Cancer Research and Treatment

Review Article

Intensity-Modulated Radiation Therapy for Uterine Cervical Cancer to Reduce Toxicity and Enhance Efficacy – an Option or a Must?: A Narrative Review: Sea-Won Lee, Aeran Kim, Sung Jong Lee, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2024;56(1):1-17. Published online August 30, 2023; DOI: https://doi.org/10.4143/crt.2023.562

Radiotherapy (RT) is a fundamental modality in treatment of cervical cancer. With advancement of technology, conventional RT used for external beam radiotherapy (EBRT) for over half a century has been rapidly replaced with intensity-modulated radiation therapy (IMRT) especially during the last decade. This newer technique is able to differentiate the intensity of radiation within the same field, thus reduces the inevitable exposure of radiation to normal organs and enables better dose delivery to tumors. Recently, the American Society for Radiation Oncology has released a guideline for RT in cervical cancer. Although a section of the guideline recommends IMRT for the purpose of toxicity reduction, a thorough review of the literature is necessary to understand the current status of IMRT in cervical cancer. This narrative review updates the recent high-level evidences regarding the efficacy and toxicity of IMRT and provides a better understanding of the most innovative techniques currently available for EBRT enabled by IMRT.

Citations

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Long term clinical outcomes of cervical cancer patients who were recommended surgery but did not undergo it: A SEER database study
Zhaoming Zhang, Hongfu Zhao, Guanghui Cheng
European Journal of Surgical Oncology.2024; 50(10): 108572. CrossRef
Treatment of secondary uterine malignancy following radiotherapy for cervical cancer: a study based on the SEER database
Xiaojing Tong, Yunyun Xiao, Haozhen Li, Hang Zhang, Jiawen Li
BMC Women's Health.2024;[Epub] CrossRef

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Special Article

Top Ten Lessons Learned from Trials in Oligometastatic Cancers: Vivian S. Tan, David A. Palma; Cancer Res Treat. 2023;55(1):5-14. Published online December 16, 2022; DOI: https://doi.org/10.4143/crt.2022.1460

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Recent evidence supports the role of aggressive local treatment in the oligometastatic setting. In this review, we discuss the top 10 lessons we have learned from trials in oligometastatic cancers. Major lessons learned pertain to definitions of oligometastatic disease, outcomes, toxicity, costs, and the combination of ablative therapies with systemic therapy, including immunotherapy. Barriers to accrual for trials and upcoming phase III trials are also reviewed. These lessons may help to inform clinical practice and may be the basis for future research in the oligometastatic space.

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In situ generated CdTe quantum dot-encapsulated hafnium polymer membrane to boost electrochemiluminescence analysis of tumor biomarkers
Haiyin Li, Zhixin Wang, Feng Li, Panpan Gai
Analytical and Bioanalytical Chemistry.2024; 416(21): 4769. CrossRef
Safety and Efficacy of Stereotactic Body Radiation Therapy for Ultra-central Thoracic Tumors: A Single Center Retrospective Review
George J. Li, Hendrick Tan, Humza Nusrat, Joe Chang, Hanbo Chen, Ian Poon, Jeevin Shahi, May Tsao, Yee Ung, Patrick Cheung, Alexander V. Louie
International Journal of Radiation Oncology*Biology*Physics.2024; 120(2): 359. CrossRef
Prevalence of non-Hodgkin lymphoma patients at high-risk of failure after CAR T-cell therapy eligible for bridging radiation therapy
Adnan Danish, Alexandra Della Pia, Lindsay Fogel, Hassan Alkhatatneh, Charles Zhao, Tony Varughese, Karine A. Al Feghali, Lauren Pascual, Brittany Sinclaire, Michael Marafelias, Joshua Zenreich, Yen-Hong Kuo, Tatyana A. Feldman, Yi Zhang, Andre H. Goy, An
Frontiers in Oncology.2024;[Epub] CrossRef
Multidisciplinary Canadian consensus on the multimodal management of high-risk and radioactive iodine-refractory thyroid carcinoma
Shereen Ezzat, Jesse D. Pasternak, Murali Rajaraman, Omar Abdel-Rahman, Andrée Boucher, Nicole G. Chau, Shirley Chen, Sabrina Gill, Martin D. Hyrcza, Nathan Lamond, Marie-Hélène Massicotte, Eric Winquist, Ozgur Mete
Frontiers in Oncology.2024;[Epub] CrossRef
Primary tumor resection in de novo metastatic breast cancer from an oligometastatic perspective: A systematic review and meta-analysis
Chen Wu, Xiang Li, Shiyang Liu, Litong Yao, Tianyi He, Yusong Wang, Haoran Dong, Shuyi Niu, Mozhi Wang, Yingying Xu
iScience.2024; 27(12): 111224. CrossRef
Oligometastasis: More Lessons to Be Learned
Kyung Hwan Kim, Yong Chan Ahn
Cancer Research and Treatment.2023; 55(1): 1. CrossRef
Role of local ablative treatment in oligometastatic non-small cell lung cancer: a meta-analysis
Chai Hong Rim, Won Kyung Cho, Sunmin Park, Won Sup Yoon, Dae Sik Yang
International Journal of Surgery.2023; 109(4): 1006. CrossRef
Re: Toni K. Choueiri, Thomas Powles, Laurence Albiges, et al. Cabozantinib plus Nivolumab and Ipilimumab in Renal-Cell Carcinoma. N Engl J Med 2023;388:1767–78
Clara Cerrato, Benjamin Pradere, Maria Carmen Mir
European Urology.2023; 84(4): e93. CrossRef
Barriers in Oligometastasis Care in Korea: Radiation Oncologists’ Perspectives
Eui Kyu Chie, Chai Hong Rim, Won Kyung Cho, Yong Chan Ahn
Cancer Research and Treatment.2023; 55(4): 1063. CrossRef

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Original Articles

Breast cancer

Impact of Postmastectomy Radiation Therapy on Breast Cancer Patients According to Pathologic Nodal Status after Modern Neoadjuvant Chemotherapy: Dowook Kim, Jin Ho Kim, In Ah Kim, Ji Hyun Chang, Kyung Hwan Shin; Cancer Res Treat. 2023;55(2):592-602. Published online October 11, 2022; DOI: https://doi.org/10.4143/crt.2022.998

Abstract PDF Supplementary Material PubReader ePub

Purpose
The utility of postmastectomy radiation therapy (PMRT) for breast cancer patients after neoadjuvant chemotherapy (NAC) is highly controversial. This study evaluated the impact of PMRT according to pathologic nodal status after modern NAC.
Materials and Methods
We retrospectively reviewed 682 patients with clinical stage II-III breast cancer who underwent NAC and mastectomy from 2013 to 2017. In total, 596 patients (87.4%) received PMRT, and 86 (12.6%) did not. We investigated the relationships among locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), overall survival (OS), and various prognostic factors. Subgroup analyses were also performed to identify patients who may benefit from PMRT.
Results
The median follow-up duration was 67 months. In ypN+ patients (n=368, 51.2%), PMRT showed significant benefits in terms of LRRFS, DFS, and OS (all p < 0.001). In multivariate analyses, histologic grade (HG) III (p=0.002), lymphovascular invasion (LVI) (p=0.045), and ypN2-3 (p=0.02) were significant risk factors for poor LRRFS. In ypN1 patients with more than two prognostic factors among luminal/human epidermal growth factor receptor-2–negative subtype, HG I-II, and absence of LVI, PMRT had no significant effect on LRRFS (p=0.18). In ypN0 patients (n=351, 48.8%), PMRT was not significantly associated with LRRFS, DFS, or OS. However, PMRT showed better LRRFS in triple-negative breast cancer (TNBC) patients (p=0.03).
Conclusion
PMRT had a major impact on treatment outcomes in patients with residual lymph nodes following NAC and mastectomy. Among ypN0 patients, PMRT may be beneficial only for those with TNBC.

Citations

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Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey
Xue-mei Chen, Chen-di Xu, Li-ping Zeng, Xiao-tong Huang, Ao-qiang Chen, Lu Liu, Liu-wen Lin, Le-cheng Jia, Hua Li, Xiao-bo Jiang
Technology in Cancer Research & Treatment.2024;[Epub] CrossRef
Does Post-Mastectomy Radiotherapy Confer Survival Benefits on Patients With 1-3 Clinically Positive Lymph Nodes Rendered Pathologically Negative After Neoadjuvant Systemic Chemotherapy: Consensus from A Pooled Analysis?
Munaser Alamoodi
European Journal of Breast Health.2024; 20(2): 81. CrossRef
Oncological outcomes of stage I–II breast cancer treatment after subcutaneous/skin-sparing mastectomies with reconstruction
E. A. Rasskazova, A. D. Zikiryakhodzhaev
MD-Onco.2024; 4(3): 37. CrossRef
Effectiveness of mat pilates on fatigue in women with breast cancer submitted to adjuvant radiotherapy: randomized controlled clinical trial
Daniele Medeiros Torres, Kelly de Menezes Fireman, Erica Alves Nogueira Fabro, Luiz Claudio Santos Thuler, Rosalina Jorge Koifman, Anke Bergmann, Sabrina da Silva Santos
Supportive Care in Cancer.2023;[Epub] CrossRef
The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review
Giulia Ferrarazzo, Alberto Nieri, Emma Firpo, Andrea Rattaro, Alessandro Mignone, Flavio Guasone, Augusto Manzara, Giuseppe Perniciaro, Stefano Spinaci
Current Oncology.2023; 30(10): 8703. CrossRef

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Gastrointestinal cancer

Radiofrequency Ablation versus Stereotactic Body Radiation Therapy in the Treatment of Colorectal Cancer Liver Metastases: Jesang Yu, Dong Hwan Kim, Jungbok Lee, Yong Moon Shin, Jong Hoon Kim, Sang Min Yoon, Jinhong Jung, Jin Cheon Kim, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Tae Won Kim, Yong Sang Hong, Sun Young Kim, Jeong Eun Kim, Jin-hong Park, So Yeon Kim; Cancer Res Treat. 2022;54(3):850-859. Published online October 13, 2021; DOI: https://doi.org/10.4143/crt.2021.674

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to compare the treatment outcomes of radiofrequency ablation (RFA) and stereotactic body radiation therapy (SBRT) for colorectal cancer liver metastases (CRLM) and to determine the favorable treatment modality according to tumor characteristics.
Materials and Methods
We retrospectively analyzed the records of 222 colorectal cancer patients with 330 CRLM who underwent RFA (268 tumors in 178 patients) or SBRT (62 tumors in 44 patients) between 2007 and 2014. Kaplan–Meier method and Cox models were used by adjusting with inverse probability of treatment weighting (IPTW).
Results
The median follow-up duration was 30.5 months. The median tumor size was significantly smaller in the RFA group than in the SBRT group (1.5 cm vs 2.3 cm, p<0.001). In IPTW-adjusted analysis, difference in treatment modality was not associated with significant differences in 1-year and 3-year recurrence-free survival (35% vs 43%, 22% vs 23%; p=0.198), overall survival (96% vs 91%, 58% vs 56%; p=0.508), and freedom from local progression (FFLP; 90% vs 72%, 78% vs 60%; p=0.106). Significant interaction effect between the treatment modality and tumor size was observed for FFLP (p=0.001). In IPTW-adjusted subgroup analysis of patients with tumor size >2 cm, the SBRT group had a higher FFLP compared with the RFA group (HR, 0.153; p<0.001).
Conclusion
SBRT and RFA showed similar local control in the treatment of patients with CRLM. Tumor size was an independent prognostic factor for local control and SBRT may be preferred for larger tumors.

