REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1634522
Parotid Preservation or Immune Protection? The Dual Dilemma in Head and Neck Cancer Radiotherapy
Provisionally accepted
- 1Department of Oncology, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, China
- 2Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- 3Department of Thyroid and Breast Surgery, Honghu People's Hospital of Jingzhou City, Jingzhou, China
- 4Department of Oncology, Hubei Cancer Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China
- 5Department of Gynaecology, Yangxin County Maternity and Child Health Hospital/Yangxin County Children's Hospital, Huangshi, China
- 6Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Head and neck cancer (HNC) represent a common category of malignant tumors. Radiotherapy, as the primary treatment modality for these tumors, while effectively controlling tumor progression, is often accompanied by a series of treatment-related side effects. As a major salivary gland in the head - and - neck region, the parotid gland (PG) is particularly susceptible to radiation damage during radiotherapy, given its anatomical proximity to the target irradiation area. The radiation dose and irradiated volume of the PG not only disrupt its physiological secretory function, leading to debilitating side effects like xerostomia and dysphagia, but also potentially compromise tumor control and patient outcomes by modulating the local and systemic immune homeostasis. This article systematically reviews the relevant research on the impact of PG irradiation on the immune microenvironment during HNC radiotherapy in recent years, and it delves into multiple levels, including cytokine changes and immune cell function alterations, aiming to offer a comprehensive theoretical basis and novel research perspectives for optimizing radiotherapy plans, reducing radiotherapy - related adverse reactions, and improving patient prognosis.
Keywords: head and neck cancer, Radiotherapy, radiation injury, Parotid Gland, immune microenvironment
Received: 24 May 2025; Accepted: 20 Aug 2025.
Copyright: © 2025 Qin, Zhang, Zhang, Yang, Yang, Xie, Zhang, Wan and Li. 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) or licensor 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.
* Correspondence:
Hui Zhang, Department of Gynaecology, Yangxin County Maternity and Child Health Hospital/Yangxin County Children's Hospital, Huangshi, China
Min Wan, Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Huachi Li, Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.