Cancer Research and Treatment

Original Articles

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

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

Citations

Citations to this article as recorded by

Reduced Dose and Selective Neck Irradiation Policy in Treating Oropharynx Cancer: Excellent Oncological Outcomes with Very Low Risk of Locoregional Failure
Eunyeong Yang, Seung Gyu Park, Kyungmi Yang, Dongryul Oh, Yong Chan Ahn
Cancer Research and Treatment.2026; 58(1): 95. CrossRef
Primary endoscopic nasopharyngectomy for nasopharyngeal carcinoma: systematic review & meta-analysis
Siyuan Ding, Leo Li, Jenny Lee, Brian Mak, Christopher Liao, Andy Chan, Levina Li, Calvin Lai, Samuel Chow, Jason Chan, David Yeung
Frontiers in Surgery.2026;[Epub] CrossRef
Tumor volume reduction during adaptive radiotherapy is a strong prognostic factor for oropharyngeal cancer: A retrospective multicenter study
Seung Gyu Park, Eunyeong Yang, Heerim Nam, Tae Gyu Kim, Dongryul Oh, Kyungmi Yang, Yong Chan Ahn
Radiotherapy and Oncology.2026; 222: 111676. CrossRef
Salivary Gland Volume Changes and Dry Mouth Symptom Following Definitive Radiation Therapy in Oropharyngeal Cancer Patients—A Comparison of Two Different Approaches: Intensity-Modulated Radiation Therapy Versus Intensity-Modulated Radiation Therapy/Intens
Seung Gyu Park, Yong Chan Ahn, Dongryul Oh, Kyungmi Yang, Sang Gyu Ju, Jin Man Kim, Dongyeol Kwon, Euncheol Choi, Han Gyul Yoon
Cancers.2025; 17(3): 554. CrossRef
International Consensus Guideline on Delineation of the Clinical Target Volumes at Different Dose Levels for Nasopharyngeal Carcinoma (2024 Version)
Shao-Jun Lin, Qiao-Juan Guo, Qin Liu, Wai-Tong Ng, Yong Chan Ahn, Hussain AlHussain, Annie W. Chan, James Chow, Melvin L.K. Chua, June Corry, Fei Han, Vincent Grégoire, Kevin J. Harrington, Chao-Su Hu, Kenneth Jensen, Johannes A. Langendijk, Quynh Thu Le,
International Journal of Radiation Oncology*Biology*Physics.2025; 123(2): 415. CrossRef
Target volume delineation of the neck for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas
Ling-Long Tang, Cheng-Long Huang, Shao-Jun Lin, Quynh-Thu Le, Brian O'Sullivan, Sue S Yom, Shao Hui Huang, Annie W Chan, Nancy Lee, Jian-Ji Pan, Michael Benedict A Mejia, Yong Chan Ahn, Kenneth C W Wong, Lachlan McDowell, Ester Orlandi, Jeppe Friborg, Yu-
The Lancet Oncology.2025; 26(9): e488. CrossRef
In Reply to Liu and Luo
Kangpyo Kim, Yong Chan Ahn
International Journal of Radiation Oncology*Biology*Physics.2024; 118(1): 308. CrossRef
Optimizing Cervical Target Volume in Patients with Nasopharyngeal Cancer Based On Nodal Drainage Distance
Yang Liu, Wenbin Yan, Chaosu Hu, Xiaodong Huang, Kai Wang, Yuan Qu, Xuesong Chen, Runye Wu, Ye Zhang, Jianghu Zhang, Jingwei Luo, Yexiong Li, Jingbo Wang, Junlin Yi
