Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Non-operative Management of Rectal Cancer with Adjuvant Chemotherapy after Chemoradiotherapy (NORMANDY): Prospective Study: Hyebin Lee, Hyung Ook Kim, Jason Joon Bock Lee, In-Gu Do, Heon-Ju Kwon, Mi Sung Kim, Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Dong-Il Park, Kyung Uk Jung, Eo Jin Kim, Dong-Hoe Koo, Hungdai Kim, Ho-Kyung Chun, KBSMC Colorectal Cancer Team, Gastrointestinal Cancer Center; Cancer Res Treat. 2026;58(2):573-580. Published online May 15, 2025; DOI: https://doi.org/10.4143/crt.2025.148

Abstract PDF Supplementary Material PubReader ePub: Purpose
Non-operative management (NOM) has emerged as a promising organ-preserving strategy for patients with rectal cancer who achieve a clinical complete response (cCR) after neoadjuvant chemoradiotherapy (CRT). However, no standardized treatment protocol has been established for watch-and-wait strategies.
Materials and Methods
This prospective study evaluated oncological outcomes of NOM combined with 4 months of adjuvant capecitabine. Patients with resectable rectal cancer (≤ 8 cm from the anal verge, cT2-4 or N+) underwent CRT (50-54 Gy in 25-27 fractions with capecitabine). Eight weeks post-CRT, a multidisciplinary team assessed cCR. Patients achieving cCR received six cycles of capecitabine (2 weeks on/1 week off) and were actively monitored.
Results
Among 89 patients receiving CRT (2018-2023), 17 (19.1%) achieved cCR and were included. The median age was 65 years, and 64.7% were male. Eleven (64.7%) completed all six cycles of adjuvant therapy. After a median follow-up of 31.4 months, 11 patients (64.7%) remained disease-free. Local regrowth occurred in six patients (35.3%) with 2- and 4-year rates of 34.5% and 47.6%, respectively. Five underwent radical surgery, and one received transanal excision with systemic chemotherapy. At the time of assessment, 15 patients (88.2%) showed no evidence of disease, while two (11.8%) received palliative chemotherapy. All patients were alive.
Conclusion
NOM with adjuvant capecitabine showed promising oncological outcomes, offering an alternative to passive watch-and-wait approaches. Further refinement through multidisciplinary strategies is warranted.

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Salvage Concurrent Chemo-radiation Therapy for Loco-regional Recurrence Following Curative Surgery of Non-small Cell Lung Cancer: Kyung Hwa Lee, Yong Chan Ahn, Hongryull Pyo, Jae Myoung Noh, Seung Gyu Park, Tae Gyu Kim, Eonju Lee, Heerim Nam, Hyebin Lee, Jong-Mu Sun, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park; Cancer Res Treat. 2019;51(2):769-776. Published online September 11, 2018; DOI: https://doi.org/10.4143/crt.2018.366

Abstract PDF PubReader ePub

Purpose
This study is to report clinical outcomes of salvage concurrent chemo-radiation therapy (CCRT) in treating patients with loco-regional recurrence (LRR) following initial complete resection of non-small cell lung cancer.
Materials and Methods
Between February 2004 and December 2016, 127 patients underwent salvage CCRT for LRR. The median radiation therapy (RT) dose was 66 Gy and clinical target volume was to cover recurrent lesion with margin without elective inclusion of regional lymphatics. Majority of patients (94.5%) received weekly platinum-based doublet chemotherapy during RT course.
Results
The median follow-up time from the start of CCRT was 25 months. The median survival duration was 49 months, and overall survival (OS) rates at 2 and 5 years were 72.9% and 43.9%. The 2- and 5-year rates of in-field failure-free survival, distant metastasis free survival, and progression free survival were 82.4% and 73.8%, 50.4% and 39.9%, and 34.6% and 22.3%, respectively. Grade ≥ 3 radiation-related esophagitis and pneumonitis occurred in 14 (11.0%) and six patients (4.7%), respectively. On both univariate and multivariate analysis, higher biologically equivalent dose (BED10) (≥ 79.2 Gy10 vs. < 79.2 Gy10; hazard ratio [HR], 0.431), smaller CTV (≤ 80 cm3 vs. > 80 cm3; HR, 0.403), and longer disease-free interval (> 1 year vs. ≤ 1 year; HR, 0.489) were significantly favorable factors for OS.
Conclusion
The current study has demonstrated that high dose salvage CCRT focused to the involved lesion only was highly effective and safe. In particular, higher BED₁₀, smaller CTV, and longer disease-free interval were favorable factors for improved survival.

