Abstract
BACKGROUND: In this article, we estimated the combined effect of radiotherapy (RT) with ultrasound (US) wave and the ability of gold nanoparticles (GNPs) to improve their combined therapeutic effects. METHODS: At first, HeLa cells received the various treatment modalities: RT (6 MV; 0.5, 1, and 2 Gy), US irradiation (1 MHz; 0.5, 1, and 1.5 W/cm², 1 minute), and RT+US. Afterwards, the enhanced effect of US on RT was evaluated. Then, the effect of the synthesized GNPs at different concentrations (0.2, 1, and 5 μg/mL, 24 hours) was evaluated to assess the effect on HeLa cells combined with RT+US. Cell survival rates in the different treatment groups at 24, 48, and 72 hours post-treatment were evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and trypan blue assays. RESULTS: Our results show US irradiation could enhance the effect of RT at the same radiation dose and could be utilized as a sensitizer agent for RT. Moreover, our findings indicate RT+US in combination with different nanoparticle concentrations could enhance the effect of RT+US so that they can improve the treatment results up to 9.93 times and act as sonodynamic-radiosensitivity. These results also indicate that the combination of RT with US along with GNPs has synergistic effects compared to RT or US alone. Cell survival results show that combining the low US waves (1.5 W/cm²), GNPs (5 μ/mL), and X-rays (2 Gy) increase the cytotoxicity on HeLa cell up to 95.8%. CONCLUSION: We concluded that GNPs could act as a good sensitizing agent in RT+US irradiation and could result in the synergistic effects.