Cancer Research and Treatment

Original Articles

Relationships between the Microbiome and Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer: Hye In Lee, Bum-Sup Jang, Ji Hyun Chang, Eunji Kim, Tae Hoon Lee, Jeong Hwan Park, Eui Kyu Chie; Received June 2, 2024 Accepted December 13, 2024 Published online December 16, 2024; DOI: https://doi.org/10.4143/crt.2024.521 [Accepted]

Abstract PDF: Purpose
This study aimed to investigate the dynamic changes in the microbiome of patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (nCRT), focusing on the relationship between the microbiome and response to nCRT.
Materials and Methods
We conducted a longitudinal study involving 103 samples from 26 patients with LARC. Samples were collected from both the tumor and normal rectal tissues before and after nCRT. Diversity, taxonomic, and network analyses were performed to compare the microbiome profiles across different tissue types, pre- and post-nCRT time-points, and nCRT responses.
Results
Between the tumor and normal tissue samples, no differences in microbial diversity and composition were observed. However, when pre- and post-nCRT samples were compared, there was a significant decrease in diversity, along with notable changes in composition. Non-responders exhibited more extensive changes in their microbiome composition during nCRT, characterized by an increase in pathogenic microbes. Meanwhile, responders had relatively stable microbiome communities with more enriched butyrate-producing bacteria. Network analysis revealed distinct patterns of microbial interactions between responders and non-responders, where butyrate-producing bacteria formed strong networks in responders, while opportunistic pathogens formed strong networks in non-responders. A Bayesian network model for predicting the nCRT response was established, with butyrate-producing bacteria playing a major predictive role.
Conclusion
Our study demonstrated a significant association between the microbiome and nCRT response in LARC patients, leading to the development of a microbiome-based response prediction model. These findings suggest potential applications of microbiome signatures for predicting and optimizing nCRT treatment in LARC patients.

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Lung and Thoracic cancer

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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Gastrointestinal cancer

Prognostic Significance of Bulky Nodal Disease in Anal Cancer Management: A Multi-institutional Study: Seok-Joo Chun, Eunji Kim, Won Il Jang, Mi-Sook Kim, Hyun-Cheol Kang, Byoung Hyuck Kim, Eui Kyu Chie; Cancer Res Treat. 2024;56(4):1197-1206. Published online April 11, 2024; DOI: https://doi.org/10.4143/crt.2024.258

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to assess the prognostic significance of bulky nodal involvement in patients with anal squamous cell carcinoma treated with definitive chemoradiotherapy.
Materials and Methods
We retrospectively analyzed medical records of patients diagnosed with anal squamous cell carcinoma who underwent definitive chemoradiotherapy at three medical centers between 2004 and 2021. Exclusion criteria included distant metastasis at diagnosis, 2D radiotherapy, and salvage treatment for local relapse. Bulky N+ was defined as nodes with a long diameter of 2 cm or greater.
Results
A total of 104 patients were included, comprising 51 with N0, 46 with non-bulky N+, and seven with bulky N+. The median follow-up duration was 54.0 months (range, 6.4 to 162.2 months). Estimated 5-year progression-free survival (PFS), loco-regional recurrence-free survival (LRRFS), and overall survival (OS) rates for patients with bulky N+ were 42.9%, 42.9%, and 47.6%, respectively. Bulky N+ was significantly associated with inferior PFS, LRRFS, and OS compared to patients without or with non-bulky N+, even after multivariate analysis. We proposed a new staging system incorporating bulky N+ as N2 category, with estimated 5-year LRRFS, PFS, and OS rates of 81.1%, 80.6%, and 86.2% for stage I, 67.7%, 60.9%, and 93.3% for stage II, and 42.9%, 42.9%, and 47.6% for stage III disease, enhancing the predictability of prognosis.
Conclusion
Patients with bulky nodal disease treated with standard chemoradiotherapy experienced poor survival outcomes, indicating the potential necessity for further treatment intensification.

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MR Imaging of Anal Cancer
Josip Nincevic, Gaiane M. Rauch, Jennifer S. Golia Pernicka
Radiologic Clinics of North America.2025;[Epub] CrossRef

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Genitourinary cancer

Neoadjuvant Cisplatin-Based Chemotherapy Followed by Selective Bladder Preservation Chemoradiotherapy in Muscle-Invasive Urothelial Carcinoma of the Bladder: Post Hoc Analysis of Two Prospective Studies: Sung Wook Cho, Sung Hee Lim, Ghee Young Kwon, Chan Kyo Kim, Won Park, Hongryull Pyo, Jae Hoon Chung, Wan Song, Hyun Hwan Sung, Byong Chang Jeong, Se Hoon Park; Cancer Res Treat. 2024;56(3):893-897. Published online February 15, 2024; DOI: https://doi.org/10.4143/crt.2024.015

Abstract PDF PubReader ePub

Purpose
Bladder preservation chemoradiotherapy (CRT) in patients with a clinical complete response (cCR) following cisplatin-based neoadjuvant chemotherapy (NAC) is a promising treatment strategy for muscle-invasive bladder urothelial carcinoma (MIBC). A combined analysis of raw data from two prospective phase II studies was performed to better evaluate the feasibility of selective bladder preservation CRT.
Materials and Methods
The analysis was based on primary efficacy data from two independent studies, including 76 MIBC patients receiving NAC followed by bladder preservation CRT. The efficacy data included metastasis-free survival (MFS) and disease-free survival (DFS). For the present analysis, starting point of survival was defined as the date of commencing CRT.
Results
Among 76 patients, 66 had a cCR following NAC. Sixty-four patients received gemcitabine and cisplatin (GC) combination chemotherapy in neoadjuvant setting, and 12 received nivolumab plus GC. Bladder preservation CRT following NAC was generally well-tolerated, with low urinary tract symptoms being the most common late complication. With a median follow-up of 64 months, recurrence was recorded in 43 patients (57%): intravesical only (n=20), metastatic only (n=16), and both (n=7). In 27 patients with intravesical recurrence, transurethral resection, and Bacillus Calmette-Guerin treatment was given to 17 patients. Salvage cystectomy was performed in 10 patients. Median DFS was 46.3 (95% confidence interval [CI], 25.1 to 67.5) months, and the median MFS was not reached. Neither DFS nor MFS appeared to be affected by any of the baseline characteristics. However, DFS was significantly longer in patients with a cCR than in those without (hazard ratio, 0.465; 95% CI, 0.222 to 0.976).
Conclusion
The strategy of NAC followed by selective bladder preservation CRT based on the cCR is feasible in the treatment of MIBC. A standardized definition of cCR is needed to better assess disease status post-NAC.

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News and prospects on radiotherapy for bladder cancer: Is trimodal therapy becoming the gold standard?
Olivier Riou, Christophe Hennequin, Jonathan Khalifa, Paul Sargos
Cancer/Radiothérapie.2024; 28(6-7): 623. CrossRef

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Lung and Thoracic cancer

Contribution of Enhanced Locoregional Control to Improved Overall Survival with Consolidative Durvalumab after Concurrent Chemoradiotherapy in Locally Advanced Non–Small Cell Lung Cancer: Insights from Real-World Data: Jeong Yun Jang, Si Yeol Song, Young Seob Shin, Ha Un Kim, Eun Kyung Choi, Sang-We Kim, Jae Cheol Lee, Dae Ho Lee, Chang-Min Choi, Shinkyo Yoon, Su Ssan Kim; Cancer Res Treat. 2024;56(3):785-794. Published online January 16, 2024; DOI: https://doi.org/10.4143/crt.2023.1014

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to assess the real-world clinical outcomes of consolidative durvalumab in patients with unresectable locally advanced non–small cell lung cancer (LA-NSCLC) and to explore the role of radiotherapy in the era of immunotherapy.
Materials and Methods
This retrospective study assessed 171 patients with unresectable LA-NSCLC who underwent concurrent chemoradiotherapy (CCRT) with or without consolidative durvalumab at Asan Medical Center between May 2018 and May 2021. Primary outcomes included freedom from locoregional failure (FFLRF), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS).
Results
Durvalumab following CCRT demonstrated a prolonged median PFS of 20.9 months (p=0.048) and a 3-year FFLRF rate of 57.3% (p=0.008), compared to 13.7 months and 38.8%, respectively, with CCRT alone. Furthermore, the incidence of in-field recurrence was significantly greater in the CCRT-alone group compared to the durvalumab group (26.8% vs. 12.4%, p=0.027). While median OS was not reached with durvalumab, it was 35.4 months in patients receiving CCRT alone (p=0.010). Patients positive for programmed cell death ligand 1 (PD-L1) expression showed notably better outcomes, including FFLRF, DMFS, PFS, and OS. Adherence to PACIFIC trial eligibility criteria identified 100 patients (58.5%) as ineligible. The use of durvalumab demonstrated better survival regardless of eligibility criteria.
Conclusion
The use of durvalumab consolidation following CCRT significantly enhanced locoregional control and OS in patients with unresectable LA-NSCLC, especially in those with PD-L1–positive tumors, thereby validating the role of durvalumab in standard care.

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Therapeutic effect of induction therapy including nab-paclitaxel followed by surgical resection for the patients with locally advanced non-small-cell lung cancer
Hidetaka Uramoto, Nozomu Motono, Shun Iwai
Journal of Cardiothoracic Surgery.2024;[Epub] CrossRef

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Gastrointestinal cancer

NESC Multicenter Phase II Trial in the Preoperative Treatment of Gastric Adenocarcinoma with Chemotherapy (Docetaxel-Cisplatin-5FU+Lenograstim) Followed by Chemoradiation Based 5FU and Oxaliplatin and Surgery: Laurent Mineur, Frederi Plat, Françoise Desseigne, Gael Deplanque, Mohamed Belkacemi, Laurence Moureau-Zabotto, Carlos D. Beyrne, Khadija Jalali, Stéphane Obled, Denis Smith, Léa Vazquez, Rania Boustany; Cancer Res Treat. 2024;56(2):580-589. Published online October 5, 2023; DOI: https://doi.org/10.4143/crt.2023.812

Abstract PDF Supplementary Material PubReader ePub

Purpose
Preoperative chemoradiation (CRT) is expected to increase the rate of curative resection and complete histological response. In this trial, we investigated the efficacy of a neoadjuvant CRT regimen in gastric adenocarcinoma (NCT01565109 trial).
Materials and Methods
Patients with stage IB to IIIC gastric adenocarcinoma, endoscopy ultrasound and computed tomography–scan diagnosed, were eligible for this phase II trial. Neoadjuvant treatment consisted of 2 cycles of chemotherapy with DCF (docetaxel, cisplatin, and 5-fluorouracil [5FU]) followed by preoperative CRT with oxaliplatin, continuous 5FU and radiotherapy (45 Gy in 25 fractions of 1.8 Gy, 5 fractions per week for 5 weeks) administered before surgery. R0-resection rate, pathological complete response (pathCR) rate, and survival (progression-free survival [PFS] and overall survival [OS]) were evaluated as primary endpoints.
Results
Among 33 patients included, 32 patients (97%) received CRT and 26 (78.8%) were resected (R0 resection for all patients resected). Among resected patients, we report pathCR in 23,1% and pathologic major response (tumor regression grade 2 according to Mandard’s classification) in 26,9%. With a median follow-up duration of 5.82 years (range, 0.4 to 9.24 years), the estimated median OS for all 33 patients was not reached; 1-, 3-, and 5-year OS rates were 85%, 61%, and 52%, respectively. Among resected patients, those whose histological response was tumor grade regression (TRG) 1-2 had significantly better OS and PFS rates than those with a TRG 3-4-5 response (p=0.019 and p=0.016, respectively).
Conclusion
Promising results from trials involving preoperative chemoradiation followed by surgery in gastric cancer need to be further evaluated in a phase III trial.