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Hongsheng Deng, Juan Zhou, Hualin Chen, Xiuyu Cai, Ran Zhong, Feng Li, Bo Cheng, Caichen Li, Qingzhu Jia, Caicun Zhou, René H. Petersen, Gaetano Rocco, Alex Brunelli, Calvin S.H. Ng, Thomas A. D’Amico, Chunxia Su, Jianxing He, Wenhua Liang, Bo Zhu
International Journal of Surgery.2024; 110(1): 238. CrossRef
Prognosis of non‐small cell lung cancer with postoperative regional lymph node recurrence
Yoichi Ohtaki, Toshiteru Nagashima, Naoko Okano, Nobuteru Kubo, Takeru Ohtaka, Noriaki Sunaga, Reiko Sakurai, Yosuke Miura, Seshiru Nakazawa, Natsuko Kawatani, Tomohiro Yazawa, Ryohei Yoshikawa, Eiji Narusawa, Ken Shirabe
Thoracic Cancer.2024; 15(11): 859. CrossRef
Durvalumab after chemoradiotherapy for locoregional recurrence of completely resected non–small‐cell lung cancer (NEJ056)
Megumi Furuta, Hidehito Horinouchi, Isao Yokota, Teppei Yamaguchi, Shoichi Itoh, Takafumi Fukui, Akira Iwashima, Jun Sugisaka, Yu Miura, Hisashi Tanaka, Taichi Miyawaki, Hiroshi Yokouchi, Keita Miura, Ryota Saito, Go Saito, Tatsuhiko Kamoshida, Yusuke Uch
Cancer Science.2024; 115(11): 3705. CrossRef
Treatment patterns and survival of patients with locoregional recurrence in early-stage NSCLC: a literature review of real-world evidence
Kathleen Bowes, Nick Jovanoski, Audrey E. Brown, Danilo Di Maio, Rossella Belleli, Shkun Chadda, Seye Abogunrin
Medical Oncology.2022;[Epub] CrossRef
Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
Radiation Oncology Journal.2021; 39(1): 24. CrossRef
Hypo-fractionated radiotherapy with concurrent chemotherapy for locoregional recurrence of non-small cell lung cancer after complete resection: A prospective, single-arm, phase II study (GASTO-1017)
NaiBin Chen, QiWen Li, SiYu Wang, Mai Xiong, YiFeng Luo, Bin Wang, Li Chen, MaoSheng Lin, XiaoBo Jiang, JianLan Fang, SuPing Guo, JinYu Guo, Nan Hu, XinLei Ai, DaQuan Wang, Chu Chu, FangJie Liu, Hao Long, JunYe Wang, Bo Qiu, Hui Liu
Lung Cancer.2021; 156: 82. CrossRef
Salvage radiation therapy for postoperative locoregionally recurrent non-small cell lung cancer: a single-center experience
Yoon Young Jo, Su Ssan Kim, Si Yeol Song, Eun Kyung Choi
Radiation Oncology Journal.2021; 39(3): 210. CrossRef
Propensity score adjusted analysis of patients with isolated locoregional recurrence versus de novo locally advanced NSCLC treated with definitive therapy
Cole Friedes, Nicholas Mai, Wei Fu, Chen Hu, Peijin Han, Kristen A. Marrone, K. Ranh Voong, Russell K. Hales
Lung Cancer.2020; 145: 119. CrossRef

