Precision Radiation Oncology最新文献

{"title":"¹⁷⁷Lu-labeled amidoxime-functionalized biodegradable microspheres for transarterial radioembolization of hepatocellular carcinoma.","authors":"Xingliang Liu, Gang Wang, Zhenwen Zhao, Haoyu Wang, Hongyu Chen, Xiao Xu, Jingdong Li, Hongjuan Ma","doi":"10.1002/pro6.70094","DOIUrl":"10.1002/pro6.70094","url":null,"abstract":"<p><strong>Purpose: </strong>Transarterial radioembolization (TARE) is an important locoregional therapy for hepatocellular carcinoma (HCC). However, clinically used yttrium-90 (⁹⁰Y) microspheres are non-biodegradable and provide limited imaging capability, while biodegradable polymeric microspheres prepared using conventional radiolabeling strategies often exhibit poor radionuclide stability.</p><p><strong>Experimental design: </strong>We designed a biodegradable radiometal-chelating microsphere based on amidoxime-functionalized polylactic acid microspheres (PLA-g-PAO-Ms) engineered via electron beam-induced graft polymerization.</p><p><strong>Results: </strong>The PLA-g-PAO-Ms exhibited a high Lu³⁺ loading capacity (33.83 mg g^-1) and underwent controlled biodegradation in vitro after approximately 20 d. Cell Counting Kit-8 (CCK-8) assays confirmed favorable cytocompatibility, with both LO2 and HepG2 cell viabilities exceeding 90% after 72 h, showing no significant difference from the control group (<i>p</i> > 0.05); by contrast, free Lu³⁺ (50 mg·L^-1) significantly reduced HepG2 viability to 51.4% (<i>p</i> < 0.001). In a rat orthotopic liver tumor model, the intra-arterial administration of ¹⁷⁷Lu-labeled PLA-g-PAO-Ms (¹⁷⁷Lu-PLA-g-PAO-Ms) resulted in pronounced tumor suppression with sustained in vivo radionuclide retention for at least 14 d. Biodistribution analysis revealed selective tumor accumulation of <b>8.79 ± 1.74 %ID g^-1</b> , significantly higher than that in normal liver (<b>1 ± 0.54 %ID g^-1</b> ) and other organs (<b> <i>P</i>< 0.001</b>), whereas free ¹⁷⁷LuCl₃ showed minimal tumor uptake (<b>0.30 ± 0.28 %ID g^-1</b> ) with predominant non-target organ accumulation.</p><p><strong>Conclusion: </strong>These findings suggest that PLA-g-PAO-Ms provide a biodegradable microsphere system capable of stable radiometal incorporation and effective tumor suppression following intra-arterial administration, offering a promising approach for interventional radionuclide therapy for HCC.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated multi-omics analysis of post-translational modifications in head and neck squamous cell carcinoma: elucidating x-ray and carbon ion irradiation effects.","authors":"Fan-Tong Xia, Zhi-Yun Liao, Si-Qi Cai, Li-Rong Zhou, Meng-Qi Yang, Xin Zhang, Dan Li, Huan Zhang, Yun-Chang Liu, Jie-Ying Yang, Jia Jiang, Yi-Hong Hu, Jiang-Dong Sui, Ying Wang","doi":"10.1002/pro6.70097","DOIUrl":"10.1002/pro6.70097","url":null,"abstract":"<p><strong>Background and purpose: </strong>Head and neck squamous cell carcinoma (HNSCC) exhibits heterogeneous responses to radiotherapy; however, the underlying multi-omics regulatory networks remain poorly characterized. This study elucidated the distinct post-translational modification (PTM) landscapes induced by X-ray and carbon-ion irradiation.</p><p><strong>Methods: </strong>Using integrated proteomics, phosphoproteomics, and acetylomics, we systematically profiled PTMs in HSC-3 cells at 30 min post-irradiation with X-ray (8 Gy) or carbon ions (4 GyE). Computational analyses included functional annotation, kinase activity prediction, and PTM crosstalk mapping.