Review Article
The application of high-dose grid radiotherapy technique
Xiaobo Li, Liuqing Jiang, Xiaodong Wu, Jianping Zhang, Benhua Xu
Published 2018-06-15
Cite as Chin J Radiat Oncol, 2018, 27(6): 624-628. DOI: 10.3760/cma.j.issn.1004-4221.2018.06.019
Abstract
High dose grid radiotherapy (GRID) refers to a single fraction of high-dose radiation (10-25 Gy) in which, beams are divided into multiple small beam lets through a grid collimator or MLC, resulting in non-uniform dose distribution of high and low dose area ( "peak-to-valley" effect) in the target volume. Recently, as 3D radiotherapy (3DRT) technology emerged, the 2D GRID has been reconfigured into 3D dose LATTICE whereby high doses are concentrated at each lattice vertex within the radiation target volume with drastically lower dose between vertices through multiple focused non-coplanar beams with different radiation techniques. Compared with 2D GRID therapy, 3D LATTICE shows significant effect on "peak-to-valley" and minimizes radiation to surrounding tissues.Experimental and clinical data have shown that LATTICE therapies can reduce toxicity to normal tissue while stimulating bystander effects, endothelial cell death and immunogenic abscopal effects leading to enhanced killing of tumor cells and further improve the control of the local and distant disease. The clinic experience with LATTICE, although limited, has demonstrated favorable outcomes, especially for treating bulky tumors and palliative intend. The exact mechanism of the clinical advantages by LATTICE is not explicitly known and a more comprehensive biological study and clinical trials are called should be carried out.
Key words:
High dose; Grid; Lattice; Bulky tumor; Hypofractionation
Contributor Information
Xiaobo Li
Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou 350001, China
Liuqing Jiang
Department of Radiation Oncology, Fudan University Affiliated Shanghai Cancer Center, Shanghai 200032, China
Xiaodong Wu
Innovative Cancer Institute, Miami 33179, Florida
Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai 201315, China
Jianping Zhang
Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou 350001, China
Benhua Xu
Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou 350001, China