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Review | Open Access

Systemic therapy-based split-course stereotactic body radiation therapy

Rong Zheng1,2,3, Bisi Wang1, Feihong Liang1, Benhua Xu1,2,3( )
Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Fuzhou, Fujian, China
Clinical Research Center for Radiology and Radiotherapy of Fujian Province (Digestive, Hematological and Breast Malignancies), Fuzhou, Fujian, China
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Abstract

Purpose

Given the therapeutic toxicity of concurrent chemoradiotherapy, the dose of chemotherapy is always limited. Hence, the question of how to administer adequate chemotherapy to synchronize stereotactic body radiation therapy (SBRT) treatment strategy for maximizing the benefits of neoadjuvant therapy to improve prognosis is a challenging and debatable issue.

Methods

We summarized the major clinical trials and preclinical studies of split-course CRT and split-course SBRT and explored the feasibility and theoretical advantages of implementing split-course SBRT and systemic therapy simultaneously.

Results

Split-course radiotherapy is a strategy mainly proposed with the aim of further reducing the toxicity of radiotherapy and improving the patient's treatment tolerance, with added features of the extended interval between the fractions instead of daily irradiation. In the past, split-course radiotherapy was not a recommended treatment strategy in terms of local tumor control rates, late response rates, and survival without significant improvement relative to continuous radiotherapy. Split-course SBRT has different biological effects compared to split-course conventional radiotherapy (CRT). The current findings suggest that the split-course SBRT model has good treatment tolerance and facilitates the implementation of adaptive radiotherapy.

Conclusion

This treatment strategy facilitates the upgrading of radiotherapy doses and the combination with systemic therapy, especially with vascular targeting agents and immunotherapy, thus avoiding the disadvantages of split-course CRT, such as reduced local control rate, increased treatment time and economic cost, and has the potential to achieve better tumor suppression.

Keywords

immunotherapychemotherapyradiotherapysplit-course radiotherapystereotactic body radiation therapy

References

1

Arcelli A, Buwenge M, Macchia G, et al. Stereotactic body radiotherapy vs conventionally fractionated chemoradiation in locally advanced pancreatic canssscer: a multicenter case-control study (PAULA-1). Cancer Med. 2020;9(21):7879-7887.
Crossref Google Scholar
2

Zhong J, Patel K, Switchenko J, et al. Outcomes for patients with locally advanced pancreatic adenocarcinoma treated with stereotactic body radiation therapy versus conventionally fractionated radiation. Cancer-Am Cancer Soc. 2017;123(18):3486-3493.
Crossref Google Scholar
3

Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. Lancet. 2019;393(10185):2051-2058.
Crossref Google Scholar
4

Nathani P, Gopal P, Rich N, et al. Hepatocellular carcinoma tumour volume doubling time: a systematic review and meta-analysis. Gut. 2021;70(2):401-407.
Google Scholar
5

Raabe A, Quaester S, Dubben HH, et al. Impact of treatment acceleration and its timing on the response of the rhabdomyosarcoma R1H of the rat to fractionated irradiation. Strahlenther Onkol. 2001;177(7):362-366.
Crossref Google Scholar
6

Blackstock AW, Bogart JA, Matthews C, et al. Split-course versus continuous thoracic radiation therapy for limited-stage small-cell lung cancer: final report of a randomized phase Ⅲ trial. Clin Lung Cancer. 2005;6(5):287-292.
Crossref Google Scholar
7

Simpson JR, Francis ME, Perez-Tamayo R, Marks RD, Rao DV. Palliative radiotherapy for inoperable carcinoma of the lung: final report of a RTOG multi-institutional trial. Int J Radiat Oncol Biol Phys. 1985;11(4):751-758.
Crossref Google Scholar
8

Holsti LR, Mattson K. A randomized study of split-course radiotheray of lung cancer: long term results. Int J Radiat Oncol Biol Phys. 1980;6(8):977-981.
Crossref Google Scholar
9