</p><p><strong>Results: </strong>Carbon ions induced 21% more phosphosites (2,781 vs. 2,301) and 61% more acetyl sites (3,324 vs. 2,070) than X-ray, demonstrating broader PTM reprogramming. Notably, carbon ion-induced histone hypoacetylation (H2AZ1K8/K5, H3C1K28/K24, and H4C1K92) and hyperphosphorylation (H1-10S2 and H3C1T119) potentially alter chromatin accessibility. Functional enrichment analyses revealed the activation of the non-homologous end-joining (NHEJ) pathway and coordinated upregulation of antigen-presenting machinery (such as CD274, TAP2, HLA-A, and PSMB8) through PTM remodeling. Distinct PTM signatures in RNA splicing factors implicate alternative splicing in radiation response. Kinase activity profiling revealed ATM hyperactivation and CDK suppression in the carbon ion group.</p><p><strong>Conclusions: </strong>Carbon ion irradiation drives distinct PTM-mediated immunomodulatory and DNA damage-response networks, providing a mechanistic rationale for combining carbon ion radiotherapy with immunotherapy. Future studies should validate the PTM-associated targets to improve HNSCC treatment.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of concurrent chemoradiotherapy with or without nimotuzumab in high-risk patients with locally advanced head and neck squamous cell carcinoma post-surgery: A real-world study.","authors":"Yuejia Zhou, Linting Zhang, Wenjuan Lai, Jingyun Tan, Jing Gao, Yajie Liu, Shubin Wang, Feng Peng, Gangling Tong","doi":"10.1002/pro6.70099","DOIUrl":"10.1002/pro6.70099","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) harboring high-risk pathological features after radical surgery face high recurrence rates. This real-world study evaluated the efficacy and safety of concurrent chemoradiotherapy (CCRT) with and without nimotuzumab in this postoperative population.</p><p><strong>Methods: </strong>Patients with LA-HNSCC who had high-risk pathological features after surgery were stratified as follows: those with extranodal extension (ENE) or positive/insufficient margins received nimotuzumab plus CCRT (NCCRT; extremely high risk), whereas those with other high-risk factors (e.g., pT3-4 and N2-3) received CCRT alone (intermediate high risk). All patients underwent intensity-modulated radiotherapy with weekly cisplatin. Overall survival (OS) was the primary endpoint, and event-free survival (EFS) and safety were secondary endpoints. To minimize confounding bias due to non-randomized treatment allocation, propensity-score matching (PSM) was performed using a 1:1 nearest neighbor matching algorithm with a caliper width of 0.2 times the standard deviation of the propensity score.</p><p><strong>Results: </strong>A total of 75 patients were enrolled in this study (CCRT, n = 50; NCCRT, <i>n</i> = 25). After PSM, 22 well-balanced pairs were identified with no significant differences in baseline characteristics between the two groups. The median follow-up time was 29.80 months (95% confidence interval [<i>CI</i>]: 25.83-33.77) in the CCRT group and 30.23 months (95% <i>CI</i>: 25.07-35.40) in the NCCRT group. In the overall cohort, the 2-year EFS and OS rates were 74.1% vs 60.6% and 85.6% vs 83.6%, respectively. In the matched cohort, the 2-year EFS and OS rates were 73.8% vs 58.3% (log-rank <i>p</i> = 0.087) and 86.2% vs 82.5% (log-rank <i>p</i> = 0.342), respectively. Univariate analysis revealed that the platelet-to-lymphocyte ratio (PLR) and hemoglobin-albumin-lymphocyte-platelet (HALP) score were significantly associated with OS in the CCRT group (<i>p</i> = 0.019 and <i>p</i> = 0.009, respectively). Treatment-related adverse events were predominantly grades 1-2, including radiodermatitis, oral mucositis, and hematological toxicities, with no significant increase in severe toxicities in the NCCRT group.</p><p><strong>Conclusions: </strong>Risk-stratified adjuvant CCRT, with or without nimotuzumab, was associated with promising outcomes and acceptable safety in patients with high-risk postoperative LA-HNSCC. Thus, PLR and HALP may serve as candidate prognostic biomarkers for intermediate-risk patients and warrant further validation. These findings are hypothesis-generating and require confirmation in prospective randomized studies with dedicated control groups.