These results clearly showed that although X-ray could induce upregulation of p-MLKL in CNE-2-RR cells, carbon ion could induce more p-MLKL expression than X-ray for both parental and PR-NPC cells (Fig. 3 and S3), indicating the unique radiobiologic effects of carbon ion and could induce more necroptosis. This evidence concerns the gene MLKL and nasopharyngeal carcinoma.