Citations

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Ablative techniques in colorectal liver metastases: A systematic review, descriptive summary of practice, and recommendations for optimal data reporting
Wee Han Ng, Catarina Machado, Alice Rooney, Robert Jones, Jonathan Rees, Samir Pathak
European Journal of Surgical Oncology.2025; 51(2): 109487. CrossRef
Treatment of Oligometastatic GI Cancers
Clayton T. Marcinak, Patrick B. Schwartz, Mustafa M. Basree, Newton Hurst, Michael Bassetti, Jeremy D. Kratz, Nataliya V. Uboha
American Society of Clinical Oncology Educational Book.2024;[Epub] CrossRef
Stereotactic radiotherapy for liver oligometastases: a pooled analysis following the estro/eortc consensus recommendations
D. Pezzulla, G. Chiloiro, E. M. Lima, G. Macchia, C. Romano, S. Reina, G. Panza, S. Cilla, A. G. Morganti, F. Cellini, M. A. Gambacorta, F. Deodato
Clinical & Experimental Metastasis.2024; 41(5): 667. CrossRef
Interventionelle Therapieoptionen bei oligometastasierten Tumoren
Max Seidensticker
Forum.2024; 39(5): 340. CrossRef
Efficacy and safety of B-ultrasound-guided radiofrequency ablation in the treatment of primary liver cancer: Systematic review and meta-analysis
Xiong Zhang, Hong-Yi Zhu, Ming Yuan
World Journal of Gastrointestinal Surgery.2024; 16(9): 2986. CrossRef
Analysis of alkaline phosphatase and γ-glutamyltransferase after radiofrequency ablation of primary liver cancer: A retrospective study
Wen-Yu Huang, Sheng Zheng, Dan Zhu, Ying-Lang Zeng, Juan Yang, Xue-Li Zeng, Pei Liu, Shun-Ling Zhang, Ming Yuan, Zhi-Xia Wang
World Journal of Gastrointestinal Surgery.2024; 16(9): 2860. CrossRef
Recent trends in radiotherapy use for major cancers in Korea
Kyungmi Yang, Jeong Eun Lee, Won Park, Yong Chan Ahn, Seung Jae Huh
Japanese Journal of Clinical Oncology.2023; 53(12): 1177. CrossRef
Combination of endoscopic ultrasound-guided radiofrequency ablation and adaptive radiation therapy for the treatment of lymph node metastases from colon adenocarcinoma: A case report
Federica Borrelli de Andreis, Maria Alessandra Calegari, Angela Romano, Maria Gabriella Brizi, Luigi Sofo, Ivo Boskoski, Guido Costamagna, Fabia Attili
Current Problems in Cancer: Case Reports.2023; 9: 100216. CrossRef
Comparison of radiofrequency ablation and ablative external radiotherapy for the treatment of intrahepatic malignancies: A hybrid meta-analysis
Chai Hong Rim, Jung Sue Lee, Soo Yeon Kim, Jinsil Seong
JHEP Reports.2023; 5(1): 100594. CrossRef
Metastasis-Directed Local Therapy of Hepatic Oligometastasis from Colorectal Cancer and Future Perspective in Radiation Therapy
Gyu Sang Yoo, Chai Hong Rim, Won Kyung Cho, Jae-Uk Jeong, Eui Kyu Chie, Hyeon-Min Cho, Jun Won Um, Yong Chan Ahn, Jong Hoon Lee
Cancer Research and Treatment.2023; 55(3): 707. CrossRef
Local Control Following Stereotactic Body Radiation Therapy for Liver Oligometastases: Lessons from a Quarter Century
Sara Mheid, Stefan Allen, Sylvia S. W. Ng, William A. Hall, Nina N. Sanford, Todd A. Aguilera, Ahmed M. Elamir, Rana Bahij, Martijn P. W. Intven, Ganesh Radhakrishna, Issa Mohamad, Jeremy De Leon, Hendrick Tan, Shirley Lewis, Cihan Gani, Teo Stanecu, Vero
Current Oncology.2023; 30(10): 9230. CrossRef
Evidence on percutaneous radiofrequency and microwave ablation for liver metastases over the last decade
Koji Tomita, Yusuke Matsui, Mayu Uka, Noriyuki Umakoshi, Takahiro Kawabata, Kazuaki Munetomo, Shoma Nagata, Toshihiro Iguchi, Takao Hiraki
Japanese Journal of Radiology.2022; 40(10): 1035. CrossRef

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General

Radiation Response Prediction Model Based on Integrated Clinical and Genomic Data Analysis: Bum-Sup Jang, Ji-Hyun Chang, Seung Hyuck Jeon, Myung Geun Song, Kyung-Hun Lee, Seock-Ah Im, Jong-Il Kim, Tae-You Kim, Eui Kyu Chie; Cancer Res Treat. 2022;54(2):383-395. Published online August 24, 2021; DOI: https://doi.org/10.4143/crt.2021.759

Abstract PDF Supplementary Material PubReader ePub

Purpose
The value of the genomic profiling by targeted gene-sequencing on radiation therapy response prediction was evaluated through integrated analysis including clinical information. Radiation response prediction model was constructed based on the analyzed findings.
Materials and Methods
Patients who had the tumor sequenced using institutional cancer panel after informed consent and received radiotherapy for the measurable disease served as the target cohort. Patients with irradiated tumor locally controlled for more than 6 months after radiotherapy were defined as the durable local control (DLC) group, otherwise, non-durable local control (NDLC) group. Significant genomic factors and domain knowledge were used to develop the Bayesian Network model to predict radiotherapy response.
Results
Altogether, 88 patients were collected for analysis. Of those, 41 (43.6%) and 47 (54.4%) patients were classified as the NDLC and DLC group, respectively. Somatic mutations of NOTCH2 and BCL were enriched in the NDLC group, whereas, mutations of CHEK2, MSH2, and NOTCH1 were more frequently found in the DLC group. Altered DNA repair pathway was associated with better local failure–free survival (hazard ratio, 0.40; 95% confidence interval, 0.19 to 0.86; p=0.014). Smoking somatic signature was found more frequently in the DLC group. Area under the receiver operating characteristic curve of the Bayesian network model predicting probability of 6-month local control was 0.83.
Conclusion
Durable radiation response was associated with alterations of DNA repair pathway and smoking somatic signature. Bayesian network model could provide helpful insights for high precision radiotherapy. However, these findings should be verified in prospective cohort for further individualization.

Citations

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Estimating the risk and benefit of radiation therapy in (y)pN1 stage breast cancer patients: A Bayesian network model incorporating expert knowledge (KROG 22–13)
Bum-Sup Jang, Seok-Joo Chun, Hyeon Seok Choi, Ji Hyun Chang, Kyung Hwan Shin
Computer Methods and Programs in Biomedicine.2024; 245: 108049. CrossRef
Prediction of Overall Disease Burden in (y)pN1 Breast Cancer Using Knowledge-Based Machine Learning Model
Seok-Joo Chun, Bum-Sup Jang, Hyeon Seok Choi, Ji Hyun Chang, Kyung Hwan Shin
Cancers.2024; 16(8): 1494. CrossRef
Selection of patients with pancreatic adenocarcinoma who may benefit from radiotherapy
I-Shiow Jan, Hui Ju Ch’ang
Radiation Oncology.2023;[Epub] CrossRef
Characterization of the gene signature correlated with favorable response to chemoradiotherapy in rectal cancer: A hypothesis‐generating study
Seung Hyuck Jeon, Eui Kyu Chie
Cancer Medicine.2023; 12(7): 8981. CrossRef
Krüppel-like Factor 10 as a Prognostic and Predictive Biomarker of Radiotherapy in Pancreatic Adenocarcinoma
Yi-Chih Tsai, Min-Chieh Hsin, Rui-Jun Liu, Ting-Wei Li, Hui-Ju Ch’ang
Cancers.2023; 15(21): 5212. CrossRef

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Head and Neck cancer

Long-term Survivals, Toxicities and the Role of Chemotherapy in Early-Stage Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiation Therapy: A Retrospective Study with 15-Year Follow-up: Lin Wang, Jingjing Miao, Huageng Huang, Boyu Chen, Xiao Xiao, Manyi Zhu, Yingshan Liang, Weiwei Xiao, Shaomin Huang, Yinglin Peng, Xiaowu Deng, Xing Lv, Weixiong Xia, Yanqun Xiang, Xiang Guo, Fei Han, Chong Zhao; Cancer Res Treat. 2022;54(1):118-129. Published online June 7, 2021; DOI: https://doi.org/10.4143/crt.2021.101

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was aimed to investigate long-term survivals and toxicities of early-stage nasopharyngeal carcinoma (NPC) in endemic area, evaluating the role of chemotherapy in stage II patients.
Materials and Methods
Totally 187 patients with newly diagnosed NPC and restaged American Joint Committee on Cancer/ International Union Against Cancer 8th T1-2N0-1M0 were retrospectively recruited. All received intensity-modulated radiotherapy (IMRT)±chemotherapy (CT) from 2001 to 2010.
Results
With 15.7-year median follow-up, 10-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were 93.3%, 93.5%, 92.9% and 88.2%, respectively. Multivariable analyses showed cervical lymph nodes positive and pre-treatment prognostic nutritional index ≥ 52.0 could independently predict DMFS (p=0.036 and p=0.011), DSS (p=0.014 and p=0.026), and OS (p=0.002 and p < 0.001); Charlson comorbidity index < 3 points could predict DSS (p=0.011); age > 45 years (p=0.002) and pre-treatment lactate dehydrogenase ≥ 240 U/L (p < 0.001) predicted OS. No grade 4 late toxicity happened; grade 3 late toxicities included subcutaneous fibrosis (4.3%), deafness or otitis (4.8%), skin dystrophy (2.1%), and xerostomia (1.1%). No differences on survivals were shown between IMRT+CT vs. IMRT alone in stage II patients, even in T2N1M0 (p > 0.05). Unsurprising, patients in IMRT+CT had more acute gastrointestinal reaction, myelosuppression, mucositis, late ear toxicity, and cranial nerve injury (all p < 0.05) than IMRT alone group.
Conclusion
Superior tumor control and satisfying long-term outcomes could be achieved with IMRT in early-stage NPC with mild late toxicities. As CT would bring more toxicities, it should be carefully performed to stage II patients.

