Compare ablation, radiation and radioligands
The main comparison is how energy reaches tissue; immune effects and clinical evidence are separate axes.
Before you start: Mechanisms explains temperature fields and radiation signals. Combination evidence explains why trials cannot be relabeled by modality.
Compare physical delivery
| Axis | Probe ablation | External-beam SBRT (stereotactic body radiation therapy) | Radioligand therapy |
|---|---|---|---|
| Delivery | Probe places cold or heat at a selected site | Beams deposit dose in a planned volume | A targeting molecule distributes a radioactive payload |
| Main targeting basis | Anatomy and accessible margin | Anatomy, motion and radiation plan | Uptake, pharmacology and radionuclide emissions |
| What limits coverage | Safe access, geometry, nearby structures | Normal-organ dose, motion, prior radiation | Heterogeneous uptake, organ exposure and supply/protocol constraints |
| Meaning of “local” | Selected treatment volume | Selected treatment volume | Radiation is emitted locally after systemic distribution |
| Evidence question | Benefit for the defined organ, cancer and goal | Benefit for the defined disease setting and dose | Benefit for the exact ligand, isotope, setting and selection criteria |
RLT is therefore systemically delivered, even though radiation deposits energy near the ligand. It is not simply the final step after ablation and SBRT fail. A disease-setting-specific systemic treatment plan remains central in metastatic TNBC.
Compare cold and heat
Cryoablation freezes and thaws tissue; radiofrequency ablation uses electrical energy to heat it; microwave ablation uses electromagnetic heating. All can provide local destruction in selected settings. Their geometry, motion sensitivity, vessel effects and nearby-structure risks differ.
The cryoprobe tip temperature is not the ice-ball edge temperature. A tip near −140 to −185 °C can create a field containing a lethal region around −20 to −40 °C inside a warmer visible edge. Common protocols use rapid freezing, slow thawing and repeated cycles. Organ- and device-specific protocols take precedence.
Cryo can preserve some antigen structure better than heating in experimental contexts. That is not proof that it provides the best immune benefit in every cancer. No universal clinical ranking supports choosing cryo, radiofrequency or microwave solely for “vaccine strength.” Local coverage and safety are immediate technical requirements.
Compare fractionation
A fraction is one radiation treatment. SBRT commonly uses fewer, larger fractions with tight geometric planning; conventional and moderately hypofractionated regimens distribute dose differently. Breast adjuvant radiation now includes several shorter schedules. Do not assume every breast course is 25–40 sessions.
Dose per fraction affects tumor damage, normal-tissue effects and signaling. In preclinical models, sufficiently high doses induced TREX1 and reduced cytosolic-DNA signaling. The approximate 12–18 Gy range from that study is model-dependent. It is not a universal cutoff for a clinical “immune dose.”
Conventional chemoradiotherapy can pair with checkpoint inhibition: PACIFIC tested durvalumab afterwards in unresectable stage III NSCLC. BOOSTER tested ablation, rather than SBRT, plus checkpoint therapy in advanced NSCLC. These examples establish specific regimens; neither establishes a TNBC abscopal schedule.
Two uses of “vaccine”
A manufactured cancer vaccine supplies selected antigen or instructions to produce it. “In-situ vaccination” describes an attempt to use a treated lesion as an antigen source. The latter does not guarantee that the right antigens are presented, that responding cells reach other lesions, or that clinical benefit follows. Both can be investigated, but they are not equivalent interventions.
Try it
A comparison table labels one modality “strongest randomized evidence” using a trial of another modality. What is the first repair?
Answer: Restore the actual intervention and population, then state the outcome and limits. Do not transfer a positive result through an analogy.
Explain it back: “I compare delivery, safety and matched clinical evidence separately.”
Explain it back
Physical differences explain the tools; trials in the relevant setting explain their benefits.
Takeaway
Physical differences explain the tools; trials in the relevant setting explain their benefits.
Sources and scope
General teaching, source-checked October 8, 2026. Expert and learner review remain pending. These lessons explain mechanisms and study interpretation; current choices are owned by the care plan and the local-priming question.