Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Role and Effectiveness of Hypofractionated Proton Beam Therapy and Combinations with Systemic Chemotherapy in Inoperable Extrahepatic Cholangiocarcinoma: Sung Uk Lee, Tae Hyun Kim, Sang Myung Woo, Jung Won Chun, Hyunjae Shin, Yu Ri Cho, Bo Hyun Kim, Young-Hwan Koh, Sang Soo Kim, Yang-Gun Suh, Sung Ho Moon, Woo Jin Lee; Cancer Res Treat. 2025;57(3):852-864. Published online December 17, 2024; DOI: https://doi.org/10.4143/crt.2024.805

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aims to assess the clinical outcomes of hypofractionated proton beam therapy (PBT) for extrahepatic cholangiocarcinoma (EHCC) and to investigate the optimal sequencing for combining PBT with chemotherapy.
Materials and Methods
We retrospectively analyzed 59 consecutive patients with inoperable EHCC treated with PBT. The median prescribed dose of PBT was 50 GyE (range, 45 to 66 GyE) in 10 fractions. The combination sequences of PBT and chemotherapy were categorized as ‘Pre-PBT chemo’ (chemotherapy before PBT), ‘Post-PBT chemo’ (chemotherapy after PBT), and ‘No pre-/post-PBT chemo’ (no chemotherapy before or after PBT). Overall survival (OS), progression-free survival (PFS), and local PFS were estimated using the Kaplan-Meier method.
Results
All patients completed the planned treatments without any interruptions, and ≥ grade 3 acute adverse events were noted in 1.6% of the cases. The 1-year and 2-year freedom from local progression (FFLP) rates were 86.1% and 66.4%, respectively, with a median time of FFLP of 30.9 months. The 1- and 2-year OS rates were 74.5% and 25.3%, respectively, with a median survival time of 16.7 months. For prognostic factor analysis, pre- or post-PBT chemo was associated with a significantly reduced hazard ratio of 0.473 (95% confidence interval, 0.233 to 0.959; p=0.038) in the multivariate analysis. The median OS times for the groups receiving no pre-/post-PBT chemo, pre-PBT chemo, and post-PBT chemo were 14.6, 18.2, and 21.8 months, respectively (p < 0.05 for each).
Conclusion
Hypofractionated PBT for inoperable EHCC has demonstrated promising FFLP and OS rates with a safe toxicity profile. The combination of PBT with chemotherapy shows potential to improve clinical outcomes.

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Genitourinary cancer

Optimal Definition of Biochemical Recurrence in Patients Who Receive Salvage Radiotherapy Following Radical Prostatectomy for Prostate Cancer: Sung Uk Lee, Jae-Sung Kim, Young Seok Kim, Jaeho Cho, Seo Hee Choi, Taek-Keun Nam, Song Mi Jeong, Youngkyong Kim, Youngmin Choi, Dong Eun Lee, Won Park, Kwan Ho Cho; Cancer Res Treat. 2022;54(4):1191-1199. Published online December 7, 2021; DOI: https://doi.org/10.4143/crt.2021.985

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study proposed the optimal definition of biochemical recurrence (BCR) after salvage radiotherapy (SRT) following radical prostatectomy for prostate cancer.
Materials and Methods
Among 1,117 patients who had received SRT, data from 205 hormone-naïve patients who experienced post-SRT prostate-specific antigen (PSA) elevation were included in a multi-institutional database. The primary endpoint was to determine the PSA parameters predictive of distant metastasis (DM). Absolute serum PSA levels and the prostate-specific antigen doubling time (PSA-DT) were adopted as PSA parameters.
Results
When BCR was defined based on serum PSA levels ranging from 0.4 ng/mL to nadir+2.0 ng/mL, the 5-year probability of DM was 27.6%-33.7%. The difference in the 5-year probability of DM became significant when BCR was defined as a serum PSA level of 0.8 ng/ml or higher (1.0-2.0 ng/mL). Application of a serum PSA level of ≥ 0.8 ng/mL yielded a c-index value of 0.589. When BCR was defined based on the PSA-DT, the 5-year probability was 22.7%-39.4%. The difference was significant when BCR was defined as a PSA-DT ≤ 3 months and ≤ 6 months. Application of a PSA-DT ≤ 6 months yielded the highest c-index (0.660). These two parameters complemented each other; for patients meeting both PSA parameters, the probability of DM was 39.5%-44.5%; for those not meeting either parameter, the probability was 0.0%-3.1%.
Conclusion
A serum PSA level > 0.8 ng/mL was a reasonable threshold for the definition of BCR after SRT. In addition, a PSA-DT ≤ 6 months was significantly predictive of subsequent DM, and combined application of both parameters enhanced predictability.

