Cancer Research and Treatment

Original Articles

Normal Brain-Sparing Radiotherapy versus Whole Brain Radiotherapy for Multiple Brain Metastasis from Non–Small Cell Lung Cancer: Sangjoon Park, Jaeho Cho, Kyung Hwan Kim, Hong In Yoon, Chang Geol Lee; Received July 23, 2024 Accepted December 2, 2024 Published online December 3, 2024; DOI: https://doi.org/10.4143/crt.2024.679 [Epub ahead of print]

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Purpose
The efficacy and lower neurotoxicity of normal brain-sparing radiotherapy (NBS-RT) with systemic therapy in treating multiple brain metastases from non–small cell lung cancer (NSCLC) is underexplored. This study compares whole brain radiotherapy (WBRT) and NBS-RT for multiple brain metastases in NSCLC, focusing on treatment outcomes and leukoencephalopathy.
Materials and Methods
This retrospective study included 503 patients with NSCLC with multiple brain metastases at a single center, treated with either WBRT or NBS-RT. Post-RT treatments included chemotherapy, targeted therapy, or immunotherapy. Main outcomes measured were intracranial control, overall survival (OS), and leukoencephalopathy incidence.
Results
In this study, 441 patients received WBRT and 62 received NBS-RT, with median ages of 62 and 61 years, respectively. A significant portion of both groups, 77.3% in WBRT and 80.6% in NBS-RT, received post-RT systemic therapy. The median number of brain metastases was 10 for WBRT and 12 for NBS-RT, with median maximal diameters of 11.7 mm in WBRT and 14.4 mm in NBS-RT. After a median follow-up of 10.9 months for WBRT and 11.8 months for NBS-RT, there were no significant differences in intracranial progression (p=0.516) or OS (p=0.492) between the groups. However, WBRT patients had a higher incidence of leukoencephalopathy than NBS-RT patients (p=0.013).
Conclusion
NBS-RT combined with systemic therapy was as effective in treating multiple brain metastases as WBRT and was less toxic. NBS-RT-based strategies deserve further investigation in a prospective setting.

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Characteristics and Treatment Advances of Postoperative Brain Metastasis in Different Lung Cancer Histological Types
Changming Dong, Xuebin Yu, Wuqiao Bao
Current Problems in Surgery.2025; : 101785. CrossRef

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Lung and Thoracic cancer

Unraveling the Impact of Sarcopenia-Induced Lymphopenia on Treatment Response and Prognosis in Patients with Stage III Non–Small Cell Lung Cancer: Insights for Optimizing Chemoradiation and Immune Checkpoint Inhibitor: Joongyo Lee, Kyung Hwan Kim, Jina Kim, Chang Geol Lee, Jaeho Cho, Hong In Yoon, Yeona Cho; Cancer Res Treat. 2025;57(2):422-433. Published online October 30, 2024; DOI: https://doi.org/10.4143/crt.2024.493

Abstract PDF Supplementary Material PubReader ePub: Purpose
Sarcopenia is a poor prognostic factor in non–small cell lung cancer (NSCLC). However, its prognostic significance in patients with NSCLC receiving immune checkpoint inhibitors (ICIs) and its relationship with lymphopenia remain unclear. We aimed to investigate the prognostic role of sarcopenia and its effect on lymphocyte recovery in patients with stage III NSCLC treated with concurrent chemoradiotherapy (CCRT) followed by ICI.
Materials and Methods
We retrospectively evaluated 151 patients with stage III NSCLC who received definitive CCRT followed by maintenance ICI between January 2016 and June 2022. Sarcopenia was evaluated by measuring the skeletal muscle area at the L3 vertebra level using computed tomography scans. Lymphocyte level changes were assessed based on measurements taken before and during CCRT and at 1, 2, 3, 6, and 12 months post-CCRT completion.
Results
Even after adjusting for baseline absolute lymphocyte count through propensity score-matching, patients with pre-radiotherapy (RT) sarcopenia (n=86) exhibited poor lymphocyte recovery and a significantly high incidence of grade ≥ 3 lymphopenia during CCRT. Pre-RT sarcopenia and grade ≥ 3 lymphopenia during CCRT emerged as prognostic factors for overall survival and progression-free survival, respectively. Concurrent chemotherapy dose adjustments, objective response after CCRT, and discontinuation of maintenance ICI were also analyzed as independent prognostic factors.
Conclusion
Our results demonstrated an association between pre-RT sarcopenia and poor survival, concurrent chemotherapy dose adjustments, and impaired lymphocyte recovery after definitive CCRT. Moreover, CCRT-induced lymphopenia not only contributed to poor prognosis but may have also impaired the therapeutic efficacy of subsequent maintenance ICI, ultimately worsening treatment outcomes.

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Aggressive Local Ablative Radiotherapy Mitigates Progression Risk in Oligometastatic Lung Adenocarcinoma: Gowoon Yang, Kyung Hwan Kim, Chang Geol Lee, Min Hee Hong, Hye Ryun Kim, Yeona Cho, Hong In Yoon; Cancer Res Treat. 2024;56(1):115-124. Published online August 29, 2023; DOI: https://doi.org/10.4143/crt.2023.600

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to determine the role of local ablative radiotherapy (LART) in oligometastatic/oligoprogressive lung adenocarcinoma.
Materials and Methods
Patients (n=176) with oligometastatic lung adenocarcinoma treated with LART were identified, and those treated with LART at the initial diagnosis of synchronous oligometastatic disease (OMD group) or treated with LART when they presented with repeat oligoprogression (OPD group) were included.
Results
In the OMD group (n=54), the 1- and 3-year progression-free survival (PFS) were 50.9% and 22.5%, respectively, whereas the 1- and 3-year overall survival in the OPD group were 75.9% and 58.1%, respectively. Forty-one patients (75.9%) received LART at all gross disease sites. Tyrosine kinase inhibitor (TKI) use and all-metastatic site LART were significant predictors of higher PFS (p=0.018 and p=0.046, respectively). In patients treated with TKIs at the time of LART (n=23) and those treated with all-metastatic site LART, the 1-year PFS was 86.7%, while that of patients not treated with all-metastatic site LART was 37.5% (p=0.006). In the OPD group (n=122), 67.2% of the patients (n=82) maintained a systemic therapy regimen after LART. The cumulative incidence of changing systemic therapy was 39.6%, 62.9%, and 78.5% at 6 months, 1 year, and 2 years after LART, respectively.
Conclusion
Aggressive LART can be an option to improve survival in patients with oligometastatic disease. Patients with synchronous oligometastatic disease receiving TKI and all-metastatic site LART may have improved PFS. In patients with repeat oligoprogression, LART might potentially extend survival by delaying the need to change the systemic treatment regimen.