Citations

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Radiation oncology for the rhinologist
Helena Levyn, Fan Yang, Nancy Y. Lee
Current Opinion in Otolaryngology & Head & Neck Surgery.2024; 32(1): 5. CrossRef
Examining patient-reported late toxicity and its association with quality of life and unmet need for symptom management among nasopharyngeal cancer survivors: a cross-sectional survey
Victor C. W. Tam, Jerry C. F. Ching, Sindy S. T. Yip, Virginia H. Y. Kwong, Catherine P. L. Chan, Kenneth C. W. Wong, Shara W. Y. Lee
Frontiers in Oncology.2024;[Epub] CrossRef
Multifactorial clinical analysis of factors affecting necrosis of nasal septal mucosal flap after salvage surgery for recurrent nasopharyngeal carcinoma
Qilin Gong, Huaying Li, Hui Liu, Youyuan Shi
Scientific Reports.2024;[Epub] CrossRef
Long noncoding RNA LINC00173 induces radioresistance in nasopharyngeal carcinoma via inhibiting CHK2/P53 pathway
Jingjing Miao, Boyu Chen, Yunyun Xiao, Runda Huang, Xiao Xiao, Shunzhen Lu, Lu Zhang, Xuguang Wang, Ying Ouyang, Xiangfu Chen, Qiuyan Chen, Yanqun Xiang, Xiang Guo, Xiaowu Deng, Lin Wang, Haiqiang Mai, Chong Zhao
Cancer Gene Therapy.2023; 30(9): 1249. CrossRef
Therapeutic hyperthermia regulates complement C3 activation and suppresses tumor development through HSPA5/NFκB/CD55 pathway in nasopharyngeal carcinoma
Chengcong Chen, Anbang Ren, Qi Yi, Jiazuo Cai, Muhammad Khan, Yunen Lin, Zhong Huang, Jie Lin, Jian Zhang, Wei Liu, Anan Xu, Yunhong Tian, YaWei Yuan, Ronghui Zheng
Clinical and Experimental Immunology.2023; 213(2): 221. CrossRef
Immunotherapy for nasopharyngeal carcinoma: Current status and prospects (Review)
Huageng Huang, Yuyi Yao, Xinyi Deng, Zongyao Huang, Yungchang Chen, Zhao Wang, Huangming Hong, He Huang, Tongyu Lin
International Journal of Oncology.2023;[Epub] CrossRef
Quality of life and swallowing outcomes after early proactive swallowing rehabilitation by either transcutaneous neuromuscular electrical stimulation or exercise‐based swallowing training in patients with nasopharyngeal carcinoma after radiotherapy
Peter K. M. Ku, Alexander C. Vlantis, Rita W. M. Wong, Thomas S. C. Hui, Thomas Law, Louisa K. Y. Ng, Eddy W. Y. Wong, W. T. Chang, David R. Johnson, Florence S. T. Mok, K. H. Wong, Victor Abdullah, Andrew van Hasselt, Kathy Y. S. Lee, Michael C. F. Tong
Laryngoscope Investigative Otolaryngology.2023; 8(6): 1532. CrossRef
Prognostic nutritional index and serum lactate dehydrogenase predict the prognosis of nasopharyngeal carcinoma patients who received intensity-modulated radiation therapy
Chunxia Zhang, Zhouwei Zhan, Yunxiang Fang, Yuanyuan Ruan, Mingan Lin, Zhisen Dai, Yanping Zhang, Shanshan Yang, Shuxiang Xiao, Bijuan Chen
Journal of Cancer Research and Clinical Oncology.2023; 149(20): 17795. CrossRef
A Systematic Review and Meta-Analysis of Studies Comparing Concurrent Chemoradiotherapy With Radiotherapy Alone in the Treatment of Stage II Nasopharyngeal Carcinoma
Yao-Can Xu, Kai-Hua Chen, Zhong-Guo Liang, Xiao-Dong Zhu
Frontiers in Oncology.2022;[Epub] CrossRef
Minimally Invasive Surgery for Early-Stage Nasopharyngeal Carcinoma
Jinping Liu, Zesheng Zeng, Dingting Wang, Gang Qin
Journal of Craniofacial Surgery.2022; 33(8): e834. CrossRef
External Validation of a Nomogram to Predict Survival and Benefit of Concurrent Chemoradiation for Stage II Nasopharyngeal Carcinoma
Pui-Lam Yip, Shing-Fung Lee, Cheuk-Wai Horace Choi, Po-Chung Sunny Chan, Ka-Wai Alice Cheung, Chung-Hang James Chow, Ka-Man Cheung, Wing-Yu Jessica Lai, Ho-Fun Victor Lee, Ka-On Lam, Chi-Leung Chiang, Chun-Yin Edwin Wong, Ming-Chun Darren Poon, Macy Tong,
Cancers.2021; 13(17): 4286. CrossRef

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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 Res Treat. 2022;54(1):96-108. Published online March 26, 2021; DOI: https://doi.org/10.4143/crt.2020.1349

Abstract PDF PubReader ePub

Purpose
This study aimed to analyze the treatment outcomes of locally recurrent nasopharyngeal cancer (NPC) patients following moderate hypo-fractionation re-irradiation (re-RT).
Materials and Methods
Sixty locally recurrent NPC patients underwent hypo-fractionation re-RT. Forty-eight point three percentage had rT3-4, and 30.0% did keratinizing squamous cell carcinoma. Intensity-modulated radiation therapy (IMRT), with or without intensity-modulated proton therapy (IMPT), was used in 66.7% of patients.
Results
With the median follow-up of 22 months (range, 2 to 254 months), 31 patients (51.7%) died, 38 (63.3%) developed further treatment failure, and 30 (50.0%) developed ≥ grade 3 toxicity (including seven grade 5) at time of analysis. The 2- and 5-year rates of overall survival, local failure-free survival, and ≥ grade 3 toxicity-free survival were 57.9% and 45.8%, 64.1% and 52.5%, and 54.8% and 44.9%, respectively. In multivariate analyses, worse factors for overall survival (OS) were iT3-4 (p=0.010) and age at re-RT ≥ 53 years (p=0.003), those for local failure-free survival (LFFS) were rT3-4 (p=0.022) and rN0-1 (p=0.035), and those for toxicity-free survival (TFS) were iT3-4 (p=0.020) and re-IMRT/IMPT (p=0.030), respectively. Cumulative dose or fraction size ≥ 3 Gy at re-RT, however, showed no significance for OS, LFFS and TFS.
Conclusion
Current re-RT with modern RT techniques by moderate hypo-fractionation scheme seemed feasible in treating locally recurrent NPC patients.

Citations

Citations to this article as recorded by

Radiation oncology for the rhinologist
Helena Levyn, Fan Yang, Nancy Y. Lee
Current Opinion in Otolaryngology & Head & Neck Surgery.2024; 32(1): 5. CrossRef
Identifying the prognostic value of MRI-based tumor response and predicting the risk of radio-resistance in re-radiotherapy for locally recurrent nasopharyngeal carcinoma
Zi-Jian Lu, Ting Liu, Jie-Yi Lin, Sheng-Ting Pei, Ling Guo, Sai-Lan Liu, Hai-Qiang Mai
Radiotherapy and Oncology.2023; 183: 109635. CrossRef
Low-dose radiotherapy effects the progression of anti-tumor response
Lei Gao, Anqi Zhang
Translational Oncology.2023; 35: 101710. CrossRef
The Role of Hypofractionation in Proton Therapy
Alexandre Santos, Scott Penfold, Peter Gorayski, Hien Le
Cancers.2022; 14(9): 2271. CrossRef
Toxicity Profiles and Survival Outcomes Among Patients With Nonmetastatic Nasopharyngeal Carcinoma Treated With Intensity-Modulated Proton Therapy vs Intensity-Modulated Radiation Therapy
Xingzhe Li, Sarin Kitpanit, Anna Lee, Dennis Mah, Kevin Sine, Eric J. Sherman, Lara A. Dunn, Loren S. Michel, James Fetten, Kaveh Zakeri, Yao Yu, Linda Chen, Jung Julie Kang, Daphna Y. Gelblum, Sean M. McBride, Chiaojung J. Tsai, Nadeem Riaz, Nancy Y. Lee
JAMA Network Open.2021; 4(6): e2113205. CrossRef

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Lung Cancer

Prognostic Factor and Clinical Outcome in Stage III Non-Small Cell Lung Cancer: A Study Based on Real-World Clinical Data in the Korean Population: Ho Cheol Kim, Wonjun Ji, Jae Cheol Lee, Hyeong Ryul Kim, Si Yeol Song, Chang-Min Choi, Korean Association for Lung Cancer, Korea Central Cancer Registry; Cancer Res Treat. 2021;53(4):1033-1041. Published online February 16, 2021; DOI: https://doi.org/10.4143/crt.2020.1350

Abstract PDF Supplementary Material PubReader ePub

Purpose
The optimal treatment for patients with stage III non-small cell lung cancer (NSCLC) remains controversial. This study aimed to investigate prognostic factors and clinical outcome in stage III NSCLC using real-world clinical data in the Korean population.
Materials and Methods
Among 8,110 patients with lung cancer selected from 52 hospitals in Korea during 2014-2016, only patients with stage III NSCLC were recruited and analyzed. A standardized protocol was used to collect clinical information and cox proportional hazards models were used to identify risk factors for mortality.
Results
A total of 1,383 patients (46.5% had squamous cell carcinoma and 40.9% had adenocarcinoma) with stage III NSCLC were enrolled, and their median age was 70 years. Regarding clinical stage, 548 patients (39.6%) had stage IIIA, 517 (37.4%) had stage IIIB, and 318 (23.0%) had stage IIIC. Pertaining to the initial treatment method, the surgery group (median survival period: 36 months) showed better survival outcomes than the non-surgical treatment group (median survival period: 18 months, p=0.001) in patients with stage IIIA. Moreover, among patients with stage IIIB and stage IIIC, those who received concurrent chemotherapy and radiation therapy (CCRT, median survival period: 24 months) showed better survival outcomes than those who received chemotherapy (median survival period: 11 months), or radiation therapy (median survival period: 10 months, p<0.001).
Conclusion
While surgery might be feasible as the initial treatment option in patients with stage IIIA NSCLC, CCRT showed a beneficial role in patients with stage IIIB and IIIC NSCLC.

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Jiyun Lee, Hee Kyung Ahn, Sang‐We Kim, Ji‐Youn Han, Sung Sook Lee, Hyung Soon Park, Hyun Woo Lee, Joo‐Hang Kim, Eunhan Cho, Reto Huggenberger, Byoung Chul Cho
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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
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Glucose metabolic heterogeneity correlates with pathological features and improves survival stratification of resectable lung adenocarcinoma
Yu-Hung Chen, Yen-Chang Chen, Kun-Han Lue, Sung-Chao Chu, Bee-Song Chang, Ling-Yi Wang, Ming-Hsun Li, Chih-Bin Lin
Annals of Nuclear Medicine.2023; 37(2): 139. CrossRef
The combined tumor-nodal glycolytic entropy improves survival stratification in nonsmall cell lung cancer with locoregional disease
Yu-Hung Chen, Kun-Han Lue, Sung-Chao Chu, Bee-Song Chang, Chih-Bin Lin
Nuclear Medicine Communications.2023; 44(1): 100. CrossRef
Prognostic value of pretherapeutic FDG PET/CT in non-small cell lung cancer with pulmonary lymphangitic carcinomatosis
Yong-Jin Park, Yunjoo Im, O. Jung Kwon, Joungho Han, Myung-Ju Ahn, Jhingook Kim, Sang-Won Um, Joon Young Choi
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A Propensity-Matched Retrospective Comparative Study with Historical Control to Determine the Real-World Effectiveness of Durvalumab after Concurrent Chemoradiotherapy in Unresectable Stage III Non-Small Cell Lung Cancer
Cheol-Kyu Park, Nakyung Jeon, Hwa-Kyung Park, Hyung-Joo Oh, Young-Chul Kim, Ha-Lim Jeon, Yong-Hyub Kim, Sung-Ja Ahn, In-Jae Oh
Cancers.2023; 15(5): 1606. CrossRef
Association between clinical outcomes and local treatment in stage IV non‐small cell lung cancer patients with single extrathoracic metastasis
Jeong Uk Lim, Hye Seon Kang, Ah Young Shin, Chang Dong Yeo, Chan Kwon Park, Sang Haak Lee, Seung Joon Kim
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Conversion therapy from unresectable stage IIIC non-small-cell lung cancer to radical surgery via anti-PD-1 immunotherapy combined with chemotherapy and anti-angiogenesis: A case report and literature review
Guohua Jia, Shuimei Zhou, Tangpeng Xu, Yabing Huang, Xiangpan Li
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A phase II, multicenter study of lazertinib as consolidation therapy in patients with locally advanced, unresectable, EGFR mutation‐positive non‐small cell lung cancer (stage III) who have not progressed following definitive, platinum‐based, chemoradiatio
Juwhan Choi, Jeong Eun Lee, Chang‐Min Choi, In‐Jae Oh, Kye Young Lee, Tae Won Jang, Seung Hyeun Lee, Eun Young Kim, Dong Won Park, Sun Hyo Park, Sung Yong Lee
Thoracic Cancer.2022; 13(23): 3431. CrossRef
Prognostic Value of Combing Primary Tumor and Nodal Glycolytic–Volumetric Parameters of 18F-FDG PET in Patients with Non-Small Cell Lung Cancer and Regional Lymph Node Metastasis
Yu-Hung Chen, Sung-Chao Chu, Ling-Yi Wang, Tso-Fu Wang, Kun-Han Lue, Chih-Bin Lin, Bee-Song Chang, Dai-Wei Liu, Shu-Hsin Liu, Sheng-Chieh Chan
Diagnostics.2021; 11(6): 1065. CrossRef

