Cancer Research and Treatment

Original Articles

Real-world Efficacy of Intravesical Gemcitabine for BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer: Hye Won Lee, Eui Hyun Jung, Kyung Hwan Kim, Hong Koo Ha, Jong Jin Oh, Seok Ho Kang, Seung-hwan Jeong, Hyeong Dong Yuk, Ji Eun Heo, Won Sik Ham, Eu Chang Hwang, Seung Il Jung, Wan Song, Bumjin Lim, Bumsik Hong, Byung Chang Jeong, Ho Kyung Seo; Received January 23, 2025 Accepted May 11, 2025 Published online May 12, 2025; DOI: https://doi.org/10.4143/crt.2025.100 [Accepted]

Abstract PDF: Purpose
This study aimed to report the real-world outcomes of intravesical gemcitabine for bacillus Calmette–Guérin (BCG) -unresponsive, high-risk, non-muscle-invasive bladder cancer (HR-NMIBC) in Korean patients who were unable or unwilling to undergo radical cystectomy (RC).
Materials and Methods
This retrospective study included 131 patients (median age: 69 years; 89% men) treated with intravesical gemcitabine for BCG-unresponsive HR-NMIBC at nine centers between May 2019 and April 2022. The primary endpoint was 1-year recurrence-free survival (RFS). The secondary endpoints included factors influencing RFS, progression-free survival (PFS), cystectomy-free survival, cancer-specific survival (CSS), overall survival (OS), and safety. Survival analysis was performed using the Kaplan–Meier method, and risk factors for recurrence were assessed using Cox regression models.
Results
Patients were followed up for a median duration of 25 months, with carcinoma in situ (CIS) in 42% of the patients. The 1-year and 2-year RFS rates were 68% and 42%, while the 1-year and 2-year PFS rates were 87% and 77%, respectively. No significant factors influencing RFS were identified. Seventeen patients underwent RC during a median follow-up of 16 months, with the condition in three patients progressing to muscle-invasive disease on final pathological analysis. The 2-year CSS and OS rates were 98% and 97%, respectively. Intravesical gemcitabine was well-tolerated, with only 7 patients (5.3%) unable to complete the full induction course.
Conclusion
Our research highlights the potential of intravesical gemcitabine as a viable bladder-sparing treatment option for BCG-unresponsive HR-NMIBC, providing real-world evidence on its safety, efficacy, and tolerability.

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Outcomes of Stereotactic Body Radiation Therapy for Large Uveal Melanoma: A Retrospective Analysis of Asian Population: Jong Won Park, Seowoong Jun, Ki Chang Keum, Christopher Seungkyu Lee, Kyung Hwan Kim; Received June 20, 2024 Accepted December 28, 2024 Published online December 31, 2024; DOI: https://doi.org/10.4143/crt.2024.580 [Epub ahead of print]

Abstract PDF Supplementary Material: Purpose
This study aimed to investigate the clinical outcomes of stereotactic body radiation therapy (SBRT) in patients with large uveal melanoma (UM).
Materials and Methods
We conducted a retrospective review of 64 consecutive patients with UM treated with CyberKnife at Yonsei Cancer Center from September 2015 to October 2021. The median radiation dose was 60 Gy (range, 48 to 64 Gy) administered in four fractions every alternate day. The local failure-free rate (LFFR), distant metastasis-free rate (DMFR), progression-free survival (PFS), and overall survival (OS) were assessed using the Kaplan-Meier method and log-rank test. Cox regression analysis was performed to analyze the predictive factors affecting survival outcomes and the factors associated with vision loss.
Results
The median tumor diameter and height were 11.5 mm and 8.4 mm, respectively. After a median follow-up of 32.1 months (range, 4.9 to 89.9 months), the 3-year LFFR, DMFR, PFS, and OS were 89.5%, 70.5%, 65.5%, and 89.4%, respectively. Enucleation was performed in 13 (20.3%) patients, with three cases attributed to disease progression. A larger tumor diameter was associated with significantly worse DMFR (hazard ratio [HR], 1.35; p=0.015) and OS (HR, 1.49; p=0.026) in the multivariate analysis. Regarding visual prognosis, 41 patients (64.1%) had baseline visual acuity ≥ 20/200, but only four patients (6.3%) maintained visual acuity ≥ 20/200 by the final follow-up. Initial visual acuity ≥ 20/40 (HR, 0.45; p=0.030) was the single favorable significant factor predicting visual retention ≥ 20/200 in multivariate analysis.
Conclusion
SBRT using CyberKnife demonstrated a comparable local control rate to that observed in historical studies for patients with large UM. Distant metastasis and treatment-related ocular toxicity remain the limitations of this treatment.