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Head/neck cancer

Intensity-Modulated Radiotherapy-Based Reirradiation for Head and Neck Cancer: A Multi-institutional Study by Korean Radiation Oncology Group (KROG 1707): Jeongshim Lee, Tae Hyung Kim, Yeon-Sil Kim, Myungsoo Kim, Jae Won Park, Sung Hyun Kim, Hyun Ju Kim, Chang Geol Lee; Cancer Res Treat. 2020;52(4):1031-1040. Published online July 7, 2020; DOI: https://doi.org/10.4143/crt.2020.310

Abstract PDF Supplementary Material PubReader ePub

Purpose
The benefits of reirradiation for head and neck cancer (HNC) have not been determined. This study evaluated the efficacy of reirradiation using intensity-modulated radiotherapy (IMRT) for recurrent or second primary HNC (RSPHNC) and identified subgroups for whom reirradiation for RSPHNC is beneficial.
Materials and Methods
A total of 118 patients from seven Korean institutions with RSPHNC who underwent IMRT-based reirradiation between 2006 and 2015 were evaluated through retrospective review of medical records. We assessed overall survival (OS) and local control (LC) within the radiotherapy (RT) field following IMRT-based reirradiation. Additionally, the OS curve according to the recursive partitioning analysis (RPA) suggested by the Multi-Institution Reirradiation (MIRI) Collaborative was determined.
Results
At a median follow-up period of 18.5 months, OS at 2 years was 43.1%. In multivariate analysis, primary subsite, recurrent tumor size, interval between RT courses, and salvage surgery were associated with OS. With regard to the MIRI RPA model, the class I subgroup had a significantly higher OS than class II or III subgroups. LC at 2 years was 53.5%. Multivariate analyses revealed that both intervals between RT courses and salvage surgery were prognostic factors affecting LC. Grade 3 or more toxicity and grade 5 toxicity rates were 8.5% and 0.8%, respectively.
Conclusion
IMRT-based reirradiation was an effective therapeutic option for patients with RSPHNC, especially those with resectable tumors and a long interval between RT courses. Further, our patients' population validated the MIRI RPA classification by showing the difference of OS according to MIRI RPA class.

Citations

Citations to this article as recorded by

Re-irradiation for head and neck cancer: outcome and toxicity analysis using a prospective single institution database
Chiara Scolari, André Buchali, Achim Franzen, Robert Förster, Paul Windisch, Stephan Bodis, Daniel R. Zwahlen, Christina Schröder
Frontiers in Oncology.2023;[Epub] CrossRef
Double trouble: A cohort study of re-irradiation and laryngectomy – Severity of and risk for pharyngocutaneous fistula
Jeffrey M. Weinberger, Narmeen abd el Qadir, Nir Hirshoren
Oral Oncology.2022; 134: 106069. CrossRef
Current radiotherapy for recurrent head and neck cancer in the modern era: a state-of-the-art review
Yue Li, Yuliang Jiang, Bin Qiu, Haitao Sun, Junjie Wang
Journal of Translational Medicine.2022;[Epub] CrossRef
Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies
Franco Ionna, Paolo Bossi, Agostino Guida, Andrea Alberti, Paolo Muto, Giovanni Salzano, Alessandro Ottaiano, Fabio Maglitto, Davide Leopardo, Marco De Felice, Francesco Longo, Salvatore Tafuto, Giuseppina Della Vittoria Scarpati, Francesco Perri
Cancers.2021; 13(10): 2371. CrossRef
Re-irradiation for recurrent or second primary head and neck cancer
Hye In Lee, Jin Ho Kim, Soon-Hyun Ahn, Eun-Jae Chung, Bhumsuk Keam, Keun-Yong Eom, Woo-Jin Jeong, Ji-Won Kim, Chan Woo Wee, Hong-Gyun Wu
Radiation Oncology Journal.2021; 39(4): 279. CrossRef

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Survival and Functional Outcome after Treatment for Primary Base of Tongue Cancer: A Comparison of Definitive Chemoradiotherapy versus Surgery Followed by Adjuvant Radiotherapy: Sangjoon Park, Yeona Cho, Jeongshim Lee, Yoon Woo Koh, Se-Heon Kim, Eun Chang Choi, Hye Ryun Kim, Ki Chang Keum, Kyung Ran Park, Chang Geol Lee; Cancer Res Treat. 2018;50(4):1214-1225. Published online December 26, 2017; DOI: https://doi.org/10.4143/crt.2017.498

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Purpose
The purpose of this study was to compare the clinical and functional outcomes in patients with primary base of tongue (BOT) cancer who received definitive radiotherapy (RT) or surgery followed by radiotherapy (SRT).
Materials and Methods
Between January 2002 andDecember 2016, 102 patientswith stage I-IVB primary BOT cancer underwent either definitive RT (n=46) or SRT (n=56), and treatment outcomeswere compared between two groups. The expression of p16 was also analyzed.
Results
The RT group had more patients with advanced T stage (T3-4) disease (58.7% vs. 35.7%, p=0.021) and who received chemotherapy (91.3% vs. 37.5%, p < 0.001) than the SRT group. At a median followup of 36.9 months (range, 3.3 to 181.5 months), the 5-year overall survival (OS) and disease-free survival (DFS) were 75.5% and 68.7%, respectively. With respect to treatment group, the 5-year OS and DFS in the RT and SRT groups did not differ significantly (OS, 68.7% vs. 80.5%, p=0.601; DFS, 63.1% vs. 73.1%, p=0.653). In multivariate analysis, OS differed significantly according to p16 expression (p16-negative vs. p16- positive; hazard ratio [HR], 0.145; 95% confidence interval [CI], 0.025 to 0.853; p=0.033). Regarding DFS, p16 expression (p16-negative vs. p16-positive; HR, 0.164; 95% CI, 0.045 to 0.598; p=0.006) showed a significant effect in multivariate analysis. Functional defects (late grade ≥ 3 dysphagia or voice alteration) were more frequently reported in the SRT than in the RT group (16.1% vs. 2.2%, p=0.021).
Conclusion
Despite advanced disease, patients in the RT group showed comparable survival outcomes and better functional preservation than those in the SRT group.

Citations

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Surgical Versus Non‐Surgical Treatment of Advanced Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta‐Analysis
Megan K. Scharner, Johnny M. Owen, Shaun A. Nguyen, Alexandra E. Kejner, Jason G. Newman, Emily Brennan, W. Greer Albergotti
Head & Neck.2025;[Epub] CrossRef
Early Death in T3‐T4 Head and Neck Cancer: NCDB Comparison of Surgical vs. Non‐Surgical Approaches
Srivatsa Surya Vasudevan, Ivan A. Alvarez, Cherie‐Ann O. Nathan, John Pang
Head & Neck.2025;[Epub] CrossRef
Treatment de‐escalation for HPV+ oropharyngeal cancer: A systematic review and meta‐analysis
Fausto Petrelli, Andrea Luciani, Antonio Ghidini, Sara Cherri, Paolo Gamba, Marta Maddalo, Paolo Bossi, Alberto Zaniboni
Head & Neck.2022; 44(5): 1255. CrossRef
Ginsenoside Rd inhibits migration and invasion of tongue cancer cells through H19/miR-675-5p/CDH1 axis
Lu CHANG, Dongxu WANG, Shaoning KAN, Ming HAO, Huimin LIU, Zhijing YANG, Qianyun XIA, Weiwei LIU
Journal of Applied Oral Science.2022;[Epub] CrossRef
Postoperative Concurrent Chemoradiotherapy Versus Radiotherapy Alone for Advanced Oral Cavity Cancer in the Era of Modern Radiation Techniques
Tae Hyung Kim, In-Ho Cha, Eun Chang Choi, Hye Ryun Kim, Hyung Jun Kim, Se-Heon Kim, Ki Chang Keum, Chang Geol Lee
Frontiers in Oncology.2021;[Epub] CrossRef
Superficial circumflex iliac artery perforator flap for tongue reconstruction after hemiglossectomy for cancer: A case report
Hong Loi Nguyen, Truong Phu M. Ho, Xuan Phu Tran, Thanh Xuan Nguyen
Oral and Maxillofacial Surgery Cases.2021; 7(2): 100219. CrossRef
Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy
Ambika Parmar, Michaelina Macluskey, Niall Mc Goldrick, David I Conway, Anne-Marie Glenny, Janet E Clarkson, Helen V Worthington, Kelvin KW Chan
Cochrane Database of Systematic Reviews.2021;[Epub] CrossRef
Larynx-preserving reconstruction after extended base of the tongue resection
Hideki Kadota, Junichi Fukushima, Sei Yoshida, Kenichi Kamizono, Muneyuki Masuda, Satoshi Toh, Ryuji Yasumatsu, Torahiko Nakashima, Takashi Nakagawa
Journal of Plastic, Reconstructive & Aesthetic Surgery.2020; 73(4): 740. CrossRef