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert consensus on clinical trial design guidelines for FLASH radiotherapy.","authors":"Hui Luo, Chen Cheng, Chengliang Yang, Bing Li, Jiandong Zhang, Jinbo Yue, Zhaoyang Lou, Hui Liu, Jing Cai, Hong Ge","doi":"10.1002/pro6.70098","DOIUrl":"https://doi.org/10.1002/pro6.70098","url":null,"abstract":"<p><p>In recent years, ultra-high dose-rate FLASH radiotherapy (FLASH-RT) has emerged as a prominent research focus in radiation oncology. A series of preclinical data indicate that FLASH-RT can achieve tumor-killing efficacy that is not inferior to that of conventional radiotherapy (CONV-RT) while significantly reducing radiation damage to normal tissues. This distinctive tissue-sparing effect is known as the \"FLASH effect.\" Rapid progress has been made in the clinical translation and application of FLASH-RT. Against this backdrop, the China Anti-Cancer Association Radiation Oncology Committee and the Chinese Medical Doctor Association Radiation Oncology Physician Committee gathered a group of experts and compiled the \"Expert Consensus on Clinical Trial Design Guidelines for FLASH Radiotherapy\" based on the latest domestic and international research advancements. This document summarizes the latest advances in FLASH-RT and offers practical guidance for its design and translational application in future clinical trials.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MR-Linac Successfully Guided the Treatment of a Free-Moving Mesenteric Mass.","authors":"Xin Wang, Tze Yee Lim, He Wang, Bouthaina Shbib Dabaja, Jinzhong Yang","doi":"10.1002/pro6.70093","DOIUrl":"10.1002/pro6.70093","url":null,"abstract":"<p><p>A patient presenting with stage I follicular lymphoma was dispositioned for a definitive and curative radiation treatment. The tumor had significant daily movement, as much as 3.83, 3.26 and 12.42 cm in the anterior-posterior, superior-inferior and left-right direction respectively. The tumor volume increased from 16.72 to 44.23 cc in first 5 fractions, followed by a downward trend. To account for the inter-fraction tumor motion, online adaptive radiation therapy was delivered using Elekta Unity MR-Linac. Each fraction, the treating physician manually delineated the planning target volume (PTV) and Unity successfully generated an optimum adaptive plan with PTV coverage ≥ 95%. This case demonstrated that MR-Linac online adaptive workflow was superior in treating a free-moving and volume changing mesenteric mass, minimizing the margin needed in conventional static plan to cover the unpredictable large daily shift.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-X-C Motif Chemokine Receptor 4 (CXCR4)-Targeted Biologically Guided Proton Spatially Fractionated Radiotherapy for Bulky Limited-Stage Small Cell Lung Cancer.","authors":"Keru Pu, Tengxiang Li, Shengnan Xu, Xue Sha, Qingtao Qiu, Jinming Yu, Yong Yin, Jie Liu","doi":"10.1002/pro6.70095","DOIUrl":"10.1002/pro6.70095","url":null,"abstract":"<p><strong>Background and purpose: </strong>To evaluate the feasibility and dosimetric safety of integrating C-X-C motif chemokine receptor 4 (CXCR4)-targeted tracer ¹ ⁸F-AlF-NOTA-QHY-04 positron emission tomography imaging with biologically guided proton spatially fractionated radiotherapy (BG-pSFRT) for bulky limited-stage small cell lung cancer.</p><p><strong>Materials and methods: </strong>Among 30 patients with bulky limited-stage small-cell lung cancer, a threshold range of 35%-40% of the maximum standard uptake value (SUV_max) showed optimal spatial correspondence with the computed tomography-based gross tumor volume (GTV). The median SUV_max was 6.96, and the Dice similarity coefficient ranged from 0.707 to 0.723. CXCR4-avid sub-volumes within GTV were characterized against the sub-targets of stereotactic body radiotherapy based partial tumor irradiation targeting hypoxic segments (SBRT-PATHY) and stereotactic centralized ablative radiation therapy (SCART). Dosimetric comparisons were performed between the BG-pSFRT and SCART plans (15-24 Gy per fraction in three fractions).