Citations

Citations to this article as recorded by

Effects of silybin on triptorelin-induced bone metabolic abnormalities in prostate cancer revealed based on TMT-based proteomics
Jianhui Li, Xuejiao Lv, Ying Jiang, Sudarshan Kasireddy
PLOS One.2026; 21(1): e0341064. CrossRef
Beyond the tumor: recurrence-prone radiomics for prognostication in negative PSMA PET/CT scans of prostate cancer
Fereshteh Yousefirizi, Sara Harsini, Mobin Mohebi, Ian Alberts, Tahir Yusufaly, Monica Luo, Hamid Abdollahi, Elmira Yazdani, Soheila Mirabedin, Maziar Sabouri, Parham Geramifar, Peyman Sheikhzadeh, Patrick Martineau, Don Wilson, François Bénard, Carlos Ur
Biomedical Physics & Engineering Express.2026; 12(4): 045011. CrossRef
Expert consensus recommendations for the management of biochemical recurrence in prostate cancer: a Delphi study across clinical scenarios
Fernando López Campos, Felipe Couñago, Juan Antonio Vallejo, Antoni Vilaseca, Daniel Pérez Fentes
Clinical and Translational Oncology.2026;[Epub] CrossRef
New Prostate MRI Scoring Systems (PI-QUAL, PRECISE, PI-RR, and PI-FAB): AJR Expert Panel Narrative Review
Adriano B. Dias, Silvia D. Chang, Fiona M. Fennessy, Soleen Ghafoor, Sangeet Ghai, Valeria Panebianco, Andrei S. Purysko, Francesco Giganti
American Journal of Roentgenology.2025;[Epub] CrossRef
Biochemical recurrence after radical prostatectomy and postoperative radiotherapy: current evidence and controversial issues
Mattia Longoni, Fabian Falkenbach, Markus Graefen, Tobias Maurer, Pierre I. Karakiewicz, Francesco Montorsi, Alberto Briganti, Giorgio Gandaglia
Current Opinion in Urology.2025; 35(5): 510. CrossRef
Radiation Therapy for Local or Biochemical Recurrence Following Radical Prostatectomy in Patients with Prostate Cancer
Hiroki Nishiyama, Gen Kawaguchi, Kozue Ito, Go Hasegawa, Yohei Ikeda, Noboru Hara, Tsutomu Nishiyama
Research and Reports in Urology.2025; Volume 17: 327. CrossRef
Prostate-specific Antigen Nadir and Time to Nadir Predict Recurrence in Postprostatectomy Patients Treated with Salvage Radiotherapy Without Androgen Deprivation Therapy
Federico Mastroleo, Riccardo Villa, Mattia Zaffaroni, Maria Giulia Vincini, Ciro Franzese, Luca Nicosia, Fabio Matrone, Alessandra Donofrio, Alessandro Magli, Luca Triggiani, Salvina Barra, Giorgia Timon, Matteo Augugliaro, Vincenzo Burgio, Giulio Francol
European Urology Oncology.2025;[Epub] CrossRef
A Prospective Randomized Multicenter Study on the Impact of [18F]F-Choline PET/CT Versus Conventional Imaging for Staging Intermediate- to High-Risk Prostate Cancer
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Journal of Nuclear Medicine.2024; 65(7): 1013. CrossRef
Comparison of the Effects of DOTA and NOTA Chelators on 64Cu-Cudotadipep and 64Cu-Cunotadipep for Prostate Cancer
Inki Lee, Min Hwan Kim, Kyongkyu Lee, Keumrok Oh, Hyunwoo Lim, Jae Hun Ahn, Yong Jin Lee, Gi Jeong Cheon, Dae Yoon Chi, Sang Moo Lim
Diagnostics.2023; 13(16): 2649. CrossRef