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Radiotherapy Versus Cordectomy in the Management of Early Glottic Cancer: Seung Yeun Chung, Kyung Hwan Kim, Ki Chang Keum, Yoon Woo Koh, Se-Heon Kim, Eun Chang Choi, Chang Geol Lee; Cancer Res Treat. 2018;50(1):156-163. Published online March 17, 2017; DOI: https://doi.org/10.4143/crt.2016.503

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to compare the treatment outcomes of definitive radiotherapy (RT) with cordectomy in patients with early glottic cancer.
Materials and Methods
A total of 165 patientswhowere diagnosedwith T1/2 squamous cell carcinoma of the glottic larynx between January 2006 and December 2012 were retrospectively analyzed. A total of 112 patients received RT and 53 patients received cordectomy. Local control (LC), disease-free survival (DFS), overall survival (OS), and larynx preservation rates after RT and cordectomy were investigated.
Results
The median follow-up period was 77.7 months (range, 10.7 to 127.0 months). The 3- and 5-year LC rates were 91.9% and 89.9%, respectively, for the RT group, and 82.8% and 73.2%, respectively, for the cordectomy group (p=0.006). The 3- and 5-year DFS rates were 87.5% and 83.7%, respectively, for the RT group and 79.2% and 68.0%, respectively, for the cordectomy group (p=0.046). No significant differences were identified in the 5-year OS (92.8% vs. 90.6%, p=0.713) or larynx preservation rates (98.2% vs. 97.2%, p=0.831) between groups. The major failure pattern was local failure (n=26), followed by regional (n=3) and distant failure (n=2). Multivariate analysis of LC showed that T2 stage (p=0.012) and receiving cordectomy as initial treatment (p=0.001) were significantly associated with poorer LC.
Conclusion
RT resulted in higher rates of LC and DFS compared to cordectomy for early glottic cancer. Treatment with radiotherapy is feasible and should be encouraged for both T1 and T2 glottic cancer.

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Oncological outcomes of surgical management for T2N0M0 glottic laryngeal squamous cell carcinoma
Jian Zhou, Cheng‐Zhi Xu, Xiao‐Ke Zhu, Yue Yang, Liang Zhou, Hong‐Li Gong, Lei Tao
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Particular aspects of laser microsurgery in malignant and premalignant glottic lesions
Mihai Tușaliu, Costinel Adrian Vrejoiu, Iulia Tiţă, Mădălina Vulpe, Adriana Lozbă, Cristian Bucur
ORL.ro.2024; 1(62): 9. CrossRef
The association between initiation weekday of radiotherapy and local control in stage 1 glottic carcinoma: a retrospective analysis
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Niema B. Razavian, Ralph B. D'Agostino, Rachel F. Shenker, Ryan T. Hughes
International Journal of Radiation Oncology*Biology*Physics.2023; 117(3): 652. CrossRef
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Takashi Kurita, Shun-ichi Chitose, Takeharu Ono, Mioko Fukahori, Shintaro Sueyoshi, Ryota Mihashi, Toshihiko Kawaguchi, Akira Hiraki, Hirohito Umeno
Practica oto-rhino-laryngologica. Suppl..2023; 163: 89. CrossRef
Comparison of Survival Outcomes of Different Treatment Options for cT1-2, N0 Glottic Carcinoma: A Propensity Score–Weighted Analysis
Qi-wei Liang, Liang Peng, Jing Liao, Chun-xia Huang, Wei-ping Wen, Wei Sun
Frontiers in Surgery.2022;[Epub] CrossRef
Survival study in early stages of glottis cancer, stratified by treatment
Yolanda Lois-Ortega, Fernando García-Curdi, Héctor Vallés-Varela, Ana Muniesa-del Campo
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Meltem Dağdelen, Merve Şahin, Tuba Kurt Çatal, Halil Cumhur Yıldırım, Songül Çavdar Karaçam, Kimia Çepni, Ömer Erol Uzel
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Ruichen Li, Qi Wang, Li Yan, Yi Zhu, Shengzi Wang, Shu Tian
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Simon Beyaert, Marc Hamoir, Aline Van Maanen, Vincent Grégoire, Sandra Schmitz
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Comparison of the Clinical Outcomes of Patients with Squamous Cell Carcinoma of the Tonsil Receiving Postoperative Ipsilateral Versus Bilateral Neck Radiotherapy: A Propensity Score Matching Analysis (KROG 11-07): Youngkyong Kim, Kwan Ho Cho, Sung Ho Moon, Chang Geol Lee, Ki Chang Keum, Sang-wook Lee, Yong Chan Ahn, Dongryul Oh, Yeon-Sil Kim, Yong Kyun Won, Hong-Gyun Wu, J. Hun Hah, Young-Taek Oh; Cancer Res Treat. 2017;49(4):1097-1105. Published online February 9, 2017; DOI: https://doi.org/10.4143/crt.2016.425

Abstract PDF PubReader ePub

Purpose
The impact of postoperative ipsilateral neck radiotherapy (INRT) versus bilateral neck radiotherapy (BNRT) on the clinical outcomes of patients with tonsillar squamous cell carcinoma was analyzed retrospectively.
Materials and Methods
Between October 2001 and June 2012, 241 patients with T1-2 and N0-N2b tonsillar carcinoma from 16 institutes underwent postoperative INRT (n=84) or BNRT (n=157) following a tonsillectomy. Seventy patientswere identified from each group by propensity score matching and compared in terms of the overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates calculated using the Kaplan-Meier method with a log-rank test.
Results
The median follow-up was 55 months (range, 3 to 133 months). The survival outcomes in the INRT and BNRT groupswere similar: 5-year OS (92.8% vs. 94.0%, p=0.985), DFS (80.5% vs. 94.2%. p=0.085), LRRFS (88.1% vs. 97.1%, p=0.083), and DMFS (92.7% vs. 97.0%, p=0.370). Subgroup analysis revealed no contralateral neck recurrence in 61 patients with T1-2N0-2a regardless of the treatment groups. For 79 patients with N2b, contralateral neck recurrence was more common in the INRT group than in the BNRT group (7.9% vs. 0.0%), but the difference was not significant (p=0.107). The overall grade ≥ 2 toxicities were lower in the INRT group: acute (45.7% vs. 74.3%, p=0.001) and late (4.3% vs. 31.4%, p < 0.001), respectively.
Conclusion
INRT is an attractive strategy for patients with T1-2N0-2a tonsillar carcinoma compared to BNRT. For patients with N2b, there was a small risk of contralateral neck recurrence when treated with INRT, but its impact on the OS was limited with successful salvage treatment.

