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Immune Modulatory Effects of Radiotherapy

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Book cover Radiation Oncology

Abstract

Radiotherapy primarily aims to stop the proliferation of tumor cells and to induce tumor cell death. It has however become more and more evident that ionizing radiation impacts the tumor cell phenotype and its microenvironment, thereby exerting both immunosuppressive and immune-activating effects. Therefore, a deeper understanding of how radiotherapy modulates the immune system is mandatory for the design of radioimmunotherapies, here defined as therapy combination of radiotherapy with immunotherapy. This chapter will summarize the current knowledge on how radiotherapy activates and suppresses the immune system, taking also into account the impact of radiation dose and timing of combination with immunotherapies on it. Immune biological challenges for combining radiotherapy with additional immune modulators are discussed. Based on the inflammatory status of a tumor, the dynamics and the interconnections of the immune system and the tumor are outlined. Finally, genetic and immune biomarkers for radiation responses are specified to better understand and to improve radioimmunotherapies for patients. It can be concluded that local and systemic antitumor immune responses can be induced by radiotherapy, but mostly only in combination with well-elaborated additional immune modulations.

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  1. Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany

    Benjamin Frey, Michael Rückert & Udo S. Gaipl

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  1. Benjamin Frey
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  2. Michael Rückert
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Correspondence to Udo S. Gaipl .

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  1. Department of Radiation Oncology, University Hospital Mannheim, Mannheim, Germany

    Frederik Wenz

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Frey, B., Rückert, M., Gaipl, U.S. (2019). Immune Modulatory Effects of Radiotherapy. In: Wenz, F. (eds) Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-52619-5_106-1

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