{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:47:37Z","timestamp":1789832857274,"version":"4.0.1"},"reference-count":101,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The brain and spinal cord, which constitute the central nervous system, were historically considered immune-privileged sites, as it was believed they lacked an equivalent to the systemic lymphatic system. However, in 2013, a pathway facilitating the clearance of waste products through the brain parenchyma via the perivascular space was proposed, garnering attention as the \u2018glymphatic system\u2019. Similar to the systemic lymphatic system, the glymphatic system plays a critical role in immune responses and has been implicated not only in Alzheimer\u2019s disease and inflammatory brain disorders but also in conditions such as hydrocephalus and glaucoma, which are associated with cerebrospinal fluid circulation impairments. Recent studies have suggested that dysfunction of the glymphatic system may promote the progression of brain tumors and reduce the efficacy of immune responses and pharmacological therapies targeting tumors. Radiotherapy is a major treatment option for brain tumors; however, while it can enhance immune responses against tumors, it may also suppress these responses at the same time. Additionally, cranial irradiation has been suggested to impair the function of the glymphatic system. This review provides an overview of the structure and functional evaluation methods of the glymphatic system, summarizes the effects of its dysfunction on brain tumor treatment, and explores recent findings on the impact of radiation therapy on glymphatic system functioning. Lastly, it also explores the potential for radiation therapy strategies that account for their effects on the glymphatic system.<\/jats:p>","DOI":"10.1093\/jrr\/rraf027","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T17:23:29Z","timestamp":1748971409000},"page":"343-353","source":"Crossref","is-referenced-by-count":11,"title":["The glymphatic system in oncology: from the perspective of a radiation oncologist"],"prefix":"10.1093","volume":"66","author":[{"given":"Kentaro","family":"Nishioka","sequence":"first","affiliation":[{"name":"Radiation Oncology Division, Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University , Nishi 7, Kita 15, Kita-ku, Sapporo, Hokkaido, 060-8638,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nagoya University Graduate School of Medicine , Tsurumai-cho 65, Showa-ku, Nagoya, Aichi, 466\u20138550,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mami","family":"Iima","sequence":"additional","affiliation":[{"name":"Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate School of Medicine , Tsurumai-cho 65, Showa-ku, Nagoya, Aichi, 466\u20138550,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiju","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Artificial Intelligence, Graduate School of Medicine, Osaka Metropolitan University , 1-4-3, Abeno-Ku, Osaka,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintaro","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nagoya University Graduate School of Medicine , Tsurumai-cho 65, Showa-ku, Nagoya, Aichi, 466\u20138550,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsukasa","family":"Saida","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Tsukuba , 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Kurokawa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine , The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Takumi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences , 8-35-1 Sakuragaoka, Kagoshima, 890-8520,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Sakata","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine , 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Ide","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Occupational and Environmental Health , 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Kansai Electric Power Hospital , 2-1-7, Fukushima, Fukushima-ku, Osaka, 553-0003,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yanagawa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Osaka University Graduate School of Medicine , 2-2 Yamadaoka, Suita, Osaka, 565-0871,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, National Cancer Center Hospital , 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seitaro","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University , 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Watabe","sequence":"additional","affiliation":[{"name":"Department of Radiology, Osaka University Graduate School of Medicine , 2-2 Yamadaoka, Suita, Osaka, 565-0871,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keitaro","family":"Sofue","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kobe University Graduate School of Medicine , 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Hirata","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Faculty of Medicine , Hokkaido University, Nishi 7, Kita 15, Kita-ku, Sapporo, Hokkaido, 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