TURKISH JOURNAL OF ONCOLOGY 2026 , Vol 41 , Num 2
Can Radiotherapy Affect Routine Biochemical Parameters? Analytical Stability of Serum Control Materials under Therapeutic Photon Exposure
Beril BALCI TOPUZ1, Ataman GÖNEL2, Mustafa YILDIRIM3
1Department of Radiation Oncology, Sanko University Faculty of Medicine, Gaziantep-Türkiye
2Department of Medical Biochemistry, Sanko University Faculty of Medicine, Gaziantep-Türkiye
3Department of Medical Oncology, Sanko University Faculty of Medicine, Gaziantep-Türkiye
DOI : 10.5505/tjo.2026.4756 OBJECTIVE
Ionizing radiation produces reactive oxygen species that may affect biomolecular integrity, but its impact on routine biochemical test accuracy is unclear. This study evaluated the analytical stability of common biochemical parameters in serum control materials following therapeutic photon irradiation.

METHODS
Commercial multi-analyte serum control solutions were irradiated with 6 MV photons at doses of 1.5-24 Gy using a clinical linear accelerator (LINAC). Thirty routinely tested biochemical parameters were analyzed on the Abbott Alinity c system. Each dose level was tested in 20 technical replicates, and percentage bias (%) from the reference value was calculated.

RESULTS
Radiation exposure caused no meaningful deviations in 96% of analytes, with all bias values within ±6%. Liver enzymes (AST, ALP, GGT, LDH) and other enzymatic markers (CK, amylase, lipase, CK-MB) showed excellent stability. Renal (urea, creatinine, uric acid), lipid (cholesterol, triglycerides, HDL, LDL), and electrolyte parameters (Na+, K+, Cl–, Ca²+, Mg²+, phosphate) remained unaffected. The only dose-dependent change was a ~10% decrease in total bilirubin at 24 Gy, consistent with its known light- and radiation-sensitive chromophore.

CONCLUSION
Serum control materials retained analytical integrity under photon doses up to 24 Gy. Except for bilirubin, all routine assays demonstrated excellent analytical stability, confirming that therapeutic radiation does not compromise biochemical test reliability. Keywords : Analytical stability; biochemical analysis; radiotherapy