Marcial VA, Hanley JA, Chang C, Davis LW, Moscol JA. Split-course radiation therapy of carcinoma of the nasopharynx: results of a national collaborative clinical trial of the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys. 1980;6(4):409-414.
Crossref Google Scholar
10

Maranzano E, Bellavita R, Rossi R, et al. Short-course versus split-course radiotherapy in metastatic spinal cord compression: results of a phase Ⅲ, randomized, multicenter trial. J Clin Oncol. 2005;23(15):3358-3365.
Crossref Google Scholar
11

Overgaard J, Hjelm-Hansen M, Johansen LV, Andersen AP. Comparison of conventional and split-course radiotherapy as primary treatment in carcinoma of the larynx. Acta Oncol. 1988;27(2):147-152.
Crossref Google Scholar
12

Weber DC, Kurtz JM, Allal AS. The impact of gap duration on local control in anal canal carcinoma treated by split-course radiotherapy and concomitant chemotherapy. Int J Radiat Oncol Biol Phys. 2001;50(3):675-680.
Crossref Google Scholar
13

Amdur RJ, Parsons JT, Mendenhall WM, Million RR, Cassisi NJ. Split-course versus continuous-course irradiation in the postoperative setting for squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys. 1989;17(2):279-285.
Crossref Google Scholar
14

Parsons JT, Thar TL, Bova FJ, Million RR. An evaluation of split-course irradiation for pelvic malignancies. Int J Radiat Oncol Biol Phys. 1980;6(2):175-181.
Crossref Google Scholar
15

Saarilahti K, Kajanti M, Lehtonen H, Hämäläinen T, Joensuu H. Repopulation during radical radiotherapy for T1 glottic cancer. Radiother Oncol. 1998;47(2):155-159.
Crossref Google Scholar
16

Hansen O, Overgaard J, Hansen HS, et al. Importance of overall treatment time for the outcome of radiotherapy of advanced head and neck carcinoma: dependency on tumor differentiation. Radiother Oncol. 1997;43(1):47-51.
Crossref Google Scholar
17

Marcial VA, Pajak TF, Rotman M, Brady LW, Amato D. "Compensated" split-course versus continuous radiation therapy of carcinoma of the tonsillar fossa. Final results of a prospective randomized clinical trial of the Radiation Therapy Oncology Group. Am J Clin Oncol. 1993;16(5):389-396.
Crossref Google Scholar
18

Kajanti M, Kaleta R, Kankaanranta L, Muhonen T, Holsti L. Effect of overall treatment time on local control in radical radiotherapy for squamous cell carcinoma of esophagus. Int J Radiat Oncol Biol Phys. 1995;32(4):1017-1023.
Crossref Google Scholar
19

Emami B, Munzenrider JE, Lee DJ, Rene JB. Radical radiation therapy of advanced lung cancer: evaluation of prognostic factors and results of continuous and split course treatment. Cancer-Am Cancer Soc. 1979;44(2):446-456.
Crossref
20

González FJ, Jaén OJ, Azinovic I, Jeremic B. Effect of radiotherapy delay in overall treatment time on local control and survival in head and neck cancer: review of the literature. Rep Pract Oncol Radiother. 2015;20(5):328-339.
Crossref Google Scholar
21

Maciejewski B, Majewski S. Dose fractionation and tumour repopulation in radiotherapy for bladder cancer. Radiother Oncol. 1991;21(3):163-170.
Crossref Google Scholar
22

Chen SW, Liang JA, Yang SN, Ko HL, Lin FJ. The adverse effect of treatment prolongation in cervical cancer by high-dose-rate intracavitary brachytherapy. Radiother Oncol. 2003;67(1):69-76.
Crossref Google Scholar
23

Domb C, Smile TD, Reddy C, et al. Updated outcomes of split course radiotherapy in elderly or infirm patients with advanced cancers of the head and neck. Anticancer Res. 2021;41(10):4995-5000.
Crossref Google Scholar
24