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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]

Abstract PDF Supplementary Material PubReader ePub

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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Adjuvant Pembrolizumab in Patients with Stage IIIA/N2 Non–Small Cell Lung Cancer Completely Resected after Neoadjuvant Concurrent Chemoradiation: A Prospective, Open-Label, Single-Arm, Phase 2 Trial: Junghoon Shin, Sehhoon Park, Kyung Hwan Kim, Eui-Cheol Shin, Hyun Ae Jung, Jong Ho Cho, Jong-Mu Sun, Se-Hoon Lee, Yong Soo Choi, Jin Seok Ahn, Jhingook Kim, Keunchil Park, Young Mog Shim, Hong Kwan Kim, Jae Myoung Noh, Yong Chan Ahn, Hongryull Pyo, Myung-Ju Ahn; Cancer Res Treat. 2024;56(4):1084-1095. Published online April 30, 2024; DOI: https://doi.org/10.4143/crt.2024.084

Abstract PDF Supplementary Material PubReader ePub

Purpose
Optimal treatment for stage IIIA/N2 non–small cell lung cancer (NSCLC) is controversial. We aimed to assess the efficacy and safety of adjuvant pembrolizumab for stage IIIA/N2 NSCLC completely resected after neoadjuvant concurrent chemoradiation therapy (CCRT).
Materials and Methods
In this open-label, single-center, single-arm phase 2 trial, patients with stage IIIA/N2 NSCLC received adjuvant pembrolizumab for up to 2 years after complete resection following neoadjuvant CCRT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS) and safety. As an exploratory biomarker analysis, we evaluated the proliferative response of blood CD39⁺PD-1⁺CD8⁺ T cells using fold changes in the percentage of proliferating Ki-67⁺ cells from days 1 to 7 of cycle 1 (Ki-67_D7/D1).
Results
Between October 2017 and October 2018, 37 patients were enrolled. Twelve (32%) and three (8%) patients harbored EGFR and ALK alterations, respectively. Of 34 patients with programmed cell death ligand 1 assessment, 21 (62%), nine (26%), and four (12%) had a tumor proportion score of < 1%, 1%-50%, and ≥ 50%, respectively. The median follow-up was 71 months. The median DFS was 22.4 months in the overall population, with a 5-year DFS rate of 29%. The OS rate was 86% at 2 years and 76% at 5 years. Patients with tumor recurrence within 6 months had a significantly lower Ki-67D7/D1 among CD39⁺PD-1⁺CD8⁺ T cells than those without (p=0.036). No new safety signals were identified.
Conclusion
Adjuvant pembrolizumab may offer durable disease control in a subset of stage IIIA/N2 NSCLC patients after neoadjuvant CCRT and surgery.

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Adjuvant immunotherapy improves survival in completely resected stage IB–III NSCLC: a systematic review and meta-analysis
Hong Huang, Pengchen Bao, Hongyu Jin, Wenyang Li, Hui Shen, Zhen Qin, Ying Pan, Xinming Su, Delei Kong
Frontiers in Oncology.2025;[Epub] CrossRef

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General

Radiation Oncologists’ Perspectives on Oligometastatic Disease: A Korean Survey Study: Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Ah Ram Chang, Eui Kyu Chie, Yong Chan Ahn, on behalf of the Oligometastasis Working Group, Korean Cancer Association; Cancer Res Treat. 2024;56(2):414-421. Published online November 22, 2023; DOI: https://doi.org/10.4143/crt.2023.876

