[Spatially fractionated radiotherapy : introduction into clinical practice]

Area of Science:

• Oncology
• Radiation Oncology
• Immunology

Context:

• Spatially fractionated radiotherapy represents an innovative approach to tumor irradiation.
• Techniques include mini-beam, micro-beam (pre-clinical), and LATTICE radiotherapy (L-RT) (clinical).
• L-RT is emerging in clinical practice with limited but promising evidence.

Purpose:

• To introduce and discuss the concept and clinical applications of spatially fractionated radiotherapy, specifically LATTICE radiotherapy.
• To highlight the potential clinical scenarios for L-RT: definitive palliative, dose escalation (boost), and salvage radiotherapy.
• To underscore the ongoing investigation into the interaction between L-RT and the immune system.

Summary:

• Spatially fractionated radiotherapy, particularly LATTICE radiotherapy (L-RT), involves partial irradiation of tumor volumes.
• While clinical evidence for L-RT is still developing, it has demonstrated excellent outcomes in palliative, boost, and salvage settings.
• Pre-clinical studies indicate a significant interaction between L-RT and the immune system, potentially leading to abscopal effects.

Impact:

• L-RT offers a novel strategy in radiation oncology with potential for improved tumor control.
• Understanding the L-RT and immune system interaction could unlock new therapeutic possibilities, including immune-mediated tumor regression.
• Further research into L-RT may refine its clinical application and expand its role in cancer treatment.