Qiu B, Xiong M, Luo Y, et al. Hypofractionated intensity modulated radiation therapy with concurrent chemotherapy in locally advanced non-small cell lung cancer: a Phase Ⅱ Prospective Clinical Trial (GASTO1011). Pract Radiat Oncol. 2021;11(5):374-383.
Crossref Google Scholar
25

Bledsoe TJ, Noble AR, Reddy CA, et al. Split-course accelerated hypofractionated radiotherapy (SCAHRT): a safe and effective option for head and neck cancer in the elderly or infirm. Anticancer Res. 2016;36(3):933-939.
Google Scholar
26

Michael M, Chander S, McKendrick J, et al. Phase Ⅱ trial evaluating the feasibility of interdigitating folfox with chemoradiotherapy in locally advanced and metastatic rectal cancer. Br J Cancer. 2014;111(10):1924-1931.
Crossref Google Scholar
27

Crehange G, Maingon P, Peignaux K, et al. Phase Ⅲ trial of protracted compared with split-course chemoradiation for esophageal carcinoma: federation Francophone de Cancerologie Digestive 9102. J Clin Oncol. 2007;25(31):4895-4901.
Crossref Google Scholar
28

Pradier O, Christiansen H, Ambrosch P, et al. A long-term follow-up study after split-course irradiation with concurrent chemotherapy (carboplatin) for locally advanced head and neck cancer and a review of the literature. ORL J Otorhinolaryngol Relat Spec. 2004;66(6):325-331.
Crossref Google Scholar
29

Cüneyt UH, Pak Y. Preliminary results of radiotherapy with or without weekly paclitaxel in locally advanced non-small cell lung cancer. J Cancer Res Clin Oncol. 2003;129(1):52-56.
Crossref Google Scholar
30

Van Laethem JL, Demols A, Gay F, et al. Postoperative adjuvant gemcitabine and concurrent radiation after curative resection of pancreatic head carcinoma: a phase Ⅱ study. Int J Radiat Oncol Biol Phys. 2003;56(4):974-980.
Crossref Google Scholar
31

Oka M, Fukuda M, Fukuda M, et al. Phase Ⅰ study of irinotecan and cisplatin with concurrent split-course radiotherapy in unresectable and locally advanced non-small cell lung cancer. Eur J Cancer. 2001;37(11):1359-1365.
Crossref Google Scholar
32

Benchalal M, Salze P, Bombaron P, et al. Concurrent split-course chemotherapy and radiotherapy for unresectable stage Ⅲ non-small cell lung cancer: preliminary results of a Phase Ⅱ study. Cancer Radiother. 1999;3(6):453-460.
Crossref Google Scholar
33

Minatel E, Gigante M, Franchin G, et al. Combined radiotherapy and bleomycin in patients with inoperable head and neck cancer with unfavourable prognostic factors and severe symptoms. Oral Oncol. 1998;34(2):119-122.
Crossref Google Scholar
34

Planting A, Helle P, Drings P, et al. A randomized study of high-dose split course radiotherapy preceded by high-dose chemotherapy versus high-dose radiotherapy only in locally advanced non-small-cell lung cancer. An EORTC Lung Cancer Cooperative Group trial. Ann Oncol. 1996;7(2):139-144.
Crossref Google Scholar
35

Kajanti M, Holsti LR, Holsti P, Möykkynen K. Effect of split-course radiotherapy on survival and local control in advanced localized prostatic carcinoma. Int J Radiat Oncol Biol Phys. 1993;26(2):211-216.
Crossref Google Scholar
36

Stryker JA, Harvey HA, Houck JR, Manders EK, Bradfield JJ. Advanced head and neck cancer: low-dose, split-course radiation therapy and simultaneous infusion of 5-fluorouracil and cisplatin. Radiology. 1990;176(2):567-571.
Crossref Google Scholar
37

