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New CRP: Efficacy of Spatially-Fractionated Radiation Therapy (SFRT) in Palliative Treatment of Lung and Cervical Cancer Patients (E33043)

New Coordinated Research Project

SFRT: The Figure illustrates a bulky abdominal-pelvic metastatic tumour being irradiated using the LATTICE technique. In this image the red ‘balls’ represent a high radiation dose which directly kills the tumour cells. The areas around the red balls represent lower dose areas, in which an immunological response is provoked in the tumour which stimulates further destruction of the tumour. (Image provided by Dr. Rolando Loria,/Radiotherapy Department Hospital Mexico, San Jose , Costa Rica, courtesy of Naipy Perez, from Innovative Cancer Centre, Miami, USA)

Lung cancer is the most common and deadliest form of cancer worldwide, accounting for 20 per cent off all cancer deaths, while cervical cancer is the second most common and the second most deadly among women. Treatments include radiation therapy in which high-energy beams from X-ray or proton sources are directed at the tumour to kill the cancer cells but carries the risk of damaging surrounding healthy tissue.

Spatially-Fractionated Radiation Therapy (SFRT) delivers high doses of radiation without exceeding the tolerance of critical neighbouring structures, particularly the skin. This is achieved by limiting the volume of tissues being exposed to high doses of radiation. Early-phase clinical studies show excellent response rates, often resulting in the dramatic and rapid resolution of large tumours.

Technological advances continue to expand the use of SFRT into unique and more reproducible formats such as GRID and LATTICE therapy and more recently SBRT PATHY techniques. Radiobiological experiments support the role of radiation-induced bystander effects, vascular alterations, and immunologic interactions. The data available to date, indicate an increased efficacy of SFRT particularly for large, bulky tumours.

To apply the benefits of SFRT at wider population levels, it is necessary to maximize implementation of this technique in countries or regions where advanced, bulky tumours are a common oncology problem, due to lack of access or availability. In the context of cervical and lung cancer this may result in a more cost-effective use of resources, and better access to treatment for the population.

In this CRP, we propose to: Use SFRT to stimulate an immunogenic response to palliative radiotherapy, which delays progression of disease at any site in patients with locally advanced and metastatic non small cell lung cancer (NSCLC) and cervical carcinoma.

Three-dimensional reconstruction of high dose volume areas within an irradiated tumour. (Image: Dr. Rolando Loria,/Radiotherapy Department Hospital Mexico, San Jose , Costa Rica)

CRP Overall Objective:

Improving palliative care of cervical and lung cancer patients.

Specific Research Objectives:

Primary objective:

  • To improve progression-free survival in metastatic locally advanced and/or bulky NSCLC and cervical carcinoma.

Secondary objectives:

  • To measure symptoms control of the treated site, overall survival, quality of life, and pain control at 6 ,12 and 26 weeks;
  • To measure clinical response in the irradiated (target) site;
  • To measure clinical response in measurable non-irradiated site(s).

How to join this CRP:

Please submit your Proposal for Research Contract or Agreement by email, no later than 30 of May 2020 to the IAEA’s Research Contracts Administration Section, using the appropriate template on the CRA web portal. Note that the same template can be used for both the research contract and technical contract.

For further information related to this CRP, potential applicants should use the contact form under the CRP page.

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