The field of precision radiation therapy has seen remarkable advancements in both experimental and computational methods. Recent literature has introduced various approaches such as Spatially Fractionated Radiation Therapy (SFRT). This unconventional treatment, demanding high-precision radiotherapy, has shown promising clinical outcomes. A comprehensive computational scheme for SFRT, extrapolated from a case report, is proposed. This framework exhibits exceptional flexibility, accommodating diverse initial conditions (shape, inhomogeneity, etc.) and enabling specific choices for sub-volume selection with administrated higher radiation doses. The approach integrates the standard linear quadratic model and, significantly, considers the activation of the immune system due to radiotherapy. This activation enhances the immune response in comparison to the untreated case. We delve into the distinct roles of the native immune system, immune activation by radiation, and post-radiotherapy immunotherapy, discussing their implications for either complete recovery or disease regrowth.

Biotechnology Research Center Technology Innovation Institute Abu Dhabi P O Box 9639 United Arab Emirates

Faculty of Mathematics and Physics Charles University 5 Holešovičkách 2 18000 Prague Czech Republic

INFN Sezione di Catania Via Santa Sofia 64 95123 Catania Italy

Institute for Applied Computing National Research Council of Italy Via dei Taurini 19 00185 Rome Italy

Istituto Oncologico del Mediterraneo Via Penninazzo 7 95029 Viagrande Italy

REM Radioterapia Via Penninazzo 11 95029 Viagrande Italy

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