Nagy-Mignotte H, Bolla M, Wuyam B, et al. Sequential combination of 5-fluorouracil, cis-platinum and irradiation in unresectable non-small cell lung cancer. Radiother Oncol. 1989;15(4):333-339.
Crossref Google Scholar
38

Taylor ST, Murthy AK, Caldarelli DD, et al. Combined simultaneous cisplatin/fluorouracil chemotherapy and split course radiation in head and neck cancer. J Clin Oncol. 1989;7(7):846-856.
Crossref Google Scholar
39

Sadeghi A, Payne D, Rubinstein L, Lad T. Combined modality treatment for resected advanced non-small cell lung cancer: local control and local recurrence. Int J Radiat Oncol Biol Phys. 1988;15(1):89-97.
Crossref Google Scholar
40

Simpson JR, Francis ME, Perez-Tamayo R, Marks RD, Rao DV. Palliative radiotherapy for inoperable carcinoma of the lung: final report of a RTOG multi-institutional trial. Int J Radiat Oncol Biol Phys. 1985;11(4):751-758.
Crossref Google Scholar
41

Fukuda M, Nakamura Y, Kinoshita A, et al. Phase Ⅱ study of irinotecan and cisplatin with concurrent split-course radiotherapy in limited-disease small cell lung cancer. Cancer Chemother Pharmacol. 2012;70(5):645-651.
Crossref Google Scholar
42

Berger B, Belka C, Weinmann M, et al. Reirradiation with alternating docetaxel-based chemotherapy for recurrent head and neck squamous cell carcinoma: update of a single-center prospective phase Ⅱ protocol. Strahlenther Onkol. 2010;186(5):255-261.
Crossref Google Scholar
43

Ariga H, Nemoto K, Miyazaki S, et al. Prospective comparison of surgery alone and chemoradiotherapy with selective surgery in resectable squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2009;75(2):348-356.
Crossref Google Scholar
44

Oka M, Fukuda M, Kuba M, et al. Phase Ⅰ study of irinotecan and cisplatin with concurrent split-course radiotherapy in limited-disease small-cell lung cancer. Eur J Cancer. 2002;38(15):1998-2004.
Crossref Google Scholar
45

Krol AD, Aussems P, Noordijk EM, Hermans J, Leer JW. Local irradiation alone for peripheral stage Ⅰ lung cancer: could we omit the elective regional nodal irradiation? Int J Radiat Oncol Biol Phys. 1996;34(2):297-302.
Crossref Google Scholar
46

Kajanti MJ, Holsti LR, Mäntylä MM. Postoperative radiotherapy of squamous cell carcinoma of the tonsil. Factors influencing survival and time to recurrence. Acta Oncol. 1992;31(1):49-52.
Crossref Google Scholar
47

Pearcey RG, MacLean GD. A phase Ⅰ/Ⅱ study combining radical radiotherapy with concurrent cisplatin in the treatment of advanced squamous cell carcinoma of the cervix. Int J Gynecol Cancer. 1992;2(4):215-219.
Crossref Google Scholar
48

Kajanti M, Holsti LR, Holsti P. Radical surgery and postoperative split-course radiotherapy in squamous cell carcinoma of the mobile tongue: factors influencing local control and the time to recurrence. Radiother Oncol. 1991;22(3):174-179.
Crossref Google Scholar
49

Osterlind K, Hansen HH, Hansen HS, et al. Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up. Br J Cancer. 1986;54(1):7-17.
Crossref Google Scholar
50

Marcial VA, Hanley JA, Hendrickson F, Ortiz H. Split-course radiation therapy of carcinoma of the base of the tongue: results of a prospective national collaborative clinical trial conducted by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys. 1983;9(4):437-443.
Crossref Google Scholar
51

Hazra TA, Chandrasekaran MS, Colman M, Prempree T, Inalsingh A. Survival in carcinoma of the lung after a split course of radiotherapy. Br J Radiol. 1974;47(560):464-466.
Crossref Google Scholar
52