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Head/neck cancer

Development of a Tongue Immobilization Device Using a 3D Printer for Intensity Modulated Radiation Therapy of Nasopharyngeal Cancer Patients: Sang Gyu Ju, Yong Chan Ahn, Yeong-bi Kim, Seung Gyu Park, Yoo-mi Choi, Cho Hee Na, Chae-Seon Hong, Dongryul Oh, Dong Yeol Kwon, Cheol Chong Kim, Dong Hyeon Kim; Cancer Res Treat. 2021;53(1):45-54. Published online September 15, 2020; DOI: https://doi.org/10.4143/crt.2020.572

Abstract PDF PubReader ePub

Purpose
This study aimed to reduce radiation doses to the tongue, a patient-specific semi-customized tongue immobilization device (SCTID) was developed using a 3D printer for helical tomotherapy (HT) of nasopharyngeal cancer (NPCa). Dosimetric characteristics and setup stability of the SCTID were compared with those of a standard mouthpiece (SMP).
Materials and Methods
For displacement and robust immobilization of the tongue, the SCTID consists of four parts: upper and lower tooth stoppers, tongue guider, tongue-tip position guide bar, and connectors. With the SCTID and SMP, two sets of planning computed tomography and HT plans were obtained for 10 NPCa patients. Dosimetric and geometric characteristics were compared. Position reproducibility of the tongue with SCTID was evaluated by comparing with planned dose and adaptive accumulated dose of the tongue and base of the tongue based on daily setup mega-voltage computed tomography.
Results
Using the SCTID, the tongue was effectively displaced from the planning target volume compared to the SMP. The median mucosa of the tongue (M-tongue) dose was significantly reduced (20.7 Gy vs. 27.8 Gy). The volumes of the M-tongue receiving a dose of 15 Gy, 30 Gy, and 45 Gy and the volumes of the mucosa of oral cavity and oropharynx (M-OC/OP) receiving a dose of 45 Gy and 60 Gy were significantly lower than using the SMP. No significant differences was observed between the planned dose and the accumulated adaptive dose in any dosimetric characteristics of the tongue and base of tongue.
Conclusion
SCTID can not only reduce the dose to the M-tongue and M-OC/OP dramatically, when compared to SMP, but also provide excellent reproducibility and easy visual verification.

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A Novel Immobilization Method for the Treatment of Head and Neck Cancer Using 3D Printing
Christopher Szewczyk, Yixiang Liao, Samer Al-Khudari, Michael J. Jelinek, Ken Tatebe
Practical Radiation Oncology.2024; 14(1): 20. CrossRef
Novel tongue-positioning device to reduce tongue motions during radiation therapy for head and neck cancer: Geometric and dosimetric evaluation
Seongmoon Jung, Bitbyeol Kim, Sung Young Lee, Won Ick Chang, Jaeman Son, Jong Min Park, Chang Heon Choi, Joo Ho Lee, Hong-Gyun Wu, Jung-in Kim, Jin Ho Kim, Minsoo Chun
PLOS ONE.2023; 18(9): e0291712. CrossRef
Dosimetric comparison between VMAT plans using the fast-rotating O-ring linac with dual-layer stacked MLC and helical tomotherapy for nasopharyngeal carcinoma
Sang Gyu Ju, Yong Chan Ahn, Yeong-bi Kim, Jin Man Kim, Dong Yeol Kwon, Byoung Suk Park, Kyungmi Yang
Radiation Oncology.2022;[Epub] CrossRef
Tongue Displacement Device in Decreasing the Radiation Dose to Tongue and Preventing Proton Beam Overshoot in Proton Therapy for Unilateral Head and Neck Cancer
Chae-Seon Hong, Dongryul Oh, Sang Gyu Ju, Yong Chan Ahn, Yeong-bi Kim, Seyjoon Park, Woojin Lee
Frontiers in Physics.2021;[Epub] CrossRef

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Risk Assessment of Secondary Primary Malignancies in Nasopharyngeal Carcinoma: A Big-Data Intelligence Platform-Based Analysis of 6,377 Long-term Survivors from an Endemic Area Treated with Intensity-Modulated Radiation Therapy during 2003-2013: Lu-Lu Zhang, Guo-Hong Li, Yi-Yang Li, Zhen-Yu Qi, Ai-Hua Lin, Ying Sun; Cancer Res Treat. 2019;51(3):982-991. Published online October 11, 2018; DOI: https://doi.org/10.4143/crt.2018.298

Abstract PDF PubReader ePub

Purpose
The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized.
Methods
and Materials Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT±chemotherapy between January 2003 and June 2013 were retrospectively analyzed. Cumulative incidence of SPMs was calculated using the Kaplan-Meier method. Cox proportional hazards model was used to identify potential risk factors for SPMs and assess whether SPMs affect overall survival.
Results
Of the 6,377 patients, 189 (3.0%) suffered SPMs (median follow-up, 62 months). One-, 2-, 3-, 4-, and 5-cumulative risks of SPMs were 0.4%, 0.9%, 1.6%, 2.2%, and 2.6%, respectively. Latency from start of IMRT to SPMs diagnosis was 37 months (range, 6 to 102 months). In patients with SPMs, 14.3% suffered SPMs within 1 year post-IMRT: 1-3 years, 38.1%; 3-5 years, 33.9%; and >5 years, 13.7%. Lung cancer was the most common SPM (50/6,377, 0.78%). Multivariate analysis demonstrated sex (male, 64% increase), age (≥50 years, 68% increase), and smoking history (41% increase) were significant risk factors for SPMs, and SPMs were associated with poorer overall survival.
Conclusion
This large cohort study confirms SPMs a dreadful complication for long-term survivors of NPC treated with IMRT. SPMs negatively impact overall survival in NPC. Close follow-up is recommended for older male survivors with a smoking history.

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Age-specific characteristics of head and neck second primary malignancies in patients treated for nasopharyngeal carcinoma: a retrospective study
Q. Jiang, T. Xu, M. Zeng, Y. He, Y. Cai, Z. Huang
International Journal of Oral and Maxillofacial Surgery.2024; 53(1): 11. CrossRef
The prevalence of gastroesophageal reflux disease and laryngopharyngeal reflux in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma
Peter K. M. Ku, Alexander C. Vlantis, Thomas S. C. Hui, Zenon W. C. Yeung, Ryan H. W. Cho, Marc H. K. Wong, Alex K. F. Lee, David C. M. Yeung, Simon Y. P. Chan, Becky Y. T. Chan, Wai‐tsz Chang, Florence Mok, Kam‐hung Wong, Jeffrey K. T. Wong, Victor Abdul
Head & Neck.2024; 46(7): 1637. CrossRef
Maxillary sinus anterior wall recurrence after intensity-modulated radiotherapy for nasopharyngeal carcinoma
Y Fang, L Wang, X Chen, C Cao
International Journal of Radiation Research.2024; 22(3): 803. CrossRef
Detection and staging of recurrent or metastatic nasopharyngeal carcinoma in the era of FDG PET/MR
Yongfeng Piao, Caineng Cao, Yuanfan Xu, Shuang Huang, Feng Jiang, Ting Jin, Qifeng Jin, Yonghong Hua, Qiaoying Hu, Xiaozhong Chen
European Archives of Oto-Rhino-Laryngology.2022; 279(1): 353. CrossRef
Second Primary Lung Adenocarcinoma After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma
Fen Xue, Xiaoshuang Niu, Chaosu Hu, Xiayun He
Frontiers in Oncology.2022;[Epub] CrossRef
Racial and ethnic disparities in nasopharyngeal cancer with an emphasis among Asian Americans
Qian Wang, Hui Xie, Yannan Li, Nicholas Theodoropoulos, Yaning Zhang, Changchuan Jiang, Chi Wen, Laura S. Rozek, Paolo Boffetta
International Journal of Cancer.2022; 151(8): 1291. CrossRef
Factors associated with the development of second primary tumours in head and neck cancer patients
Inmaculada Salcedo‐Bellido, Pilar Requena, Rocío Mateos, Carmen Ortega‐Rico, Rocío Olmedo‐Requena, Macarena Lozano‐Lorca, Juan Pedro Arrebola, Rocío Barrios‐Rodríguez
European Journal of Cancer Care.2022;[Epub] CrossRef
Nasopharyngeal carcinoma: an evolving paradigm
Kenneth C. W. Wong, Edwin P. Hui, Kwok-Wai Lo, Wai Kei Jacky Lam, David Johnson, Lili Li, Qian Tao, Kwan Chee Allen Chan, Ka-Fai To, Ann D. King, Brigette B. Y. Ma, Anthony T. C. Chan
Nature Reviews Clinical Oncology.2021; 18(11): 679. CrossRef
The Chinese Society of Clinical Oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma
Ling‐Long Tang, Yu‐Pei Chen, Chuan‐Ben Chen, Ming‐Yuan Chen, Nian‐Yong Chen, Xiao‐Zhong Chen, Xiao‐Jing Du, Wen‐Feng Fang, Mei Feng, Jin Gao, Fei Han, Xia He, Chao‐Su Hu, De‐sheng Hu, Guang‐Yuan Hu, Hao Jiang, Wei Jiang, Feng Jin, Jin‐Yi Lang, Jin‐Gao Li,
Cancer Communications.2021; 41(11): 1195. CrossRef
Radiation-induced second primary squamous cell carcinoma of the oral cavity after radiotherapy for nasopharyngeal carcinoma
Chao Liu, Lieqiang Liao, Guoying Wu, Honghong Yan, Xiaoqi Chen, Chao Wang, Xiajing Zheng, Ziyi Zeng, Zheng Zhao, Di Wu, Xuekui Liu
Oral Oncology.2020; 109: 104863. CrossRef
Second primary cancer after intensity-modulated radiotherapy for nasopharyngeal carcinoma: A territory-wide study by HKNPCSG
James C.H. Chow, Anthony H.P. Tam, Ka-Man Cheung, Victor H.F. Lee, Chi-Leung Chiang, Macy Tong, Edwin C.Y. Wong, Alice K.W. Cheung, Sunny P.C. Chan, Jessica W.Y. Lai, Roger K.C. Ngan, Wai-Tong Ng, Anne W.M. Lee, Kwok-Hung Au
Oral Oncology.2020; 111: 105012. CrossRef

