Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Combined High-Dose Radiotherapy with Sequential Gemcitabine-Cisplatin Based Chemotherapy Increase the Resectability and Survival in Locally Advanced Unresectable Intrahepatic Cholangiocarcinoma: A Multi-institutional Cohort Study: Jung Ho Im, Jeong Il Yu, Tae Hyun Kim, Tae Gyu Kim, Jun Won Kim, Jinsil Seong; Cancer Res Treat. 2024;56(3):838-846. Published online January 2, 2024; DOI: https://doi.org/10.4143/crt.2023.886

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Purpose
The locally advanced unresectable intrahepatic cholangiocarcinoma (ICC) has detrimental oncological outcomes. In this study, we aimed to investigate the efficacy of radiotherapy in patients with locally advanced unresectable ICC.
Materials and Methods
Between 2001 and 2021, 116 patients were identified through medical record who underwent radiotherapy for locally advanced unresectable ICC. The resectability of ICC is determined by the multidisciplinary team at each institution. Overall survival (OS) were analyzed using the Kaplan-Meier method, and prognostic factors were analyzed using the Cox proportional hazards model.
Results
The median equivalent radiotherapy dose in 2 Gy fractions (EQD2) was 52 Gy (range, 30 to 110 Gy). Forty-seven patients (40.5%) received sequential gemcitabine-cisplatin based chemotherapy (GEM-CIS CTx). Multivariate analysis identified two risk factors, EQD2 of ≥ 60 Gy and application of sequential GEM-CIS CTx for OS. Patients were grouped by these two risk factors: group 1, EQD2 ≥ 60 Gy with sequential GEM-CIS CTx (n=25); group 2, EQD2 < 60 Gy with sequential GEM-CIS CTx or fluoropyrimidine-based concurrent chemoradiotherapy (n=70); and group 3, radiotherapy alone (n=21). Curative resection was more frequently undergone in group 1 than in groups 2 or 3 (28% vs. 8.6% vs. 0%, respectively). Consequently, OS was significantly better in group 1 than in groups 2 and 3 (p < 0.05).
Conclusion
Combined high-dose radiotherapy with sequential GEM-CIS CTx improved oncologic outcomes in patients with locally advanced unresectable ICC. Further prospective studies are required to validate these findings.

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Immunotherapy checkpoint inhibitor-combination therapy versus chemotherapy alone among Chinese population in cholangiocarcinoma treatment: a systematic review and meta-analysis
Li Shi, Wei Du, Juan Miao, Xi-Yuan Peng, Wei Li, Attiq Ur-Rehman, Meng-Wei Ge, Lu-Ting Shen, Rui Feng, Kang Zhong, Si-Qi Gao, Hong-Lin Chen
European Journal of Clinical Pharmacology.2026;[Epub] CrossRef
The role of radiotherapy in the management of combined hepatocellular-cholangiocarcinoma: current evidence and future perspectives
Seo Hee Choi, Woong Sub Koom, Ik Jae Lee
Journal of Liver Cancer.2026; 26(1): 55. CrossRef
Conversion treatment for advanced intrahepatic cholangiocarcinoma: Opportunities and challenges
Jun-Jie Liu, Mi Zhou, Tong Yuan, Zhi-Yong Huang, Zun-Yi Zhang
World Journal of Gastroenterology.2025;[Epub] CrossRef
Optimizing radiotherapy in unresectable or metastatic intrahepatic cholangiocarcinoma: systematic review and meta-analysis of the literature
Ik Jae Lee, Ji-In Bang, Seo Hee Choi, Jung Ho Im
Radiation Oncology.2025;[Epub] CrossRef

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Risk Factors for Distant Metastasis in Extrahepatic Bile Duct Cancer after Curative Resection (KROG 1814): Younghee Park, Tae Hyun Kim, Kyubo Kim, Jeong Il Yu, Wonguen Jung, Jinsil Seong, Woo Chul Kim, Jin Hwa Choi, Ah Ram Chang, Bae Kwon Jeong, Byoung Hyuck Kim, Tae Gyu Kim, Jin Hee Kim, Hae Jin Park, Hyun Soo Shin, Jung Ho Im, Eui Kyu Chie; Cancer Res Treat. 2024;56(1):272-279. Published online July 31, 2023; DOI: https://doi.org/10.4143/crt.2023.616

Abstract PDF PubReader ePub: Purpose
Risk factors predicting distant metastasis (DM) in extrahepatic bile duct cancer (EHBDC) patients treated with curative resection were investigated.
Materials and Methods
Medical records of 1,418 EHBDC patients undergoing curative resection between Jan 2000 and Dec 2015 from 14 institutions were reviewed. After resection, 924 patients (67.6%) were surveilled without adjuvant therapy, 297 (21.7%) were treated with concurrent chemoradiotherapy (CCRT) and 148 (10.8%) with CCRT followed by chemotherapy. To exclude the treatment effect from innate confounders, patients not treated with adjuvant therapy were evaluated.
Results
After a median follow-up of 36.7 months (range, 2.7 to 213.2 months), the 5-year distant metastasis-free survival (DMFS) rate was 57.7%. On multivariate analysis, perihilar or diffuse tumor (hazard ratio [HR], 1.391; p=0.004), poorly differentiated histology (HR, 2.014; p < 0.001), presence of perineural invasion (HR, 1.768; p < 0.001), positive nodal metastasis (HR, 2.670; p < 0.001) and preoperative carbohydrate antigen (CA) 19-9 ≥ 37 U/mL (HR, 1.353; p < 0.001) were significantly associated with inferior DMFS. The DMFS rates significantly differed according to the number of these risk factors. For validation, patients who underwent adjuvant therapy were evaluated. In patients with ≥ 3 factors, additional chemotherapy after CCRT resulted in a superior DMFS compared with CCRT alone (5-year rate, 47.6% vs. 27.7%; p=0.001), but the benefit of additional chemotherapy was not observed in patients with 0-2 risk factors.
Conclusion
Tumor location, histologic differentiation, perineural invasion, lymph node metastasis, and preoperative CA 19-9 level predicted DM risk in resected EHBDC. These risk factors might help identifying a subset of patients who could benefit from additional chemotherapy after resection.

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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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Impact of lymphadenectomy extent on immunotherapy efficacy in postresectional recurred non-small cell lung cancer: a multi-institutional retrospective cohort study
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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Kangpyo Kim, Yong Chan Ahn
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MJ García-Anaya, S. Segado-Guillot, J. Cabrera-Rodríguez, MD Toledo-Serrano, JA Medina-Carmona, J. Gómez-Millán
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