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In the News
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The UCLA Department of Radiation Oncology
In The News
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Radiation Therapy and The Risk of Heart DiseaseMar, 2013 As anyone who has had chemotherapy or radiation knows, cancer treatments and collateral damage can go hand-in-hand. For quite some time, one of the consequences we've been most concerned about is the effect that radiation can have on the heart. A new study in New England Journal of Medicine tells us more about that risk-and how long it lasts. The study followed 2168 women with breast cancer who were treated with radiation between 1958 and 2001 in Sweden and Denmark. During that time, 963 of these women developed a serious heart problem and some died from heart disease. But not all women were equally at risk. The risk rose in proportion to the amount of radiation they had received and was higher in women who had cancer in their left breast (which is closer to the heart) than in women who had cancer in their right breast. It was also higher in women who were overweight, had diabetes, or smoked-other known risk factors for heart disease. The risk persisted long after the radiation exposure with 33 percent of the women developing heart problems 10 to 19 years after their breast cancer treatment and 23 percent not experiencing problems until 20 or more years later. It is important to note the study looked at women treated from 1958 - 2001. Technology has improved vastly since this time frame and the heart generally receives less radiation than it did during this study period. Therefore, this study should not dissuade women from getting radiation for breast cancer or DCIS. Much of the radiation given to these women was 10 or 20 years ago, when the technology was more primitive. But even today women should make sure that the facility that is doing the radiation is up to date on the latest techniques. Some researchers are investigating whether having women lay on their stomach, rather than on their back, so that the breast hangs down away from the heart, can reduce this risk. In an editorial accompanying the study, Dr. Javid Moslehi, co-director of the Cardio-Oncology Program at Brigham and Women's Hospital in Boston, brings up another important point: more effort needs to be made to bring cardiologists into discussions about radiation, so that they can provide their expertise during treatment planning and add previous radiation therapy to their list of risk factors for heart disease. If you have questions about radiation therapy for breast cancer and heart disease please feel free to call and speak with a UCLA radiation oncologist. Call 310-825-9771 and ask to speak with a member of the radiation oncology breast team. |
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Ovarian Cancer Care Often SubstandardMar 12, 2013
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ASTRO Announces 2012 FellowsJul 26, 2012 Dr. Michael Steinberg on astro.org -- The American Society for Radiation Oncology (ASTRO) has named its 2012 class of Fellows. Professor and chairman of the department of radiation oncology at UCLA, Michael L. Steinberg, MD, FASTRO, ASTRO president said "This year's class clearly stood out because of their distinct contributions to ASTRO and to the field of radiation oncology as a whole." |
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ASTRO Publishes Safety is No Accident: A Framework for Quality Radiation Oncology and CareJul 18, 2012 Dr. Michael Steinberg on astro.org -- The American Society for Radiation Oncology (ASTRO) is proud to announce the publication of Safety is No Accident: A Framework for Quality Radiation Oncology and Care, a comprehensive book detailing minimum recommended guidelines for radiation oncology practices. Story on astro.org » |
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NEW AT UCLA - TomoTherapyNew Cancer Treatment at UCLA Jul 11, 2012 |
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High-Dose-Rate Prostate Brachytherapy Consistently Results in High Quality DosimetryMay 31, 2012 |
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We’re Growing!Our New Santa Monica Location is Now Open New Location Contact Information » | Maps & Directions » | News story on smmirror.com » |
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Donna Karan Healing Program Coming Soon to UCLA Department of Radiation OncologyUrban Zen Integrative Therapy at UCLA Mar 19, 2012 |
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The New War on CancerMar 15, 2012 |
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The New TrueBeam™ SystemFeb 28, 2012 |
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New IUO WebsiteInstitute of Urologic Oncology Feb 21, 2012 |
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Anti-cancer Treatment Generates Therapy-resistant Cancer Stem Cells from Less Aggressive Breast Cancer CellsFeb 14, 2012 |
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Patient Profile: Grace Suomi—Young Cancer Patient Battles Ewing’s SarcomaNov 01, 2011 |