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Salvage Concurrent Chemo-radiation Therapy for Loco-regional Recurrence Following Curative Surgery of Non-small Cell Lung Cancer: Kyung Hwa Lee, Yong Chan Ahn, Hongryull Pyo, Jae Myoung Noh, Seung Gyu Park, Tae Gyu Kim, Eonju Lee, Heerim Nam, Hyebin Lee, Jong-Mu Sun, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park; Cancer Res Treat. 2019;51(2):769-776. Published online September 11, 2018; DOI: https://doi.org/10.4143/crt.2018.366

Abstract PDF PubReader ePub

Purpose
This study is to report clinical outcomes of salvage concurrent chemo-radiation therapy (CCRT) in treating patients with loco-regional recurrence (LRR) following initial complete resection of non-small cell lung cancer.
Materials and Methods
Between February 2004 and December 2016, 127 patients underwent salvage CCRT for LRR. The median radiation therapy (RT) dose was 66 Gy and clinical target volume was to cover recurrent lesion with margin without elective inclusion of regional lymphatics. Majority of patients (94.5%) received weekly platinum-based doublet chemotherapy during RT course.
Results
The median follow-up time from the start of CCRT was 25 months. The median survival duration was 49 months, and overall survival (OS) rates at 2 and 5 years were 72.9% and 43.9%. The 2- and 5-year rates of in-field failure-free survival, distant metastasis free survival, and progression free survival were 82.4% and 73.8%, 50.4% and 39.9%, and 34.6% and 22.3%, respectively. Grade ≥ 3 radiation-related esophagitis and pneumonitis occurred in 14 (11.0%) and six patients (4.7%), respectively. On both univariate and multivariate analysis, higher biologically equivalent dose (BED10) (≥ 79.2 Gy10 vs. < 79.2 Gy10; hazard ratio [HR], 0.431), smaller CTV (≤ 80 cm3 vs. > 80 cm3; HR, 0.403), and longer disease-free interval (> 1 year vs. ≤ 1 year; HR, 0.489) were significantly favorable factors for OS.
Conclusion
The current study has demonstrated that high dose salvage CCRT focused to the involved lesion only was highly effective and safe. In particular, higher BED₁₀, smaller CTV, and longer disease-free interval were favorable factors for improved survival.

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Prognosis of non‐small cell lung cancer with postoperative regional lymph node recurrence
Yoichi Ohtaki, Toshiteru Nagashima, Naoko Okano, Nobuteru Kubo, Takeru Ohtaka, Noriaki Sunaga, Reiko Sakurai, Yosuke Miura, Seshiru Nakazawa, Natsuko Kawatani, Tomohiro Yazawa, Ryohei Yoshikawa, Eiji Narusawa, Ken Shirabe
Thoracic Cancer.2024; 15(11): 859. CrossRef
Durvalumab after chemoradiotherapy for locoregional recurrence of completely resected non–small‐cell lung cancer (NEJ056)
Megumi Furuta, Hidehito Horinouchi, Isao Yokota, Teppei Yamaguchi, Shoichi Itoh, Takafumi Fukui, Akira Iwashima, Jun Sugisaka, Yu Miura, Hisashi Tanaka, Taichi Miyawaki, Hiroshi Yokouchi, Keita Miura, Ryota Saito, Go Saito, Tatsuhiko Kamoshida, Yusuke Uch
Cancer Science.2024; 115(11): 3705. CrossRef
Impact of lymphadenectomy extent on immunotherapy efficacy in post-resectional recurred non-small cell lung cancer: a multi-institutional retrospective cohort study
Hongsheng Deng, Juan Zhou, Hualin Chen, Xiuyu Cai, Ran Zhong, Feng Li, Bo Cheng, Caichen Li, Qingzhu Jia, Caicun Zhou, René Horsleben Petersen, Gaetano Rocco, Alex Brunelli, Calvin S.H. Ng, Thomas A. D’Amico, Chunxia Su, Jianxing He, Wenhua Liang, Bo Zhu
International Journal of Surgery.2023;[Epub] CrossRef
Treatment patterns and survival of patients with locoregional recurrence in early-stage NSCLC: a literature review of real-world evidence
Kathleen Bowes, Nick Jovanoski, Audrey E. Brown, Danilo Di Maio, Rossella Belleli, Shkun Chadda, Seye Abogunrin
Medical Oncology.2022;[Epub] CrossRef
Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
Radiation Oncology Journal.2021; 39(1): 24. CrossRef
Hypo-fractionated radiotherapy with concurrent chemotherapy for locoregional recurrence of non-small cell lung cancer after complete resection: A prospective, single-arm, phase II study (GASTO-1017)
NaiBin Chen, QiWen Li, SiYu Wang, Mai Xiong, YiFeng Luo, Bin Wang, Li Chen, MaoSheng Lin, XiaoBo Jiang, JianLan Fang, SuPing Guo, JinYu Guo, Nan Hu, XinLei Ai, DaQuan Wang, Chu Chu, FangJie Liu, Hao Long, JunYe Wang, Bo Qiu, Hui Liu
Lung Cancer.2021; 156: 82. CrossRef
Salvage radiation therapy for postoperative locoregionally recurrent non-small cell lung cancer: a single-center experience
Yoon Young Jo, Su Ssan Kim, Si Yeol Song, Eun Kyung Choi
Radiation Oncology Journal.2021; 39(3): 210. CrossRef
Propensity score adjusted analysis of patients with isolated locoregional recurrence versus de novo locally advanced NSCLC treated with definitive therapy
Cole Friedes, Nicholas Mai, Wei Fu, Chen Hu, Peijin Han, Kristen A. Marrone, K. Ranh Voong, Russell K. Hales
Lung Cancer.2020; 145: 119. CrossRef

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Radiation Therapy Outcome and Clinical Features of Duodenal-Type Follicular Lymphoma: Hansang Lee, Dongryul Oh, Kyungmi Yang, Young Hyeh Ko, Yong Chan Ahn, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2019;51(2):547-555. Published online July 10, 2018; DOI: https://doi.org/10.4143/crt.2018.190

Abstract PDF Supplementary Material PubReader ePub

Purpose
Duodenal-type follicular lymphoma (FL) is a rare variant of FL. There is still no consensus on the initial treatment, and clinical features including endoscopic findings are not familiar to most physicians. The objective of this study was to evaluate the outcome of patients who were initially treated with radiation therapy for duodenal-type FL.
Materials and Methods
We retrospectively analyzed 20 patients who were consecutively diagnosed with duodenaltype FL between 2008 and 2017. All patients received radiation therapywith curative intent.
Results
The median age of the patients was 52 years (range, 26 to 66 years), and females were predominant. Most patients (n=18, 90%) had stage I disease, and were diagnosed by a regular health examination in an asymptomatic state. The histological grade was one in 19 patients (95%), and the endoscopic findings were diffuse nodular (n=8), whitish granular (n=8), and mixed pattern (n=4). Radiation therapy was delivered to 17 patients with 24 Gy in 12 fractions, and to three patients with 30.6-36 Gy in 18 fractions. All patients were evaluated with endoscopy for response to radiation therapy, and complete response was achieved in 19 patients (95%). At the time of analysis, all patients survived without any evidence of late toxicities related with radiation therapy.
Conclusion
Taken together, radiation therapy alone could be effective in controlling duodenal lesion. A further study with longer follow-up duration is warranted to confirm our findings.

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Masaya Iwamuro, Takehiro Tanaka, Daisuke Ennishi, Motoyuki Otsuka
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Duodenal-type follicular lymphoma: comprehensive insights into disease characteristics and established treatment strategies
Ahmed Alnughmush, Riad El Fakih, Ruah Alyamany, Nasir Bakshi, Saud Alhayli, Mahmoud Aljurf
Current Opinion in Oncology.2024; 36(6): 577. CrossRef
Clinical characteristics and outcomes of Brazilian patients with duodenal-type follicular lymphoma: a multicenter retrospective study
Guilherme Duffles, Arthur Braga, Talita Silveira, Yana Novis, Celso Arrais, Luciana Tucunduva, Ana Rita Fonseca, Davimar Borducchi, Pedro Neffa, Fernando Blumm, Marianne de Castro Gonçalves, Frederico Moreira, Fabio Nucci, Eduardo Rego, Vanderson Rocha
Leukemia & Lymphoma.2024; : 1. CrossRef
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Jan Bosch-Schips, Xenia Parisi, Fina Climent, Francisco Vega
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Duodenal Polyposis: An Incidental Finding of Duodenal-Type Follicular Lymphoma
Rachael Hagen, Jasmine Tidwell, Emily Weng, Steven A Goldenberg, Anjiya Shaikh
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Increased Risk of Diabetes after Definitive Radiotherapy in Patients with Indolent Gastroduodenal Lymphoma
Jong Yun Baek, Do Hoon Lim, Dongryul Oh, Heerim Nam, Jae J Kim, Jun Haeng Lee, Byung-Hoon Min, Hyuk Lee
Cancer Research and Treatment.2022; 54(1): 294. CrossRef
Duodenal Follicular Lymphoma: Track or Treat?
M. Varanese, A. Lauro, I. Lattina, D. Tripodi, T. Daralioti, S. Khouzam, I. R. Marino, V. Stigliano, V. D’Andrea, S. Frattaroli, S. Sorrenti
Digestive Diseases and Sciences.2022; 67(5): 1733. CrossRef
Incidentally Found Mucosal Nodularity on the Second Portion of Duodenum
Joo Hyun Lim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(2): 163. CrossRef
Duodenal-type follicular lymphoma more than 10 years after treatment intervention: A retrospective single-center analysis
Makoto Saito, Akio Mori, Shihori Tsukamoto, Takashi Ishio, Emi Yokoyama, Koh Izumiyama, Masanobu Morioka, Takeshi Kondo, Hirokazu Sugino
World Journal of Gastrointestinal Oncology.2022; 14(8): 1552. CrossRef
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Lázaro Antonio Arango Molano, Andrés Sánchez Gil, Ileana Rocío Bautista Parada
Revista colombiana de Gastroenterología.2021; 36(4): 525. CrossRef
What do we know about duodenal‐type follicular lymphoma? From pathological definition to treatment options
Guilherme Duffles Amarante, Graham Collins, Vanderson Rocha
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Scientific Advances and the Evolution of Diagnosis, Subclassification and Treatment of Lymphoma
Judith A. Ferry
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Development of diffuse large B-cell lymphoma from duodenal type follicular lymphoma: a retrospective study of 23 cases
Masuho Saburi, Yoshiyuki Kondo, Masao Ogata, Yasuhiro Soga, Miyuki Abe, Kuniko Takano, Kazuhiro Kohno, Takayuki Nagai, Toshiyuki Nakayama
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Analysis of the response time to involved-field radiotherapy in primary gastrointestinal low-grade B-cell lymphoma
Kyu Hye Choi, Han Hee Lee, Seung-Eun Jung, Kyung-Sin Park, Joo-Hyun O, Young-Woo Jeon, Byung-Ock Choi, Seok-Goo Cho
Radiation Oncology.2020;[Epub] CrossRef