Landgren RC, Hussey DH, Barkley HJ, Samuels ML. Split-course irradiation compared to split-course irradiation plus hydroxyurea in inoperable bronchogenic carcinoma––a randomized study of 53 patients. Cancer-Am Cancer Soc. 1974;34(5):1598-1601.
Crossref
53

Sun J, Zhang T, Wang J, et al. Biologically effective dose (BED) of stereotactic body radiation therapy (SBRT) was an important factor of therapeutic efficacy in patients with hepatocellular carcinoma (≤5 cm). BMC Cancer. 2019;19(1):846.
Crossref Google Scholar
54

Thompson R, Cheung P, Chu W, et al. Outcomes of extra-cranial stereotactic body radiotherapy for metastatic colorectal cancer: dose and site of metastases matter. Radiother Oncol. 2020;142:236-245.
Crossref Google Scholar
55

Kang JI, Sufficool DC, Hsueh CT, et al. A phase Ⅰ trial of Proton stereotactic body radiation therapy for liver metastases. J Gastrointest Oncol. 2019;10(1):112-117.
Crossref Google Scholar
56

Kang JK, Kim MS, Cho CK, et al. Stereotactic body radiation therapy for inoperable hepatocellular carcinoma as a local salvage treatment after incomplete transarterial chemoembolization. Cancer-Am Cancer Soc. 2012;118(21):5424-5431.
Crossref Google Scholar
57

Higuchi Y, Serizawa T, Nagano O, et al. Three-staged stereotactic radiotherapy without whole brain irradiation for large metastatic brain tumors. Int J Radiat Oncol Biol Phys. 2009;74(5):1543-1548.
Crossref Google Scholar
58

Paik EK, Kim MS, Seo YS, et al. Feasibility of split-course stereotactic ablative radiotherapy for oligometastases. Jpn J Clin Oncol. 2018;48(6):548-554.
Crossref Google Scholar
59

Baumann BC, Wei J, Plastaras JP, et al. Stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma: high rates of local control with low toxicity. Am J Clin Oncol. 2018;41(11):1118-1124.
Crossref Google Scholar
60

Angelov L, Mohammadi AM, Bennett EE, et al. Impact of 2-staged stereotactic radiosurgery for treatment of brain metastases ≥ 2 cm. J Neurosurg. 2018;129(2):366-382.
Crossref Google Scholar
61

Serizawa T, Higuchi Y, Yamamoto M, et al. Comparison of treatment results between 3- and 2-stage Gamma Knife radiosurgery for large brain metastases: a retrospective multi-institutional study. J Neurosurg. 2018;131(1):227-237.
Crossref Google Scholar
62

Dohm A, McTyre ER, Okoukoni C, et al. Staged stereotactic radiosurgery for large brain metastases: local control and clinical outcomes of a one-two punch technique. Neurosurgery. 2018;83(1):114-121.
Crossref Google Scholar
63

Dohm AE, Hughes R, Wheless W, et al. Surgical resection and postoperative radiosurgery versus staged radiosurgery for large brain metastases. J Neurooncol. 2018;140(3):749-756.
Crossref Google Scholar
64

Yamamoto M, Higuchi Y, Serizawa T, et al. Three-stage Gamma Knife treatment for metastatic brain tumors larger than 10 cm3: a 2-institute study including re-analyses of earlier results using competing risk analysis. J Neurosurg. 2018;129(Suppl 1):77-85.
Crossref Google Scholar
65

Patel NS, Link MJ, Tombers NM, Pollock BE, Carlson ML. Quality of life in jugular paraganglioma following radiosurgery. Otol Neurotol. 2019;40(6):820-825.
Crossref Google Scholar
66

Ito D, Aoyagi K, Nagano O, et al. Comparison of two-stage Gamma Knife radiosurgery outcomes for large brain metastases among primary cancers. J Neurooncol. 2020;147(1):237-246.
Crossref Google Scholar
67

