# Lattice and GRID radiotherapy

Source: https://onco.cc/technologies/lattice-radiotherapy/  
OnCo record `lattice-radiotherapy` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Lattice radiotherapy deliberately treats a bulky tumour unevenly, placing peaks of tumour-destroying dose at spaced points inside it while the tissue between receives far less, relying on bystander and immune effects to extend the kill. It runs on standard linear accelerators, but evidence is mostly palliative and single-arm, and the mechanism is unsettled.

## Summary

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.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-09-08
- Tags: frontier; promising
- Principle: 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.
- Strengths: Debulks large tumours that cannot tolerate uniform ablative dose; Clear rationale for combining with immunotherapy; Deliverable on standard linear accelerators
- Limitations: Mechanism is not settled; Mostly palliative, single-arm evidence; No consensus on vertex spacing or dose

## Sources

- MSK spatially fractionated RT (NCT05837767): https://clinicaltrials.gov/study/NCT05837767
- Randomised SFRT vs conventional RT (NCT06980259): https://clinicaltrials.gov/study/NCT06980259

## Connected records

- roadmaps: [Radical oncology: what could change the war by 2035](https://onco.cc/roadmaps/frontier-2035/), [Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH](https://onco.cc/roadmaps/radiation-roadmap/)
- fronts: [Immunotherapy](https://onco.cc/fronts/immunotherapy/), [Radiation Therapy](https://onco.cc/fronts/radiation/)
- technologies: [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [SBRT / SABR (stereotactic radiotherapy)](https://onco.cc/technologies/sbrt/)
- terms: [Abscopal effect](https://onco.cc/terms/abscopal-effect/)

---
JSON: https://onco.cc/api/v1/entities/lattice-radiotherapy.json