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Proposal of a Pretreatment Nomogram for Predicting Local Recurrence after Intensity-Modulated Radiation Therapy in T4 Nasopharyngeal Carcinoma: A Retrospective Review of 415 Chinese Patients: Lu-Lu Zhang, Yi-Yang Li, Jiang Hu, Guan-Qun Zhou, Lei Chen, Wen-Fei Li, Ai-Hua Lin, Jun Ma, Zhen-Yu Qi, Ying Sun; Cancer Res Treat. 2018;50(4):1084-1095. Published online November 15, 2017; DOI: https://doi.org/10.4143/crt.2017.359

Abstract PDF PubReader ePub

Purpose
Local relapse-free survival (LRFS) differs widely among patients with T4 category nasopharyngeal carcinoma (NPC). We aimed to build a nomogram incorporating clinicopathological information to predict LRFS in T4 NPC after definitive intensity-modulated radiation therapy (IMRT).
Materials and Methods
Retrospective study of 415 Chinese patients with non-metastatic T4 NPC treated with definitive IMRT with or without chemotherapy at our cancer center between October 2009 and September 2013. The nomogram for LRFS at 3 and 5 years was generated based on multivariate Cox proportional hazards regression, and validated using bootstrap resampling, assessing discriminative performance using the concordance index (C-index) and determining calibration ability via calibration curves.
Results
Five-year LRFS was 88.8%. We identified and incorporated four independent prognostic factors for LRFS: ethmoid sinus invasion, primary gross tumor volume, age, and pretreatment body mass index. The C-index of the nomogram for local recurrence was 0.732 (95% confidence interval, 0.726 to 0.738), indicating excellent predictive accuracy. The calibration curve revealed excellent agreement between nomogram-predicted and observed LRFS probabilities. Risk subgroups based on total point score cutoff values enabled effective discrimination of LRFS.
Conclusion
This pretreatment nomogram enables clinicians to accurately predict LRFS in T4 NPC after definitive IMRT, and could help to facilitate personalized patient counselling and treatment strategies.

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Radiomics and Deep Learning in Nasopharyngeal Carcinoma: A Review
Zipei Wang, Mengjie Fang, Jie Zhang, Linquan Tang, Lianzhen Zhong, Hailin Li, Runnan Cao, Xun Zhao, Shengyuan Liu, Ruofan Zhang, Xuebin Xie, Haiqiang Mai, Sufang Qiu, Jie Tian, Di Dong
IEEE Reviews in Biomedical Engineering.2024; 17: 118. CrossRef
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Annals of Nuclear Medicine.2024; 38(10): 802. CrossRef
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Cancer Medicine.2023; 12(1): 223. CrossRef
Prioritizing sufficient dose to gross tumor volume over normal tissue sparing in intensity‐modulated radiotherapy treatment of T4 nasopharyngeal carcinoma
Yanyan Chen, Quxia Zhang, Tianzhu Lu, Cairong Hu, Jingfeng Zong, Yun Xu, Wei Zheng, Lisha Chen, Senan Lin, Sufang Qiu, Luying Xu, Jianji Pan, Qiaojuan Guo, Shaojun Lin
Head & Neck.2023; 45(5): 1130. CrossRef
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Bingxin Gu, Mingyuan Meng, Mingzhen Xu, David Dagan Feng, Lei Bi, Jinman Kim, Shaoli Song
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Long-Term Outcome of Definitive Radiotherapy for Early Glottic Cancer: Prognostic Factors and Patterns of Local Failure: Yu Jin Lim, Hong-Gyun Wu, Tack-Kyun Kwon, J. Hun Hah, Myung-Whun Sung, Kwang Hyun Kim, Charn Il Park; Cancer Res Treat. 2015;47(4):862-870. Published online February 13, 2015; DOI: https://doi.org/10.4143/crt.2014.203

Abstract PDF PubReader ePub

Purpose
This study evaluates the long-term results of definitive radiotherapy (RT) for early glottic cancer. Clinical and treatment factors related to local control and patterns of failure are analyzed. Materials and Methods We retrospectively reviewed 222 patients with T1-2N0 squamous cell carcinoma of the glottic larynx treated with definitive RT from 1981 to 2010. None of the patients received elective nodal RT or combined chemotherapy. The median total RT dose was 66 Gy. The daily fraction size was < 2.5 Gy in 69% and 2.5 Gy in 31% of patients. The RT field extended from the hyoid bone to the cricoid cartilage.
Results
The median age was 60 years, and 155 patients (70%) had T1 disease. The 5-year rates of local recurrence-free survival (LRFS) and ultimate LRFS with voice preservation were 87.8% and 90.3%, respectively. T2 (hazard ratio [HR], 2.30; 95% confidence interval [CI], 1.08 to 4.94) and anterior commissural involvement (HR, 3.37; 95% CI, 1.62 to 7.02) were significant prognostic factors for LRFS. In 34 patients with local recurrence, tumors recurred in the ipsilateral vocal cord in 28 patients. There were no contralateral vocal cord recurrences. Most acute complications included grade 1-2 dysphagia and/or hoarseness. There was no grade 3 or greater chronic toxicity.
Conclusion
Definitive RT achieved a high cure rate, voice preservation, and tolerable toxicity in early glottic cancer. T2 stage and anterior commissural involvement were prognostic factors for local control. Further optimization of the RT method is needed to reduce the risk of ipsilateral tumor recurrence.

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Review Article

Stereotactic Body Radiotherapy for Early Stage Lung Cancer: Yasushi Nagata; Cancer Res Treat. 2013;45(3):155-161. Published online September 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.3.155

Abstract PDF PubReader ePub

Stereotactic body radiation therapy (SBRT) is a newly developed technique currently in clinical use. SBRT originated from stereotactic radiosurgery for intracranial tumors. SBRT has been widely used clinically for lung cancer. The practice of SBRT demands different kinds of patient fixation, breathing control, target determination, treatment planning, and verifications. The history and current standard technique are reviewed. Clinical studies of lung cancer showed high local control rates with acceptable toxicities. Past and on-going clinical trials are reviewed.

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Original Articles

Bone Metastasis from Primary Hepatocellular Carcinoma: Characteristics of Soft Tissue Formation: Sangwon Kim, Mison Chun, Heejung Wang, Sungwon Cho, Young-Taek Oh, Seung-Hee Kang, Juno Yang; Cancer Res Treat. 2007;39(3):104-108. Published online September 30, 2007; DOI: https://doi.org/10.4143/crt.2007.39.3.104

Abstract PDF PubReader ePub

Purpose

To assess the characteristics of bone metastasis from hepatocellular carcinoma and the radiation field arrangement based on imaging studies.

Materials and Methods

Fifty-three patients (84 lesions) with bone metastasis from a primary hepatocellular carcinoma completed palliative radiation therapy. All patients underwent one of following imaging studies prior to the initiation of radiation therapy: a bone scan, computed tomography or magnetic resonance imaging. The median radiation dose was 30 Gy (7~40 Gy). We evaluated retrospectively the presence of soft tissue formation and the adjustment of the radiation field based on the imaging studies.

Results

Soft tissue formation at the site of bony disease was identified from either a CT/MRI scan (41 lesions) or from a symptomatic palpable mass (5 lesions). The adjustment of the radiation field size based on a bone scan was necessary for 31 of 41 soft tissue forming lesions (75.6%), after a review of the CT/MRI scan. The median survival from the initial indication of a hepatoma diagnosis was 8 months (2 to 71 months), with a 2-year survival rate of 38.6%. The median survival from the detection of a bone metastasis was 5 months (1 to 38 months) and the 1-year overall survival rate was 8.7%.

Conclusion

It was again identified that bone metastasis from a primary hepatocellular carcinoma is accompanied by soft tissue formation. From this finding, an adjustment of the radiation field size based on imaging studies is required. It is advisable to obtain a CT or MRI scan of suspected bone metastasis for better tumor volume coverage prior to the initiation of radiation therapy.

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High-dose radiotherapy is associated with better local control of bone metastasis from hepatocellular carcinoma
In-Hye Jung, Sang Min Yoon, Jungwon Kwak, Jin-Hong Park, Si Yeol Song, Sang-Wook Lee, Seung Do Ahn, Eun Kyung Choi, Jong Hoon Kim
Oncotarget.2017; 8(9): 15182. CrossRef
Bone Metastases of Hepatocellular Carcinoma: Appearance on MRI Using a Standard Abdominal Protocol
Fernanda Velloni, Miguel Ramalho, Mamdoh AlObaidy, António P. Matos, Ersan Altun, Richard C. Semelka
American Journal of Roentgenology.2016; 206(5): 1003. CrossRef
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Santiago Rodríguez, Giácomo Balbinotto Neto, Guillermo Kiss, Ajacio Brandão
Clinical Transplantation.2016; 30(4): 399. CrossRef
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Eonju Lee, Tae Gyu Kim, Hee Chul Park, Jeong Il Yu, Do Hoon Lim, Heerim Nam, Hyebin Lee, Joon Hyeok Lee
Radiation Oncology Journal.2015; 33(3): 217. CrossRef
A novel rabbit monoclonal antibody arginase-1 is highly specific and highly sensitive in hepatocellular carcinoma
David E. Tacha, Charlie Yu, Ding Zhou, Thomas Haas
Journal of Histotechnology.2015; 38(4): 128. CrossRef
The many, atypical presentations of musculoskeletal hepatocellular carcinoma (HCC) metastases
Mostafa Mohamed Mostafa Elian, Enas Ahmed Abdel Gawad
The Egyptian Journal of Radiology and Nuclear Medicine.2014; 45(4): 1183. CrossRef
Natural History of Malignant Bone Disease in Hepatocellular Carcinoma: Final Results of a Multicenter Bone Metastasis Survey
Daniele Santini, Francesco Pantano, Ferdinando Riccardi, Giovan Giuseppe Di Costanzo, Raffaele Addeo, Francesco Maria Guida, Mariella Spalato Ceruso, Sandro Barni, Paola Bertocchi, Sara Marinelli, Paolo Marchetti, Antonio Russo, Mario Scartozzi, Luca Falo
PLoS ONE.2014; 9(8): e105268. CrossRef
Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma
Shinya Hayashi
World Journal of Hepatology.2014; 6(12): 923. CrossRef
Carbon fiber reinforced PEEK Optima—A composite material biomechanical properties and wear/debris characteristics of CF-PEEK composites for orthopedic trauma implants
Ely L. Steinberg, Ehud Rath, Amir Shlaifer, Ofir Chechik, Eran Maman, Moshe Salai
Journal of the Mechanical Behavior of Biomedical Materials.2013; 17: 221. CrossRef
Role of the routine use of chest computed tomography and bone scan in staging workup of hepatocellular carcinoma
Young-Joo Jin, Han Chu Lee, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Kyung-Hyun Do, Jin Sook Ryu
Journal of Hepatology.2012; 56(6): 1324. CrossRef
Multidisciplinary Management of Recurrent Hepatocellular Carcinoma Following Liver Transplantation
Peter J. Kneuertz, David P. Cosgrove, Andrew M. Cameron, Ihab R. Kamel, Jean-Francois H. Geschwind, Joseph M. Herman, Timothy M. Pawlik
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Metastatic Hepatocellular Carcinoma to the Distal Phalanx: a Case Report and Review of Literature
Joo-Hyun Park, Jungkwon Lee, Da-Eun Jung, Soomin Ahn, Kyung-Min Lee, Bo-Kyoung Kim
The Korean Journal of Hospice and Palliative Care.2012; 15(2): 108. CrossRef
Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CT and 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation
Hyo Jung Seo, Yun Jung Choi, Hyun Jeong Kim, Yong Hyu Jeong, Arthur Cho, Jae Hoon Lee, Mijin Yun, Hye Jin Choi, Jong Doo Lee, Won Jun Kang
Nuclear Medicine and Molecular Imaging.2011; 45(3): 203. CrossRef
Radiation Therapy for Bone Metastases from Hepatocellular Carcinoma: Effect of Radiation Dose Escalation
Tae Gyu Kim, Hee Chul Park, Do Hoon Lim, Cheol Jin Kim, Hye Bin Lee, Keum Yeon Kwak, Moon Seok Choi, Joon Hyoek Lee, Kwang Cheol Koh, Seung Woon Paik, Byung Chul Yoo
The Journal of the Korean Society for Therapeutic Radiology and Oncology.2011; 29(2): 63. CrossRef

