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Cancers (Basel). 2019 Sep 6;11(9). pii: E1324. doi: 10.3390/cancers11091324.

Radiotherapy-Induced Changes in the Systemic Immune and Inflammation Parameters of Head and Neck Cancer Patients.

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Department of Radiation Medicine, National Public Health Center, 1221 Budapest, Hungary.
Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 0RQ, UK.
Université Grenoble Alpes, CEA, CNRS, IRIG, CBM, F-38000 Grenoble, France.
Maria Skłodowska-Curie Institute-Oncology Center, Gliwice Branch, 44-101 Gliwice, Poland.
Department of Radiation Oncology, Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Department of Radiobiology and Diagnostic Onco-Cytogenetics, Centre of Radiotherapy, National Institute of Oncology, 1122 Budapest, Hungary.
Department of Radiation Medicine, National Public Health Center, 1221 Budapest, Hungary.


Though radiotherapy is a local therapy, it has systemic effects mainly influencing immune and inflammation processes. This has important consequences in the long-term prognosis and therapy individualization. Our objective was to investigate immune and inflammation-related changes in the peripheral blood of head and neck cancer patients treated with radiotherapy. Peripheral blood cells, plasma and blood cell-derived RNA were isolated from 23 patients before and at two time points after radiotherapy and cellular immune parameters, plasma protein changes and gene expression alterations were studied. Increased regulatory T cells and increased CTLA4 and PD-1 expression on CD4 cells indicated an immune suppression induced by the malignant condition, which was accentuated by radiotherapy. Circulating dendritic cells were strongly elevated before treatment and were not affected by radiotherapy. Decreased endoglin levels in the plasma of patients before treatment were further decreased by radiotherapy. Expression of the FXDR, SESN1, GADD45, DDB2 and MDM2 radiation-response genes were altered in the peripheral blood cells of patients after radiotherapy. All changes were long-lasting, detectable one month after radiotherapy. In conclusion we demonstrated radiotherapy-induced changes in systemic immune parameters of head and neck cancer patients and proposed markers suitable for patient stratification worth investigating in larger patient cohorts.


PBMC; dendritic cell; gene expression; head and neck cancer; immune phenotyping; natural killer cell; plasma proteins; radiotherapy; regulatory T cell

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