</p><p><strong>Results: </strong>CXCR4-defined sub-volumes with low thresholds in BG-pSFRT demonstrated spatial concordance with putative hypoxic sub-volumes in SBRT-PATHY, whereas higher SUV_max thresholds yielded multifocal distributions that exhibited spatial discordance relative to SCART, and these multifocal imaging-defined sub-volumes were targeted in BG-pSFRT for dose escalation. Compared to proton SCART, BG-pSFRT achieved greater high-dose (V_80%), GTV coverage but slightly lower sub-volume conformity (89.04% vs. 95.55%; <i>P</i> < 0.001), and higher V_5Gy and dose per fraction (<i>P</i> < 0.001). All organ-at-risk doses met the standard 3-fraction SBRT constraints.</p><p><strong>Conclusions: </strong>CXCR4-targeted BG-pSFRT may be a dosimetrically feasible strategy for bulky limited-stage small cell lung cancer and demonstrates distinct dosimetric characteristics. The current research findings are limited to the dosimetric level and further clinical trials are required for verification.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation-free or Chemo-free: Rethinking the Best Strategy for PD-L1-High, Unresectable Stage III NSCLC.","authors":"Yongbo Xiang, Nan Bi","doi":"10.1002/pro6.70088","DOIUrl":"10.1002/pro6.70088","url":null,"abstract":"<p><p>This article discusses the emerging radiotherapy-free and chemo-free strategies in PD-L1-high, unresectable stage III NSCLC, reviewing the Evolution trial and comparing it with existing treatments. We highlight the need for further research to validate these approaches and ensure safe de-escalation without compromising curability.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¹⁸F‑FAPI‑04 PET/CT imaging of fibroblast activating protein reveals myocardial injury beyond cancer staging.","authors":"Jing Jia, Chuan Zhou, Shuzhen Yi, Jinsong Zheng, Chengqiang Li, Jingjie Qin, Yuchun Wei","doi":"10.1002/pro6.70092","DOIUrl":"10.1002/pro6.70092","url":null,"abstract":"<p><strong>Objectives: </strong>Fluorine 18 (¹⁸F)-labeled fibroblast activation protein inhibitor-04 (denoted as FAPI-04) positron emission tomography/computed tomography (PET/CT) has showed excellent diagnostic performance for multiple solid tumors. However, its utility in characterizing myocardial injury has not yet been reported. In this study, the additional value of ¹⁸F-FAPI-04 PET/CT in assessing myocardial injury was evaluated in patients with cancer.</p><p><strong>Methods: </strong>Myocardial tracer uptake in 168 patients who underwent ¹⁸F-FAPI-04 PET/CT was analyzed retrospectively. Maximum and mean standard uptake values in the myocardium (SUV_{max-myocardium} and SUV_{mean-myocardium}) and blood pool (SUV_max-BP and SUV_mean-BP) were recorded. The ratio of SUV_{max-myocardium} to SUV_mean-BP was denoted as the target-to-background ratio (TBR). Myocardial uptake higher than the background was <i>visual uptake</i> (<i>n</i> = 49), and uptake consistent with the background was <i>no visual uptake</i> (<i>n</i> = 119). Patients with abnormal uptake but without cardiovascular disease (CVD) were followed up.