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Feasibility of Selective Neck Irradiation with Lower Elective Radiation Dose in Treating Nasopharynx Cancer Patients: Won Kyung Cho, Dongryul Oh, Eonju Lee, Tae Gyu Kim, Hyebin Lee, Heerim Nam, Jae Myoung Noh, Yong Chan Ahn; Cancer Res Treat. 2019;51(2):603-610. Published online July 18, 2018; DOI: https://doi.org/10.4143/crt.2018.240

Abstract PDF PubReader ePub

Purpose
This study aimed to report the clinical outcomes following selective neck irradiation (SNI) with lower elective radiation therapy (RT) dose in treating nasopharyngeal cancer (NPC) patients.
Materials and Methods
A total of 347 NPC patients received definitive RT according to our SNI policy and were retrospectively analyzed. The clinical target volumes (CTVs) were subdivided into CTV at high risk (CTV-HR) and CTV at low risk (CTV-LR). The typical doses to gross tumor volume (GTV), CTV-HR, and CTV-LR were 68.4-70.0 Gy, 54.0-60.0 Gy, and 36.0 Gy.
Results
With the median follow-up of 68.1 months (range, 2.3 to 197.1 months), the 5-year rates of loco-regional control and progression-free survival in all the patients were 85.0% and 70.8%, respectively. Thirty patients developed regional failure and the regional control rates at 3 and 5 years were 92.6% and 91.4%, respectively. The sites of regional failure in relation to the target volume were exclusively inside GTV/CTV-HR in 20, inside and outside GTV/CTVHR in three, and exclusively outside GTV/CTV-HR in seven, which were 5.7%, 0.9%, and 2.0% of total patients, respectively.
Conclusion
The clinical outcomes by the current SNI policy were feasible and comparable to those following classic elective nodal irradiation policy.