Abstract PDF Supplementary Material PubReader ePub

Purpose
Perspectives of radiation oncologists on oligometastatic disease was investigated using multi-layered survey.
Materials and Methods
Online survey on the oligometastatic disease was distributed to the board-certified regular members of the Korean Society for Radiation Oncology. The questionnaire consisted of four domains: five questions on demographics; five on the definition of oligometastatic disease; four on the role of local therapy; and three on the oligometastatic disease classification, respectively.
Results
A total of 135 radiation oncologists participated in the survey. The median length of practice after board certification was 22.5 years (range, 1 to 44 years), and the vast majority (94.1%) answered affirmatively to the clinical experience in oligometastatic disease management. Nearly two-thirds of the respondents considered the number of involved organs as an independent factor in defining oligometastasis. Most frequently perceived upper limit on the numerical definition of oligometastasis was 5 (64.2%), followed by 3 (26.0%), respectively. Peritoneal and brain metastasis were nominated as the sites to be excluded from oligometastastic disease by 56.3% and 12.6% of the participants, respectively. Vast majority (82.1%) agreed on the role of local treatment in the management of oligometastatic disease. Majority (72%) of the participants acknowledged the European Society for Radiotherapy and Oncology (ESTRO)–European Organisation for Research and Treatment of Cancer (EORTC) classification of oligometastatic disease, however, only 43.3% answered that they applied this classification in their clinical practice. Underlying reasons against the clinical use were ‘too complicated’ (66.0%), followed by ‘insufficient supporting evidence’ (30.0%), respectively.
Conclusion
While most radiation oncologists supported the role of local therapy in oligometastatic disease, there were several inconsistencies in defining and categorizing oligometastatic disease. Continued education and training on oligometastatic disease would be also required to build consensus among participating caregivers.

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Efficacy Analysis of Hypofractionated Radiotherapy for Oligometastatic Tumors: A Retrospective Study
Qian Sun, Hanqing Zhao, Xianwen Zhang, Suli Zhang, Zelai He, Gengming Wang, Hao Jiang, Aili Xuan, Xianming Li
Technology in Cancer Research & Treatment.2025;[Epub] CrossRef
‘Perspectives of pulmonologists and thoracic surgeons on Oligometastatic disease: curability, treatment approaches, and disease trajectory’
Damla Azaklı, Inanc Yazici, Aysegul Erinc, Celal Satici
Future Oncology.2025; : 1. CrossRef
A new proposal of simplified classification of non-small cell lung cancer oligometastases for easy applicability through systematic literature analysis and meta-analysis validation
Hanseung Kang, Woohyeon Do, Yong Chan Ahn, Eui Kyu Chie, Chai Hong Rim
European Journal of Cancer.2024; 212: 115043. CrossRef

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Lung and Thoracic cancer

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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Editorial

Oligometastasis: More Lessons to Be Learned: Kyung Hwan Kim, Yong Chan Ahn, Oligometastasis Working Group, Korea Cancer Association; Cancer Res Treat. 2023;55(1):1-4. Published online January 3, 2023; DOI: https://doi.org/10.4143/crt.2023.265

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Photonic Hyperthermia Synergizes with Immune‐Activators to Augment Tumor‐Localized Immunotherapy
Tiankuan Li, Zhongqian Hu, Feifei Song, Chenyao Wu, Qizeng Miao, Zhongmin Wang, Wei Feng, Jinhe Guo, Yu Chen
Small Methods.2023;[Epub] CrossRef

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Original Articles

General

Role of Local Treatment for Oligometastasis: A Comparability-Based Meta-Analysis: Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Eui Kyu Chie, Yong Chan Ahn, The Oligometastasis Working Group, Korea Cancer Association; Cancer Res Treat. 2022;54(4):953-969. Published online August 16, 2022; DOI: https://doi.org/10.4143/crt.2022.329

Abstract PDF Supplementary Material PubReader ePub

Purpose
We intend to investigate the oncological efficacy and feasibility of local consolidative therapy (LCT) through a meta-analysis method.
Materials and Methods
Four databases including PubMed, MEDLINE, Embase, and Cochrane library were searched. Target studies are controlled trials comparing outcomes of LCT versus a control group. Primary endpoints are overall survival (OS) and progression-free survival (PFS).
Results
A total of 54 studies involving 7,242 patients were included. Pooled analyses showed that the LCT arm could achieve improved OS with pooled odds ratio of 2.896 (95% confidence interval [CI], 2.377 to 3.528; p < 0.001). Regarding PFS, pooled analyses showed pooled odds ratio of 3.045 (95% CI, 2.356 to 3.937; p < 0.001) in favor of the LCT arm. In the subgroup analyses including the studies with reliable comparability (e.g. randomized studies or intentionally matched studies without significant favorable prognosticator in LCT arms), pooled odds ratio was 2.548 (95% CI, 1.808 to 3.591; p < 0.001) favoring the LCT arm regarding OS. Regarding PFS, pooled OR was 2.656 (95% CI, 1.713 to 4.120; p < 0.001) which also favored the LCT arm. Subgroup analyses limited to the randomized controlled trials (RCT) were also performed and pooled odds ratios on OS and PFS were 1.535 (95% CI, 1.082 to 2.177; p=0.016) and 1.668 (95% CI, 1.187 to 2.344; p=0.003). The rates of grade ≥ 3 complications related to LCT was mostly low (< 10%) and not significantly higher compared to the control arm.
Conclusion
Pooled analyses results of all included studies, selected studies with reliable comparability, and RCT’s demonstrated the survival benefit of LCT. These consistent results suggest that LCT was beneficial to the patients with oligometastasis.

