Breast cancer is the most commonly diagnosed non-cutaneous cancer and is the leading cause of cancer mortality in females worldwide. Breast cancer incidence has been increasing over the last few decades; simultaneously, novel therapeutic agents including immunotherapies and targeted therapies have become more prominent in use. Radiation therapy continues to serve as a cornerstone to breast cancer treatment in both early-stage and locoregionally advanced disease. Given the improvement in systemic agents, there is increasing interest in investigating the potential synergistic effect of radiation therapy and immunotherapy. As new trials and studies emerge demonstrating the clinical benefits of immune checkpoint inhibitors (ICIs) in breast cancer, especially in PD-L1-positive triple-negative breast cancer (TNBC), it is crucial to investigate the safety and efficacy of combining immunotherapy with radiation treatment. This narrative review discusses the impact of radiation therapy on anti-tumor immunogenicity, and examines the role of immunotherapy and radiation therapy in early-stage, locally advanced, recurrent, and metastatic breast cancer. We conducted a targeted literature search between 2010 and 2024, and included phase II/III clinical trials, mechanistic studies, and ongoing trials that evaluated the combination of immunotherapy (IO) and radiation therapy (RT). We discuss ongoing clinical studies, side effects, and optimal timing of combined IO and RT to enhance therapeutic outcomes.

Radiotherapy is utilized in the treatment of various cancers of the central nervous system and head and neck. Given the high concentration of organs-at-risk in this region, care must be exercised to minimize the dose delivered to these structures. Studies have shown that excessive radiation exposure can adversely impact the eyes, potentially resulting in the loss of their function. For instance, radiation doses greater than 50 Gy have been shown to increase the incidence of retinopathy, and radiation doses as low as 0.5 Gy have been shown to induce cataract formation. In this review, we discuss the ocular complications of radiotherapy used in the treatment of cancers of the central nervous system and head and neck. We then transition to potential strategies to spare the eyes during radiotherapy in an effort to reduce the rates and severity of ocular complications and preserve vision.