Lovo EE, Barahona KC, Campos F, et al. Two-session radiosurgery for large primary tumors affecting the brain. Cureus. 2020;12(4):e7850. https://doi.org/10.7759/cureus.7850
Crossref Google Scholar
68

Ginalis EE, Cui T, Weiner J, Nie K, Danish S. Two-staged stereotactic radiosurgery for the treatment of large brain metastases: single institution experience and review of literature. J Radiosurg SBRT. 2020;7(2):105-114.
Google Scholar
69

Yomo S, Yako T, Kitazawa K, Oguchi K. Staged radiosurgery alone versus postoperative cavity radiosurgery for patients with midsize-to-large brain metastases: a propensity score matching analysis. J Neurosurg. 2021:1-8.
Crossref Google Scholar
70

Cui T, Weiner J, Danish S, et al. Evaluation of biological effective dose in gamma knife staged stereotactic radiosurgery for large brain metastases. Front Oncol. 2022;12:892139. https://doi.org/10.3389/fonc.2022.892139
Crossref Google Scholar
71

Damron EP, Dono A, Chafi H, et al. Metastatic neoplasm volume kinetics following 2-stage stereotactic radiosurgery. World Neurosurg. 2022;161:e210-e219.
Crossref Google Scholar
72

Li W, Cao Z, Chang P, et al. Clinical efficacy of PD-1 inhibitors plus split-course radiotherapy in the first-line treatment of advanced kidney cancer: a Randomized Controlled Trial. J Oncol. 2022;2022:8100323. https://doi.org/10.1155/2022/8100323
Crossref Google Scholar
73

Lawrence TS, Blackstock AW, McGinn C. The mechanism of action of radiosensitization of conventional chemotherapeutic agents. Semin Radiat Oncol. 2003;13(1):13-21.
Crossref Google Scholar
74

Mandal A, Choudhary S, Mani N, Aggarwal SK. A radiobiological and dosimetrical comparison between simultaneous integrated and sequential boost intensity-modulated arc treatment of locally advanced head-and-neck cancer. J Cancer Res Ther. 2020;16(3):508-512.
Crossref Google Scholar
75

Higgins GS, O'Cathail SM, Muschel RJ, McKenna WG. Drug radiotherapy combinations: review of previous failures and reasons for future optimism. Cancer Treat Rev. 2015;41(2):105-113.
Crossref Google Scholar
76

Gurka MK, Kim C, He AR, et al. Stereotactic body radiation therapy (SBRT) combined with chemotherapy for unresected pancreatic adenocarcinoma. Am J Clin Oncol. 2017;40(2):152-157.
Crossref Google Scholar
77

Murphy JD, Christman-Skieller C, Kim J, et al. A dosimetric model of duodenal toxicity after stereotactic body radiotherapy for pancreatic cancer. Int J Radiat Oncol Biol Phys. 2010;78(5):1420-1426.
Crossref Google Scholar
78

Chen N, Li Q, Wang S, et al. Hypo-fractionated radiotherapy with concurrent chemotherapy for locoregional recurrence of non-small cell lung cancer after complete resection: a prospective, single-arm, phase Ⅱ study (GASTO-1017). Lung Cancer. 2021;156:82-90.
Crossref Google Scholar
79

Kajanti MJ, Holsti LR, Mäntylä MM. Postoperative radiotherapy of squamous cell carcinoma of the tonsil. Factors influencing survival and time to recurrence. Acta Oncol. 1992;31(1):49-52.
Crossref Google Scholar
80

Pearcey RG, MacLean GD. A phase Ⅰ/Ⅱ study combining radical radiotherapy with concurrent cisplatin in the treatment of advanced squamous cell carcinoma of the cervix. Int J Gynecol Cancer. 1992;2(4):215-219.
Crossref Google Scholar
81

Kajanti M, Holsti LR, Holsti P. Radical surgery and postoperative split-course radiotherapy in squamous cell carcinoma of the mobile tongue: factors influencing local control and the time to recurrence. Radiother Oncol. 1991;22(3):174-179.
Crossref Google Scholar
82

