REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Combined Carbon Ion Radiotherapy and Immunotherapy: Leveraging the Immunological Advantages of Carbon Ion
Provisionally accepted
- 1Lanzhou University, Lanzhou, China
- 2Institute of Modern Physics Chinese Academy of Sciences, Lanzhou, China
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Immunotherapy represents a systemic approach to cancer treatment; however, its effectiveness can be limited by intrinsic tumor resistance or immunosuppressive mechanisms within the tumor microenvironment. In contrast, carbon ion radiotherapy (CIRT) demonstrates considerable immunomodulatory potential owing to its distinct biological properties. The exposure of tumor-associated antigens, increased immune cell infiltration and activity, and modifications in the immune microenvironment after CIRT provide a mechanistic rationale for combining CIRT with immunotherapy. Furthermore, strategies aimed at converting the tumor microenvironment from immunosuppressive to immunostimulatory, or those targeting immune checkpoints, are currently under active exploration. This review summarizes the latest advances in combining heavy ion radiotherapy with immunotherapy, encompassing both preclinical and clinical studies. Based on the immunological advantages of CIRT, it provides a comprehensive summary and in-depth exploration of the potential of this combined treatment modality for future clinical applications, along with a theoretical foundation to support it.
Keywords: Carbon ions radio therapy, combined therapy, Heavy-ion, Immunotherapy, Radioimmunity
Received: 16 Nov 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Chen, Ma, Pan, Zhang, Zhang, Di and Ran. 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: Juntao Ran
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