Lattice and GRID radiotherapy
Deliberately treating a big tumour unevenly, with a lattice of very high dose peaks inside it, instead of a uniform dose.
Spatially fractionated radiotherapy places vertices of ablative dose inside a bulky tumour while valleys receive far less, exploiting bystander and immune effects rather than uniform coverage. Studies active in 2026 include Memorial Sloan Kettering (NCT05837767, recruiting), a randomised comparison against conventional radiotherapy in China (NCT06980259, recruiting), and combinations with checkpoint blockade (NCT07428148, NYU; NCT07041788). Most published series are palliative and single-arm.
How it works
High-dose vertices spaced across the tumour create steep dose gradients; abscopal and bystander signalling plus vascular damage are proposed to extend the effect beyond the peaks.
- Debulks large tumours that cannot tolerate uniform ablative dose
- Clear rationale for combining with immunotherapy
- Deliverable on standard linear accelerators
- Mechanism is not settled
- Mostly palliative, single-arm evidence
- No consensus on vertex spacing or dose
Latest papers
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