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. 2020 Jun 24;12:19. doi: 10.1038/s41368-020-00087-0

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 2 — Potential mechanisms by which CSCs induce relapse and metastasis. CSCs have innate radioresistance. Both the CSC niche and tumour microenvironment can enhance the radioresistance of CSCs and support CSC survival during radiotherapy through the expression of multiple cytokines that contribute to increased stemness and self-renewal of CSCs and induce EMT and hypoxic conditions, resulting in higher migration and invasion of CSCs, further leading to tumour recurrence and metastasis