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BioMed Research International
Volume 2013, Article ID 658126, 8 pages
Review Article

Immune Modulation and Stereotactic Radiation: Improving Local and Abscopal Responses

1Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, P.O. Box 356043, Seattle, WA 98195, USA
2Department of Radiation Oncology & Molecular Radiation Sciences, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, Baltimore, MD 21218, USA
3Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, Baltimore, MD 21218, USA
4Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, MD 21218, USA
5Department of Urology, Johns Hopkins Medicine, Baltimore, MD 21218, USA

Received 16 June 2013; Revised 5 October 2013; Accepted 5 October 2013

Academic Editor: Rumiana Koynova

Copyright © 2013 Jing Zeng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


New and innovative treatment strategies for cancer patients in the fields of immunotherapy and radiotherapy are rapidly developing in parallel. Among the most promising preclinical treatment approaches is combining immunotherapy with radiotherapy where early data suggest synergistic effects in several tumor model systems. These studies demonstrate that radiation combined with immunotherapy can result in superior efficacy for local tumor control. More alluring is the emergence of data suggesting an equally profound systemic response also known as “abscopal” effects with the combination of radiation and certain immunotherapies. Studies addressing optimal radiation dose, fractionation, and modality to be used in combination with immunotherapy still require further exploration. However, recent anecdotal clinical reports combining stereotactic or hypofractionated radiation regimens with immunotherapy have resulted in dramatic sustained clinical responses, both local and abscopal. Technologic advances in clinical radiation therapy has made it possible to deliver hypofractionated regimens anywhere in the body using stereotactic radiation techniques, facilitating further clinical investigations. Thus, stereotactic radiation in combination with immunotherapy agents represents an exciting and potentially fruitful new space for improving cancer therapeutic responses.