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Reduced Dose and Selective Neck Irradiation Policy in Treating Oropharynx Cancer: Excellent Oncological Outcomes with Very Low Risk of Locoregional Failure
Eunyeong Yang, Seung Gyu Park, Kyungmi Yang, Dongryul Oh, Yong Chan Ahn
Cancer Research and Treatment.2026; 58(1): 95. CrossRef
Primary endoscopic nasopharyngectomy for nasopharyngeal carcinoma: systematic review & meta-analysis
Siyuan Ding, Leo Li, Jenny Lee, Brian Mak, Christopher Liao, Andy Chan, Levina Li, Calvin Lai, Samuel Chow, Jason Chan, David Yeung
Frontiers in Surgery.2026;[Epub] CrossRef
Tumor volume reduction during adaptive radiotherapy is a strong prognostic factor for oropharyngeal cancer: A retrospective multicenter study
Seung Gyu Park, Eunyeong Yang, Heerim Nam, Tae Gyu Kim, Dongryul Oh, Kyungmi Yang, Yong Chan Ahn
Radiotherapy and Oncology.2026; 222: 111676. CrossRef
Salivary Gland Volume Changes and Dry Mouth Symptom Following Definitive Radiation Therapy in Oropharyngeal Cancer Patients—A Comparison of Two Different Approaches: Intensity-Modulated Radiation Therapy Versus Intensity-Modulated Radiation Therapy/Intens
Seung Gyu Park, Yong Chan Ahn, Dongryul Oh, Kyungmi Yang, Sang Gyu Ju, Jin Man Kim, Dongyeol Kwon, Euncheol Choi, Han Gyul Yoon
Cancers.2025; 17(3): 554. CrossRef
International Consensus Guideline on Delineation of the Clinical Target Volumes at Different Dose Levels for Nasopharyngeal Carcinoma (2024 Version)
Shao-Jun Lin, Qiao-Juan Guo, Qin Liu, Wai-Tong Ng, Yong Chan Ahn, Hussain AlHussain, Annie W. Chan, James Chow, Melvin L.K. Chua, June Corry, Fei Han, Vincent Grégoire, Kevin J. Harrington, Chao-Su Hu, Kenneth Jensen, Johannes A. Langendijk, Quynh Thu Le,
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Target volume delineation of the neck for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas
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Dosimetric Comparison and Selection Criteria of Intensity-Modulated Proton Therapy and Intensity-Modulated Radiation Therapy for Adaptive Re-Plan in T3-4 Nasopharynx Cancer Patients
Mincheol Ko, Kyungmi Yang, Yong Chan Ahn, Sang Gyu Ju, Dongryul Oh, Yeong-bi Kim, Dong Yeol Kwon, Seyjoon Park, Kisung Lee
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Dongryul Oh
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MJ García-Anaya, S. Segado-Guillot, J. Cabrera-Rodríguez, MD Toledo-Serrano, JA Medina-Carmona, J. Gómez-Millán
Critical Reviews in Oncology/Hematology.2023; 186: 103994. CrossRef
Can Definitive Radiation Therapy Substitute Surgical Resection in Locally Advanced T3 or T4 Sinonasal Squamous Cell Carcinoma?
Kangpyo Kim, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Han-Sin Jeong, Man Ki Chung, Sang Duk Hong, Chung-Hwan Baek
International Journal of Radiation Oncology*Biology*Physics.2023; 117(4): 893. CrossRef
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Yang Liu, Ziou Du, Shiyu Song, Junlin Yi
Holistic Integrative Oncology.2023;[Epub] CrossRef
Involved site radiation therapy in stage I-III nasopharyngeal carcinoma with limited lymph node burden (ISRT-NPC) or elective region irradiation: a study protocol for a multicenter non-inferiority randomized controlled phase III clinical trial
Yang Liu, Yaqian Han, Feng Liu, Desheng Hu, Zhijian Chen, Peiguo Wang, Jingao Li, Jiyong Qin, Feng Jin, Yexiong Li, Jingbo Wang, Junlin Yi
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Karol Jelonek, Katarzyna Mrowiec, Dorota Gabryś, Piotr Widłak
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Donghyeok Kim, Nalee Kim, Sungmin Koh, Man Ki Chung, Young-Ik Son, Dongryul Oh, Han-Sin Jeong, Yong Chan Ahn
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Heerim Nam, Yong Chan Ahn, Kyungmi Yang, Dongryul Oh, Jae Myoung Noh
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Teng Hwee Tan, Huili Zheng, Timothy Cheo, Jeremy Tey, Yu Yang Soon
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Wen-Shan Liu, Ju-Chun Chien, Yu-Hsien Huang, Po-Chun Chen, Wei-Lun Huang, Shao-Wei Chiang, Ching-Chih Lee, Bor-Hwang Kang, Yu-Chang Hu
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Kyungmi Yang, Yong Chan Ahn, Heerim Nam, Sang Duk Hong, Dongryul Oh, Jae Myoung Noh
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Han Gyul Yoon, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Seung Gyu Park, Heerim Nam, Sang Gyu Ju, Dongyeol Kwon, Seyjoon Park
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Wai Tong Ng, Raymond K. Y. Tsang, Jonathan J. Beitler, Remco de Bree, Andrés Coca‐Pelaz, Avraham Eisbruch, Orlando Guntinas‐Lichius, Anne W. M. Lee, Antti A. Mäkitie, William M. Mendenhall, Sandra Nuyts, Alessandra Rinaldo, K. Thomas Robbins, Juan P. Rodr
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Cancer Science.2019; 110(9): 2867. CrossRef

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Tumor Volume Reduction Rate during Adaptive Radiation Therapy as a Prognosticator for Nasopharyngeal Cancer: Hyebin Lee, Yong Chan Ahn, Dongryul Oh, Heerim Nam, Jae Myoung Noh, Su Yeon Park; Cancer Res Treat. 2016;48(2):537-545. Published online July 14, 2015; DOI: https://doi.org/10.4143/crt.2015.081