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Efficacy of Cisplatin-Containing Chemotherapy Regimens in Patients of Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-analysis
Obaid Ur Rehman, Eeshal Fatima, Zain Ali Nadeem, Arish Azeem, Jatin Motwani, Habiba Imran, Hadia Mehboob, Alishba Khan, Omer Usman
Journal of Gastrointestinal Cancer.2024; 55(2): 559. CrossRef
The Comparison of FLOT and DCF Regimens as Perioperative Treatment for Gastric Cancer
Gökhan Uçar, Serhat Sekmek, İrfan Karahan, Yakup Ergün, Özlem Aydın İsak, Sezai Tunç, Mutlu Doğan, Fatih Gürler, Doğan Bayram, Yusuf Açıkgöz, Selin Aktürk Esen , Burak Civelek, Fahriye Tuğba Köş , Öznur Bal, Efnan Algın, Tülay Eren, Gökşen İnanç İmamoğ
Oncology.2024; : 1. CrossRef

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Head and Neck cancer

Individualized Concurrent Chemotherapy for Patients with Stage III-IVa Nasopharyngeal Carcinoma Receiving Neoadjuvant Chemotherapy Combined with Definitive Intensity-Modulated Radiotherapy: Pengjie Ji, Qiongjiao Lu, Xiaoqiang Chen, Yuebing Chen, Xiane Peng, Zhiwei Chen, Cheng Lin, Shaojun Lin, Jingfeng Zong; Cancer Res Treat. 2023;55(4):1113-1122. Published online May 11, 2023; DOI: https://doi.org/10.4143/crt.2022.1651

Abstract PDF Supplementary Material PubReader ePub

Purpose
This retrospective study aimed to re-evaluate the effect of concurrent chemotherapy in patients with locally advanced nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiotherapy (IMRT).
Materials and Methods
A total of 498 patients who received neoadjuvant chemotherapy (NCT) combined with concurrent chemoradiotherapy (CCRT) or IMRT were retrospectively reviewed. The distribution of baseline characteristics was balanced using propensity score matching. Additionally, the results of NCT+IMRT and NCT+CCRT were compared using Kaplan-Meier survival analysis, and differences in survival rates were analyzed using the log rank test.
Results
There were no significant differences in overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and local progression-free survival (LRFS) between the two groups. Patients were further categorized into risk subgroups based on pretreatment Epstein-Barr virus (EBV) DNA cutoff values using receiver operating characteristic curve analysis. There were no statistically significant differences in OS, PFS, DMFS, and LRFS between patients who received NCT+CCRT and NCT+IMRT in the high-risk group. In the low-risk group, although there were no differences between NCT+CCRT and NCT+IMRT in OS, PFS, and LRFS, patients who received NCT+CCRT had better DMFS than those who received NCT+IMRT.
Conclusion
Pretreatment EBV DNA level can be used to individualize concurrent chemotherapy for patients with locally advanced NPC. Patients with low pretreatment EBV DNA levels may benefit from concurrent chemotherapy, whereas those with high levels may not. Other treatment modalities need to be explored for high-risk patients to improve their prognosis.

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Global trends in research of nasopharyngeal carcinoma: a bibliometric and visualization analysis
Guilin An, Jie Liu, Ting Lin, Lan He, Yingchun He
Frontiers in Oncology.2024;[Epub] CrossRef

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Lung and Thoracic cancer

Predictors of Post-chemoradiotherapy Pulmonary Complication in Locally Advanced Non–Small Cell Lung Cancer: Tae Hoon Lee, Byung-Hee Kang, Hak Jae Kim, Hong-Gyun Wu, Joo Ho Lee; Cancer Res Treat. 2023;55(3):865-874. Published online January 19, 2023; DOI: https://doi.org/10.4143/crt.2022.1538

Abstract PDF PubReader ePub

Purpose
We investigated the clinical effects and predictive factors of severe post-chemoradiotherapy pulmonary complications (PCPC) in locally advanced non–small cell lung cancer (LA-NSCLC).
Materials and Methods
Medical records of 317 patients who underwent definitive concurrent chemoradiation (CCRT) for LA-NSCLC were reviewed retrospectively. PCPC was defined as an event of admission or emergency department visit for acute or subacute pulmonary inflammatory complications, including pneumonitis and pneumonia, within 6 months after CCRT initiation. Patient characteristics, baseline lung function tests, radiation dosimetric parameters, and laboratory tests were analyzed to investigate their association with PCPC. Prognostic endpoints were disease progression rate (DPR) and overall survival (OS).
Results
PCPC was reported in 53 patients (16.7%). The OS of patients with PCPC was significantly worse (35.0% in 2 years) than that of patients without PCPC (67.0% in 2 years, p < 0.001). However, 2-year DPRs were 77.0% and 70.7% in patients with and without PCPC, respectively, which were not significantly different (p=0.087). In multivariate logistic regression, PCPC was independently associated with grade ≥ 1 hypoalbuminemia during CCRT (odds ratio [OR], 5.670; 95% confidence interval [CI], 2.487 to 13.40; p < 0.001), lower diffusing capacity of carbon monoxide (DLCO) (per mL/min/mmHg; OR, 0.855; 95% CI, 0.743 to 0.974; p=0.022), and higher lung V5 (per 10%; OR, 1.872; 95% CI, 1.336 to 2.699; p < 0.001).
Conclusion
PCPC might be a clinical endpoint to evaluate complications and predict the survival of patients subjected to CCRT for LA-NSCLC. Hypoalbuminaemia, DLCO, and lung V5 might predict PCPC in LA-NSCLC.

Citations

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Pneumonitis Risk After Chemoradiotherapy With and Without Immunotherapy in Patients With Locally Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis
Chong Han, Jingping Qiu, Lu Bai, Tingting Liu, Jun Chen, He Wang, Jun Dang
International Journal of Radiation Oncology*Biology*Physics.2024; 119(4): 1179. CrossRef
Prognostic Biomarkers of Systemic Inflammation in Non-Small Cell Lung Cancer: A Narrative Review of Challenges and Opportunities
Mark Stares, Leo R. Brown, Dhruv Abhi, Iain Phillips
Cancers.2024; 16(8): 1508. CrossRef
Comparison of post-chemoradiotherapy pneumonitis between Asian and non-Asian patients with locally advanced non-small cell lung cancer: a systematic review and meta-analysis
Tingting Liu, Sihan Li, Silu Ding, Jingping Qiu, Chengbo Ren, Jun Chen, He Wang, Xiaoling Wang, Guang Li, Zheng He, Jun Dang
eClinicalMedicine.2023; 64: 102246. CrossRef

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EGFR Mutation–Positive Unresectable Stage III Non-Squamous Lung Cancer Is Associated with a High Incidence of Brain Metastasis: Hongsik Kim, Sehhoon Park, Hyun Ae Jung, Jong-Mu Sun, Se-Hoon Lee, Jin Seok Ahn, Myung-Ju Ahn; Cancer Res Treat. 2023;55(2):498-505. Published online October 4, 2022; DOI: https://doi.org/10.4143/crt.2022.388

Abstract PDF PubReader ePub

Purpose
The impact of epidermal growth factor receptor (EGFR) mutation in locally advanced non–small cell lung cancer (NSCLC) remains controversial. This study was conducted to investigate the clinical outcomes and recurrence patterns after definitive chemoradiotherapy (CRT) in patients with unresectable stage III non-squamous-cell lung cancer according to EGFR mutation status.
Materials and Methods
We retrospectively reviewed 604 patients with pathologically confirmed stage III NSCLC who were treated with definitive CRT and were examined for EGFR mutation at Samsung Medical Center, Korea, from January 2013 to December 2018. Among them, we identified 236 patients with stage III non-squamous-cell lung cancer who were treated with definitive CRT and were examined for EGFR mutation status. We analyzed the frequency of EGFR mutation, progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and recurrence pattern.
Results
Among 236 patients, EGFR mutation was detected in 71 patients (30.1%) and the median follow-up duration was 41.7 months. There were no significant differences in PFS (9.9 vs. 10.9 months, p=0.236), and ORR to CRT (93.0% vs. 90.3%, p=0.623) according to EGFR mutation status. However, the EGFR mutant group showed significantly higher recurrence (88.7% vs. 75.2%, p=0.022), distant metastasis (76.1% vs. 61.2%, p=0.036) rates, especially brain (38.0% vs. 12.7%, p < 0.001), and better median OS (59.2 vs. 41.3 months, p=0.037) compared with patients without EGFR mutation.
Conclusion
Patients with EGFR mutation–positive unresectable stage III non-squamous lung cancer exhibited higher recurrence and distant metastasis rates, especially brain metastasis.

Citations

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TFAP2A facilitates the metastasis and radioresistance of esophageal cancer by promoting EGFR transcription
Jinjin Yuan, Junqi Liu, Ruitai Fai, Zongwen Liu
Naunyn-Schmiedeberg's Archives of Pharmacology.2025;[Epub] CrossRef
Prognostic Factors in Postoperative Brain Metastases Derive From Non-small Cell Lung Cancer: A Retrospective Analysis
Haibin Chen, Liang Sun, Zhi Yang, Yuanyuan Qu, Nanyang Tong, Caixing Sun, Liang Xia
Clinical Medicine Insights: Oncology.2024;[Epub] CrossRef
Brain metastasis screening in the molecular age
Joanna K Tabor, Amanda Onoichenco, Vinayak Narayan, A Gabriella Wernicke, Randy S D’Amico, Morana Vojnic
Neuro-Oncology Advances.2023;[Epub] CrossRef

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Gastrointestinal cancer

A Phase II Study of Preoperative Chemoradiotherapy with Capecitabine Plus Simvastatin in Patients with Locally Advanced Rectal Cancer: Hyunji Jo, Seung Tae Kim, Jeeyun Lee, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Jeong Il Yu, Hee Chul Park, Doo Ho Choi, Yoonah Park, Yong Beom Cho, Jung Wook Huh, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Won Ki Kang; Cancer Res Treat. 2023;55(1):189-195. Published online June 8, 2022; DOI: https://doi.org/10.4143/crt.2021.1527

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Purpose
The purpose of this phase II trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, to preoperative chemoradiotherapy (CRT) with capecitabine confers a clinical benefit to patients with locally advanced rectal cancer (LARC).
Materials and Methods
Patients with LARC (defined by clinical stage T3/4 and/or lymph node positivity) received preoperative radiation (45-50.4 Gy in 25-28 daily fractions) with concomitant capecitabine (825 mg/m2 twice per day) and simvastatin (80 mg, daily). Curative surgery was planned 4-8 weeks after completion of the CRT regimen. The primary endpoint was pathologic complete response (pCR). The secondary endpoints included sphincter-sparing surgery, R0 resection, disease-free survival, overall survival, the pattern of failure, and toxicity.
Results
Between October 2014 and July 2017, 61 patients were enrolled; 53 patients completed CRT regimen and underwent total mesorectal excision. The pCR rate was 18.9% (n=10) by per-protocol analysis. Sphincter-sparing surgery was performed in 51 patients (96.2%). R0 resection was achieved in 51 patients (96.2%). One patient experienced grade 3 liver enzyme elevation. No patient experienced additional toxicity caused by simvastatin.
Conclusion
The combination of 80 mg simvastatin with CRT and capecitabine did not improve pCR in patients with LARC, although it did not increase toxicity.

Citations

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Short- and long-term outcomes of neoadjuvant chemotherapy compared with neoadjuvant chemoradiotherapy for locally advanced rectal cancer: an updated meta-analysis
Yue Guo, Zhifeng Guo, Jiaojiao Zhang, Guowu Qian, Wangquan Ji, Linlin Song, Zhe Guo, Zhuo Han
BMC Gastroenterology.2025;[Epub] CrossRef
Effects of Hyperlipidemia on Osseointegration of Dental Implants and Its Strategies
Haiyang Sun, Shuhuai Meng, Junyu Chen, Qianbing Wan
Journal of Functional Biomaterials.2023; 14(4): 194. CrossRef

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Role of Esophagectomy after Chemoradiation Therapy in Patients with Locally Advanced Squamous Cell Carcinoma: A Comparative Analysis Stratified by Clinical Response to Chemoradiation Therapy: Jesang Yu, Jong Hoon Kim, Sung-Bae Kim, Sook Ryun Park, Young-Hee Kim, Hyeong Ryul Kim, Hyun Joo Lee, Ho June Song, Kye Jin Song, Jeong Yun Jang, Yoon Young Jo, Ye Jin Yoo; Cancer Res Treat. 2022;54(4):1148-1156. Published online December 20, 2021; DOI: https://doi.org/10.4143/crt.2021.885

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to evaluate the long-term effect of esophagectomy in patients with esophageal squamous cell carcinoma (ESCC) by comparing the chemoradiotherapy (CRT)-only group and the trimodality treatment (TMT) group who received concurrent CRT followed by surgery.
Materials and Methods
We included 412 operable ESCC patients treated with TMT or CRT between January 2005 and December 2015. The oncological outcomes of the two groups were compared using a weighted Cox proportional-hazards model with inverse probability of treatment weighting (IPTW).
Results
The median survival time was 64 and 32 months in the TMT (n=270) and CRT (n=142) groups, respectively (p < 0.001). After IPTW, the median overall survival (OS) remained significantly higher in the TMT group than in the CRT group (61 months vs. 32 months, p=0.016). Moreover, the TMT group showed a better local recurrence-free rate (LRFR, p < 0.001) and distant metastasis-free rate (p=0.007). In the subgroup of patients with clinical complete response (cCR), the OS was not significantly different between the two groups, both before and after IPTW adjustment (p=0.35 and p=0.93). However, among non-cCR patients, the OS was significantly higher in the TMT group (64% vs. 45%, p < 0.001).
Conclusion
In patients with locally advanced ESCC, TMT was superior to CRT in terms of OS and LRFR. Such difference was more prominent in the non-cCR subgroup. In patients who achieved cCR, esophagectomy was effective in improving LRFR but not OS, suggesting that esophagectomy may be omitted in complete responders.

