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      Abscopal Effect after Radiosurgery for Solitary Brain Metastasis from Non-small Cell Lung Cancer

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          Abstract

          The abscopal effect is a phenomenon relating to the treatment of metastatic cancer in which localized irradiation to a tumor concurrently causes shrinkage of tumors distant from the area of treatment. Localized radiotherapy is thought to cause anti-tumor immunologic responses that lead to regression and remission of cancers distant to the initial location of treatment. We present a 47-year-old male with brain metastasis from non-small cell lung cancer (NSCLC) who went into remission following stereotactic radiosurgery treatment to a brain lesion, in the absence of systemic treatment. We discuss the novelty of this case and its importance to future research on the abscopal effect. Though it is difficult to distinguish the abscopal effect from spontaneous remission of non-targeted cancer, this report sheds insight on the potential for improving treatment for the leading cause of cancer death worldwide.

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          Most cited references4

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          The abscopal effect of local radiotherapy: using immunotherapy to make a rare event clinically relevant.

          Recently, immunologic responses to localized irradiation are proposed as mediator of systemic effects after localized radiotherapy (called the abscopal effect). Here, we give an overview of both preclinical and clinical data about the abscopal effect in particular and link them with the immunogenic properties of radiotherapy.
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            Effects of radiation on the metastatic process

            Radiotherapy remains one of the corner stones in the treatment of various malignancies and often leads to an improvement in overall survival. Nonetheless, pre-clinical evidence indicates that radiation can entail pro-metastatic effects via multiple pathways. Via direct actions on cancer cells and indirect actions on the tumor microenvironment, radiation has the potential to enhance epithelial-to-mesenchymal transition, invasion, migration, angiogenesis and metastasis. However, the data remains ambiguous and clinical observations that unequivocally prove these findings are lacking. In this review we discuss the pre-clinical and clinical data on the local and systemic effect of irradiation on the metastatic process with an emphasis on the molecular pathways involved.
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              Spontaneous Regression of Thoracic Metastases While Progression of Brain Metastases After Stereotactic Radiosurgery and Stereotactic Body Radiotherapy for Metastatic Renal Cell Carcinoma: Abscopal Effect Prevented by the Blood-Brain Barrier?

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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                26 December 2018
                December 2018
                : 10
                : 12
                : e3777
                Affiliations
                [1 ] Family Medicine, Ascension Macomb-Oakland, Madison Heights, USA
                [2 ] Oncology, Ascension Macomb-Oakland, Warren, USA
                [3 ] Radiation Oncology, Ascension Macomb-Oakland, Rochester Hills, USA
                [4 ] Radiation Oncology, Ascension Macomb-Oakland, Warren, USA
                Author notes
                Article
                10.7759/cureus.3777
                6395017
                b3805f28-4016-489b-ad0f-1019c23bb7fe
                Copyright © 2018, Hamilton et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 2 December 2018
                : 19 December 2018
                Categories
                Radiation Oncology
                Radiology
                Oncology

                abscopal effect,radiosurgery,radiotherapy,non-small cell lung cancer,squamous cell carcinoma,brain metastases,irradiation,radiation therapy,immunotherapy

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