (beta emitter), and (212)Pb (mixed alpha/beta emitter). Simulations accounted for physical, physicochemical, and chemical stages, with validation against published data for (177)Lu and (225)Ac. RESULTS: Alpha emitter (225)Ac exhibited the highest DSB/Gbp/decay (1.646 in nucleus geometry) and absorbed dose (0.256 Gy/decay), followed by (212)Pb (0.455 DSB/Gbp/decay, 0.0684 Gy/decay), and (177)Lu (0.0058 DSB/Gbp/decay, 0.0007 Gy/decay). DSB yields increased with proximity to the nucleus, with (225)Ac showing up to 284 times greater DSB/Gbp/decay than (177)Lu. Validation showed < 10% divergence from reference studies. CONCLUSIONS: Geant4-DNA simulations highlight the superior radiobiological effectiveness of alpha emitters, particularly (225)Ac, for inducing DNA damage and emphasize the importance of source localization. These findings enhance our understanding of TRT's radiobiological effects and can be used to support development of refined therapeutic strategies.