Citations

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Diagnosing Complete Response to Preoperative Chemoradiation in Esophageal Cancer Using Dynamic Contrast-Enhanced MRI Response Criteria
Yura Ahn, Jooae Choe, Hyun Joo Lee, Sook Ryun Park, Jong-Hoon Kim, Ho June Song, Min-Ju Kim, Yong-Hee Kim
Korean Journal of Radiology.2025; 26(3): 269. CrossRef
Comparison of esophageal cancer survival after neoadjuvant chemoradiotherapy plus surgery versus definitive chemoradiotherapy: A systematic review and meta-analysis
Junli Ke, Yujie Xie, Shenyang Huang, Wei Wang, Zhengang Zhao, Wanli Lin
Asian Journal of Surgery.2024; 47(9): 3827. CrossRef
Multi-disciplinary management of esophageal carcinoma: Current practices and future directions
Chanyoot Bandidwattanawong
Critical Reviews in Oncology/Hematology.2024; 197: 104315. CrossRef
Practice pattern and risk of not receiving planned surgery after neoadjuvant chemoradiotherapy for locally advanced oesophageal squamous cell carcinoma
Tae Hee Hong, Tae Ho Kim, Genehee Lee, Jeonghee Yun, Yeong Jeong Jeon, Junghee Lee, Sumin Shin, Seong Yong Park, Jong Ho Cho, Yong Soo Choi, Young Mog Shim, Jong-Mu Sun, Dongryul Oh, Hong Kwan Kim
European Journal of Cardio-Thoracic Surgery.2024;[Epub] CrossRef
Induction Therapy of Tislelizumab Combined with Cisplatin and 5-Fluorouracil and Subsequent Conversion Surgery in Patients with Unresectable Advanced Esophageal Squamous Cell Carcinoma: A Phase 2, Single Center Study
Tongpeng Xu, Jianan Bai, Kun Zhao, Xiaofeng Chen, Shuhui Wang, Shusheng Zhu, Chongqi Sun, Chenhui Zhao, Ting Wang, Ling Zhu, Meizhen Hu, Fei Pang, Junling Zhang, Wei Wang, Yongqian Shu, Fang Li, Yue Zhou
Annals of Surgical Oncology.2024; 31(13): 9321. CrossRef
Unveiling Therapeutic Targets for Esophageal Cancer: A Comprehensive Review
Rakesh Acharya, Ananya Mahapatra, Henu Kumar Verma, L. V. K. S. Bhaskar
Current Oncology.2023; 30(11): 9542. CrossRef
Nomogram for predicting pathologic complete response following preoperative chemoradiotherapy in patients with esophageal squamous cell carcinoma
Young Seob Shin, Jeong Yun Jang, Ye Jin Yoo, Jesang Yu, Kye Jin Song, Yoon Young Jo, Sung-Bae Kim, Sook Ryun Park, Ho June Song, Yong-Hee Kim, Hyeong Ryul Kim, Jong Hoon Kim
Gastroenterology Report.2023;[Epub] CrossRef

6,014 View
128 Download
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7 Crossref

Genitourinary Cancer

Neoadjuvant Chemotherapy–Guided Bladder-Sparing Treatment for Muscle-Invasive Bladder Cancer: Results of a Pilot Phase II Study: Hongzhe Shi, Wen Zhang, Xingang Bi, Dong Wang, Zejun Xiao, Youyan Guan, Kaopeng Guan, Jun Tian, Hongsong Bai, Linjun Hu, Chuanzhen Cao, Weixing Jiang, Zhilong Hu, Jin Zhang, Yan Chen, Shan Zheng, Xiaoli Feng, Changling Li, Yexiong Li, Jianhui Ma, Yueping Liu, Aiping Zhou, Jianzhong Shou; Cancer Res Treat. 2021;53(4):1156-1165. Published online February 10, 2021; DOI: https://doi.org/10.4143/crt.2020.1356

Abstract PDF Supplementary Material PubReader ePub

Purpose
Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy.
Materials and Methods
Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate.
Results
Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory.
Conclusion
After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.

Citations

Citations to this article as recorded by

Concomitant chemotherapy in trimodal treatment of patients with muscle invasive bladder cancer: A systematic review of prospective trials
Camille Baudelin, Paul Sargos, Derek Dinart, Christophe Hennequin, Diego Teyssonneau, Lucie Meynard, Nam-Son Vuong, Félix Lefort, Michael Baboudjian, Guilhem Roubaud
Critical Reviews in Oncology/Hematology.2025; 205: 104557. CrossRef
Does Bladder Cancer Subtype Influence Pathologic Complete Response (pCR) and Pelvic Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) Response Evaluation After Neoadjuvant Chemotherapy? Pathological Perspective
Ji Min Kim, Euno Choi, Sun Hee Sung, Jungmin Jo, Dong-Hyeon Lee, Sanghui Park
Clinical Genitourinary Cancer.2024; 22(2): 224. CrossRef
A comparative analysis of radical cystectomy with perioperative chemotherapy, chemoradiation therapy, or systemic therapy in patients with clinically advanced node-positive bladder cancer (cN2/N3)
Harshit Garg, Mukund Bhandari, Furkan Dursun, Michael A. Liss, Dharam Kaushik, Robert S. Svatek, Ahmed M. Mansour
Frontiers in Oncology.2024;[Epub] CrossRef
Clinical efficacy analysis of partial cystectomy and radical cystectomy in the treatment of muscle-invasive sarcomatoid carcinoma of the urinary bladder
Jiansheng Xiao, Hua Chen, Jiaqi Ge, Tairong Liu
Frontiers in Oncology.2024;[Epub] CrossRef
Downstaging guided neoadjuvant strategy shift and bladder preservation in locally advanced bladder cancer: A case report
Gan Du, Zhichao Jiang, Wang Qu, Jin Zhang, Shan Zheng, Yueping Liu, Aiping Zhou, Hongzhe Shi, Jianzhong Shou
Heliyon.2024; 10(6): e27685. CrossRef
Editorial: Organ-sparing surgery for genitourinary cancers
Gongwei Long, Xingyuan Xiao, Haoran Liu, Yucong Zhang, Chunguang Yang
Frontiers in Oncology.2024;[Epub] CrossRef
News and prospects on radiotherapy for bladder cancer: Is trimodal therapy becoming the gold standard?
Olivier Riou, Christophe Hennequin, Jonathan Khalifa, Paul Sargos
Cancer/Radiothérapie.2024; 28(6-7): 623. CrossRef
Health-related quality of life after curative treatment for muscle-invasive bladder cancer
Elisabeth Grobet-Jeandin, Ugo Pinar, Jérôme Parra, Morgan Rouprêt, Thomas Seisen
Nature Reviews Urology.2023; 20(5): 279. CrossRef
Combined Modality Bladder-Sparing Therapy for Muscle-Invasive Bladder Cancer: How (Should) We Do It? A Narrative Review
Artur Lemiński, Wojciech Michalski, Bartłomiej Masojć, Krystian Kaczmarek, Bartosz Małkiewicz, Jakub Kienitz, Barbara Zawisza-Lemińska, Michał Falco, Marcin Słojewski
Journal of Clinical Medicine.2023; 12(4): 1560. CrossRef
Survival after sequential neoadjuvant chemotherapy followed by trimodal treatment or radical cystectomy for muscle-invasive bladder cancer
Pierre-Louis Reignier, Hélène Gauthier, Christophe Hennequin, Quiterie Aussedat, Evanguelos Xylinas, François Desgrandchamps, Stéphane Culine, Alexandra Masson-Lecomte, Clément Dumont
World Journal of Urology.2023; 41(11): 3249. CrossRef
Neoadjuvant chemotherapy with gemcitabine and cisplatin followed by selective bladder preservation chemoradiotherapy in muscle-invasive urothelial carcinoma of bladder
Hyun Hwan Sung, Hana Kim, Ryul Kim, Chan Kyo Kim, Ghee Young Kwon, Won Park, Wan Song, Byong Chang Jeong, Se Hoon Park
Investigative and Clinical Urology.2022; 63(2): 168. CrossRef
Disease Management of Clinical Complete Responders to Neoadjuvant Chemotherapy of Muscle-Invasive Bladder Cancer: A Review of Literature
Jie Wu, Rui-Yang Xie, Chuan-Zhen Cao, Bing-Qing Shang, Hong-Zhe Shi, Jian-Zhong Shou
Frontiers in Oncology.2022;[Epub] CrossRef
Contemporary Staging for Muscle-Invasive Bladder Cancer: Accuracy and Limitations
Patrick J. Hensley, Valeria Panebianco, Eugene Pietzak, Alexander Kutikov, Raghu Vikram, Matthew D. Galsky, Shahrokh F. Shariat, Morgan Roupret, Ashish M. Kamat
European Urology Oncology.2022; 5(4): 403. CrossRef

13,059 View
200 Download
14 Web of Science
13 Crossref

Gastrointestinal Cancer

Phase II Trial of Postoperative Adjuvant Gemcitabine and Cisplatin Chemotherapy Followed by Chemoradiotherapy with Gemcitabine in Patients with Resected Pancreatic Cancer: Kyung-Hun Lee, Eui Kyu Chie, Seock-Ah Im, Jee Hyun Kim, Jihyun Kwon, Sae-Won Han, Do-Youn Oh, Jin-Young Jang, Jae-Sung Kim, Tae-You Kim, Yung-Jue Bang, Sun Whe Kim, Sung W. Ha; Cancer Res Treat. 2021;53(4):1096-1103. Published online December 30, 2020; DOI: https://doi.org/10.4143/crt.2020.928

Abstract PDF PubReader ePub

Purpose
Despite curative resection, the 5-year survival for patients with resectable pancreatic cancer is less than 20%. Recurrence occurs both locally and at distant sites and effective multimodality adjuvant treatment is needed.
Materials and Methods
Patients with curatively resected stage IB-IIB pancreatic adenocarcinoma were eligible. Treatment consisted of chemotherapy with gemcitabine 1,000 mg/m² on days 1 and 8 and cisplatin 60 mg/m² on day 1 every 3 weeks for two cycles, followed by chemoradiotherapy (50.4 Gy/28 fx) with weekly gemcitabine (300 mg/m²/wk), and then gemcitabine 1,000 mg/m² on days 1 and 8 every 3 weeks for four cycles. The primary endpoint was 1-year disease-free survival rate. The secondary endpoints were disease-free survival, overall survival, and safety.
Results
Seventy-four patients were enrolled. One-year disease-free survival rate was 57.9%. Median disease-free and overall survival were 15.0 months (95% confidence interval [CI], 11.6 to 18.4) and 33.0 months (95% CI, 21.8 to 44.2), respectively. At the median follow-up of 32 months, 57 patients (77.0%) had recurrence including 11 patients whose recurrence was during the adjuvant treatment. Most of the recurrences were systemic (52 patients). Stage at the time of diagnosis (70.0% in IIA, 51.2% in IIB, p=0.006) were significantly related with 1-year disease-free survival rate. Toxicities were generally tolerable, with 53 events of grade 3 or 4 hematologic toxicity and four patients with febrile neutropenia.
Conclusion
Adjuvant gemcitabine and cisplatin chemotherapy followed by chemoradiotherapy with gemcitabine and maintenance gemcitabine showed efficacy and good tolerability in curatively resected pancreatic cancer.