Citations

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Identifying Trends in Oncology Research through a Bibliographic Analysis of Cancer Research and Treatment
Choong-kun Lee, Jeong Min Choo, Yong Chan Ahn, Jin Kim, Sun Young Rha, Chai Hong Rim
Cancer Research and Treatment.2025; 57(1): 11. CrossRef
The Society of Thoracic Surgeons (STS) Clinical Practice Guideline on Surgical Management of Oligometastatic Non-small Cell Lung Cancer
Mara B. Antonoff, Kyle G. Mitchell, Samuel S. Kim, Hai V. Salfity, Svetlana Kotova, Robert Taylor Ripley, Alfonso L. Neri, Pallavi Sood, Saumil G. Gandhi, Yasir Y. Elamin, Jessica S. Donington, David R. Jones, Elizabeth A. David, Stephen G. Swisher, Isabe
The Annals of Thoracic Surgery.2025; 119(3): 495. CrossRef
Maintaining First-Line Therapy Plus Radiation Therapy May Prolong Progression-Free Survival and Delay Second-Line Therapy for Oligoprogressive Hepatocellular Carcinoma
Boyu Leng, Haohua Wang, Yunfan Ge, Xiaoli Sun, Pingping Dong, Xinzhe Dong, Xuezhang Duan, Quan Wang, Yaoxiong Xia, Lijuan Ding, Honghai Dai, Tianxing Liu, Fang Shi, Xiang Zhang, Jinbo Yue
International Journal of Radiation Oncology*Biology*Physics.2025; 122(2): 325. CrossRef
The patterns of systemic metastasis in major salivary gland cancer and therapeutic implications
Subi Oh, Younghac Kim, Hyojun Kim, Eunhye Kim, Sook-young Woo, Nayeon Choi, Junhun Cho, Dongryul Oh, Yong-Chan Ahn, Sehhoon Park, Myung-Ju Ahn, Han-Sin Jeong
Oral Oncology.2025; 164: 107258. CrossRef
Surgery for Stage IV Disease—Is It Prime Time Yet?
Marianna V. Papageorge, Mara B. Antonoff
Surgical Oncology Clinics of North America.2025;[Epub] CrossRef
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 Research and Treatment.2024; 56(1): 115. CrossRef
MR-guided stereotactic radiotherapy of infra-diaphragmatic oligometastases: Evaluation of toxicity and dosimetric parameters
Mette van Overeem Felter, Pia Krause Møller, Mirjana Josipovic, Susanne Nørring Bekke, Uffe Bernchou, Eva Serup-Hansen, Kasper Madsen, Parag J. Parikh, Joshua Kim, Poul Geertsen, Claus P. Behrens, Ivan R. Vogelius, Mette Pøhl, Tine Schytte, Gitte Fredberg
Radiotherapy and Oncology.2024; 192: 110090. CrossRef
Clinical implication of neck dissection for metastatic lymph nodes originating from non-head and neck regions
Min Ji Kim, So Hee Kang, MinSu Kwon, Young Ho Jung, Seung-Ho Choi, Soon Yuhl Nam, Yoon Se Lee
Acta Oto-Laryngologica.2024; 144(2): 153. CrossRef
Surgery for Oligometastatic Pancreatic Cancer: Defining Biologic Resectability
Shruti Koti, Lyudmyla Demyan, Gary Deutsch, Matthew Weiss
Annals of Surgical Oncology.2024; 31(6): 4031. CrossRef
Radiation Oncologists’ Perspectives on Oligometastatic Disease: A Korean Survey Study
Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Ah Ram Chang, Eui Kyu Chie, Yong Chan Ahn
Cancer Research and Treatment.2024; 56(2): 414. CrossRef
Radiation Oncologists’ Perspectives on Oligometastatic Prostate Cancer: A Survey from Korean Oligometastasis Working Group
Gyu Sang Yoo, Sunmin Park, Chai Hong Rim, Won Kyung Cho, Ah Ram Chang, Young Seok Kim, Yong Chan Ahn, Eui Kyu Chie
Current Oncology.2024; 31(6): 3239. CrossRef
Local Ablative Therapy Combined With Pembrolizumab in Patients With Synchronous Oligometastatic Non-Small Cell Lung Cancer: A Recursive Partitioning Analysis
Hye In Lee, Eun Kyung Choi, Su Ssan Kim, Young Seob Shin, Junhee Park, Chang-Min Choi, Shinkyo Yoon, Hyeong Ryul Kim, Young Hyun Cho, Si Yeol Song
International Journal of Radiation Oncology*Biology*Physics.2024; 120(3): 698. CrossRef
Retrospective Analysis of Efficacy and Toxicity of Stereotactic Body Radiotherapy and Surgical Resection of Adrenal Metastases from Solid Tumors
Jamie Lütscher, Hans Gelpke, Adrian Zehnder, Laetitia Mauti, Christian Padevit, Hubert John, Nidar Batifi, Daniel Rudolf Zwahlen, Robert Förster, Christina Schröder
Cancers.2024; 16(15): 2655. CrossRef
A new proposal of simplified classification of non-small cell lung cancer oligometastases for easy applicability through systematic literature analysis and meta-analysis validation
Hanseung Kang, Woohyeon Do, Yong Chan Ahn, Eui Kyu Chie, Chai Hong Rim
European Journal of Cancer.2024; 212: 115043. CrossRef
Oligometastasis: More Lessons to Be Learned
Kyung Hwan Kim, Yong Chan Ahn
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Top Ten Lessons Learned from Trials in Oligometastatic Cancers
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Genomic Characteristics and the Potential Clinical Implications in Oligometastatic Non–Small Cell Lung Cancer
Rongxin Liao, Kehong Chen, Jinjin Li, Hengqiu He, Guangming Yi, Mingfeng Huang, Rongrong Chen, Lu Shen, Xiaoyue Zhang, Zaicheng Xu, Zhenzhou Yang, Yuan Peng
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Metastasis-Directed Local Therapy of Hepatic Oligometastasis from Colorectal Cancer and Future Perspective in Radiation Therapy
Gyu Sang Yoo, Chai Hong Rim, Won Kyung Cho, Jae-Uk Jeong, Eui Kyu Chie, Hyeon-Min Cho, Jun Won Um, Yong Chan Ahn, Jong Hoon Lee
Cancer Research and Treatment.2023; 55(3): 707. CrossRef
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Eui Kyu Chie, Chai Hong Rim, Won Kyung Cho, Yong Chan Ahn
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Impact of high dose radiotherapy for breast tumor in locoregionally uncontrolled stage IV breast cancer: a need for a risk-stratified approach
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Ah Reum Lim, Chai Hong Rim
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Increased Radiosensitivity of Solid Tumors Harboring ATM and BRCA1/2 Mutations: Kyung Hwan Kim, Han Sang Kim, Seung-seob Kim, Hyo Sup Shim, Andrew Jihoon Yang, Jason Joon Bock Lee, Hong In Yoon, Joong Bae Ahn, Jee Suk Chang; Cancer Res Treat. 2022;54(1):54-64. Published online June 4, 2021; DOI: https://doi.org/10.4143/crt.2020.1247

