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Updated: Sep 16, 2025

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy
Published on: July 3, 2014
The dark side of radiotherapy
András Piffkó1, Sean P Pitroda2, Ralph R Weichselbaum2
1Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA; The Ludwig Center for Metastasis Research, University of Chicago, Chicago, IL, USA; Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Abstract:
Radiotherapy (RT), while pivotal in cancer control, may paradoxically promote metastasis through systemic effects. Emerging evidence implicates RT-induced growth factors and immune modulation-especially via amphiregulin-epidermal growth factor receptor (EGFR) signaling-in facilitating metastatic outgrowth at distant sites. This effect underscores the need to refine RT strategies, identify high-risk patients, and explore therapeutic combinations targeting myeloid cells and EGFR pathways to mitigate pro-metastatic consequences and optimize outcomes in the immunotherapy era.
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