Osterlind K, Hansen HH, Hansen HS, et al. Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up. Br J Cancer. 1986;54(1):7-17.
Crossref Google Scholar
83

Marcial VA, Hanley JA, Hendrickson F, Ortiz H. Split-course radiation therapy of carcinoma of the base of the tongue: results of a prospective national collaborative clinical trial conducted by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys. 1983;9(4):437-443.
Crossref Google Scholar
84

Hazra TA, Chandrasekaran MS, Colman M, Prempree T, Inalsingh A. Survival in carcinoma of the lung after a split course of radiotherapy. Br J Radiol. 1974;47(560):464-466.
Crossref Google Scholar
85

Higuchi Y, Serizawa T, Nagano O, et al. Three-staged stereotactic radiotherapy without whole brain irradiation for large metastatic brain tumors. Int J Radiat Oncol Biol Phys. 2009;74(5):1543-1548.
Crossref Google Scholar
86

Hsieh CH, Chang HT, Lin SC, et al. Toxic risk of stereotactic body radiotherapy and concurrent helical tomotherapy followed by erlotinib for non-small-cell lung cancer treatment–case report. BMC Cancer. 2010;10:696.
Crossref Google Scholar
87

Angelov L, Mohammadi AM, Bennett EE, et al. Impact of 2-staged stereotactic radiosurgery for treatment of brain metastases ≥ 2 cm. J Neurosurg. 2018;129(2):366-382.
Crossref Google Scholar
88

Vaupel P, Mayer A. Hypoxia in cancer: significance and impact on clinical outcome. Cancer Metastasis Rev. 2007;26(2):225-239.
Crossref Google Scholar
89

Harriss-Phillips WM, Bezak E, Potter A. Stochastic predictions of cell kill during stereotactic ablative radiation therapy: do hypoxia and reoxygenation really matter? Int J Radiat Oncol Biol Phys. 2016;95(4):1290-1297.
Crossref Google Scholar
90

Carlson DJ, Keall PJ, Loo BJ, Chen ZJ, Brown JM. Hypofractionation results in reduced tumor cell kill compared to conventional fractionation for tumors with regions of hypoxia. Int J Radiat Oncol Biol Phys. 2011;79(4):1188-1195.
Crossref Google Scholar
91

Brown JM, Carlson DJ, Brenner DJ. The tumor radiobiology of SRS and SBRT: are more than the 5 Rs involved? Int J Radiat Oncol Biol Phys. 2014;88(2):254-262.
Crossref Google Scholar
92

Higuchi Y, Serizawa T, Nagano O, et al. Three-staged stereotactic radiotherapy without whole brain irradiation for large metastatic brain tumors. Int J Radiat Oncol Biol Phys. 2009;74(5):1543-1548.
Crossref Google Scholar
93

Hafeez S, McDonald F, Lalondrelle S, et al. Clinical outcomes of image guided adaptive hypofractionated weekly radiation therapy for bladder cancer in patients unsuitable for radical treatment. Int J Radiat Oncol Biol Phys. 2017;98(1):115-122.
Crossref Google Scholar
94

McDonald F, Lalondrelle S, Taylor H, et al. Clinical implementation of adaptive hypofractionated bladder radiotherapy for improvement in normal tissue irradiation. Clin Oncol (R Coll Radiol). 2013;25(9):549-556.
Crossref Google Scholar
95

Bruggeman AR, Sarkar RR, Ahn GS, et al. Split course palliative radiotherapy for advanced lung cancer with 3D planning based analysis of outcome: a retrospective review. Ann Palliat Med. 2022;11(2):423-430.
Crossref Google Scholar
96

Domb C, Smile TD, Reddy C, et al. Updated outcomes of split course radiotherapy in elderly or infirm patients with advanced cancers of the head and neck. Anticancer Res. 2021;41(10):4995-5000.
Crossref Google Scholar
97