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Claire M. Rooney, Shao Hui Huang, Jie Su, Scott Bratman, John Cho, John de Almeida, Michael Glogauer, David Goldstein, Ezra Hahn, Ali Hosni, Andrew Hope, Jonathan Irish, John Kim, Brian O'Sullivan, Jolie Ringash, Anna Spreafico, Jillian Tsai, John Waldron
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Association of Unilateral Radiotherapy With Contralateral Lymph Node Failure Among Patients With Squamous Cell Carcinoma of the Tonsil
Niema B. Razavian, Ralph B. D’Agostino, Cole R. Steber, Corbin A. Helis, Ryan T. Hughes
JAMA Network Open.2023; 6(2): e2255209. CrossRef
Low contralateral neck recurrence risk with ipsilateral neck radiotherapy in N2b tonsillar squamous cell carcinoma
Divya Natesan, Christina K. Cramer, Taofik Oyekunle, Donna Niedzwiecki, David M. Brizel, Yvonne M. Mowery
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Jared H Hara, Stanley I Gutiontov, Sophia Uddin, Ari J Rosenberg, Alexander T Pearson, Zhen Gooi, Elizabeth A Blair, Nishant Agrawal, Everett E Vokes, Daniel T Ginat, Daniel J Haraf, Aditya Juloori
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Dose-Response Relationship between Radiation Dose and Loco-regional Control in Patients with Stage II-III Esophageal Cancer Treated with Definitive Chemoradiotherapy: Hyun Ju Kim, Yang-Gun Suh, Yong Chan Lee, Sang Kil Lee, Sung Kwan Shin, Byung Chul Cho, Chang Geol Lee; Cancer Res Treat. 2017;49(3):669-677. Published online October 6, 2016; DOI: https://doi.org/10.4143/crt.2016.354

Abstract PDF PubReader ePub

Purpose
The correlation between radiation dose and loco-regional control (LRC) was evaluated in patients with stage II-III esophageal cancer treated with definitive concurrent chemoradiotherapy (CRT).
Materials and Methods
Medical records of 236 stage II-III esophageal cancer patients treated with definitive CRT at Yonsei Cancer Center between 1994 and 2013were retrospectively reviewed. Among these, 120 received a radiation dose of < 60 Gy (standard-dose group), while 116 received ≥ 60 Gy (high-dose group). The median doses of radiation in the standard- and high-dose groups were 50.4 and 63 Gy, respectively. Concurrent 5-fluorouracil/cisplatin chemotherapy was administered to most patients.
Results
There were no differences in patient characteristics between the two groups except for high Karnofsky performance status and lower-thoracic lesions being more prevalent in the standard-dose group. The median progression-free survival (PFS) and overall survival (OS) times were 13.2 months and 26.2 months, respectively. Patients in the high-dose group had significantly better 2-year LRC (69.1% vs. 50.3%, p=0.002), median PFS (16.7 months vs. 11.7 months, p=0.029), and median OS (35.1 months vs. 22.3 months, p=0.043). Additionally, LRC exhibited a dose-response relationship and the complete response rate was significantly higher in the high-dose group (p=0.006). There were no significant differences in treatment-related toxicities between the groups.
Conclusion
A higher radiation dose (> 60 Gy) is associated with increased LRC, PFS, and OS in patients with stage II-III esophageal cancer treated with definitive CRT.

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Tumor Stage-Related Role of Radiotherapy in Patients with an External Auditory Canal and Middle Ear Carcinoma: Jinhyun Choi, Se-Heon Kim, Yoon Woo Koh, Eun Chang Choi, Chang Geol Lee, Ki Chang Keum; Cancer Res Treat. 2017;49(1):178-184. Published online July 4, 2016; DOI: https://doi.org/10.4143/crt.2016.165

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to evaluate the clinical outcomes of patients treated with radiotherapy (RT) for a carcinoma of the external auditory canal (EAC) and middle ear.
Materials and Methods
The records of 32 patients who received RT from 1990 to 2013 were reviewed retrospectively. The Pittsburgh classification was used to stage all the cancers (early stage, T1/T2 [n=12]; advanced stage, T3/T4 or N positive [n=20]). Twenty-one patients (65.6%) were treated with postoperative RT and 11 patients (34.4%) were treated with definitive RT. The median radiation doses for postoperative and definitive RT were 60 Gy and 64.8 Gy, respectively. Chemotherapy was administered to seven patients (21.9%).
Results
The 5-year overall survival and disease-free survival rates for all patients were 57% and 52%, respectively. The disease control rates for the patients with early stage versus advanced stage carcinomawere 55.6% (5/9) and 50% (6/12) in the postoperative RT group and 66.7% (2/3) and 37.5% (3/8) in the definitive RT group, respectively. Overall, 15 cases (14 patients, 46.7%) experienced treatment failure; these failures were classified as local in four cases, regional in one case, and distant in 10 cases. The median follow-up period after RT was 51 months (range, 7 to 286 months).
Conclusion
Patients with early stage carcinoma achieved better outcomes when definitive RT was used. Advanced stage carcinoma patients experienced better outcomes with postoperative RT. The high rate of distant failure after RT, with or without surgery, reflected the lack of a consensus regarding the best therapeutic approach for treating carcinoma of the EAC and middle ear.

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Optimal Adjuvant Treatment for Curatively Resected Thoracic Esophageal Squamous Cell Carcinoma: A Radiotherapy Perspective: Kyung Hwan Kim, Jee Suk Chang, Ji Hye Cha, Ik Jae Lee, Dae Joon Kim, Byoung Chul Cho, Kyung Ran Park, Chang Geol Lee; Cancer Res Treat. 2017;49(1):168-177. Published online June 23, 2016; DOI: https://doi.org/10.4143/crt.2016.142

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Purpose
The purpose of this study was to evaluate the benefits of adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma (ESCC) and determine the optimal adjuvant treatments.
Materials and Methods
One hundred ninety-five patients who underwent a curative resection for thoracic ESCC between 1994 and 2014 were reviewed retrospectively. Postoperatively, the patients received no adjuvant treatment (no-adjuvant group, n=68), adjuvant chemotherapy (AC group, n=62), radiotherapy (RT group, n=41), or chemoradiotherapy (CRT group, n=24). Chemotherapy comprised cisplatin and 5-fluorouracil administration every 3 weeks. The median RT dose was 45.0 Gy (range, 34.8 to 59.4 Gy). The overall survival (OS), disease-free survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) rates were estimated.
Results
At a median follow-up duration of 42.2 months (range, 6.3 to 215.2 months), the 5-year OS and DFS were 37.6% and 31.4%, respectively. After adjusting for other clinicopathologic variables, the AC and CRT groups had a significantly better OS and DFS compared to the no-adjuvant group (p < 0.05). The LRR rate was significantly lower in the RT and CRT groups than in the no-adjuvant group (p < 0.05), whereas no significant difference was observed in the AC group. In the no-adjuvant and AC groups, 25% of patients received high-dose salvage RT due to LRR. The DM rates were similar. The anastomotic stenosis and leakage were similar in the treatment groups.
Conclusion
Adjuvant treatment might prolong survival after an ESCC resection, and RT contributes to a reduction of the LRR. Overall, the risks and benefits should be weighed properly when selecting the optimal adjuvant treatment.

