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Charged particle therapy (using protons or heavier ions) is considered one of the most advanced radiotherapy techniques, but its cost remains higher than conventional X-ray therapy. The most important question to be addressed to justify a more widespread use of particle therapy is whether they can be more effective than X-rays in combination with immunotherapy. Protons and heavy ions have physical advantages compared to X-rays that lead to a reduced damage to the immune cells, that are required for an effective immune response. Moreover, densely ionizing radiation may have biological advantages, due to different cell death pathways and release of cytokine mediators of inflammation. We will discuss results in esophageal cancer patients showing that charged particles can reduce the damage to blood lymphocytes compared to X-rays, and preliminary in vitro studies pointing to an increased release of immune-stimulating cytokines after heavy ion exposure. Pre-clinical and clinical studies are ongoing to test these hypotheses.<\/jats:p>","DOI":"10.1259\/bjr.20190224","type":"journal-article","created":{"date-parts":[[2019,7,18]],"date-time":"2019-07-18T11:45:06Z","timestamp":1563450306000},"source":"Crossref","is-referenced-by-count":79,"title":["Harnessing radiation to improve immunotherapy: better with particles?"],"prefix":"10.1093","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4615-553X","authenticated-orcid":false,"given":"Marco","family":"Durante","sequence":"first","affiliation":[{"name":"GSI Helmholtzzentrum f\u00fcr Schwerionenforschung, Biophysics Department , Darmstadt , Germany"},{"name":"Technische Universit\u00e4t Darmstadt, Institut f\u00fcr Festk\u00f6rperphysik , Darmstadt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Formenti","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Weill Cornell Medical College , New York, NY , 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