Avanced bulky tumors warrant aggressive therapy to attempt to maximize local control of the disease. Spatially fractionated radiation therapy (GRID) delivers a single-fraction of high dose radiation to these tumors with a curative or palliative goal. GRID therapy may be combined with fractionated radiation therapy or used in a therapeutic multi-modality setting to achieve control of the bulky disease. Current clinical data confirms the value of GRID therapy in the management of large volume of disease with an acceptable toxicity profile. GRID therapy has broad systemic effects leading to increases in a variety of cytokines that correlate with clinical outcome.
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