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. 2023 Jul 11;4:1180869. doi: 10.3389/froh.2023.1180869

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© 2023 Sharon, Daher-Ghanem, Zaid, Gough and Kravchenko-Balasha.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Overview of the main radiation-induced changes in the tumor environment and cancer cells. The local and systemic effects of irradiation can be linked to the radiation dose and fractionation. Although the initial effect of radiation therapy (RT) is cell death due to DNA damage, accumulating evidence from recent studies demonstrates multiple local and systemic molecular alterations induced by RT. These include antigen release and antigen-specific T-cells activation; molecular changes in the tumor microenvironment (TME) due to direct effects of RT or interactions between dying cells and the TME; RT-induced development of resistant subpopulations within the tumor; lymphocyte loss; abscopal effect; trafficking of dendritic cells (DC) from tumors to the tumor-draining lymph node (LN).