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<p>Radiotherapy is a&#xa0;central component of oncological treatments. In addition to its primary goal of locally destroying tumor cells, radiation-induced cellular stress responses also trigger immunological changes. By inducing antitumor immunity, the tumor can be targeted locally, and ideally, systemic immune reactions are initiated that can also act against tumor masses outside the radiation field, such as metastases. These so-called “abscopal effects”, however, typically only occur when radiotherapy is combined with immunotherapies. They are frequently observed in preclinical settings but are rarely seen in clinical practice. To better harness these effects, an understanding of the immunological mechanisms—such as T&#xa0;cell activation against the tumor—is crucial. Additionally, alongside the immune-activating effects of radiation therapy, its immunosuppressive effects must also be considered, especially in order to develop optimal combination therapies. Here, not only the type of immunotherapy, such as the inhibition of immune checkpoint molecules, but also the radiation dose and fractionation must be taken into account. For effective radioimmunotherapy combinations, a&#xa0;wide range of other biological challenges must be considered, such as the size of the radiation field including lymph node irradiation, the type and sequence of combination therapy, and the dynamics of the resulting antitumor immune responses. The latter also play an important role in patient stratification based on immunological and imaging parameters. Radiotherapy and immunotherapy are good partners, but they must be very well coordinated.</p>

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Immunologische Effekte der Strahlentherapie

  • 期刊论文

  • 发表日期：

    2025年7月3日

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  • Udo S. Gaipl,
  • Anna-Jasmina Donaubauer,
  • Tina Jost,
  • Florian Putz,
  • Benjamin Frey

摘要

Radiotherapy is a central component of oncological treatments. In addition to its primary goal of locally destroying tumor cells, radiation-induced cellular stress responses also trigger immunological changes. By inducing antitumor immunity, the tumor can be targeted locally, and ideally, systemic immune reactions are initiated that can also act against tumor masses outside the radiation field, such as metastases. These so-called “abscopal effects”, however, typically only occur when radiotherapy is combined with immunotherapies. They are frequently observed in preclinical settings but are rarely seen in clinical practice. To better harness these effects, an understanding of the immunological mechanisms—such as T cell activation against the tumor—is crucial. Additionally, alongside the immune-activating effects of radiation therapy, its immunosuppressive effects must also be considered, especially in order to develop optimal combination therapies. Here, not only the type of immunotherapy, such as the inhibition of immune checkpoint molecules, but also the radiation dose and fractionation must be taken into account. For effective radioimmunotherapy combinations, a wide range of other biological challenges must be considered, such as the size of the radiation field including lymph node irradiation, the type and sequence of combination therapy, and the dynamics of the resulting antitumor immune responses. The latter also play an important role in patient stratification based on immunological and imaging parameters. Radiotherapy and immunotherapy are good partners, but they must be very well coordinated.