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General

Patterns of Proton Beam Therapy Use in Clinical Practice between 2007 and 2019 in Korea: Sung Uk Lee, Kyungmi Yang, Sung Ho Moon, Yang-Gun Suh, Gyu Sang Yoo; Cancer Res Treat. 2021;53(4):935-943. Published online May 17, 2021; DOI: https://doi.org/10.4143/crt.2021.409

Abstract PDF Supplementary Material PubReader ePub

Purpose
Proton beam therapy (PBT) is a state-of-the-art technology employed in radiotherapy (RT) for cancer patients. This study characterized how PBT has been used in clinical practice in Korea.
Materials and Methods
Patients who received any type of RT between 2007 and 2019 were identified from the radiation oncology registry of the two PBT facilities operating in Korea (National Cancer Center and Samsung Medical Center). The chi-square test was used to identify patient- and treatment-related characteristics associated with the receipt of PBT.
Results
A total of 54,035 patients had been treated with some form of RT in the two institutions, of whom 5,398 received PBT (10.0%). The number of patients who receive PBT has gradually increased since PBT first started, from 162 patients in 2007 to 1,304 patients in 2019. Among all types of cancer, PBT use in liver cancer has been steadily increasing from 20% in 2008-2009 to 32% in 2018-2019. In contrast, that in prostate cancer has been continuously decreasing from 20% in 2008-2009 to < 10% in 2018-2019. Male sex, very young or old age, stage I-II disease, residency in non-capital areas, a definitive setting, a curative treatment aim, enrollment in a clinical trial, re-irradiation and insurance coverage were significantly associated with the receipt of PBT (all p < 0.05).
Conclusion
Since PBT started in Korea, the number of patients receiving PBT has increased to more than 1,000 per year and treatment indications have expanded. Liver cancer is the most common primary tumor among all PBT cases in Korea.

Citations

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Proton Versus Photon Radiotherapy for Non-Small Cell Lung Cancer: Updated Evidence from a Systematic Review and Meta-Analysis
Chiung-Chen Fang, Wen-Cheng Chen, Ming-Shao Tsai, Miao-Fen Chen
Cancers.2026; 18(3): 453. CrossRef
Proton beam therapy versus photon therapy for multiple malignancies: An umbrella systematic review and meta-analysis
Zhenyu Ma, Qipeng Yuan, Mei Liu, Ziniu Tang, Peng Shang, Chen Wang, Xiaoqing Xu, Jinbo Yue
Critical Reviews in Oncology/Hematology.2026; 222: 105276. CrossRef
“Particle therapy - future for the Baltic states?” – synthesis of the expert workshop report
Kristaps Paļskis, Erika Korobeinikova, Dace Bogorada-Saukuma, Anna Maria Camarda, Rebecca Taylor, Elena Benedetto, Edgars Mamis, Maija Radziņa, Andrejs Ērglis, Diana Adliene, Manjit Dosanjh, Maurizio Vretenar, Toms Torims
Health and Technology.2024; 14(5): 965. CrossRef
Proton Therapy in The Treatment of Head And Neck Cancers- Review
Kamila Bała, Yana Samovich, Karolina Dorobisz
Current Oncology Reports.2024; 26(11): 1380. CrossRef
PTCOG international survey of practice patterns and trends in utilization of proton therapy for breast cancer
J. Isabelle Choi, Camille Hardy-Abeloos, Alicia Lozano, Alexandra Hanlon, Carlos Vargas, John H. Maduro, Julie Bradley, Birgitte Offersen, Bruce Haffty, Mark Pankuch, Richard Amos, Nalee Kim, Shannon M. MacDonald, Youlia Kirova, Robert W. Mutter
Clinical and Translational Radiation Oncology.2024; 48: 100847. CrossRef
Recent trends in radiotherapy use for major cancers in Korea
Kyungmi Yang, Jeong Eun Lee, Won Park, Yong Chan Ahn, Seung Jae Huh
Japanese Journal of Clinical Oncology.2023; 53(12): 1177. CrossRef