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Patterns of Failure after Postoperative Radiation Therapy for Endometrial Carcinoma: Suzy Kim, Hong-Gyun Wu, Hyo-Pyo Lee, Soon-Beom Kang, Yong-Sang Song, Noh-Hyun Park, Sung Whan Ha; Cancer Res Treat. 2006;38(3):133-138. Published online June 30, 2006; DOI: https://doi.org/10.4143/crt.2006.38.3.133

Abstract PDF PubReader ePub

Purpose

We tried to investigate the outcome and patterns of failure of endometrial cancer patients who were treated with surgery and postoperative radiation therapy (RT).

Materials and Methods

Eighty-three patients with endometrial cancer who received postoperative RT between May 1979 and August 2000 were included in this retrospective study. Forty-one patients received total abdominal hysterectomy, 41 patients received Wertheim's operation and 1 underwent vaginal hysterectomy. Pelvic lymph node dissection or pelvic lymph node sampling was done in 56 patients and peritoneal cytology was done in 35. All the patients were staged according to 1988 FIGO (International Federation of Gynecology and Obstetrics) staging system; 2 were stage IA, 23 were stage IB, 20 were stage IC, 4 were stage IIA, 5 were stage IIB, 9 were stage IIIA, 2 were stage IIIB and 18 were stage IIIC. The histologic diagnoses were adenocarcinoma in seventy-four patients (89%). The histologic grades were Grade 1, 2 and 3 in 21 (25%), 43 (52%) and 10 (12%) patients, respectively. All the patients received external beam RT (EBRT) with a median dose of 5,040 cGy (range: 4,500~5,075 cGy) to the whole pelvis. Five patients with pathologically confirmed paraaortic lymph node metastasis received 4500 cGy to the paraaortic lymph nodes. Fifteen patients received low-dose intracavitary brachytherapy after their EBRT. A total dose of 7,500~9,540 cGy (median dose: 8511) was prescribed to the vaginal surface.

Results

Overall, 11 patients (13%) experienced disease relapse: 4 with initial stage I or II disease and 7 with initial stage III disease. Among the 54 stage I or II patients, 1 (2%) relapsed in the pelvis only, 2 (4%) relapsed in the vagina and distant organs, and 1 (2%) relapsed in the paraaortic lymph nodes (PANs). Among the 29 stage III patients, 1 (3%) relapsed in the vagina. The most common sites of failure for the stage III patients were the peritoneum (3 patients, 10%), PANs (2 patients, 7%), and lung (2 patients, 7%). With a median follow-up period of 86 months, the overall survival (OS) and disease-free survival (DFS) rates at 5 years were 87% for both. The five-year DFS rate was 93%, 100% and 74% for the stage I, II and III patients, respectively. Three patients experienced severe radiation-related late complications: RTOG (Radiation Therapy Oncology Group) grade 3 radiation cystitis was seen in one patient, and grade 3 bowel obstruction was seen in two patients.

Conclusions

Postoperative RT was useful for controlling pelvic disease. The major patterns of failure for stage III patients were peritoneal seeding and distant metastasis. Selective use of whole abdominal radiotherapy or adjuvant chemotherapy may improve the therapeutic outcome of these patients.

Citations

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Pattern of care and clinical outcome of patients with carcinoma endometrium and the impact of central histopathological review on management: A tertiary cancer centre experience
Rakhi Verma, Ajeet K. Gandhi, Madhup Rastogi, Vachaspati K. Mishra, Vikas Sharma, Akash Agarwal, Saumya Shukla, Rohini Khurana, Rahat Hadi, Anoop K. Srivastava, Nuzhat Husain
Journal of Cancer Research and Therapeutics.2024; 20(5): 1557. CrossRef
Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma?
Jennifer Yoon, Halle Fitzgerald, Yaqun Wang, Qingyang Wang, Irina Vergalasova, Mohamed A. Elshaikh, Irina Dimitrova, Shari Damast, Jessie Y. Li, Emma C. Fields, Sushil Beriwal, Andrew Keller, Elizabeth A. Kidd, Melissa Usoz, Shruti Jolly, Elizabeth Jawors
Practical Radiation Oncology.2022; 12(2): e123. CrossRef
Efficacy of Para-Aortic Lymphadenectomy in Early-Stage Endometrioid Uterine Corpus Cancer
Seo-Yun Tong, Jong-Min Lee, Jae-Kwan Lee, Jae Weon Kim, Chi-Heum Cho, Seok-Mo Kim, Sang-Yoon Park, Chan-Yong Park, Ki-Tae Kim
Annals of Surgical Oncology.2011; 18(5): 1425. CrossRef
Current status in the management of uterine corpus cancer in Korea
Nan-Hee Jeong, Jong-Min Lee, Seon-Kyung Lee
Journal of Gynecologic Oncology.2010; 21(3): 151. CrossRef

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Evaluation of Parotid Gland Function following Intensity Modulated Radiation Therapy for Head and Neck Cancer: Seok Ho Lee, Tae Hyun Kim, Joo Young Kim, Sung Yong Park, Hong Ryull Pyo, Kyung Hwan Shin, Dae Yong Kim, Joo Young Kim, Kwan Ho Cho; Cancer Res Treat. 2006;38(2):84-91. Published online April 30, 2006; DOI: https://doi.org/10.4143/crt.2006.38.2.84

Abstract PDF PubReader ePub

Purpose

This study was undertaken to determine the parotid gland tolerance dose levels following intensity modulated radiation therapy (IMRT) for treating patients who suffered with head and neck cancer.

Materials and Methods

From February 2003 through June 2004, 34 head and neck patients with 6 months of follow-up were evaluated for xerostomia after being treated by IMRT. Their median age was 59 years (range: 29~78). Xerostomia was assessed using a 4-question xerostomia questionnaire score (XQS) and a test for the salivary flow rates (unstimulated and stimulated: USFR and SSFR, respectively). The patients were also given a validated LENT SOMA scale (LSS) questionnaire. Evaluations were performed before IMRT and at 1, 3 and 6 months after IMRT.

Results

All 34 patients showed significant changes in the XQS, LSS and Salivary Flow rates (USFR and SSFR) after IMRT. No significant changes in the XQS or LSS were noted in 12 patients who received a total parotid mean dose of ≤3,100 cGy at 1, 3 and 6 months post-IMRT relative to the baseline values. However, for the 22 patients who received >3,100 cGy, significant increases in the XQS and LSS were observed. The USFR and SSFR from the parotid glands in 7 patients who received ≤2,750 cGy were significantly preserved at up to 6 months after IMRT. However, the USFR and SSFR in 27 patients who were treated with >2,750 cGy were significantly lower than the baseline values at all times after IMRT.

Conclusion

We suggest that the total parotid mean dose should be limited to ≤2,750 cGy to preserve the USFR and SSFR and so improve the subsequent quality of life.

Citations

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Evaluation of the Effect of Photobiomodulation on Radiation-Induced Xerostomia in Head and Neck Cancer Patients: A Randomized Clinical Trial
Pegah Mosannen Mozaffari, Zahra Delavarian, Reza Fekrazad, Azar Fani Pakdel, Mahdokht Rashed Mohassel, Mohammad Taghi Shakeri, Ala Ghazi
Journal of Lasers in Medical Sciences.2024; 15: e4. CrossRef
Salivary microbiome changes distinguish response to chemoradiotherapy in patients with oral cancer
Marcell Costa de Medeiros, Stephanie The, Emily Bellile, Nickole Russo, Ligia Schmitd, Erika Danella, Priyanka Singh, Rajat Banerjee, Christine Bassis, George R. Murphy, Maureen A. Sartor, Isabelle Lombaert, Thomas M. Schmidt, Avi Eisbruch, Carol Anne Mur
Microbiome.2023;[Epub] CrossRef
Translation and cross-cultural adaption of the Chinese version of the Vanderbilt Head and Neck Symptom Survey version 2.0: a tool for oral symptom assessment in head and neck cancer patients
Min Jin, Li Sun, Rui Meng, Wenjing Wang, Rui Sun, Jing Huang, You Qin, Bian Wu, Qian Ding, Gang Peng, Tao Zhang, Kunyu Yang
Health and Quality of Life Outcomes.2021;[Epub] CrossRef
Study of dosimetry and clinical factors for assessment of xerostomia in head and neck squamous cell carcinoma treated by intensity-modulated radiotherapy: A prospective study
Vrinda Singla, Vipul Nautiyal, Meenu Gupta, Viney Kumar, Shivani Mehra, Mushtaq Ahmad
Journal of Carcinogenesis.2021; 20(1): 14. CrossRef
Radiotherapy-related quality of life in patients with head and neck cancers: a meta-analysis
Xiuhong Ge, Zhengluan Liao, Jianhua Yuan, Dewang Mao, Yumei Li, Enyan Yu, Xunheng Wang, Zhongxiang Ding
Supportive Care in Cancer.2020; 28(6): 2701. CrossRef
Xerostomia, salivary characteristics and gland volumes following intensity‐modulated radiotherapy for nasopharyngeal carcinoma: a two‐year follow up
CPC Sim, YL Soong, EPP Pang, C Lim, GD Walker, DJ Manton, EC Reynolds, JTS Wee
Australian Dental Journal.2018; 63(2): 217. CrossRef
Radiotherapy changes salivary properties and impacts quality of life of children with Hodgkin disease
L. Marangoni-Lopes, L.P. Rodrigues, R.H. Mendonça, M. Nobre-dos Santos
Archives of Oral Biology.2016; 72: 99. CrossRef
Is linac-based volumetric modulated arc therapy better than helical tomotherapy in the radiotherapy of nasopharyngeal carcinoma?
Vincent W. C. Wu, Bing-kin Choi, Ho-nam Chan, Ruby Lam, Yu-king Wong, Alan W. L. Mui, George Chiu
Journal of Radiation Oncology.2015; 4(1): 29. CrossRef
Preventing and Therapeutic Effect of Propolis in Radiotherapy Induced Mucositis of Head and Neck Cancers: A Triple-Blind, Randomized, Placebo-Controlled Trial
Abbas Javadzadeh Bolouri, Atessa Pakfetrat, Arghavan Tonkaboni, Seyed Amir Aledavood, Mohsen Fathi Najafi, Zahra Delavarian, Mohammad Taghi Shakeri, Azade Mohtashami
Iranian Journal of Cancer Prevention.2015;[Epub] CrossRef
Evaluation of an automated knowledge based treatment planning system for head and neck
Jerome Krayenbuehl, Ian Norton, Gabriela Studer, Matthias Guckenberger
Radiation Oncology.2015;[Epub] CrossRef
Translation and validation of the Chinese version of the quality of life radiation therapy instrument and the head & neck module (QOL-RTI/H&N)
Xin-lin Chen, Zhen-wen Qiu, Mo-fa Gu, Yong Su, Li-zhi Liu, Yan Liu, Chuan-wei Mo, Qian Xu, Juan Sun, Dong-hai Li
Health and Quality of Life Outcomes.2014;[Epub] CrossRef
Correlation of Parotid Gland Function in Head and Neck Cancer Patients treated with Intensity-modulated Radiotherapy
Sonal Vahanwala, Sukhjinder Kaur Khosa, Sandeep S Pagare
International Journal of Head and Neck Surgery.2012; 3(1): 1. CrossRef
Effects of Intensity-modulated Radiotherapy on Human Oral Microflora
Zi-Yang SHAO, Zi-Sheng TANG, Chao YAN, Yun-Tao JIANG, Rui MA, Zheng LIU, Zheng-Wei HUANG
Journal of Radiation Research.2011; 52(6): 834. CrossRef