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The Society of Thoracic Surgeons/American Society for Radiation Oncology Updated Clinical Practice Guidelines on Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction
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Radical esophagectomy for stage II and III thoracic esophageal squamous cell carcinoma followed by adjuvant radiotherapy with or without chemotherapy: Which is more beneficial?
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Homeobox D10, a tumor suppressor, inhibits the proliferation and migration of esophageal squamous cell carcinoma
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Adjuvant radiotherapy for stage pN1M0 esophageal squamous cell carcinoma: Results from a Chinese two‐center study
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Comparison of the effect of postoperative radiotherapy with surgery alone for esophagus squamous cell carcinoma patients
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The impact of adjuvant therapies on patient survival and the recurrence patterns for resected stage IIa–IVa lower thoracic oesophageal squamous cell carcinoma
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Erratum

ERRATUM: Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy: Min Kyu Kang, Dongryul Oh, Kwan Ho Cho, Sung Ho Moon, Hong-Gyun Wu, Dae-Seog Heo, Yong Chan Ahn, Keunchil Park, Hyo Jung Park, Jun Su Park, Ki Chang Keum, Jihye Cha, Jun Won Kim, Yeon-Sil Kim, Jin Hyoung Kang, Young-Taek Oh, Ji-Yoon Kim, Sung Hwan Kim, Jin-Hee Kim, Chang Geol Lee; Cancer Res Treat. 2016;48(1):425-425. Published online January 10, 2016; DOI: https://doi.org/10.4143/crt.2014.141.2; Corrects: Cancer Res Treat 2015;47(4):871

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Original Articles

The Role of Neoadjuvant Chemotherapy in the Treatment of Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Study (KROG 11-06) Using Propensity Score Matching Analysis: Jin Ho Song, Hong-Gyun Wu, Bhum Suk Keam, Jeong Hun Hah, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Hyo Jung Park, Chang Geol Lee, Ki Chang Keum, Jihye Cha, Kwan Ho Cho, Sung Ho Moon, Ji-Yoon Kim, Woong-Ki Chung, Young Taek Oh, Won Taek Kim, Moon-June Cho, Chul Seung Kay, Yeon-Sil Kim; Cancer Res Treat. 2016;48(3):917-927. Published online December 28, 2015; DOI: https://doi.org/10.4143/crt.2015.265

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Purpose
We compared the treatment results and toxicity in nasopharyngeal carcinoma (NPC) patients treated with concurrent chemotherapy (CCRT) alone (the CRT arm) or neoadjuvant chemotherapy followed by CCRT (the NCT arm). Materials and Methods A multi-institutional retrospective study was conducted to review NPC patterns of care and treatment outcome. Data of 568 NPC patients treated by CCRT alone or by neoadjuvant chemotherapy followed by CCRT were collected from 15 institutions. Patients in both treatment arms were matched using the propensity score matching method, and the clinical outcomes were analyzed.
Results
After matching, 300 patients (150 patients in each group) were selected for analysis. Higher 5-year locoregional failure-free survival was observed in the CRT arm (85% vs. 72%, p=0.014). No significant differences in distant failure-free survival (DFFS), disease-free survival (DFS), and overall survival were observed between groups. In subgroup analysis, the NCT arm showed superior DFFS and DFS in stage IV patients younger than 60 years. No significant difference in compliance and toxicity was observed between groups, except the radiation therapy duration was slightly shorter in the CRT arm (50.0 days vs. 53.9 days, p=0.018). Conclusion This study did not show the superiority of NCT followed by CCRT over CCRT alone. Because NCT could increase the risk of locoregional recurrences, it can only be considered in selected young patients with advanced stage IV disease. The role of NCT remains to be defined and should not be viewed as the standard of care.

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Age is a significant biomarker for the selection of neoadjuvant chemotherapy plus radiotherapy versus concurrent chemoradiotherapy in patients with advanced nasopharyngeal carcinoma
Yihong Lin, Xiongbin Yu, Linbin Lu, Hong Chen, Junxian Wu, Yaying Chen, Qin Lin, Xuewen Wang, Xi Chen, Xiong Chen
Cancer Biomarkers.2023; 37(1): 1. CrossRef
Effect of Induction Chemotherapy in Nasopharyngeal Carcinoma: An Updated Meta-Analysis
Shan-Shan Yang, Jian-Gui Guo, Jia-Ni Liu, Zhi-Qiao Liu, En-Ni Chen, Chun-Yan Chen, Pu-Yun OuYang, Fei Han, Fang-Yun Xie
Frontiers in Oncology.2021;[Epub] CrossRef
Concurrent chemoradiotherapy with additional chemotherapy for nasopharyngeal carcinoma: A pooled analysis of propensity score‐matching studies
Minmin Li, Bin Zhang, Qiuying Chen, Lu Zhang, Xiaokai Mo, Zhuozhi Chen, Zhe Jin, Luyan Chen, Jingjing You, Shuixing Zhang
Head & Neck.2021; 43(6): 1912. CrossRef
Longitudinal Assessment of Intravoxel Incoherent Motion Diffusion Weighted Imaging in Evaluating the Radio-sensitivity of Nasopharyngeal Carcinoma Treated with Intensity-Modulated Radiation Therapy
Youping Xiao, Ying Chen, Yunbin Chen, Zhuangzhen He, Yiqi Yao, Jianji Pan
Cancer Research and Treatment.2019; 51(1): 345. CrossRef
Less is more: role of additional chemotherapy to concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal cancer management
Yong Chan Ahn
Radiation Oncology Journal.2019; 37(2): 67. CrossRef
A Pairwise Meta-Analysis of Induction Chemotherapy in Nasopharyngeal Carcinoma
Pu-Yun OuYang, Xiao-Min Zhang, Xing-Sheng Qiu, Zhi-Qiao Liu, Lixia Lu, Yuan-Hong Gao, Fang-Yun Xie
The Oncologist.2019; 24(4): 505. CrossRef
Induction chemotherapy for locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiation: A systematic review and meta-analysis
Teng Hwee Tan, Yu Yang Soon, Timothy Cheo, Francis Ho, Lea Choung Wong, Jeremy Tey, Ivan W.K. Tham
Radiotherapy and Oncology.2018; 129(1): 10. CrossRef
Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma
Jiraporn Setakornnukul, Kullathorn Thephamongkhol
BMC Cancer.2018;[Epub] CrossRef
TPF induction chemotherapy followed by concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma: Long term results of a Tunisian series
N. Toumi, W. Ben Kridis, W. Mnejja, R. Bouzguenda, A. Khanfir, A. Ghorbel, J. Daoud, M. Frikha
Cancer/Radiothérapie.2018; 22(3): 216. CrossRef
Does concurrent chemoradiotherapy preceded by chemotherapy improve survival in locally advanced nasopharyngeal cancer patients? Experience from Ghana
Joel Yarney, Naa A. Aryeetey, Alice Mensah, Emmanuel D. Kitcher, Verna Vanderpuye, Charles Aidoo, Kenneth Baidoo
Cancers of the Head & Neck.2017;[Epub] CrossRef
Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in nasopharyngeal carcinoma patients with cervical nodal necrosis
Mei Lan, Chunyan Chen, Ying Huang, Li Tian, Zhijun Duan, Fei Han, Junfang Liao, Meiling Deng, Terence T. Sio, Anussara Prayongrat, Lie Zheng, Shaoxiong Wu, Taixiang Lu
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A retrospective paired study: efficacy and toxicity of nimotuzumab versus cisplatin concurrent with radiotherapy in nasopharyngeal carcinoma
H. M. Li, P. Li, Y. J. Qian, X. Wu, L. Xie, F. Wang, H. Zhang, L. Liu
BMC Cancer.2016;[Epub] CrossRef