Abstract PDF Supplementary Material PubReader ePub

Purpose
Preclinical data indicate that response to radiotherapy (RT) depends on DNA damage repair. In this study, we investigated the role of mutations in genes related to DNA damage repair in treatment outcome after RT.
Materials and Methods
Patients with solid tumor who participated in next generation sequencing panel screening using biopsied tumor tissue between October 2013 and February 2019 were reviewed and 97 patients that received RT were included in this study. Best response to RT and the cumulative local recurrence rate (LRR) were compared according to absence or presence of missense, nonsense, and frameshift mutations in ATM and/or BRCA1/2.
Results
Of the 97 patients, five patients harbored mutation only in ATM, 22 in only BRCA1/2, and six in both ATM and BRCA1/2 (ATM^mtBRCA^mt). Propensity score matching was performed to select the control group without mutations (ATM^wtBRCA^wt, n=33). In total, 90 RT-treated target lesions were evaluated in 66 patients. Highest objective response rate of 80% was observed in ATM^mtBRCA^mt lesions (p=0.007), which was mostly durable. Furthermore, the cumulative 1-year LRR was the lowest in ATM^mtBRCA^mt lesions and the highest in ATM^wtBRCA^wt lesions (0% vs. 47.9%, p=0.008). RT-associated toxicities were observed in 10 treatments with no significant difference among the subgroups (p=0.680).
Conclusion
Tumors with ATM and BRCA1/2 mutations exhibited superior tumor response and local control after RT compared to tumors without these mutations. The results are hypothesis generating and suggest the need for integrating the tumor mutation profile of DNA repair genes during treatment planning.