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Clinical Outcomes of Postoperative Radiotherapy Following Radical Prostatectomy in Patients with Localized Prostate Cancer: A Multicenter Retrospective Study (KROG 18-01) of a Korean Population: Sung Uk Lee, Kwan Ho Cho, Won Park, Won Kyung Cho, Jae-Sung Kim, Chan Woo Wee, Young Seok Kim, Jin Ho Kim, Taek-Keun Nam, Jaeho Cho, Song Mi Jeong, Youngkyong Kim, Su Jung Shim, Youngmin Choi, Jun-Sang Kim; Cancer Res Treat. 2020;52(1):167-180. Published online June 25, 2019; DOI: https://doi.org/10.4143/crt.2019.126

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to investigate the clinical outcomes of postoperative radiotherapy (PORT) patients who underwent radical prostatectomy for localized prostate cancer.
Materials and Methods
Localized prostate cancer patients who received PORT after radical prostatectomy between 2001 and 2012 were identified retrospectively in a multi-institutional database. In total, 1,117 patients in 19 institutions were included. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ≥ nadir+2 after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA regardless of its value.
Results
Ten-year biochemical failure-free survival, clinical failure-free survival, distant metastasisfree survival, overall survival (OS), and cause-specific survival were 60.5%, 76.2%, 84.4%, 91.1%, and 96.6%, respectively, at a median of 84 months after PORT. Pre-PORT PSA ≤ 0.5 ng/ml and Gleason’s score ≤ 7 predicted favorable clinical outcomes, with 10-year OS rates of 92.5% and 94.1%, respectively. The 10-year OS rate was 82.7% for patients with a PSA > 1.0 ng/mL and 86.0% for patients with a Gleason score of 8-10. The addition of longterm ADT (≥ 12 months) to PORT improved OS, particularly in those with a Gleason score of 8-10 or ≥ T3b.
Conclusion
Clinical outcomes of PORT in a Korean prostate cancer population were very similar to those in Western countries. Lower Gleason score and serum PSA level at the time of PORT were significantly associated with favorable outcomes. Addition of long-term ADT (≥ 12 months) to PORT should be considered, particularly in unfavorable risk patients with Gleason scores of 8-10 or ≥ T3b.

Citations

Citations to this article as recorded by

Delayed Salvage Radiation Therapy Guided by Contrast-Enhanced Local and Whole-Body Diffusion-Weighted Magnetic Resonance Imaging During Prostate-Specific-Antigen-Based Surveillance After Radical Prostatectomy: A Retrospective Cohort Study
Tadashi Matsumoto, Shoji Morishita, Tomohiko Matsuyama, Kazuhiro Katahira, Yasuyuki Hamada, Kazumasa Hara, Shinsuke Hamada, Chikako Awazu, Takahiro Otsuka, Shigeo Yamada, Hirohito Otsuka, Takahiro Watakabe, Yoshiyuki Fukugawa, Natsuo Oya
Advances in Radiation Oncology.2026; 11(11): 102123. CrossRef
Optimal Definition of Biochemical Recurrence in Patients Who Receive Salvage Radiotherapy Following Radical Prostatectomy for Prostate Cancer
Sung Uk Lee, Jae-Sung Kim, Young Seok Kim, Jaeho Cho, Seo Hee Choi, Taek-Keun Nam, Song Mi Jeong, Youngkyong Kim, Youngmin Choi, Dong Eun Lee, Won Park, Kwan Ho Cho
Cancer Research and Treatment.2022; 54(4): 1191. CrossRef
A discussion on controversies and ethical dilemmas in prostate cancer screening
Satish Chandra Mishra
Journal of Medical Ethics.2021; 47(3): 152. CrossRef
Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
Sung Uk Lee, Kwan Ho Cho, Jin Ho Kim, Young Seok Kim, Taek-Keun Nam, Jae-Sung Kim, Jaeho Cho, Seo Hee Choi, Su Jung Shim, Jin Hee Kim, Ah Ram Chang
Technology in Cancer Research & Treatment.2021;[Epub] CrossRef

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