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The Clinical Usefulness of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography (PET) to Predict Oncologic Outcomes and PET-Based Radiotherapeutic Considerations in Locally Advanced Nasopharyngeal Carcinoma: Hong In Yoon, Kyung Hwan Kim, Jeongshim Lee, Yun Ho Roh, Mijin Yun, Byoung Chul Cho, Chang Geol Lee, Ki Chang Keum; Cancer Res Treat. 2016;48(3):928-941. Published online December 11, 2015; DOI: https://doi.org/10.4143/crt.2015.275

Abstract PDF Supplementary Material PubReader ePub

Purpose
We investigated ¹⁸F-fluorodeoxyglucose positron emission tomography (PET)-derived parameters as prognostic indices for disease progression and survival in locally advanced nasopharyngeal carcinoma (NPC) and the effect of high-dose radiotherapy for a subpopulation with PET-based poor prognoses.
Materials and Methods
Ninety-seven stage III and Iva-b NPC patients who underwent definitive treatment and PET were reviewed. For each primary, nodal, and whole tumor, maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) were evaluated.
Results
Based on the C-index (0.666) and incremental area under the curve (0.669), the whole tumor TLGwas the most useful predictorfor progression-free survival (PFS); thewhole tumor TLG cut-off value showing the best predictive performance was 322.7. In multivariate analysis, whole tumor TLG was a significant prognostic factor for PFS (hazard ratio [HR], 0.3; 95% confidence interval [CI], 0.14 to 0.65; p=0.002) and OS (HR, 0.29; 95% CI, 0.11 to 0.79; p=0.02). Patients with low whole tumor TLG showed the higher 5-year PFS in the subgroup for only patients receiving intensity modulated radiotherapy (77.4% vs. 53.0%, p=0.01). In the subgroup of patients with high whole tumor TLG, patients receiving an EQD2 ≥ 70 Gy showed significantly greater complete remission rates (71.4% vs. 33.3%, p=0.03) and higher 5-year OS (74.7% vs. 19.6%, p=0.02).
Conclusion
Our findings demonstrated that whole tumor TLG could be an independent prognostic factor and high-dose radiotherapy could improve outcomes for NPC showing high whole tumor TLG.

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Clinical significance of post-chemoradiotherapy 2-[18F]FDG PET/CT response in locally advanced nasopharyngeal carcinoma: A real-world study
Yiwen Mo, Yuan Wei, Liping Liang, Tingfan Wu, Xinling Li, Ruping Li, Wei Fan, Yingying Hu, Xu Zhang
Oral Oncology.2025; 161: 107160. CrossRef
Predictive significance of pretreatment 18F‐FDG PET volumetric parameters on survival outcomes in pediatric patients with locally advanced undifferentiated nasopharyngeal carcinoma
Gihan El‐Hennawy, Salma ElMenawi, Eman Nasr Said, Wael Zekri, Mohamed Zaghloul, Ahmed Mustafa Abd Elsalam, Habiba El‐Fendy, Ismail Elantably
Pediatric Blood & Cancer.2024;[Epub] CrossRef
The prognostic value of the ratio of standard uptake value of lymph node to primary tumor before treatment of locally advanced nasopharyngeal carcinoma
Yunlong Lou, Dandan Chen, Zheng Lin, Jianda Sun, Li Song, Wenzhong Chen, Ming Zhang, Yibiao Chen
European Archives of Oto-Rhino-Laryngology.2023; 280(1): 347. CrossRef
Strategy to minimize induced 24Na, 56Mn activity in concrete composites used for fast neutron shielding: impact of cement and rock aggregates
A. A. Shanbhag, Sabyasachi Paul, S. C. Sharma, M. S. Kulkarni
Journal of Radioanalytical and Nuclear Chemistry.2023; 332(8): 3093. CrossRef
Prognostic value of primary tumor and lymph node volumetric metabolic parameters at pre-treatment F-18 FDG PET/CT in nasopharyngeal carcinoma
Bedriye Büşra Demirel, Seda Gülbahar Ateş, Ebru Atasever Akkaş, Fatih Göksel, Gülin Uçmak
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition).2023; 42(6): 367. CrossRef
Valor pronóstico de los parámetros metabólicos volumétricos del tumor primario y ganglios linfáticos en el PET/TC pretratamiento en el carcinoma nasofaríngeo
B.B. Demirel, S. Gülbahar Ateş, E. Atasever Akkaş, F. Göksel, G. Uçmak
Revista Española de Medicina Nuclear e Imagen Molecular.2023; 42(6): 367. CrossRef
The role of PET/CT in radiotherapy for nasopharyngeal carcinoma
Hongjia Li, Ziren Kong, Yongbo Xiang, Rong Zheng, Shaoyan Liu
Frontiers in Oncology.2022;[Epub] CrossRef
Prognostic Factors for Overall Survival in Nasopharyngeal Cancer and Implication for TNM Staging by UICC: A Systematic Review of the Literature
Chi Leung Chiang, Qiaojuan Guo, Wai Tong Ng, Shaojun Lin, Tiffany Sze Wai Ma, Zhiyuan Xu, Youping Xiao, Jishi Li, Tianzhu Lu, Horace Cheuk Wai Choi, Wenqi Chen, Eric Sze Chun Chau, Peter Ho Yin Luk, Shao Hui Huang, Brian O’Sullivan, Jianji Pan, Anne Wing
Frontiers in Oncology.2021;[Epub] CrossRef
Value of early evaluation of treatment response using 18F-FDG PET/CT parameters and the Epstein-Barr virus DNA load for prediction of outcome in patients with primary nasopharyngeal carcinoma
Yu-Hung Chen, Kai-Ping Chang, Sung-Chao Chu, Tzu-Chen Yen, Ling-Yi Wang, Joseph Tung-Chieh Chang, Cheng-Lung Hsu, Shu-Hang Ng, Shu-Hsin Liu, Sheng-Chieh Chan
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Oncotarget.2017; 8(20): 33884. CrossRef

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Overexpression of SOX2 Is Associated with Better Overall Survival in Squamous Cell Lung Cancer Patients Treated with Adjuvant Radiotherapy: Hong In Yoon, Kyu Hyun Park, Eun-Jung Lee, Ki Chang Keum, Chang Geol Lee, Chul Hoon Kim, Yong Bae Kim; Cancer Res Treat. 2016;48(2):473-482. Published online August 12, 2015; DOI: https://doi.org/10.4143/crt.2015.116

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to investigate the prognostic significance of SOX2 gene amplification and expression in patients with American Joint Committee on Cancer stage III lung squamous cell carcinoma (SCC) who underwent surgery followed by adjuvant radiotherapy.
Materials and Methods
Pathological specimens were obtained from 33 patients with stage III lung SCC treated with surgery followed by adjuvant radiotherapy between 1996 and 2008. SOX2 gene amplification and protein expression were analyzed using fluorescent in situ hybridization and immunohistochemistry, respectively. Patients were divided into two groups according to their SOX2 gene amplification and protein expression status. Kaplan-Meier estimates and a Cox proportional hazards model were used to identify the prognostic factors affecting patient survival.
Results
The median follow-up period for surviving patientswas 58 months (range, 5 to 102 months). SOX2 gene amplification was observed in 22 patients and protein overexpression in 26 patients. SOX2 overexpression showed significant association with SOX2 gene amplification (p=0.002). In multivariate analysis, SOX2 overexpression was a significant prognostic factor for overall survival (OS) (hazard ratios [HR], 0.1; 95% confidence interval [CI], 0.002 to 0.5; p=0.005) and disease-free survival (DFS) (HR, 0.15; 95% CI, 0.04 to 0.65; p=0.01). Age (HR, 0.33; 95% CI, 0.11 to 0.98; p=0.046) and total radiation dose (HR, 0.13; 95% CI, 0.02 to 0.7; p=0.02) were the independent prognostic factors for OS and DFS. Patients with SOX2 amplification did not show a longer OS (p=0.95) and DFS (p=0.48).
Conclusion
Our data suggested that SOX2 overexpression could be used as a positive prognostic factor in patients with stage III lung SCC receiving adjuvant radiotherapy.

