Time to rejuvenate ultra-low dose whole-body radiotherapy of cancer

Crit Rev Oncol Hematol. 2021 Apr:160:103286. doi: 10.1016/j.critrevonc.2021.103286. Epub 2021 Mar 2.

Abstract

The results of clinical trials performed from the 1930s until the end of the 20th century in which total-body ultra-low level ionizing radiation (TB-LLR) was used demonstrate that this form of treatment can be equal or superior to other systemic anti-neoplastic modalities in terms of the rates of remissions, toxicity, and side effects. In this review, we provide the rationale for TB-LLR and analyze the results of reliable clinical trials in patients with predominantly lymphoproliferative disorders but also advanced solid cancers. The doses used in these trials did not exceed 0.1-0.2 Gy per fraction and cumulative totals ranged from 1 to 4 Gy. Based on the reviewed results we conclude that it is appropriate to revive interest in and resume clinical investigations of TB-LLR in order to refine and improve the effectiveness of such treatment, whether employed alone or in combination with other anticancer strategies.

Keywords: Cancer radiotherapy; Total-body exposures; Ultra-low ionizing radiation.

Publication types

  • Review

MeSH terms

  • Humans
  • Neoplasms* / radiotherapy
  • Radiation, Ionizing
  • Radiotherapy Dosage
  • Whole-Body Irradiation