Abscopal Effect of Radiotherapy in the Immunotherapy Era: Systematic Review of Reported Cases

Mounting evidence suggests that radiation stimulates the immune system and this contributes to the abscopal effect, which is defined as "response at a distance from the irradiated volume." Though identified more than 50 years ago, the abscopal effect is revisited today. One rationale is th...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2019-02, Vol.11 (2), p.e4103-e4103
Main Authors: Dagoglu, Nergiz, Karaman, Sule, Caglar, Hale B, Oral, Ethem N
Format: Article
Language:English
Subjects:
Cancer therapies
Chemotherapy
Clinical trials
Deoxyribonucleic acid
DNA
Evidence-based medicine
Fractionation
Histology
Immune system
Immunotherapy
Liver
Melanoma
Metastasis
Oncology
Patients
Radiation Oncology
Radiation therapy
Stem cells
Systematic review
Tumors
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Summary:Mounting evidence suggests that radiation stimulates the immune system and this contributes to the abscopal effect, which is defined as "response at a distance from the irradiated volume." Though identified more than 50 years ago, the abscopal effect is revisited today. One rationale is that the abscopal effect is often observed with efficient immunotherapy. Here, we give an overview of the clinical data on the abscopal effect, generated by a combination of immunotherapy and radiotherapy (RT). Only papers that included RT in combination with immunotherapy were evaluated according to four main categories including RT parameters, sequencing of therapies, the definition of the abscopal effect, and patient selection. Twenty-four cases in 15 reports were reviewed. The results varied. Patient ages ranged from 24 to 74. RT dose (median total dose 18-58 Gy) varied. Biologically effective dose (BED) 10 was calculated to be a median 49.65 Gy (28-151 Gy). The time to a documented abscopal response ranged from less than a month to 12 months. The large variation concerning fractionation and sequencing of therapies indicates that these conflicting points need to be resolved, to generate for the abscopal effect to be clinically significant.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.4103