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Daniela Grimm, Johann Bauer, Petra Wise, Marcus Krüger, Ulf Simonsen, Markus Wehland, Manfred Infanger, Thomas J. Corydon
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Balsam Rizeq, Zain Zakaria, Allal Ouhtit
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Lung Cancers: Molecular Characterization, Clonal Heterogeneity and Evolution, and Cancer Stem Cells
Ugo Testa, Germana Castelli, Elvira Pelosi
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SOX2 knockdown inhibits the migration and invasion of basal cell carcinoma cells by targeting the SRPK1‑mediated PI3K/AKT signaling pathway
Zhuo‑Ran Li, Yong Jiang, Jian‑Zhong Hu, Yang Chen, Quan‑Zhong Liu
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Qingbao Li, Fang Liu, Yuan Zhang, Lei Fu, Cong Wang, Xuan Chen, Shanghui Guan, Xiangjiao Meng
Oncotarget.2016; 7(23): 34520. CrossRef

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Definitive Chemoradiotherapy Versus Surgery Followed by Adjuvant Radiotherapy in Resectable Stage III/IV Hypopharyngeal Cancer: Jun Won Kim, Mi Sun Kim, Se-Heon Kim, Joo Hang Kim, Chang Geol Lee, Gwi Eon Kim, Ki Chang Keum; Cancer Res Treat. 2016;48(1):45-53. Published online March 13, 2015; DOI: https://doi.org/10.4143/crt.2014.340

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to compare the treatment outcomes for locally advanced resectable hypopharyngeal cancer between organ-preserving chemoradiotherapy (CRT) and surgery followed by radiotherapy (SRT).
Materials and Methods
We reviewed 91 patients with stage III/IV hypopharyngeal squamous cell carcinoma treated with radiotherapy (RT). In the CRT group (n=34), 18 patients were treated with concurrent CRT and 16 patients with induction chemotherapy plus concurrent CRT. In the SRT group (n=57), six patients were treated with total laryngopharyngectomy, 34 patients with total laryngectomy (TL) and partial pharyngectomy (PP), and 17 patients with PP, which were followed by adjuvant radiotherapy (n=41) or CRT (n=16). The median RT dose was 70 Gy for CRT and 59.4 Gy for SRT.
Results
Five-year local control (84.1% vs. 90.9%), and disease-free survival (DFS, 51.0% vs. 52.7%) and overall survival (OS, 58.6% vs. 56.6%) showed no significant difference between the CRT and SRT groups. The functional larynx-preservation rate was higher in the CRT group (88.2% vs. 29.8%). Treatment-related toxicity, requiring surgical intervention, occurred more frequently in the SRT group (37% vs. 12%). In the SRT group, TL resulted in a significantly higher DFS than larynx-sparing surgery (63.9% vs. 26.5%, p=0.027). Treatment outcome of the SRT group improved when only patients with TL were considered (n=40); however, 5-year OS (67.1% vs. 58.6%, p=0.830) and DFS (63.9% vs. 51.0%, p=0.490) did not improve significantly when compared to the CRT group.
Conclusion
Organ preserving CRT provided a treatment outcome that is comparable to SRT for locally advanced hypopharyngeal cancer, while offering an opportunity for functional larynx-preservation and reduced treatment-related toxicity.

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Eun-Jae Chung, Woo-Jin Jeong, Young Ho Jung, Seong Keun Kwon, Tack-Kyun Kwon, Soon-Hyun Ahn, Myung-Whun Sung, Bhumsuk Keam, Dae-Seog Heo, Jin Ho Kim, Hong-Gyun Wu, Keun-Wook Lee, Keun-Yong Eom, Young-Soo Rho
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Robert Smee, Janet R. Williams, Damian P. Kotevski
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Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy: Min Kyu Kang, Dongryul Oh, Kwan Ho Cho, Sung Ho Moon, Hong-Gyun Wu, Dae-Seog Heo, Yong Chan Ahn, Keunchil Park, Hyo Jung Park, Jun Su Park, Ki Chang Keum, Jihye Cha, Jun Won Kim, Yeon-Sil Kim, Jin Hyoung Kang, Young-Taek Oh, Ji-Yoon Kim, Sung Hwan Kim, Jin-Hee Kim, Chang Geol Lee; Cancer Res Treat. 2015;47(4):871-878. Published online February 13, 2015; DOI: https://doi.org/10.4143/crt.2014.141; Correction in: Cancer Res Treat 2016;48(1):425

Abstract PDF PubReader ePub

Purpose
To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngeal carcinoma, we compared the treatment outcomes of patients treated with curative radiotherapy with or without chemotherapy. Materials and Methods From 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002 stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitals in South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvant chemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in 80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gy to 74.2 Gy (median, 70 Gy).
Results
Median follow-up was 48 months (range, 7 to 97 months) for all patients. At the last followup, 13 patients had died and 32 had experienced treatment failure; locoregional failure occurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival, and overall survival were 86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that the significant prognostic factors were concurrent chemotherapy and N stage for locoregional relapse-free survival, concurrent chemotherapy for progression-free survival, and age and N stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improved distant metastasis-free survival. Conclusion Concurrent chemotherapy significantly improved 5-year locoregional relapse-free survival and progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvant chemotherapy failed to improve either.