Citations

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NUDT21 interacts with NDUFS2 to activate the PI3K/AKT pathway and promotes pancreatic cancer pathogenesis
Xiao-Dong Huang, Yong-Wei Chen, Lv Tian, Li Du, Xiao-Chen Cheng, Yu-Xin Lu, Dong-Dong Lin, Feng-Jun Xiao
Journal of Cancer Research and Clinical Oncology.2024;[Epub] CrossRef
Efficacy of Cisplatin-Containing Chemotherapy Regimens in Patients of Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-analysis
Obaid Ur Rehman, Eeshal Fatima, Zain Ali Nadeem, Arish Azeem, Jatin Motwani, Habiba Imran, Hadia Mehboob, Alishba Khan, Omer Usman
Journal of Gastrointestinal Cancer.2024; 55(2): 559. CrossRef
OTUB1/NDUFS2 axis promotes pancreatic tumorigenesis through protecting against mitochondrial cell death
Xiao-Dong Huang, Li Du, Xiao-Chen Cheng, Yu-Xin Lu, Qiao-Wei Liu, Yi-Wu Wang, Ya-Jin Liao, Dong-Dong Lin, Feng-Jun Xiao
Cell Death Discovery.2024;[Epub] CrossRef
Impact of obesity on pathological complete remission in early stage breast cancer patients after neoadjuvant chemotherapy: a retrospective study from a German University breast center
Johannes Felix Englisch, Alexander Englisch, Dominik Dannehl, Kenneth Eissler, Christian Martin Tegeler, Sabine Matovina, Léa Louise Volmer, Diethelm Wallwiener, Sara Y. Brucker, Andreas Hartkopf, Tobias Engler
Archives of Gynecology and Obstetrics.2024; 311(2): 437. CrossRef
A Photothermal Therapy Study Based on Electrospinning Nanofibers Blended and Coated with Polydopamine Nanoparticles
Chunhong Sui, Yijia Luo, Xiao Xiao, Jiaxue Liu, Xiaotong Shao, Yingxue Xue, Cheng Wang, Wenliang Li
ChemistrySelect.2023;[Epub] CrossRef
Ivermectin and gemcitabine combination treatment induces apoptosis of pancreatic cancer cells via mitochondrial dysfunction
Da Eun Lee, Hyeon Woong Kang, So Yi Kim, Myeong Jin Kim, Jae Woong Jeong, Woosol Chris Hong, Sungsoon Fang, Hyung Sun Kim, Yun Sun Lee, Hyo Jung Kim, Joon Seong Park
Frontiers in Pharmacology.2022;[Epub] CrossRef
CircLMTK2 Silencing Attenuates Gemcitabine Resistance in Pancreatic Cancer by Sponging miR-485-5p and to Target PAK1
Yeting Lu, Shuping Zhou, Gong Cheng, Yi Ruan, Yuan Tian, Kaiji Lv, Shuo Han, Xinhua Zhou, Xiangya Ding
Journal of Oncology.2022; 2022: 1. CrossRef
Effects of Radiotherapy and Chemotherapy on Postoperative Prognosis of Patients Undergoing Radical Surgery for Pancreatic Cancer—Based on SEER Database Analysis
媛媛苏
Advances in Clinical Medicine.2022; 12(10): 9540. CrossRef
Zebrafish Patient-Derived Xenografts Identify Chemo-Response in Pancreatic Ductal Adenocarcinoma Patients
Alice Usai, Gregorio Di Franco, Margherita Piccardi, Perla Cateni, Luca Emanuele Pollina, Caterina Vivaldi, Enrico Vasile, Niccola Funel, Matteo Palmeri, Luciana Dente, Alfredo Falcone, Dimitri Giunchi, Alessandro Massolo, Vittoria Raffa, Luca Morelli
Cancers.2021; 13(16): 4131. CrossRef
Hypoxia-Induced ZWINT Mediates Pancreatic Cancer Proliferation by Interacting With p53/p21
Peng Chen, Zhiwei He, Jie Wang, Jian Xu, Xueyi Jiang, Yankun Chen, Xinyuan Liu, Jianxin Jiang
Frontiers in Cell and Developmental Biology.2021;[Epub] CrossRef

6,925 View
153 Download
10 Crossref

Central nervous system

Clinical and Genomic Characteristics of Adult Diffuse Midline Glioma: Changhee Park, Tae Min Kim, Jeong Mo Bae, Hongseok Yun, Jin Wook Kim, Seung Hong Choi, Soon-Tae Lee, Joo Ho Lee, Sung-Hye Park, Chul-Kee Park; Cancer Res Treat. 2021;53(2):389-398. Published online November 9, 2020; DOI: https://doi.org/10.4143/crt.2020.694

Abstract PDF Supplementary Material PubReader ePub

Purpose
The treatment outcomes and genomic profiles of diffuse midline glioma (DMG) in adult patients are rarely characterized. We performed a retrospective study to evaluate the clinicogenomic profiles of adult patients with brain DMG.
Materials and Methods
Patients aged ≥ 18 years diagnosed with brain DMG at Seoul National University Hospital were included. The clinicopathological parameters, treatment outcomes, survival, and genomic profiles using 82-gene targeted next-generation sequencing (NGS) were analyzed. The 6-month progression-free survival (PFS6) after radiotherapy and overall survival (OS) were evaluated.
Results
Thirty-three patients with H3-mutant brain DMG were identified. The median OS from diagnosis was 21.8 months (95% confidence interval [CI], 13.2 to not available [NA]) and involvement of the ponto-medullary area tended to have poor OS (median OS, 20.4 months [95% CI, 9.3 to NA] vs. 43.6 months [95% CI, 18.2 to NA]; p=0.07). Twenty-four patients (72.7%) received radiotherapy with or without temozolomide. The PFS6 rate was 83.3% (n=20). Patients without progression at 6 months showed significantly prolonged OS compared with those with progression at 6 months (median OS, 24.9 months [95% CI, 20.4 to NA] vs. 10.8 months [95% CI, 4.0 to NA]; p=0.02, respectively). Targeted NGS was performed in 13 patients with DMG, among whom nine (69.2%) harbored concurrent TP53 mutation. Two patients (DMG14 and DMG23) with PIK3CA^R38S+E545K and KRAS^G12A mutations received matched therapies. Patient DMG14 received sirolimus with a PFS of 8.4 months.
Conclusion
PFS6 after radiotherapy was associated with prolonged survival in adult patients with DMG. Genome-based matched therapy may be an encouraging approach for progressive adult patients with DMG.

Citations

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The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study
Vincenzo Di Nunno, Giuseppe Lombardi, Matteo Simonelli, Giuseppe Minniti, Angela Mastronuzzi, Valentina Di Ruscio, Martina Corrà, Marta Padovan, Marta Maccari, Mario Caccese, Giorgia Simonetti, Arianna Berlendis, Mariangela Farinotti, Bianca Pollo, Manila
Journal of Neuro-Oncology.2024; 167(1): 145. CrossRef
Neuroradiological, genetic and clinical characteristics of histone H3 K27-mutant diffuse midline gliomas in the Kansai Molecular Diagnosis Network for CNS Tumors (Kansai Network): multicenter retrospective cohort
Nobuhide Hayashi, Junya Fukai, Hirokazu Nakatogawa, Hiroshi Kawaji, Ema Yoshioka, Yoshinori Kodama, Kosuke Nakajo, Takehiro Uda, Kentaro Naito, Noriyuki Kijima, Yoshiko Okita, Naoki Kagawa, Yoshinobu Takahashi, Naoya Hashimoto, Hideyuki Arita, Koji Takano
Acta Neuropathologica Communications.2024;[Epub] CrossRef
Genetic alteration analysis of non-pediatric diffuse midline glioma, H3 K27-altered
Hanbin Jang, Seyoung Moon, Hyun Jung Kwon, Sejoon Lee, Gheeyoung Choe, Kyu Sang Lee
Human Pathology.2024; 154: 105709. CrossRef
How to treat histone 3 altered gliomas: molecular landscape and therapeutic developments
Vincenzo Di Nunno, Enrico Franceschi, Lidia Gatto, Alicia Tosoni, Stefania Bartolini, Alba Ariela Brandes
Expert Review of Clinical Pharmacology.2023; 16(1): 17. CrossRef
Genomic profiles of IDH-mutant gliomas: MYCN-amplified IDH-mutant astrocytoma had the worst prognosis
Kwanghoon Lee, Seong-Ik Kim, Eric Eunshik Kim, Yu-Mi Shim, Jae-Kyung Won, Chul-Kee Park, Seung Hong Choi, Hongseok Yun, Hyunju Lee, Sung-Hye Park
Scientific Reports.2023;[Epub] CrossRef
Radiotherapy and radio‐sensitization in H3K27M‐mutated diffuse midline gliomas
Chao Liu, Shuwen Kuang, Lei Wu, Quan Cheng, Xuan Gong, Jun Wu, Longbo Zhang
CNS Neuroscience & Therapeutics.2023; 29(7): 1721. CrossRef
Volumetric response and pattern of failure of histone altered high grade glioma in adults following management with radiation therapy
A. Knight, P. Horsley, A. Yuile, J. Yim, M. Suh, V. Venketesha, M. Kastelan, H. Wheeler, M. Back
Journal of Neuro-Oncology.2023; 163(1): 281. CrossRef
Differences in survival prognosticators between children and adults with H3K27M‐mutant diffuse midline glioma
Xuan Gong, Shuwen Kuang, Dongfeng Deng, Jun Wu, Longbo Zhang, Chao Liu
CNS Neuroscience & Therapeutics.2023; 29(12): 3863. CrossRef
Adult spinal cord diffuse midline glioma, H3 K27-altered mimics symptoms of central nervous system infection: a case report
Xue Chen, Yi Li, Hui Bu, YueLi Zou, JunYing He, Hu Liu
Frontiers in Neurology.2023;[Epub] CrossRef
Clinicogenetic characteristics and the effect of radiation on the neural stem cell niche in subventricular zone-contacting glioblastoma
Jee Ye Kahng, Byung-Hee Kang, Soon-Tae Lee, Seung Hong Choi, Tae Min Kim, Chul-Kee Park, Jae-Kyung Won, Sung-Hye Park, Jaeman Son, Joo Ho Lee
Radiotherapy and Oncology.2023; 186: 109800. CrossRef
H3 K27M-Altered Diffuse Midline Gliomas: A Review
Karol Wiśniewski, Andrew Ghaly, Kate Drummond, Andreas Fahlstrӧm
Indian Journal of Neurosurgery.2023; 12(02): 104. CrossRef
Adult diffuse midline gliomas H3 K27-altered: review of a redefined entity
Carlos Axel López-Pérez, Xochitl Franco-Mojica, Ricardo Villanueva-Gaona, Alexandra Díaz-Alba, Marco Antonio Rodríguez-Florido, Victor Garcia Navarro
Journal of Neuro-Oncology.2022; 158(3): 369. CrossRef
H3K27M-Altered Diffuse Midline Gliomas Among Adult Patients: A Systematic Review of Clinical Features and Survival Analysis
Othman Bin-Alamer, Adrian E. Jimenez, Tej D. Azad, Chetan Bettegowda, Debraj Mukherjee
World Neurosurgery.2022; 165: e251. CrossRef
Molecular profile and clinical features of patients with gliomas using a broad targeted next generation‑sequencing panel
Ourania Romanidou, Paraskevi Apostolou, Kyriakos Kouvelakis, Kyriakos Tsangaras, Alexia Eliades, Achilleas Achilleos, Charalambos Loizides, Christos Lemesios, Marios Ioannides, Elena Kypri, George Koumbaris, Kyriaki Papadopoulou, Athanasios Papathanasiou,
Oncology Letters.2022;[Epub] CrossRef

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231 Download
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14 Crossref

Gastrointestinal cancer

Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma Incorporating Hematological Biomarkers: Yingjia Wu, Jinbin Chen, Lei Zhao, Qiaoqiao Li, Jinhan Zhu, Hong Yang, Suping Guo, Mian Xi; Cancer Res Treat. 2021;53(1):172-183. Published online September 4, 2020; DOI: https://doi.org/10.4143/crt.2020.594

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to develop a nomogram for predicting pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC) by integrating hematological biomarkers and clinicopathological characteristics.
Materials and Methods
Between 2003 and 2017, 306 ESCC patients who underwent neoadjuvant CRT followed by esophagectomy were analyzed. Besides clinicopathological factors, hematological parameters before, during, and after CRT were collected. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for pCR. A nomogram model was built and internally validated.
Results
Absolute lymphocyte count (ALC), lymphocyte to monocyte ratio, albumin, hemoglobin, white blood cell, neutrophil, and platelet count generally declined, whereas neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) increased significantly following neoadjuvant CRT. After surgery, 124 patients (40.5%) achieved a pCR. The pCR group demonstrated significantly more favorable survival than the non-pCR group. On multivariate analysis, significant factors associated with pCR included sex, chemotherapy regimen, post-CRT endoscopic finding, pre-CRT NLR, ALC nadir during CRT, and post-CRT PLR, which were incorporated into the prediction model. The nomogram indicated good accuracy in predicting pCR, with a C-index of 0.75 (95% confidence interval, 0.71 to 0.78).
Conclusion
Female, chemotherapy regimen of cisplatin/vinorelbine, negative post-CRT endoscopic finding, pre-CRT NLR (≤ 2.1), ALC nadir during CRT (> 0.35 ×10⁹/L), and post-CRT PLR (≤ 83.0) were significantly associated with pCR in ESCC patients treated with neoadjuvant CRT. A nomogram incorporating hematological biomarkers to predict pCR was developed and internally validated, showing good predictive performance.

