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In situ Tumor Ablation with Radiation Therapy: Its Effect on the Tumor Microenvironment and Anti-tumor Immunity

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Tumor Ablation

Part of the book series: The Tumor Microenvironment ((TTME,volume 5))

Abstract

The delivery of external beam radiation therapy (RT) for cancer with intent to cure has been optimized over the last 80 years and standardized to a protocol with doses fractionated into around 2 Gy amounts delivered daily five times per week to the tumor with a relatively homogeneous field and with the total dose being determined by what adjacent late responding normal tissues might tolerate. The radiobiological principles that underlie the success of such treatments have been elaborated with the most important being the relative sparing of tissues that turnover slowly (late responding tissues) compared with rapidly (acute responding tissues and many cancers) by small dose fractions. The aim of classical RT is therefore to preserve normal tissue function while curing cancer.

The development of more precise dose delivery techniques, accompanied by improved computing and imaging capabilities, have recently added an extra dimension to what can be achieved with RT for cancer. Important trends have emerged towards the use of hypofractionated or high ablative oligofractionated doses. The latter in particular have given early results in treatment of early stage non-small-cell lung cancer, solitary metastases, and some other indications that are very promising and encourage further innovation. The aims of these different types of treatments are however different from those of conventional RT.

This changing face of RT is accompanied by a changing radiobiology. The microenvironmental effects and immunological consequences of high dose fractions are still under investigation but higher than conventional dose fractions are likely to promote more tumor microvasculature damage and pro-inflammatory and pro-oxidant responses that will enhance “danger” signaling in tissues and promote RT-induced anti-tumor immune responses. Optimization of the more advantageous radiobiological aspects of these altered radiation schedules and delivery techniques is a clear and urgent clinical need if we are to improve their radiotherapeutic benefits.

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Acknowledgment

The authors have no conflicts of interest.

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Authors and Affiliations

  1. Division Molecular and Cellular Oncology, Department of Radiation Oncology, David Geffen School of Medicine, University of California at Los Angles (UCLA), Room B3-109, 90095-1714, Los Angeles, CA, USA

    William H. McBride & Dörthe Schaue

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  1. William H. McBride
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  2. Dörthe Schaue
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Correspondence to William H. McBride .

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Editors and Affiliations

  1. and Immunology, Tel Aviv University, Department of Clinical Microbiology, Tel Aviv, 69978, Israel

    Yona Keisari

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McBride, W., Schaue, D. (2013). In situ Tumor Ablation with Radiation Therapy: Its Effect on the Tumor Microenvironment and Anti-tumor Immunity. In: Keisari, Y. (eds) Tumor Ablation. The Tumor Microenvironment, vol 5. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4694-7_6

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