Theodore L. Deweese, MD

Metastasis-directed therapy with stereotactic ablative radiotherapy has emerged as a promising complementary technique for the management of low-volume metastatic prostate cancer.

In this review we detail the rationale supporting a combination of immunotherapy and stereotactic radiation. Additionally, we discuss the evidence for the immune stimulatory effects of focused radiation and the role that radiation may play in enhancing the systemic treatment effects of immunotherapy.

The ultimate goal of radiation therapy (RT) is to deliver enough radiation to eradicate all tumor clonogens within the irradiated field while also minimizing dose to adjacent normal structures so as to cause no (or minimal) normal tissue injury. With few exceptions, the dose of radiation currently delivered to most anatomic sites is limited by the tolerance of these adjacent normal organs, thereby restricting the dose of radiation deposited in tumors to an amount that may or may not be ideal to realize an optimal cure. The goal of many advanced technologies introduced into RT are aimed at addressing this problem.