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UCLA Health System - Jonsson Comprehensive Cancer Center to Acquire ViewRay Radiation Therapy Research SystemSep 27, 2011 |
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Shorter Course of Radiation May Treat Prostate CancerSep 27, 2011 Researchers See Potential Benefits for a 5-Week Course of Radiation Therapy |
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Metabolic State of Brain Cancer Stem Cells is Significantly Different Than That of Differentiated Cancer CellsSep 6, 2011 |
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New Physicians!We are excited to announce the addition of two new faculty physicians to Radiation Oncology Department. Dr. Mitchell Kamrava and Dr. Susan McCloskey joined the prestigious Radiation Oncology Clinical Faculty on July 1, 2011. Dr. Kamrava will be the second faculty to join the Brachytherapy program at UCLA. Dr. McCloskey is known for her health policy research and will be focusing on Breast and many other cancers. |
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What’s Your Radiation Risk?April 04, 2011 Dr. Keisuke Iwamoto on lifescript.com |
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Myths About Japanese Radiation DisspelledMarch 30, 2011 Dr. Keisuke Iwamoto on UCLA News|Week |
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Can Japan's Nuclear Fallout Affect The U.S.?March, 2011 Dr. William McBride on KTLA.com |
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Radiation Crisis in Japan and Cancer Risk?March 29, 2011 UCLA Doctor Keisuke Iwamoto on KTLA Dr. Kei Iwamoto, an associate professor of radiation oncology and a radiation biologist at UCLA, discusses the radiation crisis in Japan on KTLA news. |
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Japan Earthquake: Could Nuclear Power Plant Radiation Reach L.A?March 17, 2011 Dr. William McBride on blogs.laweekly.com |
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Live chat: The potential health hazards of radiation with Keisuke IwamotoMarch 17, 2011 Doctor Keisuke Iwamoto on latimes.com |
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Doctors Try to Ease Radiation Exposure FearsMarch 16, 2011 Dr. William McBride on cbn.com |
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Fears Radiation Will Spread From Japan to Calif.March 26, 2011 Dr. Keisuke Iwamoto on KABC |
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Radiation exposure: What we know from Hiroshima and NagasakiMarch 15, 2011 Dr. William McBride on latimes.com |
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Radiation Risk Adds to Fears in Japan DisasterMarch 14, 2011 UCLA Scientist William McBride, on KABC |
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High-Dose-Rate Brachytherapy Gets Patients Back to Normal Living More QuicklyProstate Cancer Treatment and Breast Cancer Treatment: The goal of brachytherapy, or internal radiation therapy, is to precisely target the radiation exposure to the tumor where it is needed and avoid surrounding healthy tissues. Brachytherapy Treatment Video >> |
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UCLA Radiation Oncologist and Cancer Researcher Receives Gold Medal, Highest Honor Bestowed by Radiation Oncology SocietyNov 10, 2010 Scientist William McBride, whose research focuses on the role of damage response to radiation in normal tissue and malignant tumors, has been given the Gold Medal award by the American Society for Radiation Oncology, the highest honor bestowed by the 10,000-member organization. McBride, director of the division of cellular and molecular oncology in the Department of Radiation Oncology at UCLA, received the award during organization’s 52nd annual meeting, held last week in San Diego. |
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UCLA Radiation Oncology Earns ACR Accreditation
UCLA Grant to Develop Medical Countermeasures Against Radiological and Nuclear Attacks Renewed
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| Scientist William McBride |
Oct 14, 2010
Radiation Oncologists Seeking to Discover Compounds that will Help Mitigate Damage to Immune System
Researchers in the Radiation Oncology Department at UCLA’s Jonsson Comprehensive Cancer Center have received a $14 million grant to develop countermeasures that will help treat damage caused by radiological or nuclear threats such as a dirty bomb attack. The grant, awarded by the National Institute of Allergy and Infectious Diseases, is a renewal of a five-year $14 million grant first awarded to UCLA in 2005. Scientist William McBride, a professor of radiation oncology and a Jonsson Cancer Center researcher, serves as UCLA’s principal investigator. View PDF version >>
Article on globalsecuritynewswire.org >>
Article on news-medical.net >>
Article on today.ucla.edu >>
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| Dr. Michael Steinberg |
ASTRO Elections
Sep 08, 2010
The American Society for Radiation Oncology (ASTRO) announced UCLA's Michael L. Steinberg, M.D., FASTRO as President-elect.
ASTRO is the largest radiation oncology society in the world, with more than 10,000 members who specialize in treating patients with radiation therapies.