Citations

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Meng Zhang, Yukun Lu, Hongfu Sun, Chuanke Hou, Zichun Zhou, Xiao Liu, Qichao Zhou, Zhenjiang Li, Yong Yin
Translational Oncology.2024; 39: 101804. CrossRef
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Wei-Xiang Qi, Shuyan Li, Jifeng Xiao, Huan Li, Jiayi Chen, Shengguang Zhao
Frontiers in Immunology.2024;[Epub] CrossRef
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Xing Gao, Hidde C G Overtoom, Ben M Eyck, Shi-Han Huang, Daan Nieboer, Pieter C van der Sluis, Sjoerd M Lagarde, Bas P L Wijnhoven, Yin-Kai Chao, Jan J B van Lanschot
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Yunsong Liu, Zeliang Ma, Yongxing Bao, Xin Wang, Yu Men, Xujie Sun, Feng Ye, Kuo Men, Jianjun Qin, Nan Bi, Liyan Xue, Zhouguang Hui
Heliyon.2024; 10(13): e33702. CrossRef
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Esra KEKİLLİ, Ebru ATASEVER AKKAŞ, Serab UYAR, Emre YEKEDÜZ
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Yalan Yang, Dao Xin, Huike Wang, Lulu Guan, Xiangrui Meng, Taiying Lu, Xiwen Bai, Feng Wang
Journal of Inflammation Research.2023; Volume 16: 1443. CrossRef
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Esophagus.2023; 20(4): 691. CrossRef
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Wei‐Xiang Qi, Xiaoyan Wang, Chengqiang Li, Shuyan Li, Huan Li, Feifei Xu, Jiayi Chen, Shengguang Zhao, Hecheng Li
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Lian-Qiang Han, Ting-Ting Cui, Nian-Jun Xiao, Wen Li
Journal of Cancer Research and Clinical Oncology.2023; 149(17): 15413. CrossRef
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Dan He, Shulan Du, Songyuan He, Hao Song, Bo Pu, Guojun Zhang, Chuan Yang
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Young Seob Shin, Jeong Yun Jang, Ye Jin Yoo, Jesang Yu, Kye Jin Song, Yoon Young Jo, Sung-Bae Kim, Sook Ryun Park, Ho June Song, Yong-Hee Kim, Hyeong Ryul Kim, Jong Hoon Kim
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Yaotian Zhang, Ning Han, Xue Zeng, Chaonan Sun, Shichen Sun, Xinchi Ma, Yanyu Zhang, Zhuang Liu, Zilan Qin, Hong Guo, Yubing Li, Na Zhang, Bruno Vincenzi
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Xiaoyan Sun, Yingnan Feng, Bin Zhang, Wuhao Huang, Xiaoliang Zhao, Hua Zhang, Dongsheng Yue, Changli Wang
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The predictive value of peripheral blood cells and lymphocyte subsets in oesophageal squamous cell cancer patients with neoadjuvant chemoradiotherapy
Jin Zhou, Hai-Ping Lin, Xin Xu, Xiao-Hang Wang, Ling Rong, Yao Zhang, Lei Shen, Lei Xu, Wei-Ting Qin, Qing Ye, Xiu-Mei Ma, Yong-Rui Bai
Frontiers in Immunology.2022;[Epub] CrossRef

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Associations of Genetic Variations in Mismatch Repair Genes MSH3 and PMS1 with Acute Adverse Events and Survival in Patients with Rectal Cancer Receiving Postoperative Chemoradiotherapy: Jie Yang, Ying Huang, Yanru Feng, Hongmin Li, Ting Feng, Jinna Chen, Luxi Yin, Weihu Wang, Shulian Wang, Yueping Liu, Yongwen Song, Yexiong Li, Jing Jin, Wen Tan, Dongxin Lin; Cancer Res Treat. 2019;51(3):1198-1206. Published online December 26, 2018; DOI: https://doi.org/10.4143/crt.2018.527

Abstract PDF Supplementary Material PubReader ePub

Purpose
Mismatch repair (MMR) deficiency plays a critical role in rectal cancer. This study aimed to explore the associations between genetic variations in seven MMR genes and adverse events (AEs) and survival of patients with rectal cancer treated with postoperative chemoradiotherapy (CRT).
Materials and Methods
Fifty single nucleotide polymorphisms in seven MMR (MLH1, MLH3, MSH2, MSH3, MSH6, PMS1 and PMS2) genes were genotyped by Sequenom MassARRAY method in 365 patients with locally advanced rectal cancer receiving postoperative CRT. The associations between genotypes and AEs were measured by odds ratios and 95% confidence intervals (CIs) by unconditional logistic regression model. The associations between genetic variations and survival were computed by the hazard ratios and 95% CIs by Cox proportional regression model.
Results
The most common grade ≥ 2 AEs in those 365 patients, in decreasing order, were diarrhea (44.1%), leukopenia (29.6%), and dermatitis (18.9%). Except 38 cases missing, 61 patients (18.7%) died during the follow-up period. We found MSH3 rs12513549, rs33013 and rs6151627 significantly associated with the risk of grade ≥ 2 diarrhea. PMS1 rs1233255 had an impact on the occurrence of grade ≥2 dermatitis. Meanwhile, PMS1 rs4920657, rs5743030, and rs5743100 were associated with overall survival (OS) time of rectal cancer.
Conclusion
These results suggest that MSH3 and PMS1 polymorphisms may play important roles in AEs prediction and prognosis of rectal cancer patients receiving postoperative CRT, which can be potential genetic biomarkers for rectal cancer personalized treatment.

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CircPMS1 promotes proliferation of pulmonary artery smooth muscle cells, pulmonary microvascular endothelial cells, and pericytes under hypoxia
Xiaoyi Hu, Shang Wang, Hui Zhao, Yaqin Wei, Ruowang Duan, Rong Jiang, Wenhui Wu, Qinhua Zhao, Sugang Gong, Lan Wang, Jinming Liu, Ping Yuan
Animal Models and Experimental Medicine.2024; 7(3): 310. CrossRef
Systematic Review of Genetic Polymorphisms Associated with Acute Pain Induced by Radiotherapy for Head and Neck Cancers
Vivian Salama, Yimin Geng, Jillian Rigert, Clifton D. Fuller, Sanjay Shete, Amy C. Moreno
Clinical and Translational Radiation Oncology.2023; 43: 100669. CrossRef
Tumor-infiltrating lymphocytes, PD-L1, and MMR-deficiency combined characterization may identify subgroups of rectal cancer patients who would benefit from immunotherapy
Alexandra Giatromanolaki, Christos Kavazis, Anastasia G. Gkegka, Maria Kouroupi, Alexandra Tsaroucha, Michael Pitiakoudis, Michael I. Koukourakis
Immunobiology.2023; 228(6): 152756. CrossRef
SYVN1‐mediated ubiquitination and degradation of MSH3 promotes the apoptosis of lens epithelial cells
Xiaojuan Chen, Guowei Zhang, Pengfei Li, Jianfeng Yu, Lihua Kang, Bai Qin, Ying Wang, Jian Wu, Yong Wang, Junfang Zhang, Miaomiao Qin, Huaijin Guan
The FEBS Journal.2022; 289(18): 5682. CrossRef
Dietary methyl donor nutrients, DNA mismatch repair polymorphisms, and risk of colorectal cancer based on microsatellite instability status
Jimi Kim, Jeonghee Lee, Jae Hwan Oh, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim, Hee Jin Chang
European Journal of Nutrition.2022; 61(6): 3051. CrossRef
Identification of a novel germline frameshift mutation p.D300fs of PMS1 in a patient with hepatocellular carcinoma
Xiaobin Li, Yuling Wu, Peisu Suo, Guifeng Liu, Lifeng Li, Xiaoni Zhang, Shifu Chen, Mingyan Xu, Lele Song
Medicine.2020; 99(5): e19076. CrossRef
Potential Functional Variants in DNA Repair Genes Are Associated with Efficacy and Toxicity of Radiotherapy in Patients with Non-Small-Cell Lung Cancer
Zhiguang Yang, Zhaoyu Liu
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Micronuclei Formation upon Radioiodine Therapy for Well-Differentiated Thyroid Cancer: The Influence of DNA Repair Genes Variants
Luís S. Santos, Octávia M. Gil, Susana N. Silva, Bruno C. Gomes, Teresa C. Ferreira, Edward Limbert, José Rueff
Genes.2020; 11(9): 1083. CrossRef

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Impact of Mucin Proportion in the Pretreatment MRI on the Outcomes of Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiotherapy: Eunji Kim, Kyubo Kim, Se Hyung Kim, Sae-Won Han, Tae-You Kim, Seung-Yong Jeong, Kyu Joo Park, Jaemoon Koh, Gyeong Hoon Kang, Eui Kyu Chie; Cancer Res Treat. 2019;51(3):1188-1197. Published online December 20, 2018; DOI: https://doi.org/10.4143/crt.2018.434

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to evaluate treatment response to neoadjuvant chemoradiotherapy (CRT) with regard to mucin status in pathology and pretreatment magnetic resonance imaging (MRI) in locally advanced rectal cancer.
Materials and Methods
Between 2003 and 2011, 306 patients with locally advanced rectal cancer received neoadjuvant CRT followed by surgery, and mucinous adenocarcinoma (MAC) was found in 27 (8.8%). All MAC patients had MRI before and after CRT and mucin proportion at MRI was measured. Therapeutic response was assessed by pathology after total mesorectal excision. To determine the optimal cut-off for mucin proportion in predicting good CRT response (near total or total regression) and negative circumferential resection margin (CRM), the receiver-operating characteristic analysis was performed.
Results
After neoadjuvant CRT, overall downstaging occurred in 44.4% of MAC and 72.4% of non-MAC (p=0.001), and positive CRM (≤1 mm) was observed more frequently in MAC (p<0.001). The optimal threshold for treatment response was 30% for mucin proportion, and there are nine with low mucin proportion (<30%) and 18 with high mucin proportion (≥30%) in pretreatment MRI. Negative CRM and tumor downstaging occurred more common in patients with mucin <30%, although statistically insignificant (p=0.071 and p=0.072, respectively). Regarding oncologic outcomes, lower mucin proportion in pretreatment MRI was associated with better disease-free and overall survival in MAC group (p=0.092 and 0.056, respectively), but the difference did not reach statistical significance.
Conclusion
Poor treatment outcome with neoadjuvant CRT was observed in patients with MAC, especially those with high mucin proportion at pretreatment MRI.

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Mucinous histology is a negative predictor of neoadjuvant chemoradiotherapy for locally advanced rectal adenocarcinoma
Xiangwen Tan, Yiwei Zhang, Xiaofeng Wu, Qing Fang, Yunhua Xu, Shuxiang Li, Jinyi Yuan, Xiuda Peng, Kai Fu, Shuai Xiao
BMC Gastroenterology.2024;[Epub] CrossRef
Incomplete Resection Is Twice as Likely in Locally Advanced Mucinous Compared to Nonmucinous Rectal Adenocarcinoma: A National Propensity‐Matched Analysis
Leah E. Hendrick, Samer Naffouje, Iman Imanirad, Allan Lima Pereira, Tiago Biachi, Julian Sanchez, Sophie Dessureault, Amalia Stefanou, Sean P. Dineen, Seth Felder
Journal of Surgical Oncology.2024;[Epub] CrossRef
Accelerated T2W Imaging with Deep Learning Reconstruction in Staging Rectal Cancer: A Preliminary Study
Lan Zhu, Bowen Shi, Bei Ding, Yihan Xia, Kangning Wang, Weiming Feng, Jiankun Dai, Tianyong Xu, Baisong Wang, Fei Yuan, Hailin Shen, Haipeng Dong, Huan Zhang
Journal of Imaging Informatics in Medicine.2024;[Epub] CrossRef
Mucinous rectal cancers: clinical features and prognosis in a population-based cohort
Malin Enblad, Klara Hammarström, Joakim Folkesson, Israa Imam, Milan Golubovik, Bengt Glimelius
BJS Open.2022;[Epub] CrossRef
Mucin-Containing Rectal Cancer: A Review of Unique Imaging, Pathology, and Therapeutic Response Features
David D. Childs, Caio Max Sao Pedro Rocha Lima, Yi Zhou
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Advances in radiological staging of colorectal cancer
R.J. Goiffon, A. O'Shea, M.G. Harisinghani
Clinical Radiology.2021; 76(12): 879. CrossRef
A Comprehensive Evaluation of Associations Between Routinely Collected Staging Information and The Response to (Chemo)Radiotherapy in Rectal Cancer
Klara Hammarström, Israa Imam, Artur Mezheyeuski, Joakim Ekström, Tobias Sjöblom, Bengt Glimelius
Cancers.2020; 13(1): 16. CrossRef

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EGFR Mutation Is Associated with Short Progression-Free Survival in Patients with Stage III Non-squamous Cell Lung Cancer Treated with Concurrent Chemoradiotherapy: Song Ee Park, Jae Myoung Noh, You Jin Kim, Han Sang Lee, Jang Ho Cho, Sung Won Lim, Yong Chan Ahn, Hongryull Pyo, Yoon-La Choi, Joungho Han, Jong-Mu Sun, Se Hoon Lee, Jin Seok Ahn, Keunchil Park, Myung-Ju Ahn; Cancer Res Treat. 2019;51(2):493-501. Published online June 18, 2018; DOI: https://doi.org/10.4143/crt.2018.125

Abstract PDF PubReader ePub

Purpose
This study was conducted to evaluate the relationship between epidermal growth factor receptor (EGFR) mutation and clinical outcomes in patients with stage III non-squamous cell lung cancer treated with definitive concurrent chemoradiotherapy (CCRT).
Materials and Methods
From January 2008 to December 2013, the medical records of 197 patients with stage III non- squamous non-small cell lung cancer treated with definitive CCRT were analyzed to determine progression-free survival (PFS) and overall survival (OS) according to EGFR mutation status.
Results
Among 197 eligible patients, 81 patients were EGFR wild type, 36 patients had an EGFR mutation (exon 19 Del, n=18; L858R, n=9, uncommon [G719X, L868, T790M], n=9), and 80 patients had unknown EGFR status. The median age was 59 years (range, 28 to 80 years) and 136 patients (69.0%) were male. The median follow-up duration was 66.5 months (range, 1.9 to 114.5 months). One hundred sixty-four patients (83.2%) experienced disease progression. Median PFS was 8.9 months for the EGFR mutation group, 11.8 months for EGFR wild type, and 10.5 months for the unknown EGFR group (p=0.013 and p=0.042, respectively). The most common site of metastasis in the EGFR mutant group was the brain. However, there was no significant difference in OS among the three groups (34.6 months for EGFR mutant group vs. 31.9 months for EGFR wild type vs. 22.6 months for EGFR unknown group; p=0.792 and p=0.284). A total of 29 patients (80.6%) with EGFR mutation were treated with EGFR tyrosine kinase inhibitor (gefitinib, n=24; erlotinib, n=3; afatinib, n=2) upon progression.
Conclusion
EGFR mutation is associatedwith short PFS and the brain is the most common site of distant metastasis in patients with stage III non- squamous cell lung cancer treated with CCRT.