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to evaluate the prognostic significance of the tumor volume reduction rate (TVRR) measured during adaptive definitive radiation therapy (RT) for nasopharyngeal cancer (NPC).
Materials and Methods
We reviewed the RT records of 159 NPC patients treated with definitive RT with or without concurrent chemotherapy between January 2006 and February 2013. Adaptive re-planning was performed in all patients at the third week of RT. The pre- and mid-RT gross tumor volumes (GTVs) of the primary tumor and the metastatic lymph nodes were measured and analyzed for prognostic implications.
Results
After a median follow-up period of 41.5 months (range, 11.2 to 91.8 months) for survivors, there were 43 treatment failures. The overall survival and progression-free survival (PFS) rates at 5 years were 89.6% and 69.7%, respectively. The mean pre-RT GTV, mid-RT GTV, and TVRR were 45.9 cm3 (range, 1.5 to 185.3 cm3), 26.7 cm3 (1.0 to 113.8 cm3), and –41.9% (range, –87% to 78%), respectively. Patients without recurrence had higher TVRR than those with recurrence (44.3% in the no recurrence group vs. 34.0% in the recurrence group, p=0.004), and those with TVRR > 35% achieved a significantly higher rate of PFS at 5 years (79.2% in TVRR > 35% vs. 53.2% in TVRR ≤ 35%; p < 0.001). In multivariate analysis, TVRR was a significant factor affecting PFS (hazard ratio, 2.877; 95% confidence interval, 1.555 to 5.326; p=0.001).
Conclusion
TVRR proved to be a significant prognostic factor in NPC patients treated with definitive RT, and could be used as a potential indicator for early therapeutic modification during the RT course.

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Guanzhi Ye, Gaojian Pan, Shengrong Lin, Jie Jiang, Xiaolei Zhu, Guojun Geng
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Tumor volume reduction during adaptive radiotherapy is a strong prognostic factor for oropharyngeal cancer: A retrospective multicenter study
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Radiotherapy and Oncology.2026; 222: 111676. CrossRef
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Definitive Bimodality Concurrent Chemoradiotherapy in Patients with Inoperable N2-positive Stage IIIA Non-small Cell Lung Cancer: Jae Myoung Noh, Yong Chan Ahn, Hyebin Lee, Hongryull Pyo, BoKyong Kim, Dongryul Oh, Hyojung Park, Eonju Lee, Keunchil Park, Jin Seok Ahn, Myung-Ju Ahn, Jong-Mu Sun; Cancer Res Treat. 2015;47(4):645-652. Published online February 12, 2015; DOI: https://doi.org/10.4143/crt.2014.144

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Purpose
This study was conducted to evaluate the treatment outcomes following definitive bimodality concurrent chemoradiotherapy (CCRT) in patients with inoperable N2-positive stage IIIA (N2- IIIA) non-small cell lung cancer (NSCLC). Materials and Methods From May 1997 to December 2012, 65 out of 633 patients with N2-IIIA NSCLC received bimodality therapy. The treatment modality was selected during/after neoadjuvant CCRT in 21 patients or primarily at diagnosis in 44 through a multidisciplinary consensus meeting. The median age was 65 years (range, 36 to 76 years). Sixty patients (92.3%) had clinically evident N2 disease, while 22 (33.8%) had multi-station N2 involvement. The median radiation therapy dose was 66 Gy in 33 fractions, while the dose was elevated to 72 Gy in 13 patients who had a treatment break due to delayed decision regarding resectability. The most frequent chemotherapy regimen was weekly paclitaxel or docetaxel plus cisplatin or carboplatin (54, 83.1%).
Results
During the median follow-up of 18.8 months (range, 1.6 to 173.1 months), 34 patients (52.3%) experienced disease progression, with distant metastasis being the most common first treatment failure pattern (23, 34.8%). The median and 2-year rates of progression-free survival were 18.8 months and 45.9%, respectively. The median and 2-year rates of overall survival were 28.6 months and 50.1%, respectively. Conclusion Definitive bimodality therapy in patients with N2-IIIA NSCLC demonstrated favorable outcomes, while trimodality therapy could be considered for candidates for less than pneumonectomy.

Citations

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