Ra-SBRT is Potential Immune Adjuvant for Innate Immune Cell Populations in Advance Stage NSCLC Patients

: Bystander toxicity and tissue fibrosis are the major complications with conventional radiation therapy for cancer patients. In this context, we here propose RapidArc - Stereotactic Body Radiation Therapy (Ra-SBRT) as a noninvasive and immune adjuvant approach for the successful eradication of advance stage NSCLC. Ra-SBRT is highly focused and capable of destroying tumors with high grade metastatic lesions and spared normal tissues. Follow up of stage 4 th NSCLC patient revealed that Ra-SBRT is potentially immunogenic which was evident by increased number of iNOS+ Tumor Associated macrophages (M1-TAM), Siglac-8+ eosinophils, basophils and subsequent prolongation of disease free survival of 4 th stage NSCLC patients by 3 years. This study demonstrated M1 retuning potential of Ra-SBRT which is a pre-requisite of effective management of inoperable and highly metastatic tumors of lung with least or no bystander impact.