{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:52:04Z","timestamp":1791597124991,"version":"4.3.4"},"reference-count":115,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006472","name":"Universitatea de Medicin\u0103 \u0219i Farmacie \u201cGrigore T. Popa\u201d Ia\u0219i.\u201d","doi-asserted-by":"publisher","award":["326475"],"award-info":[{"award-number":["326475"]}],"id":[{"id":"10.13039\/501100006472","id-type":"DOI","asserted-by":"publisher"}]},{"award":["326475"],"award-info":[{"award-number":["326475"]}],"id":[{"id":"https:\/\/ror.org\/03hd30t45","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Radiotherapy can simultaneously promote tumor immunogenicity and damage the systemic immune compartments required to sustain antitumor responses. In breast cancer, radiation-induced lymphopenia is influenced by treatment geometry, irradiated volume, low-dose exposure, marrow and lymphoid irradiation, fractionation, and delivery characteristics, while nanoparticle radioenhancement can amplify tumor response through physical, redox, DNA-repair, and immune mechanisms. This hypothesis-driven translational review examines whether nanoparticle-generated biological amplification could be redirected from tumor intensification toward immune-dose shaping while preserving tumor control and immunogenicity. The evidence supports seven interacting dimensions of potential exchange: physical dose, volume\/spatial exposure, distributed low-dose exposure, marrow dose, geometry\/modality, fractionation, and temporal\/delivery exposure. Formal nanoparticle-enabled dose exchange remains limited, with the clearest breast-specific evidence confined to in vitro isoeffect analysis; no study has yet demonstrated preserved tumor isoeffect and immunogenicity together with reduced multicompartment immune injury after nanoparticle-enabled exposure reduction. We, therefore, propose a dual-endpoint framework integrating tumor control, immunogenicity, multicompartment immune preservation, dosimetry, and nanoparticle biodistribution, together with a staged translational pathway from quantitative preclinical exchange studies to comparative clinical testing. This strategy remains hypothesis-generating, with triple-negative breast cancer representing a particularly informative initial setting.<\/jats:p>","DOI":"10.3390\/ijms27198928","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:40:17Z","timestamp":1791596417000},"page":"8928","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nanoparticle-Enabled Immune-Dose Shaping in Breast Cancer Radiotherapy: Reconciling Tumor Immunogenicity with Systemic Immune Preservation"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9749-0610","authenticated-orcid":false,"given":"Sorinel","family":"Lunca","sequence":"first","affiliation":[{"name":"Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"2nd Department of Surgical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7767-0975","authenticated-orcid":false,"given":"Stefan","family":"Morarasu","sequence":"additional","affiliation":[{"name":"Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"2nd Department of Surgical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Mihail","family":"Dimofte","sequence":"additional","affiliation":[{"name":"Grigore T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"2nd Department of Surgical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15618","DOI":"10.1038\/ncomms15618","article-title":"DNA exonuclease Trex1 regulates radiotherapy-induced tumour immunogenicity","volume":"8","author":"Alard","year":"2017","journal-title":"Nat. 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