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The art of war: using genetic insights to understand and harness radiation sensitivity in hematologic malignancies
N. Ari Wijetunga, Joachim Yahalom, Brandon S. Imber
Frontiers in Oncology.2025;[Epub] CrossRef
Effects of Ataxia-Telangiectasia Mutated Variants on Radionecrosis and Local Control After Stereotactic Radiation Surgery for Non-Small Cell Lung Cancer Brain Metastases
Warren Floyd, David Carpenter, Eugene Vaios, Rachel Shenker, Peter Hendrickson, Justus D. Adamson, William M. Giles, Chunhao Wang, Karen Allen, Trey Mullikin, Scott R. Floyd, John P. Kirkpatrick, Michelle Green, Zachary J. Reitman
Advances in Radiation Oncology.2024; 9(1): 101320. CrossRef
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Makiko Urabe, Kenji Ikezawa, Kazuhiro Kozumi, Yugo Kai, Ryoji Takada, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Hirofumi Akita, Kazuyoshi Ohkawa
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Robustness of carbon‐ion radiotherapy against DNA damage repair associated radiosensitivity variation based on a biophysical model
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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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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
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The association between initiation weekday of radiotherapy and local control in stage 1 glottic carcinoma: a retrospective analysis
Masashi Endo, Satoru Takahashi, Yukiko Fukuda, Kohei Okada, Kazunari Ogawa, Michiko Nakamura, Masahiro Kawahara, Keiko Akahane, Eri Murakami, Chiaki Shibayama, Ryutaro Onaga, Takafumi Nagatomo, Takeharu Kanazawa, Hiroshi Nishino, Harushi Mori, Katsuyuki S
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Giuseppe Licci, Luca Giovanni Locatello, Giandomenico Maggiore, Flavia Cozzolino, Saverio Caini, Oreste Gallo
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Manuel Christoph Ketterer, Rainer Beck, Matthias Cohnen, Andreas Knopf
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Niema B. Razavian, Ralph B. D'Agostino, Rachel F. Shenker, Ryan T. Hughes
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Yajing Du, Shali Shao, Minghe Lv, Yi Zhu, Li Yan, Tiankui Qiao
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Simon Beyaert, Marc Hamoir, Aline Van Maanen, Vincent Grégoire, Sandra Schmitz
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A. Mucha-Małecka, A. Chrostowska, K. Urbanek, K. Małecki
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Patterns of Care for Radiotherapy in the Neoadjuvant and Adjuvant Treatment of Gastric Cancer: A Twelve-Year Nationwide Cohort Study in Korea: Jee Suk Chang, Young Choi, Jaeyong Shin, Kyung Hwan Kim, Ki Chang Keum, Hyo Song Kim, Woong Sub Koom, Eun-Cheol Park; Cancer Res Treat. 2018;50(1):118-128. Published online March 8, 2017; DOI: https://doi.org/10.4143/crt.2016.575

Abstract PDF Supplementary Material PubReader ePub

Purpose
Although Korea has the highest incidence of gastric cancer worldwide and D2-lymphadenectomies are routinely performed, radiotherapy (RT) practice patterns have not been well studied. Therefore, we examined RT usage trends for neoadjuvant/adjuvant patients and identified factors associated with RT. We also examined survival benefits and net medical cost advantages of adding RT.
Materials and Methods
Patients diagnosed with gastric cancer who underwent gastrectomy from 2002-2013 were identified using National Health Insurance Service-National Sample Cohort.
Results
Annually, 30.9 cases per 100,000 population in crude rate underwent gastrectomy in 230 hospitals and 49.8% received neoadjuvant/adjuvant therapy in 182 hospitals. For neoadjuvant/adjuvant patients, postoperative chemo-RT was administered in 4% of cases in 26 hospitals. No significant trends regarding treatment type were observed over time. Having undergone RT was inversely associated with being ≥ 60 years old and having a low income. Having undergone RT was positively related to having a Charlson comorbidity index ≥ 4, hospital location and hospital volume (≥ 2,000 beds). Significant portions of patients treated with RT in this nation (52%) were concentrated in one large-volume hospital. Use of RT linked to increased cost of primary treatment, yet not to reduced overall medical expense. RT did not influence both on overall and disease-specific survivals after adjusting for potential confounders (p > 0.05).
Conclusion
RT was uncommonly utilized as adjuvant or neoadjuvant treatment by physicians in Korea. Despite intrinsic drawback in this data, we did not find either survival benefit or net medical cost advantage by adding RT in adjuvant treatment.