Park HJ, Griffin RJ, Hui S, Levitt SH, Song CW. Radiation-induced vascular damage in tumors: implications of vascular damage in ablative hypofractionated radiotherapy (SBRT and SRS). Radiat Res. 2012;177(3):311-327.
Crossref Google Scholar
98

Garcia-Barros M, Paris F, Cordon-Cardo C, et al. Tumor response to radiotherapy regulated by endothelial cell apoptosis. Science. 2003;300(5622):1155-1159.
Crossref Google Scholar
99

Fuks Z, Kolesnick R. Engaging the vascular component of the tumor response. Cancer Cell. 2005;8(2):89-91.
Crossref Google Scholar
100

Lan J, Li R, Yin LM, et al. Targeting myeloid-derived suppressor cells and programmed death ligand 1 confers therapeutic advantage of ablative hypofractionated radiation therapy compared with conventional fractionated radiation therapy. Int J Radiat Oncol Biol Phys. 2018;101(1):74-87.
Crossref Google Scholar
101

Finkelstein SE, Timmerman R, McBride WH, et al. The confluence of stereotactic ablative radiotherapy and tumor immunology. Clin Dev Immunol. 2011;2011:439752. https://doi.org/10.1155/2011/439752
Crossref Google Scholar
102

Song CW, Kim MS, Cho LC, Dusenbery K, Sperduto PW. Radiobiological basis of SBRT and SRS. Int J Clin Oncol. 2014;19(4):570-578.
Crossref Google Scholar
103

Filatenkov A, Baker J, Mueller AM, et al. Ablative Tumor radiation can change the tumor immune cell microenvironment to induce durable complete remissions. Clin Cancer Res. 2015;21(16):3727-3739.
Crossref Google Scholar
104

Lee Y, Auh SL, Wang Y, et al. Therapeutic effects of ablative radiation on local tumor require CD8+ T cells: changing strategies for cancer treatment. Blood. 2009;114(3):589-595.
Crossref Google Scholar
105

Lugade AA, Moran JP, Gerber SA, et al. Local radiation therapy of B16 melanoma tumors increases the generation of tumor antigen-specific effector cells that traffic to the tumor. J Immunol. 2005;174(12):7516-7523.
Crossref Google Scholar
106

Nishikawa H, Sakaguchi S. Regulatory T cells in tumor immunity. Int J Cancer. 2010;127(4):759-767.
Crossref Google Scholar
107

Aryankalayil MJ, Makinde AY, Gameiro SR, et al. Defining molecular signature of pro-immunogenic radiotherapy targets in human prostate cancer cells. Radiat Res. 2014;182(2):139-148.
Crossref Google Scholar
108

Mohiuddin M, McDay J, Leeper D, Kramer S. Optimum fractionation for irradiation of carcinoma of the bladder. Experiments based on one case. Acta Radiol Oncol Radiat Phys Biol. 1979;18(1):11-16.
Crossref Google Scholar
109

Glynne-Jones R, Hall M, Nagtegaal ID. The optimal timing for the interval to surgery after short course preoperative radiotherapy (5 ×5 Gy) in rectal cancer––are we too eager for surgery? Cancer Treat Rev. 2020;90:102104. https://doi.org/10.1016/j.ctrv.2020.102104
Crossref Google Scholar
Precision Radiation Oncology
Volume 6 Issue 4,
December 2022
Pages 306-320
DOI: 10.1002/pro6.1176
Cite this article:
Zheng R, Wang B, Liang F, et al. Systemic therapy-based split-course stereotactic body radiation therapy. Precision Radiation Oncology, 2022, 6(4): 306-320. https://doi.org/10.1002/pro6.1176

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Received: 13 September 2022
Revised: 18 October 2022
Accepted: 28 October 2022
Published: 27 November 2022
© 2022 The Authors. Precision Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Shandong Cancer Hospital & Institute.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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