Clinical Cancer Research.2024; 30(9): 1801. CrossRef
Dosimetric Comparison and Selection Criteria of Intensity-Modulated Proton Therapy and Intensity-Modulated Radiation Therapy for Adaptive Re-Plan in T3-4 Nasopharynx Cancer Patients
Mincheol Ko, Kyungmi Yang, Yong Chan Ahn, Sang Gyu Ju, Dongryul Oh, Yeong-bi Kim, Dong Yeol Kwon, Seyjoon Park, Kisung Lee
Cancers.2024; 16(19): 3402. CrossRef
Less is more: level IB-sparing radiation therapy in nasopharyngeal cancer
Dongryul Oh
Radiation Oncology Journal.2023; 41(1): 1. CrossRef
Dose and volume de-escalation of radiotherapy in head and neck cancer
MJ García-Anaya, S. Segado-Guillot, J. Cabrera-Rodríguez, MD Toledo-Serrano, JA Medina-Carmona, J. Gómez-Millán
Critical Reviews in Oncology/Hematology.2023; 186: 103994. CrossRef
Can Definitive Radiation Therapy Substitute Surgical Resection in Locally Advanced T3 or T4 Sinonasal Squamous Cell Carcinoma?
Kangpyo Kim, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Han-Sin Jeong, Man Ki Chung, Sang Duk Hong, Chung-Hwan Baek
International Journal of Radiation Oncology*Biology*Physics.2023; 117(4): 893. CrossRef
Progress in the comprehensive treatment of nasopharyngeal carcinoma: a review for risk-stratified management strategies
Yang Liu, Ziou Du, Shiyu Song, Junlin Yi
Holistic Integrative Oncology.2023;[Epub] CrossRef
Involved site radiation therapy in stage I-III nasopharyngeal carcinoma with limited lymph node burden (ISRT-NPC) or elective region irradiation: a study protocol for a multicenter non-inferiority randomized controlled phase III clinical trial
Yang Liu, Yaqian Han, Feng Liu, Desheng Hu, Zhijian Chen, Peiguo Wang, Jingao Li, Jiyong Qin, Feng Jin, Yexiong Li, Jingbo Wang, Junlin Yi
BMC Cancer.2023;[Epub] CrossRef
The Metabolic Footprint of Systemic Effects in the Blood Caused by Radiotherapy and Inflammatory Conditions: A Systematic Review
Karol Jelonek, Katarzyna Mrowiec, Dorota Gabryś, Piotr Widłak
Metabolites.2023; 13(9): 1000. CrossRef
Oncological and Functional Outcomes of Larynx-preserving Surgery for Hypopharyngeal Cancer: A Comparison with Definitive Radiation-based Treatment
Donghyeok Kim, Nalee Kim, Sungmin Koh, Man Ki Chung, Young-Ik Son, Dongryul Oh, Han-Sin Jeong, Yong Chan Ahn
Cancer Research and Treatment.2022; 54(1): 84. CrossRef
Re-irradiation with Moderate Hypo-fractionation Using Intensity Modulated Photon or Proton Radiation Therapy in Locally Recurrent Squamous Cell Carcinoma of Nasopharynx
Heerim Nam, Yong Chan Ahn, Kyungmi Yang, Dongryul Oh, Jae Myoung Noh
Cancer Research and Treatment.2022; 54(1): 96. CrossRef
Risk of Stroke in Nasopharyngeal Cancer Survivors
Teng Hwee Tan, Huili Zheng, Timothy Cheo, Jeremy Tey, Yu Yang Soon
Neurology.2022;[Epub] CrossRef