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Observational Study Comparing Efficacy and Safety between Neoadjuvant Concurrent Chemoradiotherapy and Chemotherapy for Patients with Unresectable Locally Advanced or Metastatic Gastric Cancer
Yung-Sung Yeh, Ming-Yii Huang, Cheng-Jen Ma, Ching-Wen Huang, Hsiang-Lin Tsai, Yen-Cheng Chen, Ching-Chun Li, Fang-Jung Yu, Hsiang-Yao Shih, Jaw-Yuan Wang
Journal of Oncology.2020; 2020: 1. CrossRef
Opportunities and limitations of CT - assessment of neoadjuvant chemoradiation therapy of gastric cancer
T. A. Agababyan, N. K. Silanteva, V. Yu. Skoropad, S. A. Ivanov, A. D. Kaprin, Yu. A. Komin, A. Yu. Usacheva, D. D. Kudryavtsev
Research and Practical Medicine Journal.2019; 6(4): 92. CrossRef
Outcomes of radiation therapy for resectable M0 gastric cancer
Weipeng Gong, Hongwei Zhao, Shanshan Liu, Jie Guan, Xin Liu, Qingsheng Hou, Zhenyu Zhu, Hongliang Guo
Oncotarget.2018; 9(2): 1726. CrossRef

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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

Abstract PDF PubReader ePub

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
Stephanie G. Worrell, Karyn A. Goodman, Nasser K. Altorki, Jonathan B. Ashman, Traves D. Crabtree, Jennifer Dorth, Scott Firestone, David H. Harpole, Wayne L. Hofstetter, Theodore S. Hong, Kalie Kissoon, Geoffrey Y. Ku, Daniela Molena, Joel E. Tepper, Tho
Practical Radiation Oncology.2024; 14(1): 28. CrossRef
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
Stephanie G. Worrell, Karyn A. Goodman, Nasser K. Altorki, Jonathan B. Ashman, Traves D. Crabtree, Jennifer Dorth, Scott Firestone, David H. Harpole, Wayne L. Hofstetter, Theodore S. Hong, Kalie Kissoon, Geoffrey Y. Ku, Daniela Molena, Joel E. Tepper, Tho
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Esophageal cancer: Treatment challenges and controversies
Piyush Kumar, Ankita Mehta
Journal of Current Oncology.2021; 4(1): 41. CrossRef
Radical esophagectomy for stage II and III thoracic esophageal squamous cell carcinoma followed by adjuvant radiotherapy with or without chemotherapy: Which is more beneficial?
Bingwen Zou, Yan Tu, Duwen Liao, Yong Xu, Jin Wang, Meijuan Huang, Li Ren, Jiang Zhu, Youling Gong, Yongmei Liu, Lin Zhou, Xiaojuan Zhou, Feng Peng, You Lu
Thoracic Cancer.2020; 11(3): 631. CrossRef
A meta-analysis on surgery with or without postoperative radiotherapy to treat squamous cell esophageal carcinoma
Hao-Nan Lin, Long-Qi Chen, Qi-Xin Shang, Yong Yuan, Yu-Shang Yang
International Journal of Surgery.2020; 80: 184. CrossRef
Homeobox D10, a tumor suppressor, inhibits the proliferation and migration of esophageal squamous cell carcinoma
Jin Zhang, Shiyuan Liu, Danjie Zhang, Zhenchuan Ma, Liangzhang Sun
Journal of Cellular Biochemistry.2019; 120(8): 13717. CrossRef
Adjuvant radiotherapy for stage pN1M0 esophageal squamous cell carcinoma: Results from a Chinese two‐center study
Wenjie Ni, Junqiang Chen, Zefen Xiao, Shufei Yu, Wencheng Zhang, Zongmei Zhou, Dongfu Chen, Qinfu Feng, Xiaohui Chen, Yu Lin, Kunshou Zhu, Shugeng Gao, Qi Xue, Yousheng Mao, Guiyu Cheng, Kelin Sun, Xiangyang Liu, Dekang Fang
Thoracic Cancer.2019; 10(6): 1431. CrossRef
Comparison of the effect of postoperative radiotherapy with surgery alone for esophagus squamous cell carcinoma patients
Xiao-han Zhao, Duo Wang, Fang Wang, Shu-chai Zhu
Medicine.2018; 97(47): e13168. CrossRef
The impact of adjuvant therapies on patient survival and the recurrence patterns for resected stage IIa–IVa lower thoracic oesophageal squamous cell carcinoma
Yichun Wang, Liyang Zhu, Wanli Xia, Liming Wu, Fan Wang
World Journal of Surgical Oncology.2018;[Epub] CrossRef
A retrospective study of pattern of recurrence after radical surgery for thoracic esophageal carcinoma with or without postoperative radiotherapy
Yichun Wang, Li Zhang, Dongmei Ye, Wanli Xia, Jun Jiang, Xiumei Wang, Mingxia Zhang, Fan Wang
Oncology Letters.2018;[Epub] CrossRef
Pattern of lymph node metastasis in thoracic esophageal squamous cell carcinoma with poor differentiation
Jinling Zhang, Yuanyuan Liu, Fengyuan Che, Yi Luo, Wei Huang, Xueyuan Heng, Baosheng Li
Molecular and Clinical Oncology.2018;[Epub] CrossRef
Negative lymph node at station 108 is a strong predictor of overall survival in esophageal cancer
Jinling Zhang, Xueyuan Heng, Yi Luo, Luning Li, Haiyan Zhang, Fengyuan Che, Baosheng Li
Oncology Letters.2018;[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
European Journal of Nuclear Medicine and Molecular Imaging.2019; 46(3): 650. CrossRef
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Oncotarget.2017; 8(20): 33884. CrossRef

