Immunotherapy and radiotherapy

Radiotherapy is a cornerstone of both curative and palliative cancer treatment. Advances in radiotherapy technology and technique have provided incremental gains in the precision and accuracy of treatment delivery. Impetus for these developments has focused on improving tumour targeting with normal tissue avoidance. These spatial gains have provided opportunity for both dose escalation and extreme […]Radiotherapy is a cornerstone of both curative and palliative cancer treatment. Advances in radiotherapy technology and technique have provided incremental gains in the precision and accuracy of treatment delivery. Impetus for these developments has focused on improving tumour targeting with normal tissue avoidance. These spatial gains have provided opportunity for both dose escalation and extreme hypofractionation in an attempt to improve local disease control and clinical outcomes. For the most part, the clinical efficacy of radiotherapy has been attributed to the local effects of ionising radiotherapy via cell death mediated through direct and indirect DNA damage. However, radiotherapy has also been shown to mediate an anti-tumour effect that extends beyond the irradiated target volume. Irradiated tumour cells can in fact release signals that influence the cell death of non-irradiated tumour cells through stimulation of the immune response. Knowledge of the underlying biological mechanisms driving this effect is still being elucidated and exploiting its potential for cancer patient benefit is also in the very early stages. This article provides an overview of the promising but far from simple relationship between radiotherapy and the immune response.

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