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Concurrent chemoradiotherapy versus radiotherapy alone in older patients with stage II nasopharyngeal carcinoma after intensity-modulated radiotherapy: A propensity score-matched cohort study
Fang Wang, Lu Zhou, Li-Jun Zhang, Chang-Bin Xie, Zhi-Wei Liao, Xiao-Dan Lin, Yue-Feng Wen
Radiotherapy and Oncology.2024; 191: 110081. CrossRef
A Systematic Review and Meta-Analysis of Studies Comparing Concurrent Chemoradiotherapy With Radiotherapy Alone in the Treatment of Stage II Nasopharyngeal Carcinoma
Yao-Can Xu, Kai-Hua Chen, Zhong-Guo Liang, Xiao-Dong Zhu
Frontiers in Oncology.2022;[Epub] CrossRef
MRI-identified multidimensional nodal features predict survival and concurrent chemotherapy benefit for stage II nasopharyngeal carcinoma
Yang Liu, Jianghu Zhang, Jingbo Wang, Runye Wu, Xiaodong Huang, Kai Wang, Yuan Qu, Xuesong Chen, Yexiong Li, Ye Zhang, Junlin Yi
Radiology and Oncology.2022; 56(4): 479. CrossRef
The efficacy of chemotherapy in survival of stage II nasopharyngeal carcinoma
Xin-Bin Pan, Ling Li, Song Qu, Long Chen, Shi-Xiong Liang, Xiao-Dong Zhu
Oral Oncology.2020; 101: 104520. CrossRef
Survival of stage II nasopharyngeal carcinoma patients with or without concurrent chemotherapy: A propensity score matching study
Di‐Han Liu, Xiao‐Yu Zhou, You‐Guang Pan, Si Chen, Zheng‐Hao Ye, Gang‐Dong Chen
Cancer Medicine.2020; 9(4): 1287. CrossRef
Concurrent Chemoradiotherapy With or Without Induction Chemotherapy for Patients with Stage II Nasopharyngeal Carcinoma: An Update
Ting Jin, Qun Zhang, Dong-Hua Luo, Feng Jiang, Qi-Feng Jin, Yuan-Yuan Chen, Xiao-Zhong Chen, Wei-Min Mao
Translational Oncology.2020; 13(1): 25. CrossRef
Predictive factors of chemotherapy use in stage II nasopharyngeal carcinoma
Xin-Bin Pan, Shi-Ting Huang, Kai-Hua Chen, Yan-Ming Jiang, Xiao-Dong Zhu
Medicine.2019; 98(7): e14512. CrossRef
The role of chemotherapy in the treatment of stage II nasopharyngeal carcinoma: Retrospective analysis of the national cancer database
Zaheer Ahmed, Lara Kujtan, Kevin Kennedy, Valerie Wood, David Schomas, Janakiraman Subramanian
Cancer Medicine.2019; 8(4): 1500. CrossRef
Patterns of Failure and Survival Trends in 3,808 Patients with Stage II Nasopharyngeal Carcinoma Diagnosed from 1990 to 2012: A Large-Scale Retrospective Cohort Study
Xue-Song Sun, Di-Han Liu, Sai-Lan Liu, Qiu-Yan Chen, Shan-Shan Guo, Yue-Feng Wen, Li-Ting Liu, Hao-Jun Xie, Qing-Nan Tang, Yu-Jing Liang, Xiao-Yun Li, Jin-Jie Yan, Ming-Huang Hong, Jun Ma, Lin-Quan Tang, Hai-Qiang Mai
Cancer Research and Treatment.2019; 51(4): 1449. CrossRef
Combined chemoradiation vs radiation therapy alone in stage-II nasopharyngeal carcinoma: A meta-analysis of the published literature
Sufang Wang, Shan Li, Liangfang Shen
Current Problems in Cancer.2018; 42(3): 302. CrossRef
The efficacy of induction chemotherapy in the treatment of stage II nasopharyngeal carcinoma in intensity modulated radiotherapy era
Pei-Jing Li, Hao-Yuan Mo, Dong-Hua Luo, Wei-Han Hu, Ting Jin
Oral Oncology.2018; 85: 95. CrossRef
Concurrent chemoradiotherapy degrades the quality of life of patients with stage II nasopharyngeal carcinoma as compared to radiotherapy
Xin-Bin Pan, Shi-Ting Huang, Kai-Hua Chen, Yan-Ming Jiang, Jia-Lin Ma, Song Qu, Ling Li, Long Chen, Xiao-Dong Zhu
Oncotarget.2017; 8(8): 14029. CrossRef
Chemotherapy use and survival in stage II nasopharyngeal carcinoma
Xin-Bin Pan, Shi-Ting Huang, Kai-Hua Chen, Xiao-Dong Zhu
Oncotarget.2017; 8(60): 102573. CrossRef
Long-term survival of nasopharyngeal carcinoma patients with Stage II in intensity-modulated radiation therapy era
Qiaojuan Guo, Tianzhu Lu, Shaojun Lin, Jingfeng Zong, Zhuhong Chen, Xiaofei Cui, Yu Zhang, Jianji Pan
Japanese Journal of Clinical Oncology.2016; 46(3): 241. CrossRef
Comparison of the efficacy between concurrent chemoradiotherapy with or without adjuvant chemotherapy and intensity-modulated radiotherapy alone for stage II nasopharyngeal carcinoma
Kai-Hua Chen, Xiao-Dong Zhu, Ling Li, Song Qu, Zhen-Qiang Liang, Xia Liang, Xin-Bin Pan, Zhong-Guo Liang, Yan-Ming Jiang
Oncotarget.2016; 7(42): 69041. CrossRef
Propensity score matching analysis of cisplatin-based concurrent chemotherapy in low risk nasopharyngeal carcinoma in the intensity-modulated radiotherapy era
Lu-Ning Zhang, Yuan-Hong Gao, Xiao-Wen Lan, Jie Tang, Zhen Su, Jun Ma, Wuguo Deng, Pu-Yun OuYang, Fang-Yun Xie
Oncotarget.2015; 6(41): 44019. CrossRef

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Predicting Survival in Patients with Advanced Non-squamous Non-small Cell Lung Cancer: Validating the Extent of Metastasis: Dong Soo Lee, Jin Hyoung Kang, Chang Geol Lee, Seoung Jun Kim, Young Jin Choi, Kyo Young Lee, Yeon Sil Kim; Cancer Res Treat. 2013;45(2):95-102. Published online June 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.2.95

Abstract PDF PubReader ePub

PURPOSE
A number of factors related to overall survival (OS) have been addressed in advanced non-small cell lung cancer (NSCLC). This study was conducted to determine the impact of whole-body metastatic regions on survival outcome in advanced non-squamous NSCLC.
MATERIALS AND METHODS
Between March 2005 and February 2011, 112 eligible patients with newly confirmed stage IV non-squamous NSCLC, available for epidermal growth factor receptor (EGFR) mutation status 18-21 analysis, and accessible for the determination of pretreatment whole-body metastatic regions were enrolled in this retrospective study. The total number of synchronous metastatic regions was scored according to the following disease sites: abdomen/pelvis, lung to lung/pulmonary lymphangitic spread, bone, pleura/pleural effusion/pericardial effusion, neck/axillary lymph nodes, other soft tissue, brain.
RESULTS
The median age of the cohort was 65 years (range, 31 to 88 years). The median whole-body metastatic score was 2 (range, 1 to 6), and bone and lung to lung were the most common metastatic sites. EGFR mutations were observed in 40 (35.7%) patients with a deletion in exon 19 and Leu858Arg mutation in exon 21 being detected in 16 (40.0%) and 19 (47.5%) patients, respectively. Multivariate analysis for OS revealed that treatment factors (p=0.005), performance status (p=0.006), whole-body metastatic score (p<0.001), and EGFR mutation status (p=0.095) were significantly or marginally associated with OS.
CONCLUSION
The results of the present study demonstrated that whole-body metastatic extent strongly affects survival outcome, even after adjustment for other significant variables in advanced non-squamous NSCLC. The clinical validity of more curative multimodal approaches in cohorts with limited metastases remains to be explored.

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Management of rocoregional recurrent breast cancer: Kyung Ran Park, Jong Young Lee, Chang Geol Lee, Chang Ok Suh, John Kyu Loh Juhn, Gwi Eon Kim, Soo Gon Kim, Won Yong Oh, Eun Hee Koh, Byung Soo Kim; J Korean Cancer Assoc. 1992;24(5):684-694.

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