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¹⁸F-FDG/PET May Help to Identify a Subgroup of Patients with T1-T2 Breast Cancer and 1-3 Positive Lymph Nodes Who Are at a High Risk of Recurrence after Mastectomy: Jee Suk Chang, Jeongshim Lee, Hyun Jung Kim, Kyung Hwan Kim, Mijin Yun, Seung Il Kim, Ki Chang Keum, Chang-Ok Suh, Yong Bae Kim; Cancer Res Treat. 2016;48(2):508-517. Published online September 9, 2015; DOI: https://doi.org/10.4143/crt.2015.172

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to assess the utility of positron emission tomography (PET) for predicting recurrence among patients with T1-T2/N1 breast cancer who were treated with mastectomy. Materials and Methods Of 712 consecutive patients with T1-T2/N1 breast cancer treated during 2003-2012, 109 had undergone preoperative 18F-fluorodeoxyglucose/PET and were included. Metabolic (maximum standardized uptake value [SUVmax]), volumetric (metabolic tumor volume [MTV]), and combined (total lesion glycolysis [TLG]) indices were measured. The resulting values were analyzed and compared with clinical outcome.
Results
At the median follow-up of 46.7 months, the 3-year relapse-free survival (RFS) rate was 95.2%. SUVmax (area under curve, 0.824) was more useful than MTV or TLG as a means of identifying patients at high risk for any recurrence. In multivariate analysis, SUVmax remained an independent risk factor for RFS (p=0.006). Using the method of Contal and O’Quigley, a SUVmax threshold of 5.36 showed the best predictive performance. The PET-based highrisk group (≥ 5.36 in either breast or nodes) had more T1c-T2, high-grade, hormone-receptor negative, and invasive ductal carcinoma tumors than the low-risk group (< 5.36 in both breast and nodes). The prognosis was much worse when high SUVmax (≥ 5.36) was detected in nodes (p < 0.001). In the no-radiotherapy cohort, the PET-based high-risk group had increased risk of locoregional recurrence when compared to the low-risk group (p=0.037). Conclusion High SUVmax on preoperative PET showed association with elevated risk of locoregional recurrence and any recurrence. Pre-treatment PET may improve assessments of recurrence risk and clarify indications for post-mastectomy radiotherapy in this subset of patients.

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