Research Article

Irradiation and Immunological and Oxidative Stress Parameters (TNF-α and MDA) in Breast Cancer Patients in Najaf Governorate

Abstract

Background: Breast cancer treatment can alter systemic inflammatory and oxidativestress parameters. This study evaluated serum tumor necrosis factor-alpha (TNF-α) and malondialdehyde (MDA) across treatment stages, with particular attention to the reported radiation dose of 2.5 Gy per fraction. Radiation therapy was delivered strictly using a linear accelerator with high-energy radiation. Methods: Thirty-six female participants aged 35–60 years were divided into four groups (n=9 each): healthy controls, patients assessed after chemotherapy and before radiation-dose administration, patients after the first radiation-dose session, and patients after the fifteenth session. The reported dose was 2.5 Gy per fraction delivered via linear accelerator X-ray beams. If 15 fractions were each delivered at this dose, the nominal cumulative dose by fraction 15 would be 37.5 Gy. Serum TNF-α and MDA were measured by sandwich ELISA; group comparisons used ANOVA and post-hoc tests. Results: Serum TNF-α levels were significantly elevated in all patient groups compared to healthy controls (G1: 97.09 ± 18.03 pg/mL vs. G2: 418.89 ± 98.70 pg/mL, p=0.0001). Chemotherapy (G2) triggered systemic pro-inflammatory cytokine surges, whereas the first radiation-dose session (G3: 298.31 ± 59.87 pg/mL) and the fifteenth radiation-dose session (G4: 299.15 ± 69.89 pg/mL) resulted in significantly lower TNF-α levels compared to G2 (p=0.004 and p=0.003, respectively). Conversely, serum MDA reached a peak postchemotherapy (G2: 536.54 ± 60.67 pg/mL) and demonstrated a significant progressive reduction during radiation-dose administration (G3: 412.66 ± 62.21 pg/mL; G4: 342.51 ± 37.21 pg/mL, p=0.001 compared to G2; p=0.05 between G3 and G4). Conclusions: Chemotherapy significantly elevates serum TNF-α and malondialdehyde (MDA) levels (p ≤ 0.001) in breast cancer patients compared to healthy controls, driven by systemic inflammation and oxidative stress. Conversely, localized radiotherapy exhibits lower TNF-α levels and a significant reduction in MDA (p = 0.01) compared to chemotherapy alone. Continuous daily radiation sessions further decrease MDA levels (p = 0.05), indicating a positive redox balance, subsiding treatment toxicity, and progressive tissue recovery. 

Authors affiliation:

Doaa Falah Razzaq Aldabbag (ORCID): Department of Physics, College of Science, University of Kufa, Najaf, Iraq.
Dahlia K. Gatea (ORCID): Department of Physics, College of Science, University of Basrah, Basrah, Iraq. 

How To Cite: D.F.R. Aldabbag and D.K. Gatea. Irradiation and Immunological and Oxidative Stress Parameters (TNF-α and MDA) in Breast Cancer Patients in Najaf Governorate. Healthcare Studies, 4(2):92–97, 2026. https://doi.org/10.58612/hs4212