Irradiating the Brain Site That Harbors Stem Cells Improves Progression-free Survival in Patients with Deadly Cancers
July 22, 2010
Patients with deadly glioblastomas who received high doses of radiation that hit a portion of the brain that harbors neural stem cells had double the progression-free survival time as patients who had lower doses or no radiation targeting the area, a study from the Radiation Oncology Department at UCLA’s Jonsson Comprehensive Cancer Center has found. Patients who underwent high doses of radiation that hit the specific neural stem cell site, known as the stem cell niche, experienced 15 months of progression-free survival, while patients receiving lower or no doses to this region experienced 7.2 months of progression-free survival, said Dr. Frank Pajonk, an associate professor of radiation oncology, a cancer center researcher and senior author of the study.
Article on biomedcentral.com >>
Article on sciencedaily.com >>
View PDF version >>
The UCLA Department of Radiation Oncology is pleased to announce the appointment of Patrick Kupelian, M.D.
July 01, 2010
The UCLA Department of Radiation Oncology is pleased to announce the appointment of Patrick Kupelian, M.D., Professor and Vice-Chair of Clinical Operations and Clinical Research. Dr. Kupelian comes to UCLA from M.D. Anderson Cancer Center in Orlando, FL, where he was the Chairman and Scientific Director of Research for Radiation Oncology. He completed his residency training in Radiation Oncology at the University of Texas M.D. Anderson Cancer Center in Houston, and completed a fellowship at the Cleveland Clinic Foundation. Dr. Kupelian specializes in genitourinary and pulmonary malignancies and is an internationally known expert in the development and evaluation of cutting edge technologies in Radiation Oncology. For appointments: (310) 825-9775 www.radonc.ucla.edu
Dr. Jeffrey Demanes receives the American College of Radiation Oncology (ACRO) Gold Medal
February 26, 2010
The American College of Radiation Oncology honored Dr. Jeffrey Demanes MD, FACRO with the Gold Medal Award at this year's conference.
Dr. Demanes specializes in brachytherapy. He pioneered the use of high-dose-rate brachytherapy in prostate, head and neck, breast, GI, and gynecologic cancer. His research explores the novel use of brachytherapy in the treatment of cancer.
Learn more about HDR Brachytherapy >>
Radiation Oncology Patient Celebrates 100th Birthday
November 16, 2009
Doctors, nurses, technicians and other staff of the Radiation Oncology Department surprised patient Lydia Topalian with a party to celebrate her 100th birthday.
Read More >>
UCLA Has New Weapon in Battle Against Cancer
UCLA's Department of Radiation Oncology has acquired a new cancer-fighting device, allowing for higher doses of radiation in a smaller amount of time. They are the first center in the Los Angeles region to install the Novalis Tx, a non-invasive stereotactic radiosurgery mechanism that includes three imaging modalities.
Click to see coverage on CBS2 >>
Ronald Reagan UCLA Medical Center Rated Best Hospital in West for 19th Consecutive Year in U.S. News & World Report Survey
July 10, 2008
Ronald Reagan UCLA Medical Center ranks as one of the top three American hospitals - and the best hospital in the western United States for the 19th consecutive year - according to a U.S. News & World Report survey that reviewed patient outcomes data, reputation among physicians and other care-related factors.
The news comes on the heels of the hospital's June 29 move into its new state-of the-art building, the Ronald Reagan UCLA Medical Center.
The 19th annual "America's Best Hospitals" guide highlights U.S. News & World Report's July 21 edition. The rankings are also available online at www.usnews.com/besthospitals.
In Vivo Imaging, Tracking and Targeting of Cancer Stem Cells
Written by Dr. Frank Pajonk
Cancers contain a small population of so-called cancer stem cells. Their frequency varies between the different types of cancer, but it is generally thought to be in the order of 1 in 10,000 cells. These cells are the only cells, able to regrow the entire tumor after debulking surgery, chemotherapy, and radiation treatment while all of their progeny lack this ability. Additionally, cancer stem cells are relatively resistant to radiation therapy and highly resistant to established chemotherapeutic agents. In order to cure a cancer, all cancer stem cells have to be eliminated, which can be achieved by complete surgical resection or if the surrounding normal tissue allows for application of a sufficient radiation dose, lethal for all cancer stem cells.
