Roentgen Centennial Lecture: discovering the past, inventing the future

Radiotherapy and immunology

The majority of cancer patients receive radiotherapy during the course of treatment, delivered with curative intent for local tumor control or as part of a multimodality regimen aimed at eliminating distant metastasis. A major focus of research has been DNA damage; however, in the past two decades, emphasis has shifted to the important role the immune system plays in radiotherapy-induced anti-tumor effects. Radiotherapy reprograms the tumor microenvironment, triggering DNA and RNA sensing cascades that activate innate immunity and ultimately enhance adaptive immunity. In opposition, radiotherapy also induces suppression of anti-tumor immunity, including recruitment of regulatory T cells, myeloid-derived suppressor cells, and suppressive macrophages. The balance of pro- and anti-tumor immunity is regulated in part by radiotherapy-induced chemokines and cytokines. Microbiota can also influence radiotherapy outcomes and is under clinical investigation. Blockade of the PD-1/PD-L1 axis and CTLA-4 has been extensively investigated in combination with radiotherapy; we include a review of clinical trials involving inhibition of these immune checkpoints and radiotherapy.

The history of radiation therapy (part I)

In 1903, on the basis of Morozov Institute of the Moscow Imperial University (currently, P. Herzen Moscow Oncology Research Center, a branch of the National Medical Research Radiological Center, Ministry of Health of the Russian Federation), the first specialized unit in Russia was opened – department of radiation therapy of oncological diseases, in which scientific research in the field of medical radiology was officially launched in our country for the first time. The first studies in the field of radiation therapy can be attributed to this period.

The article presents a brief summary of the historical development of radiotherapy in the world and in Russia; provides information on the achievements of global importance, fundamental for this scientific field. The activities of leading Russian organizations in the field of radiation therapy are reviewed; names of scientists, doctors and other specialists who have made a significant contribution to its development are provided. The main literature sources relevant to the field are given.

The data in this article may be of interest and be useful for biomedical scientists, practicing radiologists and radiotherapists, oncologists, medical and graduate students, interns and other specialists.