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Induction Chemotherapy Plus Concurrent Chemoradiotherapy Versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma in Children and Adolescents: A Matched Cohort Analysis: Yang Li, Lin-Quan Tang, Li-Ting Liu, Shan-Shan Guo, Yu-Jing Liang, Xue-Song Sun, Qing-Nan Tang, Jin-Xin Bei, Jing Tan, Shuai Chen, Jun Ma, Chong Zhao, Qiu-Yan Chen, Hai-Qiang Mai; Cancer Res Treat. 2018;50(4):1304-1315. Published online January 8, 2018; DOI: https://doi.org/10.4143/crt.2017.463

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to evaluate the long-term clinical outcome and toxicity of induction chemotherapy (IC) followed by concomitant chemoradiotherapy (CCRT) compared with CCRT alone for the treatment of children and adolescent locoregionally advanced nasopharyngeal carcinoma (LACANPC).
Materials and Methods
A total of 194 locoregionally advanced nasopharyngeal carcinoma patients youngerthan 21 years who received CCRT with or without IC before were included in the study population. Overall survival (OS) rate, progression-free survival (PFS) rate, locoregional recurrence-free survival (LRFS) rate, and distant metastasis-free survival (DMFS) rate were assessed by the Kaplan-Meier method and a log-rank test. Treatment toxicities were clarified and compared between two groups.
Results
One hundred and thiry of 194 patients received IC+CCRT. Patients who were younger and with more advanced TNM stage were more likely to receive IC+CCRT and intensive modulated radiotherapy. The addition of IC before CCRT failed to improve survival significantly. The matched analysis identified 43 well-balanced patients in both two groups. With a median follow-up of 51.5 months, no differences were found between the IC+CCRT group and the CCRT group in 5-year OS (83.7% vs. 74.6%, p=0.153), PFS (79.2% vs. 73.4%, p=0.355), LRFS (97.7% vs. 88.2%, p=0.083), and DMFS (81.6% vs. 81.6%, p=0.860). N3 was an independent prognostic factor predicting poorer OS, PFS, and DMFS. The addition of IC was associated with increased rates of grade 3 to 4 neutropenia.
Conclusion
This study failed to demonstrate that adding IC before CCRT could provide a significant additional survival benefit for LACANPC patients. Further investigations are warranted.

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Naoya Murakami, Taisuke Mori, Yuko Kubo, Seiichi Yoshimoto, Kimiteru Ito, Yoshitaka Honma, Takao Ueno, Kenya Kobayashi, Hiroyuki Okamoto, Narikazu Boku, Kana Takahashi, Koji Inaba, Kae Okuma, Hiroshi Igaki, Yuko Nakayama, Jun Itami
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The efficacy and safety of induction chemotherapy combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in nasopharyngeal carcinoma patients: a systematic review and meta-analysis
Bi-Cheng Wang, Bo-Ya Xiao, Guo-He Lin, Chang Wang, Quentin Liu
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Update in pediatric nasopharyngeal undifferentiated carcinoma
Line Claude, Emmanuel Jouglar, Loig Duverge, Daniel Orbach
The British Journal of Radiology.2019;[Epub] CrossRef

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The Impact of Surgical Timing on Pathologic Tumor Response after Short Course and Long Course Preoperative Chemoradiation for Locally Advanced Rectal Adenocarcinoma: Sea-Won Lee, Jong Hoon Lee, In Kyu Lee, Seong Taek Oh, Dae Yong Kim, Tae Hyun Kim, Jae Hwan Oh, Ji Yeon Baek, Hee Jin Chang, Hee Chul Park, Hee Cheol Kim, Eui Kyu Chie, Taek-Keun Nam, Hong Seok Jang; Cancer Res Treat. 2018;50(3):1039-1050. Published online November 21, 2017; DOI: https://doi.org/10.4143/crt.2017.252

Abstract PDF PubReader ePub

Purpose
A pooled analysis of multi-institutional trials was performed to analyze the effect of surgical timing on tumor response by comparing short course concurrent chemoradiotherapy (CCRT) with long course CCRT followed by delayed surgery in locally advanced rectal cancer.
Materials and Methods
Three hundred patients with cT3-4N0-2 rectal adenocarcinoma were included. Long course patients from KROG 14-12 (n=150) were matched 1:1 to 150 short course patients from KROG 10-01 (NCT01129700) and KROG 11-02 (NCT01431599) according to stage, age, and other risk factors. The primary endpoint was to determine the interval between surgery and the last day of neoadjuvant CCRT which yields the best tumor response after the short course and long course CCRT. Downstaging was defined as ypT0-2N0M0 and pathologic complete response (ypCR) was defined as ypT0N0M0, respectively.
Results
Both the long and short course groups achieved lowest downstaging rates at < 6 weeks (long 20% vs. short 8%) and highest downstaging rates at 6-7 weeks (long 44% vs. short 40%). The ypCR rates were lowest at < 6 weeks (both long and short 0%) and highest at 6-7 weeks (long 21% vs. short 11%) in both the short and long course arms. The downstaging and ypCR rates of long course group gradually declined after the peak at 6-7 weeks and those of the short course group trend to constantly increase afterwards.
Conclusion
It is optimal to perform surgery at least 6 weeks after both the short course and long course CCRT to obtain maximal tumor regression in locally advanced rectal adenocarcinoma.

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Association between personality types and low anterior resection syndrome in rectal cancer patients following surgery
Ting‐Yu Chiang, Yu‐Jen Hsu, Yih‐Jong Chern, Chun‐Kai Liao, Wen‐Sy Tsai, Pao‐Shiu Hsieh, Hung‐Chih Hsu, Yu‐Fen Lin, Hsiu‐Lan Lee, Jeng‐Fu You
Cancer Medicine.2024;[Epub] CrossRef
Lateral Lymph Node Size and Tumor Distance From Anal Verge Accurately Predict Positive Lateral Pelvic Lymph Nodes in Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Diseases of the Colon & Rectum.2023; 66(6): 785. CrossRef
Robotic Lateral Pelvic Lymph Node Dissection Could Harvest More Lateral Pelvic Lymph Nodes over Laparoscopic Approach for Mid-to-Low Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ri Na Yoo, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Biomedicines.2023; 11(6): 1556. CrossRef
Does a long interval between neoadjuvant chemoradiotherapy and surgery benefit the clinical outcomes of locally advanced rectal cancer? A systematic review and meta analyses
Miao Yu, Deng-Chao Wang, Sheng Li, Li-Yan Huang, Jian Wei
International Journal of Colorectal Disease.2022; 37(4): 855. CrossRef
Predicting Factors of Complete Pathological Response in Locally Advanced Rectal Cancer
AmirHossein Latif, Mohammad Shirkhoda, Mohammad Reza Rouhollahi, Saeed Nemati, Seyed Hossein Yahyazadeh, Kazem Zendehdel, Ahmad Reza Soroush, Aidin Yaghoobi Notash
Middle East Journal of Digestive Diseases.2022; 14(4): 443. CrossRef
Practical recommendation for treatment of patients with colon cancer during covid-19 pandemic
M. Yu. Fedyanin
Meditsinskiy sovet = Medical Council.2020; (9): 213. CrossRef
Meta-analysis of the effect of extending the interval after long-course chemoradiotherapy before surgery in locally advanced rectal cancer
É J Ryan, D P O'Sullivan, M E Kelly, A Z Syed, P C Neary, P R O'Connell, D O Kavanagh, D C Winter, J M O'Riordan
British Journal of Surgery.2019; 106(10): 1298. CrossRef
Preoperative short-course radiotherapy (5 × 5 Gy) with delayed surgery versus preoperative long-course radiotherapy for locally resectable rectal cancer: a meta-analysis
Wang Qiaoli, Huang Yongping, Xiong Wei, Xu Guoqiang, Ju Yunhe, Liu Qiuyan, Li Cheng, Guo Mengling, Li Jiayi, Xiong Wei, Yang Yi
International Journal of Colorectal Disease.2019; 34(12): 2171. CrossRef
Comparison of long course and short course preoperative radiotherapy in the treatment of locally advanced rectal cancer: a systematic review and meta-analysis
Yongjun Yu, Yuwei Li, Chen Xu, Zhao Zhang, Xipeng Zhang
Revista Española de Enfermedades Digestivas.2018;[Epub] CrossRef

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Are We Predicting Disease Progress of the Rectal Cancer Patients without Surgery after Neoadjuvant Chemoradiotherapy?: Bo Young Oh, Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun; Cancer Res Treat. 2018;50(3):634-645. Published online July 3, 2017; DOI: https://doi.org/10.4143/crt.2017.069

Abstract PDF PubReader ePub

Purpose
There are patients who do not undergo surgery, regardless of tumor response for neoadjuvant chemoradiotherapy (nCRT) in rectal cancer. However, there have been few reports focused on how oncologic outcomes are worse in these patients. We sought to investigate oncologic outcomes for these non-operated patients with rectal cancer after nCRT.
Materials and Methods
A total of 1,063 records of patients with rectal cancer who were treated with nCRT from January 2002 to December 2013 were retrospectively reviewed. We categorized patients into the non-operated group (n=77), transanal local excision (TLE) group (n=54), ortotal mesorectal excision (TME) group (n=932) and compared each group using propensity score matching.
Results
In the non-operated group, the most common reason for no surgery was patient refusal (n=64). Eleven patients were considered to have achieve clinical complete response (cCR), which was an independent prognostic factor of progression-free survival (p=0.045). In patients with disease progression in the non-operated group, the overall survival did not improved according to salvage treatments (p=0.451). The non-operated group showed worse survivals compared to the TLE or TME group before and after matching (p < 0.001). This finding was also noted in the analysis of survival only in patients with cCR.
Conclusion
In this study, non-operated patients did not secure oncologic safety regardless of cCR after nCRT. Our results suggest that a non-operative management must be carefully considered even if cCR is achieved.

