UCLA Journal of Radiation Oncology SPRING 2024 - Flipbook - Page 16
UCLA RADIATION ONCOLOGY JOURNAL
All patients first received a base radiation
dose of 4 Gy × 10 fractions followed by an
adaptive SABR boost to target any remaining
metabolically active cancer. The first ten patients
received a boost dose of 25 Gy (low, 5 Gy × 5
fractions). If this was deemed safe within a
specified follow-up period, patients proceeded
to receive a higher boost dose of 30 Gy
(intermediate, 6 Gy × 5 fractions), followed by 35
Gy (high, 7 Gy × 5 fractions), all with concurrent
weekly chemotherapy.
if it’s done thoughtfully with adaptive radiation,”
said Dr. Beth Neilsen, a study author and
radiation oncology resident at UCLA. “For the
intermediate dose regimen, the incidence of
severe side effects was relatively low and showed
potential for better local control of the cancer.”
Along with determining the maximum tolerated
dose of this novel and personalized approach,
the researchers aimed to improve progressionfree survival and shorten the overall duration
of treatment for locally advanced non-small cell
lung cancer.
“This study contributes to ongoing efforts
to improve the treatment of lung cancer, a
leading cause of cancer-related death,” said
Dr. Michael Steinberg, professor and chair of
radiation oncology at the David Geffen School
of Medicine, director of Clinical Affairs at the
UCLA Health Jonsson Comprehensive Cancer
Center and one of the senior authors on the
study. “The integration of adaptive radiation
with chemotherapy offers a novel approach that
shows promise in terms of safety, effectiveness
and improved patient outcomes, paving the way
for more effective and personalized treatments.”
The authors note this approach could be
explored further in future trials with the
addition of consolidation immunotherapy, which
is now standard of care in this setting.
The investigators observed the most promising
results in the intermediate-dose cohort, where
patients received a total of 70 Gy in 15 fractions,
inclusive of a 30 Gy boost. This dosage showed
a favorable balance between side effects while
being a very effective treatment.
The investigators also noted the study has
limitations, including a small sample size and
need for longer follow-up to assess late side
effects.
Rates of two-year local control, which is when
the cancer does not grow back, were 74.1%,
85.7%, and 100.0% for the low-, intermediate-,
and high-dose cohorts. Two-year overall survival
was 30.0%, 76.2%, and 55.6% for the low-,
intermediate-, and high-dose cohorts.
The study’s senior author is Dr. Percy Lee, who
was a professor of radiation oncology at UCLA
when the research was conducted and is now a
There were no severe toxic effects observed
practicing radiation oncologist at City of Hope.
in the intermediate-dose boost cohort. Most
Other involved UCLA researchers include Dr.
patients experienced some degree of mild side
effects which included fatigue, and inflammation Jonathan Goldman, Dr. Edward Garon, Dr. Jay
of the esophagus or lungs resulting in sore throat Lee, Carol Felix, Minsong Cao, Stephen Tenn and
Daniel Low. ☐
or cough, respectively. The high dose regimen
led to severe treatment-related side effects in
two cases.
Contributed by: Denise Heady
Denise Heady is a science communications and media relations
manager at UCLA Health. She covers the clinical cancer program
“Our data shows patients may benefit from
along with basic and clinical translational research for the UCLA
targeted, high-dose radiation with chemotherapy Health Jonsson Comprehensive Cancer Center.
16