Over the last 5 years, several groups of researchers have identified proteins on the surface of cancer stem cells, which are not present on their daughter cells. These proteins can be detected by specific antibodies and allow for prospective identification of cancer stem cells. However, in order to do this, tumors have to be removed from the body.
Recently, DMCO researchers observed that cancer stem cells are resistant to Velcade, a drug that inhibits a protease named proteasome and is used to treat patients suffering from multiple myeloma and mantle cell lymphoma. While they investigated the reasons for this resistance, they discovered that this resistance could be utilized to identify cancer stem cells in living animals and they demonstrated for the first time that elimination of cancer stem cells was sufficient for tumor regression in solid tumors. This novel imaging system enables DMCO researchers to test how established and novel treatment options need to be combined to eliminate cancer stem cells and thus cure cancer with radiation therapy even more efficiently. The full article can be found in the March 4th issue of the Journal of the National Cancer Institute (http://jnci.oxfordjournals.org/).
Resistance to Radiation Therapy (RT)
Written by Dr. Nicholas Cacalano
Resistance to radiation therapy (RT) is a hallmark of deadly cancers such as glioblastoma multiforme (GBM), which has a dismal 2-3% five-year survival rate. Much effort has been focused on developing novel molecular therapies that sensitize tumors to RT and improve patient survival and quality of life. Researchers in the Radiation Oncology Department at UCLA have found that a molecule called Suppressor of Cytokine Signaling (SOCS)-3, is overexpressed in radioresistant glioblastoma multiforme (GBM), and confers protection from radiation-induced cell death. Using genetically engineered cells, they found that cells lacking SOCS3 are more sensitive to radiation because they fail to activate the expression of p21, a molecule that is critical for radioprotective responses such as cell cycle arrest and DNA repair. In contrast, cells expressing SOCS3 can more effectively recover from irradiation by undergoing p21-mediated cell cycle arrest. The research team concluded that SOCS3 overexpression in GBM can increase radiation resistance by promoting p21 expression, cell cycle arrest, and DNA repair following therapeutic doses of radiation. This work suggests that molecular targeting of SOCS3 may be a novel strategy for overcoming radiation resistance of tumor cells and increasing the effectiveness of radiation therapy.
SOCS3 regulates p21 expression and cell cycle arrest in response to DNA damage.
Sitko JC, Yeh B, Kim M, Zhou H, Takaesu G, Yoshimura A, McBride WH, Jewett A, Jamieson CA, Cacalano NA.
Cell Signal. 2008 Dec;20(12):2221-30.
Grants and Awards 2008
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Diana L. Gage, MD, PhD RSNA Research Resident Grant Radiosensitization with Anti-VEGF in Glioblastoma Cells |
Glioblastoma is the most aggressive form of brain cancer, accounting for approximately 40% of all primary malignant brain tumors. Despite optimal treatment with surgery, radiotherapy and chemotherapy, the prognosis for these patients remains poor. Adjuvant temozolomide with radiotherapy serves as the standard of care for newly-diagnosed cases. Recently, antiangiogenic therapy using bevacizumab (BV) in combination with irinotecan has emerged as a promising development in the treatment of recurrent glioblastoma. BV is a humanized monoclonal antibody directed against the vascular endothelial growth factor (VEGF). Besides its role in angiogenesis, VEGF may act in an autocrine manner to enhance cellular survival, providing a pro-survival feedback loop that may decrease the efficacy of temozolomide and/or radiation. BV treatment is expected to inhibit this feedback loop to increase cytoxicity. Therefore VEGF blockade may directly inhibit tumor growth in a paracrine/autocrine fashion. In our institution, we have undertaken a phase II trial that combines BV upfront with radiotherapy/temozolomide. Interim clinical observation has been accepted for publication. Our current proposal is to use the U87MG glioblastoma cell culture model to examine the mechanism by which BV may potentiate the efficacy of radiotherapy and temozolomide.
Specific Aims:
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To establish whether VEGF signaling is modulated by the administration of radiotherapy, temozolomide, and concurrent radiotherapy/temozolomide by measuring VEGF level via ELISA assay in both the conditioned media and the cell lysate.
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To evaluate the effects of BV on the cytotoxicity of radiotherapy, temozolomide, and concurrent radiotherapy/temozolomide by quantifying cell survival using clonogenic assay; and elucidating cell death mechanism using TUNEL assay and flow cytometry.