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Long-term efficacy of transanal local excision versus total mesorectal excision after neoadjuvant treatment for rectal cancer: A meta-analysis
Yihui Lei, Li Lin, Qiming Shao, Weiping Chen, Guoyan Liu, Antonio Brillantino
PLOS ONE.2023; 18(11): e0294510. CrossRef
Non-operative Management (NOM) of Rectal Cancer: Literature Review and Translation of Evidence into Practice
Christopher J. Anker, Dmitriy Akselrod, Steven Ades, Nancy A. Bianchi, Nataniel H. Lester-Coll, Peter A. Cataldo
Current Colorectal Cancer Reports.2021; 17(2): 23. CrossRef
Prognostic Factors and Treatment of Recurrence after Local Excision of Rectal Cancer
Moon Suk Choi, Jung Wook Huh, Jung Kyong Shin, Yoon Ah Park, Yong Beom Cho, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee
Yonsei Medical Journal.2021; 62(12): 1107. CrossRef
Treatment of stage I‐III rectal cancer: Who is refusing surgery?
Adam C. Fields, Pamela W. Lu, James Yoo, Jennifer Irani, Joel E. Goldberg, Ronald Bleday, Nelya Melnitchouk
Journal of Surgical Oncology.2020; 121(6): 990. CrossRef
MRI Assessment of Complete Response to Preoperative Chemoradiation Therapy for Rectal Cancer: 2020 Guide for Practice from the Korean Society of Abdominal Radiology
Seong Ho Park, Seung Hyun Cho, Sang Hyun Choi, Jong Keon Jang, Min Ju Kim, Seung Ho Kim, Joon Seok Lim, Sung Kyoung Moon, Ji Hoon Park, Nieun Seo
Korean Journal of Radiology.2020; 21(7): 812. CrossRef
Survival Effects of Cytoreductive Surgery for Refractory Patients after Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer
Wonkyo Shin, Joseph J. Noh, Sang-Soo Seo, Sokbom Kang, Chel-Hun Choi, Sang-Yoon Park, Byoung-Gie Kim, Myong Cheol Lim
Yonsei Medical Journal.2020; 61(11): 935. CrossRef
Oncologic Risk of Rectal Preservation Against Medical Advice After Chemoradiotherapy for Rectal Cancer: A Multicenter Comparative Cross‐Sectional Study with Rectal Preservation as Supported by Surgeon
Kwang‐Seop Song, Sung Chan Park, Dae Kyung Sohn, Jae Hwan Oh, Min Jung Kim, Ji Won Park, Seung‐Bum Ryoo, Seung‐Yong Jeong, Kyu Joo Park, Heung‐Kwon Oh, Duck‐Woo Kim, Sung‐Bum Kang
World Journal of Surgery.2019; 43(12): 3216. CrossRef

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The Role of Consolidation Chemoradiotherapy in Locally Advanced Pancreatic Cancer Receiving Chemotherapy: An Updated Systematic Review and Meta-Analysis: Jeffrey S. Chang, Yen-Feng Chiu, Jih-Chang Yu, Li-Tzong Chen, Hui-Ju Ch’ang; Cancer Res Treat. 2018;50(2):562-574. Published online June 9, 2017; DOI: https://doi.org/10.4143/crt.2017.105

Abstract PDF Supplementary Material PubReader ePub

Purpose
The role of consolidation chemoradiation (CCRT) after systemic chemotherapy in locally advanced pancreatic cancer (LAPC) is still controversial. We aim to evaluate the effectiveness of CCRT in LAPC using systematic review and meta-analysis of prospective studies.
Materials and Methods
Prospective clinical trials of LAPC receiving chemotherapy with or without subsequent CCRT were included in the analysis. We systematically searched in PubMed, MEDLINE, Embase, and Web of Science. The primary outcome of interest was 1-year survival. Secondary endpoints were median overall survival, progression-free survival, toxicity, and resection rate.
Results
Forty-one studies with 49 study arms were included with a total of 1,018 patients receiving CCRT after induction chemotherapy (ICT) and 954 patients receiving chemotherapy alone. CCRT after ICT did not improve 1-year survival significantly in LAPC patients compared with chemotherapy alone (58% vs. 52%). ICT lasted for at least 3 months revealed significantly improved survival of additional CCRT to LAPC patients compared to chemotherapy alone (65% vs. 52%). A marginal survival benefit of consolidation CCRT was noted in studies using maintenance chemotherapy (59% vs. 52%), and fluorouracil-based CCRT (64% vs. 52%), as well as in studies conducted after the 2010 (64% vs. 55%).
Conclusion
The survival benefit of ICT+CCRT over chemotherapy alone in treating LAPC was noted when ICT lasted for at least 3 months. Fluorouracil-based CCRT, and maintenance chemotherapy were associated with improved clinical outcomes.

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Effect of Radiotherapy in Neoadjuvant Treatment of Borderline Resectable and Locally Advanced Pancreatic Cancer
Peng Tang, Junfeng Zhang, Qiang Zhou, Wenmin Yi, Huaizhi Wang
Pancreas.2025; 54(3): e246. CrossRef
Total Neoadjuvant Therapy in Localized Pancreatic Cancer: Is More Better?
Rita Saúde-Conde, Benjelloun El Ghali, Julie Navez, Christelle Bouchart, Jean-Luc Van Laethem
Cancers.2024; 16(13): 2423. CrossRef
Issues in the 2022 revision of the Clinical Practice Guidelines for Pancreatic Cancer -Radiotherapy-
Yoshinori ITO, Satoaki NAKAMURA, Takayuki OHGURI, Masanori SOMEYA, Makoto SHINOTO
Suizo.2023; 38(2): 121. CrossRef
Can Concurrent Chemoradiotherapy Add Meaningful Benefit in Addition to Induction Chemotherapy in the Management of Borderline Resectable and Locally Advanced Pancreatic Cancer?
Animesh Saha, Jonathan Wadsley, Bhawna Sirohi, Rebecca Goody, Alan Anthony, Karthikeyan Perumal, Danny Ulahanan, Fiona Collinson
Pancreas.2023; 52(1): e7. CrossRef
Predictors of Acute and Late Toxicity in Patients Receiving Chemoradiation for Unresectable Pancreatic Cancer
Rishi Das, Madeline R. Abbott, Scott W. Hadley, Vaibhav Sahai, Filip Bednar, Joseph R. Evans, Matthew J. Schipper, Theodore S. Lawrence, Kyle C. Cuneo
Advances in Radiation Oncology.2023; 8(6): 101266. CrossRef
A phase II randomised trial of induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced pancreatic cancer: the Taiwan Cooperative Oncology Group T2212 study
Yung-Yeh Su, Yen-Feng Chiu, Chung-Pin Li, Shih-Hung Yang, Johnson Lin, Shyh-Jer Lin, Ping-Ying Chang, Nai-Jung Chiang, Yan-Shen Shan, Hui-Ju Ch’ang, Li-Tzong Chen
British Journal of Cancer.2022; 126(7): 1018. CrossRef
Results of a single-arm pilot study of 32P microparticles in unresectable locally advanced pancreatic adenocarcinoma with gemcitabine/nab-paclitaxel or FOLFIRINOX chemotherapy
P.J. Ross, H.S. Wasan, D. Croagh, M. Nikfarjam, N. Nguyen, M. Aghmesheh, A.M. Nagrial, D. Bartholomeusz, A. Hendlisz, T. Ajithkumar, C. Iwuji, N.E. Wilson, D.M. Turner, D.C. James, E. Young, M.T. Harris
ESMO Open.2022; 7(1): 100356. CrossRef
Korean clinical practice guideline for pancreatic cancer 2021: A summary of evidence-based, multi-disciplinary diagnostic and therapeutic approaches

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Current status of non-surgical treatment of locally advanced pancreatic cancer
Stavros Spiliopoulos, Maria Teresa Zurlo, Annachiara Casella, Letizia Laera, Giammarco Surico, Alessia Surgo, Alba Fiorentino, Nicola de'Angelis, Roberto Calbi, Riccardo Memeo, Riccardo Inchingolo
World Journal of Gastrointestinal Oncology.2021; 13(12): 2064. CrossRef
Characterization of Oncolytic Vaccinia Virus Harboring the Human IFNB1 and CES2 Transgenes
Euna Cho, S M Bakhtiar Ul Islam, Fen Jiang, Ju-Eun Park, Bora Lee, Nam Deuk Kim, Tae-Ho Hwang
Cancer Research and Treatment.2020; 52(1): 309. CrossRef
ESTRO IORT Task Force/ACROP recommendations for intraoperative radiation therapy in unresected pancreatic cancer
Felipe A. Calvo, Marco Krengli, Jose M. Asencio, Javier Serrano, Philip Poortmans, Falk Roeder, Robert Krempien, Frank W. Hensley
Radiotherapy and Oncology.2020; 148: 57. CrossRef
Novel strategies using modern radiotherapy to improve pancreatic cancer outcomes: toward a new standard?
Christelle Bouchart, Julie Navez, Jean Closset, Alain Hendlisz, Dirk Van Gestel, Luigi Moretti, Jean-Luc Van Laethem
Therapeutic Advances in Medical Oncology.2020;[Epub] CrossRef
Photon versus carbon ion irradiation: immunomodulatory effects exerted on murine tumor cell lines
Laura Hartmann, Philipp Schröter, Wolfram Osen, Daniel Baumann, Rienk Offringa, Mahmoud Moustafa, Rainer Will, Jürgen Debus, Stephan Brons, Stefan Rieken, Stefan B. Eichmüller
Scientific Reports.2020;[Epub] CrossRef
Contemporary management of borderline resectable pancreatic ductal adenocarcinoma
Kyriaki Lekka, Evanthia Tzitzi, Alexander Giakoustidis, Vassilios Papadopoulos, Dimitrios Giakoustidis
Annals of Hepato-Biliary-Pancreatic Surgery.2019; 23(2): 97. CrossRef
Duration of chemotherapy prior to chemoradiation affects survival outcomes for resected stage I‐II or unresected stage III pancreatic cancer
Sung J. Ma, Austin J. Iovoli, Gregory M. Hermann, Kavitha M. Prezzano, Anurag K. Singh
Cancer Medicine.2019; 8(9): 4110. CrossRef
Current Clinical Strategies of Pancreatic Cancer Treatment and Open Molecular Questions
Maximilian Brunner, Zhiyuan Wu, Christian Krautz, Christian Pilarsky, Robert Grützmann, Georg F. Weber
International Journal of Molecular Sciences.2019; 20(18): 4543. CrossRef

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Redefining the Positive Circumferential Resection Margin by Incorporating Preoperative Chemoradiotherapy Treatment Response in Locally Advanced Rectal Cancer: A Multicenter Validation Study: Joo Ho Lee, Eui Kyu Chie, Seung-Yong Jeong, Tae-You Kim, Dae Yong Kim, Tae Hyun Kim, Sun Young Kim, Ji Yeon Baek, Hee Jin Chang, Min Ju Kim, Sung Chan Park, Jae Hwan Oh, Sung Hwan Kim, Jong Hoon Lee, Doo Ho Choi, Hee Chul Park, Sung-Bum Kang, Jae-Sung Kim; Cancer Res Treat. 2018;50(2):506-517. Published online May 24, 2017; DOI: https://doi.org/10.4143/crt.2016.607

Abstract PDF PubReader ePub

Purpose
This study was conducted to validate the prognostic influence of treatment response among patients with positive circumferential resection margin for locally advanced rectal cancer.
Materials and Methods
Clinical data of 197 patientswith positive circumferentialresection margin defined as ≤ 2 mm after preoperative chemoradiotherapy followed by total mesorectal excision between 2004 and 2009were collected forthis multicenter validation study. All patients underwent median 50.4Gy radiationwith concurrentfluoropyrimidine based chemotherapy. Treatmentresponse was dichotomized to good response, including treatmentresponse of grade 2 or 3, and poor response, including grade 0 or 1.
Results
After 52 months median follow-up, 5-year overall survival (OS) for good responders and poor responders was 79.1% and 48.4%, respectively (p < 0.001). In multivariate analysis, circumferential resection margin involvement and treatment response were a prognosticator for OS and locoregional recurrence-free survival. In subgroup analysis, good responders with close margin showed significantly better survival outcomes for survival. Good responders with involved margin and poor responders with close margin shared similar results, whereas poorresponderswith involved margin hadworst survival (5-year OS, 81.2%, 57.0%, 50.0%, and 32.4%, respectively; p < 0.001).
Conclusion
Among patients with positive circumferential resection margin after preoperative chemoradiotherapy, survival of the good responders was significantly better than poor responders. Subgroup analysis revealed that definition of positive circumferential resection margin may be individualized as involvement for good responders, whereas ≤ 2 mm for poor responders.

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Tailored Strategy for Locally Advanced Rectal Carcinoma (GRECCAR 4): Long-term Results From a Multicenter, Randomized, Open-Label, Phase II Trial
Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stephanie Nougaret
Diseases of the Colon & Rectum.2022; 65(8): 986. CrossRef
Colorectal Cancer Surgery Quality in Manitoba: A Population-Based Descriptive Analysis
Iresha Ratnayake, Jason Park, Natalie Biswanger, Allison Feely, Grace Musto, Kathleen Decker
Current Oncology.2021; 28(3): 2239. CrossRef

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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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Incorporating Erlotinib or Irinotecan Plus Cisplatin into Chemoradiotherapy for Stage III Non-small Cell Lung Cancer According to EGFR Mutation Status: Youngjoo Lee, Ji-Youn Han, Sung Ho Moon, Byung-Ho Nam, Kun Young Lim, Geon Kook Lee, Heung Tae Kim, Tak Yun, Hye Jin An, Jin Soo Lee; Cancer Res Treat. 2017;49(4):981-989. Published online January 6, 2017; DOI: https://doi.org/10.4143/crt.2016.522

Abstract PDF Supplementary Material PubReader ePub

Purpose
Concurrent chemoradiotherapy (CCRT) is the standard care for stage III non-small cell lung cancer (NSCLC) patients; however, a more effective regimen is needed to improve the outcome by better controlling occult metastases. We conducted two parallel randomized phase II studies to incorporate erlotinib or irinotecan-cisplatin (IP) into CCRT for stage III NSCLC depending on epidermal growth factor receptor (EGFR) mutation status.
Materials and Methods
Patients with EGFR-mutant tumors were randomized to receive three cycles of erlotinib first and then either CCRT with erlotinib followed by erlotinib (arm A) or CCRT with IP only (arm B). Patients with EGFR unknown or wild-type tumors were randomized to receive either three cycles of IP before (arm C) or after CCRT with IP (arm D).
Results
Seventy-three patients were screened and the study was closed early because of slow accrual after 59 patients were randomized. Overall, there were seven patients in arm A, five in arm B, 22 in arm C, and 25 in arm D. The response rate was 71.4% and 80.0% for arm A and B, and 70.0% and 73.9% for arm C and D. The median overall survival (OS) was 39.3 months versus 31.2 months for arm A and B (p=0.442), and 16.3 months versus 25.3 months for arm C and D (p=0.050). Patients with sensitive EGFR mutations had significantly longer OS than EGFR-wild patients (74.8 months vs. 25.3 months, p=0.034). There were no unexpected toxicities.
Conclusion
Combined-modality treatment by molecular diagnostics is feasible in stage III NSCLC. EGFR-mutant patients appear to be a distinct subset with longer survival.