High Superior-Middle Pharyngeal Constrictor Muscle Mean Dose Correlates with Severe Late Lung Infection and Survival in Nasopharyngeal Cancer Patients
Wen-Shan Liu, Ju-Chun Chien, Yu-Hsien Huang, Po-Chun Chen, Wei-Lun Huang, Shao-Wei Chiang, Ching-Chih Lee, Bor-Hwang Kang, Yu-Chang Hu
Cancer Management and Research.2022; Volume 14: 1063. CrossRef
Application of Carotid Duplex Ultrasonography in the Surveillance of Carotid Artery Stenosis after Neck Irradiation
Deng-Yu Kuo, Yen-Wen Wu, Chen-Hsi Hsieh, Li-Jen Liao, Pei-Wei Shueng
Reviews in Cardiovascular Medicine.2022;[Epub] CrossRef
Simultaneous Reduction of Volume and Dose in Clinical Target Volume for Nasopharyngeal Cancer Patients
Wen-Shan Liu, Kuo-Wang Tsai, Bor-Hwang Kang, Ching-Chieh Yang, Wei-Lun Huang, Ching-Chih Lee, Yu-Chang Hu, Kuo-Ping Chang, Hsiu-Min Chen, Yaoh-Shiang Lin
International Journal of Radiation Oncology*Biology*Physics.2021; 109(2): 495. CrossRef
Clinical features of post-radiation nasopharyngeal necrosis and their outcomes following surgical intervention in nasopharyngeal cancer patients
Kyungmi Yang, Yong Chan Ahn, Heerim Nam, Sang Duk Hong, Dongryul Oh, Jae Myoung Noh
Oral Oncology.2021; 114: 105180. CrossRef
Early Clinical Outcomes of Intensity Modulated Radiation Therapy/Intensity Modulated Proton Therapy Combination in Comparison with Intensity Modulated Radiation Therapy Alone in Oropharynx Cancer Patients
Han Gyul Yoon, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Seung Gyu Park, Heerim Nam, Sang Gyu Ju, Dongyeol Kwon, Seyjoon Park
Cancers.2021; 13(7): 1549. CrossRef
Contemporary management of the neck in nasopharyngeal carcinoma
Wai Tong Ng, Raymond K. Y. Tsang, Jonathan J. Beitler, Remco de Bree, Andrés Coca‐Pelaz, Avraham Eisbruch, Orlando Guntinas‐Lichius, Anne W. M. Lee, Antti A. Mäkitie, William M. Mendenhall, Sandra Nuyts, Alessandra Rinaldo, K. Thomas Robbins, Juan P. Rodr
Head & Neck.2021; 43(6): 1949. CrossRef
Development and Validation of Web-Based Nomograms to Precisely Predict Survival Outcomes of Non-metastatic Nasopharyngeal Carcinoma in an Endemic Area
Ji-Jin Yao, Li Lin, Tian-Sheng Gao, Wang-Jian Zhang, Wayne R. Lawrence, Jun Ma, Ying Sun
Cancer Research and Treatment.2021; 53(3): 657. CrossRef
Advances in cancer imaging require renewed radiotherapy dose and target volume concepts
Johannes H.A.M. Kaanders, Sven van den Bosch, Tim Dijkema, Abrahim Al-Mamgani, Cornelis P.J. Raaijmakers, Wouter V. Vogel
Radiotherapy and Oncology.2020; 148: 140. CrossRef
Early clinical outcomes of helical tomotherapy/intensity‐modulated proton therapy combination in nasopharynx cancer
Seung Gyu Park, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Sang Gyu Ju, Dongyeol Kwon, Kwanghyun Jo, Kwangzoo Chung, Eunah Chung, Woojin Lee, Seyjoon Park
Cancer Science.2019; 110(9): 2867. CrossRef

