Stereotactic body radiation therapy (SBRT) utilizing a small number of high-dose radiation therapy fractions continues to expand in clinical application. Although many approaches have been proposed to radiosensitize tumors with conventional fractionation, how these radiosensitizers will translate to SBRT remains largely unknown. Here, we review our current understanding of how SBRT eradicates tumors, including the potential contributions of endothelial cell death and immune system activation. In addition, we identify several new opportunities for radiosensitization generated by the move toward high dose per fraction radiation therapy.
From the *Department of Radiation Oncology, Duke University, Durham; †Department of Internal Medicine, Moses H. Cone Memorial Hospital, Greensboro; and ‡Department of Pharmacology & Cancer Biology, Duke University, Durham, NC.
Conflicts of Interest and Source of Funding: D.G.K. serves on the scientific advisory board and owns stock in Lumicell Inc, which is commercializing intraoperative imaging technology. D.G.K. has received research funding from Lumicell Inc, GlaxoSmithKline, and Janssen. D.G.K. is a founder of XRad Therapeutics and owns stock in XRad Therapeutics. The other authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.
Reprints: David G. Kirsch, MD, PhD, Duke University Medical Center, Box 91006 Durham, NC 27708. E-mail: firstname.lastname@example.org.