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Dose-Response Relationship between Radiation Dose and Loco-regional Control in Patients with Stage II-III Esophageal Cancer Treated with Definitive Chemoradiotherapy: Hyun Ju Kim, Yang-Gun Suh, Yong Chan Lee, Sang Kil Lee, Sung Kwan Shin, Byung Chul Cho, Chang Geol Lee; Cancer Res Treat. 2017;49(3):669-677. Published online October 6, 2016; DOI: https://doi.org/10.4143/crt.2016.354

Abstract PDF PubReader ePub

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

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Long-Term Outcome of Distal Cholangiocarcinoma after Pancreaticoduodenectomy Followed by Adjuvant Chemoradiotherapy: A 15-Year Experience in a Single Institution: Byoung Hyuck Kim, Kyubo Kim, Eui Kyu Chie, Jeanny Kwon, Jin-Young Jang, Sun Whe Kim, Do-Youn Oh, Yung-Jue Bang; Cancer Res Treat. 2017;49(2):473-483. Published online August 23, 2016; DOI: https://doi.org/10.4143/crt.2016.166

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to evaluate the long-term outcome in patients undergoing pancreaticoduodenectomy (PD) followed by adjuvant chemoradiotherapy for distal cholangiocarcinoma (DCC) in a high-volume center and to identify the prognostic impact of clinicopathologic factors.
Materials and Methods
A total of 132 consecutive patients who met the inclusion criteria were retrieved from the institutional database from January 1995 to September 2009. All patients received adjuvant treatments at a median of 45 days after the surgery. Median follow-up duration was 57 months (range, 6 to 225 months) for all patients and 105 months for survivors (range, 13 to 225 months).
Results
The 5-year locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) rates were 70.7%, 55.7%, 49.4%, and 48.1%, respectively. Univariate analysis revealed poorly differentiated (P/D) tumors and lymph node (LN) metastasis were significantly associated with DMFS and OS. Additionally, preoperative carbohydrate antigen 19-9 level was significantly correlated with DFS, LRRFS, and DMFS. Upon multivariate analysis for OS, P/D tumors (p=0.015) and LN metastasis (p=0.003) were significant prognosticators that predicted inferior OS. Grade 3 or higher late gastrointestinal toxicity occurred in only one patient (0.8%).
Conclusion
Adjuvant chemoradiotherapy after PD for DCC is an effective and tolerable strategy without significant side effects. During long-term follow-up, we found that prognosis of DCC was mainly influenced by histologic differentiation and LN metastasis. For patients with these risk factors, further research should focus on improving adjuvant strategies as well as other treatment approaches.

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Patterns, timing and predictors of recurrence following pancreaticoduodenectomy for distal cholangiocarcinoma: An international multicentre retrospective cohort study
Peter LZ. Labib, Thomas B. Russell, Jemimah L. Denson, Mark A. Puckett, Fabio Ausania, Elizabeth Pando, Keith J. Roberts, Ambareen Kausar, Vasileios K. Mavroeidis, Ricky H. Bhogal, Gabriele Marangoni, Sarah C. Thomasset, Adam E. Frampton, Duncan R. Spaldi
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Liver Transplantation for Cholangiocarcinoma
Nadine Soliman, Ashton A. Connor, Sudha Kodali, Rafik Mark Ghobrial
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Impact of adjuvant therapy on outcomes after curative‐intent resection for distal cholangiocarcinoma
Jing‐Jing Hou, Shishir K. Maithel, Sharon M. Weber, George Poultsides, Christopher L. Wolfgang, Ryan C. Fields, Jin He, Charles Scoggins, Kamron Idrees, Perry Shen, Xu‐Feng Zhang, Timothy M. Pawlik
Journal of Surgical Oncology.2023; 127(4): 607. CrossRef
The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma
Pavel Skalicky, Ondrej Urban, Jiri Ehrmann, Hana Svebisova, Dusan Klos, Jana Tesarikova, Cestmir Neoral, Katerina Knapkova, Martin Lovecek
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Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea: Byung Sup Kim, Ho Jun Seol, Do-Hyun Nam, Chul-Kee Park, Il Han Kim, Tae Min Kim, Jeong Hoon Kim, Young Hyun Cho, Sang Min Yoon, Jong Hee Chang, Seok-Gu Kang, Eui Hyun Kim, Chang-Ok Suh, Tae-Young Jung, Kyung-Hwa Lee, Chae-Yong Kim, In Ah Kim, Chang-Ki Hong, Heon Yoo, Jin Hee Kim, Shin-Hyuk Kang, Min Kyu Kang, Eun-Young Kim, Sun-Hwan Kim, Dong-Sup Chung, Sun-Chul Hwang, Joon-Ho Song, Sung Jin Cho, Sun-Il Lee, Youn-Soo Lee, Kook-Jin Ahn, Se Hoon Kim, Do Hun Lim, Ho-Shin Gwak, Se-Hoon Lee, Yong-Kil Hong; Cancer Res Treat. 2017;49(1):193-203. Published online June 27, 2016; DOI: https://doi.org/10.4143/crt.2015.473

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample.
Materials and Methods
A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively.
Results
After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients,respectively. The methylation status of O⁶-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period.
Conclusion
Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.

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Is There a Role for Adjuvant Therapy in R0 Resected Gallbladder Cancer?: A Propensity Score-Matched Analysis: Se-Il Go, Young Saing Kim, In Gyu Hwang, Eun Young Kim, Sung Yong Oh, Jun Ho Ji, Haa-Na Song, Se Hoon Park, Joon Oh Park, Jung Hun Kang; Cancer Res Treat. 2016;48(4):1274-1285. Published online February 12, 2016; DOI: https://doi.org/10.4143/crt.2015.502

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to assess the role of adjuvant therapy in stage I-III gallbladder cancer (GBC) patients who have undergone R0 resection.
Materials and Methods
Clinical data were collected on 441 consecutive patients who underwent R0 resection for stage I-III GBC. Eligible patients were classified into adjuvant therapy and surveillance only groups. Propensity score matching (PSM) between the two groups was performed, adjusting clinical factors.
Results
In total, 84 and 279 patients treated with adjuvant therapy and followed up with surveillance only, respectively, were included in the analysis. Before PSM, the 5-year relapse-free survival (RFS) rate was lower in the adjuvant therapy group than in the surveillance only group (50.8% vs. 74.8%, p < 0.001), although there was no statistically significant difference in the 5-year overall survival (OS) rate (66.2% vs. 79.5%, p=0.089). After the PSM, baseline characteristics became comparable and there were no differences in the 5-year RFS (50.8% vs. 64.8%, p=0.319) and OS (66.2% vs. 70.4%, p=0.703) rates between the two groups.
Conclusion
The results suggest that fluoropyrimidine-based adjuvant therapy is not indicated in stage I-III GBC patients who have undergone R0 resection.

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Prospective Randomized Controlled Trial Comparing Adjuvant Chemotherapy vs. No Chemotherapy for Patients with Carcinoma of Gallbladder Undergoing Curative Resection
Sundeep Singh Saluja, Phani Kumar Nekarakanti, Pramod Kumar Mishra, Anurita Srivastava, Kishore Singh
Journal of Gastrointestinal Surgery.2022; 26(2): 398. CrossRef
Adjuvant Therapy for Resectable Biliary Tract Cancer: A Bayesian Network Analysis
Xiuqiong Chen, Fanqiao Meng, Hua Xiong, Yanmei Zou
Frontiers in Oncology.2021;[Epub] CrossRef
Current standards and future perspectives in adjuvant treatment for biliary tract cancers
Angela Lamarca, Julien Edeline, Mairéad G McNamara, Richard A Hubner, Masato Nagino, John Bridgewater, John Primrose, Juan W Valle
Cancer Treatment Reviews.2020; 84: 101936. CrossRef
Prognostic factors and patterns of loco-regional failure in patients with R0 resected gallbladder cancer
Jung Ho Im, Woo Jung Lee, Chang Moo Kang, Ho Kyoung Hwang, Jinsil Seong
HPB.2020; 22(8): 1168. CrossRef
Prognostic Factors for Operated Gallbladder Cancer
Bala Basak Oven Ustaalioglu, Ahmet Bilici, Mesut Seker, Umut Kefeli, Dincer Aydin, Serkan Celik, Tarik Demir, Burcak Erkol
Journal of Gastrointestinal Cancer.2019; 50(3): 451. CrossRef
Role of Adjuvant Chemotherapy in Resected T2N0 Gall Bladder Cancer
Abhay K. Kattepur, Shraddha Patkar, Mahesh Goel, Anant Ramaswamy, Vikas Ostwal
Journal of Gastrointestinal Surgery.2019; 23(11): 2232. CrossRef
A systematic review of the effectiveness of adjuvant therapy for patients with gallbladder cancer
Carlos Manterola, Galo Duque, Luis Grande, Xabier de Aretxabala, Roque Conejeros, Tamara Otzen, Nayely García
HPB.2019; 21(11): 1427. CrossRef
Adjuvant Chemoradiotherapy is Associated with Improved Survival for Patients with Resected Gallbladder Carcinoma: A Systematic Review and Meta-analysis
Byoung Hyuck Kim, Jeanny Kwon, Eui Kyu Chie, Kyubo Kim, Young Hoon Kim, Dong Wan Seo, Amol K. Narang, Joseph M. Herman
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Randomized clinical trial of adjuvant gemcitabine chemotherapy versus observation in resected bile duct cancer
T Ebata, S Hirano, M Konishi, K Uesaka, Y Tsuchiya, M Ohtsuka, Y Kaneoka, M Yamamoto, Y Ambo, Y Shimizu, F Ozawa, A Fukutomi, M Ando, Y Nimura, M Nagino, S Nakamori, T Ajiki, H Baba, R Yamaguchi, M Kawai, H Nagano, F Miura, T Arai, Y Nishiwaki, S Kawasaki
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Adjuvant systemic therapy and postoperative outcomes after resection of node positive gallbladder cancer
Jiong-Jie Yu, Xin-Fei Xu, Tian Yang
International Journal of Surgery.2018; 54: 307. CrossRef
The efficiency and regimen choice of adjuvant chemotherapy in biliary tract cancer
Luxi Yin, Qi Xu, Jingjing Li, Qing Wei, Jieer Ying
Medicine.2018; 97(50): e13570. CrossRef
Surgical Management of Gallbladder Cancer
Gyulnara G. Kasumova, Omidreza Tabatabaie, Robert M. Najarian, Mark P. Callery, Sing Chau Ng, Andrea J. Bullock, Robert A. Fisher, Jennifer F. Tseng
Annals of Surgery.2017; 266(4): 625. CrossRef

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Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy: Min Kyu Kang, Dongryul Oh, Kwan Ho Cho, Sung Ho Moon, Hong-Gyun Wu, Dae-Seog Heo, Yong Chan Ahn, Keunchil Park, Hyo Jung Park, Jun Su Park, Ki Chang Keum, Jihye Cha, Jun Won Kim, Yeon-Sil Kim, Jin Hyoung Kang, Young-Taek Oh, Ji-Yoon Kim, Sung Hwan Kim, Jin-Hee Kim, Chang Geol Lee; Cancer Res Treat. 2015;47(4):871-878. Published online February 13, 2015; DOI: https://doi.org/10.4143/crt.2014.141; Correction in: Cancer Res Treat 2016;48(1):425

Abstract PDF PubReader ePub

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

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Yao-Can Xu, Kai-Hua Chen, Zhong-Guo Liang, Xiao-Dong Zhu
Frontiers in Oncology.2022;[Epub] CrossRef
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Xin-Bin Pan, Shi-Ting Huang, Kai-Hua Chen, Xiao-Dong Zhu
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