This study will lay the groundwork for understanding the interplay among anti-VEGF, radiotherapy, and temozolomide in the treatment of glioblastoma. The long-term plan of this project is to analyze the roles of anti-VEGF as a radiosensitizer in animal models.
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Brian Yeh, MD The Role of TNF-Alpha Signaling in Normal Brain Tissue Response to Radiation |
Radiation therapy is an important treatment modality for brain tumors, but the outcome is generally dismal. Most patients with glioblastoma succumb to the disease within a year. Increasing radiation dose increases the time to recurrence for these patients, but at the cost of increased complications. Patients receiving whole brain irradiation for metastatic tumors also suffer a high rate of neurological complications, which can be severely debilitating. Therefore, an improved understanding of the normal brain tissue response to radiation is critical to increasing the therapeutic benefit of radiation therapy. Until recently, it has been thought that the late delayed effects of radiation therapy are the irreversible result of damage at the time of radiation. However, this paradigm is shifting to one in which the immediate damage at the time of radiation is only the beginning of a cascade of events which results in late radiation injury. Recent preclinical data suggest that TNFR2 plays a radioprotective role in the brain, while TNFR1 may be involved in promoting radiation-induced demyelination. Increased understanding of the mechanism of TNFR2-mediated radioprotection and the relationships between TNF-alpha signaling and the normal brain tissue response to radiation may lead to therapeutic options that can prevent or ameliorate the side effects of radiation therapy to the brain.
The specific aims of this proposal are:
- To determine whether radiation-induced acute apoptosis in the various cell compartments of the brain is mediated through TNFR1 signaling and negatively regulated through
TNFR2 signaling. - To determine if subacute radiation-induced gliosis in the brain requires TNFR2 signaling and is regulated by TNFR1.
- To identify downstream mediators of TNFR2-mediated radioprotection and to determine the effect of TNF-alpha signaling modulators on this pathway. The effect of TNF-alpha
signaling modulation on the incidence of radiation-induced seizures and neurodegeneration will be also analyzed in a mouse model.
Precision-Oriented Radiotherapy for the Treatment of Head and Neck Cancer
Written by Dr. Steve P. Lee
Radiation is a powerful tool for cancer treatment. It works by delivering focused energy (i.e., dose) to destroy chemical bonds within the genetic material (DNA) of a cell. Consequently the cell loses its capability to duplicate itself and leads eventually to its death. In principle, the chance of controlling such tumor growth with radiation increases with the amount of dose it receives. Unfortunately, radiation particles cannot distinguish normal cells from cancerous ones, and undesirable damage to normal tissues might occur if care is not taken to precisely localize the dosage onto the intended target. This is of particular importance for cancers of the head and neck, which often mingle with or abut important normal structures that 
might be similarly sensitive to radiation damage. Read full article.
| Figure 1. The difference in treatment volume coverage by traditional RT vs. PORT. Note that by attempting to spare normal tissues such as blood vessel, nerve or airway (which may be safely treated by traditional RT with relatively lower dose), the border of PORT may inadvertently spare microscopic tumor cells not detected by radiological scans. |
UCLA Researcher Co-Authors New PET/CT Head and Neck Study
Percy Lee, M.D., Assistant Professor and Director of the Stereotactic Body Radiation Therapy (SBRT) program at UCLA was a co-author with investigators from Stanford University on a study in-press in the International Journal of Radiation Oncology, Biology and Physics (IJROBP), the top radiation oncology journal. In this study, 85 head and neck patients received 18-flurodeoxyglucose positron emission tomography (18- FDG PET/CT)-guided chemoradiotherapy. High metabolic tumor volume (MTV), as defined by PET, was found to be a poor prognostic factor for disease relapse and survival. Dr. Lee was one of the principal investigators and the first author of a similar study in lung cancer recently published in IJROBP, the very first study of its kind. Read full article.
These results support the use of metabolic information from PET for radiation planning, and suggest that MTV was a more reliable measure of tumor burden and therefore, treatment outcome. At UCLA, we are one of few expert centers that routinely incorporate metabolic information in radiation treatment planning. In addition, we lead in investigating the role of PET/CT in radiation therapy with the ultimate goal of benefiting our patients and improving their outcomes.
