title: [Non-targeted effects (bystander, abscopal) of external beam radiation therapy: an overview for the clinician].
abstract: Radiotherapy is advocated in the treatment of cancer of over 50 % of patients. It has long been considered as a focal treatment only. However, the observation of effects, such as fatigue and lymphopenia, suggests that systemic effects may also occur. The description of bystander and abscopal effects suggests that irradiated cells may exert an action on nearby or distant unirradiated cells, respectively. A third type of effect that involves feedback interactions between irradiated cells was more recently described (cohort effect). This new field of radiation therapy is yet poorly understood and the definitions suffer from a lack of reproducibility in part due to the variety of experimental models. The bystander effect might induce genomic instability in non-irradiated cells and is thus extensively studied for a potential risk of radiation-induced cancer. From a therapeutic perspective, reproducing an abscopal effect by using a synergy between ionizing radiation and immunomodulatory agents to elicit or boost anticancer immune responses is an interesting area of research. Many applications are being developed in particular in the field of hypofractionated stereotactic irradiation of metastatic disease.
authors.affiliation: Département de radiothérapie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Sun
authors.affiliation: Centre régional d'oncologie Hassan-II, BP 2013, Oued Nachef, Oujda, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Sbai
authors.affiliation: Centre Jean-Bernard, clinique Victor-Hugo, 9, rue Beauverger, 72000 Le Mans, France.
authors.forename: G
authors.initials: G
authors.lastname: Ganem
authors.affiliation: Université Nice-Sophia Antipolis, 33, avenue Valombrose, 06189 Nice, France.
authors.forename: M
authors.initials: M
authors.lastname: Boudabous
authors.affiliation: UMR 152 Pharma-Dev, université Toulouse-3, 31062 Toulouse cedex 09, France; UMR 152 Pharma-Dev, institut de recherche pour le développement (IRD), 31062 Toulouse cedex 09, France.
authors.forename: F
authors.initials: F
authors.lastname: Collin
authors.affiliation: Département de radiologie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Marcy
authors.affiliation: Unité de thérapie cellulaire et génique, faculté de médecine, université Nice-Sophia Antipolis, 33, avenue Valombrose, 06189 Nice, France.
authors.forename: A
authors.initials: A
authors.lastname: Doglio
authors.affiliation: Université Nice-Sophia Antipolis, 33, avenue Valombrose, 06189 Nice, France; Département de radiothérapie, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France. Electronic address: jthariat@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Thariat
mesh_terms: D024201:Bystander Effect / Q000528:radiation effects*; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000379:methods; D011879:Radiotherapy Dosage
keywords: Abscopal; Bystander; Cellular communication; Cohorte; Communication cellulaire; Distance; Distant or abscopal effect, cohort effect; Effet; Immunity; Immunité; Local bystander effect; Long-range bystander; Systémique; Tumeur; Tumor