</p><p><strong>Results: </strong>Myocardial uptake higher than the background was <i>visual uptake</i> (<i>n</i> = 49), and uptake consistent with the background was <i>no visual uptake</i> (<i>n</i> = 119). The prevalence of hypertension, diabetes mellitus (DM), CVD, and levels of cardiac troponin T and pro-BNP were higher in <i>the visual uptake group</i> (all <i>p</i> < 0.05). SUV_{max-myocardium} and TBR were significantly correlated with age and pro-BNP levels (<i>p</i> < 0.05). Hypertension, DM, CVD, pro-BNP>125 pg/mL, and prior chest radiotherapy were independent risk factors for abnormal uptake (<i>p</i> < 0.05). The area under the curve (AUC) values of myocardial ¹⁸F-FAPI-04 uptake to predict myocardial injury were 0.79 and 0.87 for SUV_{max-myocardium} and TBR, respectively (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>¹⁸F-FAPI-04 PET/CT imaging identified features of myocardial injury in patients with cancer, providing complementary value beyond tumor staging.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":"268-278"},"PeriodicalIF":3.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precise delineation of radiation targets for thoracic tumors in the immunotherapy era: From immune mechanisms to clinical practice.","authors":"Xiaoying Chen, Minxiao Yi, Yu Deng, Qian Shen","doi":"10.1002/pro6.70090","DOIUrl":"10.1002/pro6.70090","url":null,"abstract":"<p><p>As a core modality for local control of thoracic tumors, including lung and esophageal cancers, radiotherapy (RT) shows synergistic effects with immunotherapy, fundamentally reshaping the landscape of cancer treatment. Given the rapid advancements in immunotherapy, this review explores the critical role of precise delineation of radiotherapy targets in achieving synergistic effects between RT and immunotherapy. It elucidates the dual-edged nature of RT, which can both activate antitumor immune responses and suppress immune function. Notably, larger radiation target volumes often cause destruction of tumor-draining lymph nodes and reduce the number of peripheral blood lymphocytes, thereby impairing the efficacy of immunotherapy. To address this challenge, we discuss strategies tailored to thoracic tumors, including reducing target volumes, optimizing irradiation fields, and adjusting target positioning to protect key immune components. Furthermore, we highlight recent advancements in multimodal imaging, real-time dynamic tracking technologies, and deep learning-enabled automated segmentation methods that can increase the precision of target delineation. Additionally, emerging RT techniques, such as proton therapy and FLASH-RT, demonstrate unique advantages in minimizing irradiation of normal tissues and circulating immune cells while enhancing immunomodulatory effects and thereby facilitating precise RT. This review aims to provide a theoretical foundation and technical support for accurate target delineation in the era of immunotherapy, particularly for thoracic malignancies, to promote the deep integration of RT and immunotherapy and improve patient outcomes.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":"371-387"},"PeriodicalIF":3.6,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of proton therapy on the tumor immune system and clinical implications: A review.","authors":"Rundong Liu, Mei Tao, Min Fu, Yingjia Hu, Zhen Tao, Guangyuan Hu","doi":"10.1002/pro6.70089","DOIUrl":"10.1002/pro6.70089","url":null,"abstract":"<p><p>Proton therapy, an emerging radiation therapy technique, has gained significant attention owing to its unique physical properties and biological effects. This review aims to explore the impact of proton therapy on the tumor immune system and of its combination with other therapies. This review outlines the fundamental principles and oncological applications of proton therapy, followed by an analysis of its impact on the immune system-encompassing draining lymph nodes, peripheral blood immune cells, tumor cell immune responses, and the tumor microenvironment. We further discuss current combinatorial strategies with immunotherapy and/or chemotherapy, which point toward promising clinical directions.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":" ","pages":"388-402"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}