10,904 View
233 Download
27 Web of Science
27 Crossref

Prognostic Impact of Elective Supraclavicular Nodal Irradiation for Patients with N1 Breast Cancer after Lumpectomy and Anthracycline Plus Taxane-Based Chemotherapy (KROG 1418): A Multicenter Case-Controlled Study: Haeyoung Kim, Won Park, Jeong Il Yu, Doo Ho Choi, Seung Jae Huh, Yeon-Joo Kim, Eun Sook Lee, Keun Seok Lee, Han-Sung Kang, In Hae Park, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung-Sik Lee, Jung Soo Kim, Jihye Cha; Cancer Res Treat. 2017;49(4):970-980. Published online January 4, 2017; DOI: https://doi.org/10.4143/crt.2016.382

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy.
Materials and Methods
We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups.
Results
A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI.
Conclusion
We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.

Citations

Citations to this article as recorded by

Patient-Reported Outcomes Between Whole-Breast Plus Regional Irradiation and Whole-Breast Irradiation Only in pN1 Breast Cancer After Breast-Conserving Surgery and Taxane-Based Chemotherapy: A Randomized Phase 3 Clinical Trial (KROG 17-01)
Nalee Kim, Won Park, Haeyoung Kim, Won Kyung Cho, Sung Ja Ahn, Mi Young Kim, Shin-Hyung Park, Ik Jae Lee, Inbong Ha, Jin Hee Kim, Tae Hyun Kim, Kyu Chan Lee, Hyung-Sik Lee, Tae Gyu Kim, Kyung Hwan Shin, Jong Hoon Lee, Jinhong Jung, Oyeon Cho, Yong Bae Kim
International Journal of Radiation Oncology*Biology*Physics.2025; 121(2): 341. CrossRef
De-escalation of regional nodal irradiation fields in pT1-2N1 breast cancer patients after breast conserving surgery: retrospective real-world clinical experience
Ji Hyun Hong, Jin-Ho Song, Kyu-Hye Choi, Shin Woo Kim, Woo-Chan Park, Jieun Lee, Ahwon Lee, Jun Kang, Byung-Ock Choi
Frontiers in Oncology.2025;[Epub] CrossRef
The optimal regional irradiation volume for breast cancer patients: A comprehensive systematic review and network meta-analysis of published studies
Wei-Xiang Qi, Lu Cao, Cheng Xu, Gang Cai, Jiayi Chen
Frontiers in Oncology.2023;[Epub] CrossRef
Protocol for the postoperative radiotherapy in N1 breast cancer patients (PORT-N1) trial, a prospective multicenter, randomized, controlled, non-inferiority trial of patients receiving breast-conserving surgery or mastectomy
Tae Hoon Lee, Ji Hyun Chang, Bum-Sup Jang, Jae Sik Kim, Tae Hyun Kim, Won Park, Yong Bae Kim, Su Ssan Kim, Wonshik Han, Han-Byoel Lee, Kyung Hwan Shin
BMC Cancer.2022;[Epub] CrossRef
What Is High-risk Breast Cancer With Pathologically Negative Lymph Nodes for Regional Recurrence?
Sang-Won Kim, Won Kyung Cho, Doo Ho Choi, Haeyoung Kim, Oyeon Cho, Won Park, Mison Chun
International Journal of Radiation Oncology*Biology*Physics.2021; 111(4): 992. CrossRef
Regional nodal irradiation in pT1-2N1 breast cancer patients treated with breast-conserving surgery and whole breast irradiation
Shin-Hyung Park, Jae-Chul Kim
Radiation Oncology Journal.2020; 38(1): 44. CrossRef
Prediction of nodal staging in breast cancer patients with 1-2 sentinel nodes in the Z0011 era
Fabio Corsi, Luca Sorrentino, Sara Albasini, Daniela Bossi, Carlo Morasso, Laura Villani, Marta Truffi
Medicine.2020; 99(35): e21721. CrossRef
Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy
Xuran Zhao, Yu Tang, Shulian Wang, Yong Yang, Hui Fang, Jianyang Wang, Hao Jing, Jianghu Zhang, Guangyi Sun, Siye Chen, Jing Jin, Yongwen Song, Yueping Liu, Bo Chen, Shunan Qi, Ning Li, Yuan Tang, Ningning Lu, Hua Ren, Yexiong Li
Radiation Oncology.2020;[Epub] CrossRef
Comparison of Dose Distribution in Regional Lymph Nodes in Whole-Breast Radiotherapy vs. Whole-Breast Plus Regional Lymph Node Irradiation: An In Silico Planning Study in Participating Institutions of the Phase III Randomized Trial (KROG 1701)
Haeyoung Kim, Heejung Kim, Won Park, Jong Yun Baek, Sung Ja Ahn, Mi Young Kim, Shin-Hyung Park, Ik Jae Lee, Inbong Ha, Jin Hee Kim, Tae Hyun Kim, Kyu Chan Lee, Hyung-Sik Lee, Tae Gyu Kim, Jin Ho Kim, Jong Hoon Lee, Jinhong Jung, Oyeon Cho, Jee Suk Chang,
Cancers.2020; 12(11): 3261. CrossRef
Clinical Significance of Lymph-Node Ratio in Determining Supraclavicular Lymph-Node Radiation Therapy in pN1 Breast Cancer Patients Who Received Breast-Conserving Treatment (KROG 14-18): A Multicenter Study
Jaeho Kim, Won Park, Jin Kim, Doo Choi, Yeon-Joo Kim, Eun Lee, Kyung Shin, Jin Kim, Kyubo Kim, Yong Kim, Sung-Ja Ahn, Jong Lee, Mison Chun, Hyung-Sik Lee, Jung Kim, Jihye Cha
Cancers.2019; 11(5): 680. CrossRef
Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23
Kyubo Kim, Hae Jin Park, Kyung Hwan Shin, Jin Ho Kim, Doo Ho Choi, Won Park, Seung Do Ahn, Su Ssan Kim, Dae Yong Kim, Tae Hyun Kim, Jin Hee Kim, Jiyoung Kim
Cancer Research and Treatment.2018; 50(4): 1316. CrossRef

13,651 View
320 Download
11 Web of Science
11 Crossref

First
Prev
Page of 1
Next
Last

Search