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Retrospective Analysis of the Treatment Results for Patients with Squamous Cell Carcinoma of Tonsil: Ah Ram Chang, Hong-Gyun Wu, Charn Il Park, Kwang-Hyun Kim, Myung-Whun Sung, Dae-Seog Heo; Cancer Res Treat. 2005;37(2):92-97. Published online April 30, 2005; DOI: https://doi.org/10.4143/crt.2005.37.2.92

Abstract PDF PubReader ePub

Purpose

There has been no definitive randomized study to identify the optimal therapeutic regimen for treating squamous cell carcinoma of tonsil. The purpose of this study was to retrospectively evaluate the treatment outcome according to various combinations of surgery, radiation therapy and chemotherapy.

Materials and Methods

Fifty-six patients with tonsillar carcinoma, who were treated at Seoul National University Hospital from March 1985 to August 2001, were the subjects of this study. Twenty-one patients received surgery followed by radiation therapy (SRT), 16 patients underwent radiation therapy alone (RT), and 19 patients received neoadjuvant chemotherapy and radiation therapy (CRT). The median radiation dose was 66.6 Gy for the SRT group and 70.2 Gy for the RT and CRT groups. Surgery comprised extended tonsillectomy and modified radical neck dissection of the involved neck. Cisplatin and 5-fluorouracil were used every three weeks for 3 cycles in the SRT group. The median follow-up was 73.2 months.

Results

The distribution of T-stage was 4 cases of T1, 14 cases of T2, 1 case of T3 and 2 cases of T4 staging in the SRT group, 2 cases of T1, 6 cases of T2, 5 cases of T3 and 3 cases of T4 staging in the RT group and 0 cases of T1, 7 cases of T2, 9 cases of T3 and 3 cases of T4 staging in the CRT group. The distribution of N-stage was 5 cases of N0, 2 cases of N1, 13 cases of N2 and 1 case of N3 staging in the SRT group, 6 cases of N0, 5 cases of N1, 5 cases of N2 and 0 cases of N3 staging in the RT group, and 2 cases of N0, and 7 cases of N1, 9 cases of N2 and 1 case of N3 staging in the CRT group. The five-year overall survival rate (OSR) for all patients was 78%. The five-year OSR was 80% for the SRT group, 71% for the RT group, and 80% for the CRT group (p=ns). The five-year disease-free survival rate was 93% for the CRT group and 71% for the RT group (p=0.017). Four patients developed local failure and one patient failed at a regional site in the RT group, and one patient failed at a primary site in the CRT group. The five-year DFS was 84% for patients who had undergone neck dissection and 76% for patients who had not undergone neck dissection (p=ns). Treatment-related complications of grade 3 or 4 occurred in 15 patients, and the incidence of complication was not different between each of the treatment methods.

Conclusion

Although the patients with more advanced T stage were included in the RT and CRT groups, the OSR was not statistically different according to the treatment methods. In the radical radiation therapy group, the addition of neoadjuvant chemotherapy showed an improvement in the disease-free survival. Because of the retrospective nature of our study and the small number of patients, this study cannot draw any definite conclusions, but it suggests that radiation therapy with chemotherapy can be a good alternative option for squamous cell carcinoma of tonsil. Controlled randomized study is necessary to confirm this hypothesis.

Citations

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Long-term results of ipsilateral radiotherapy for tonsil cancer
Tae Ryool Koo, Hong-Gyun Wu
Radiation Oncology Journal.2013; 31(2): 66. CrossRef
Definitive Radiotherapy versus Postoperative Radiotherapy for Tonsil Cancer
Tae Ryool Koo, Hong-Gyun Wu, J. Hun Hah, Myung-Whun Sung, Kwang-Hyun Kim, Bhumsuk Keam, Tae Min Kim, Se-Hoon Lee, Dong-Wan Kim, Dae-Seog Heo, Charn Il Park
Cancer Research and Treatment.2012; 44(4): 227. CrossRef
Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation
Laura M. Dooley, Kevin L. Potts, Liz D. Wilson, Zachary J. Cappello, Jeffrey M. Bumpous
The Laryngoscope.2011; 121(8): 1656. CrossRef
EGFR mutations and human papillomavirus in squamous cell carcinoma of tongue and tonsil
Im Il Na, Hye Jin Kang, Soo Youn Cho, Jae Soo Koh, Jin Kyung Lee, Byeong Cheol Lee, Guk Haeng Lee, Yong Sik Lee, Hyung Jun Yoo, Baek-Yeol Ryoo, Sung Hyun Yang, Yoon Sang Shim
European Journal of Cancer.2007; 43(3): 520. CrossRef

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High Dose Radiation Therapy Concurrent with Chemotherapy in Locally Advanced Nasopharynx Cancer: Min Kyu Kang, Yong Chan Ahn, Won Park, Keunchil Park, Chung Hwan Baek, Young Ik Son, Jeong Eun Lee, Young Je Park, Hee Rim Nam, Kyoung Ju Kim, Do Hoon Lim, Seung Jae Huh; Cancer Res Treat. 2003;35(5):391-399. Published online October 31, 2003; DOI: https://doi.org/10.4143/crt.2003.35.5.391

Abstract PDF: PURPOSE
Here, our results from a prospective treatment protocol of concurrent radiochemotherapy (CRCT), which was conducted for locally advanced nasopharynx cancers, between April 1994 and May 2001, are reported. MATERIALS AND METHODS: A total of 52 consecutive eligible patients were accumulated for this protocol. The median radiation doses to the primary site, involved nodes and uninvolved neck were 72, 61.2 and 45 Gy, using a serial shrinking field technique. The boost techniques were 3-dimensional conformal radiation therapy in 45, intracavitary brachytherapy in 3 and 2-dimensional radiation therapy, with multiple small fields, in 2 patients. Two chemotherapy regimens were used: the first regimen, used in 8 patients during the earlier part of the study duration, consisted of 2 cycles of cisplatin plus 5- fluorouracil every 4 weeks, with concurrent radiation therapy, and 4 cycles with the same agents every 4 weeks, adjuvantly; the second regimen, used in 44 patients during the later part, consisted of 3 cycles of cisplatin every 3 weeks, with concurrent radiation therapy and 3 cycles of adjuvant cisplatin plus 5-fluorouracil every 3 weeks. RESULTS: The median follow-up period of the survivors was 32 months. The male to female ratio was 36/16, with a median age of 48 years. The stages, according to the new AJCC staging system (1997), were IIb in 6, III in 23, IVa in 14 and IVb in 9 patients. Fifty and 32 patients completed the planned radiation therapy and concurrent chemotherapy, respectively. Two patients died, 1 of septic shock during the CRCT and the other of malnutrition during the adjuvant chemotherapy. There were 12 failures in 11 patients: 7 locoregional recurrences, 1 within and 6 outside the radiation target volume, and 5 distant metastases. The locoregional control, disease-free survival and overall survival rates were 84.3, 78.8 and 92.8% at 3 years, respectively. CONCLUSION: High dose radiation therapy, coupled with concurrent chemotherapy, was judged a highly effective treatment for locally advanced nasopharynx cancers.

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Review Article

Treatment of Small Cell Lung Cancer: Atsushi Horiike, Nagahiro Saijo; Cancer Res Treat. 2003;35(3):177-180. Published online June 30, 2003; DOI: https://doi.org/10.4143/crt.2003.35.3.177

Abstract PDF: Among patients with lung cancer, approximately 15% have small cell lung cancer (SCLC), SCLC is usually staged as either limited and extensive. Extensive-stage SCLC is treated primarily with chemotherapy. A recent Japanese randomized trial compared cisplatin and irinotecan (IP) with cisplatin and etoposide (EP). Patients in the IP arm did significantly better than patients in the EP arm. In the IP arm, the response rate was 84%, and the median overall survival period was 12.8 months. Limited- stage SCLC is usually treated with concurrent chemotherapy and accelerated radiation therapy, and approximately 20% of patients are cured. Future research should focus on optimizing chemotherapy regimens and radiation therapy schedules. The role of molecular targeted drugs in the treatment of SCLC must also be evaluated.

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Original Articles

Conjunctival Lymphoma: Retrospective Analysis of the Treatment Result and Complications with Radiation Therapy: Kyoung Ju Kim, Seung Do Ahn, Eun Kyung Choi, Hyesook Chang, Jong Hoon Kim; Cancer Res Treat. 2002;34(1):58-61. Published online February 28, 2002; DOI: https://doi.org/10.4143/crt.2002.34.1.58

Abstract PDF: PURPOSE
In order to evaluate the response to radiation therapy and to analyze the patterns of failure, survival and complications, we performed a retrospective analysis of patients with conjunctival lymphoma.
MATERIALS AND METHODS
From November 1991 to March 1999, 11 patients were diagnosed as conjunctival lymphoma at Asan Medical Center. Five patients had bilateral involvements, and a total of 16 eyes received radiation therapy. Using 6 to 9 MeV electrons or 4 MV photon beams, all patients were treated with a single anterior field to total doses ranging from 30 Gy to 45 Gy delivered in 10 to 25 fractions. The median follow up period was 57 Months.
RESULTS
All patients achieved a complete response with radiation therapy. Two of 16 eyes that were treated (12.5%) developed local recurrence after radiation therapy, however they were salvaged with 30 Gy of reirradiation. The five-year local control was 88.9%. One out of 11 patients (9.9%) developed lung metastasis and received chest irradiation. At the last follow up, one had died of pneumonia and 10 patients were alive without disease evidence. The five-year overall survival rate was 77.8% and 5-year disease free survival was 77.8%. Cataract and dry eye occurred in one patient (9.9%) respectively.
CONCLUSION
Radiation therapy is a very effective and safe treatment modality for conjunctival lymphoma. The local control rate of radiotherapy was excellent and complications were acceptable. Radiation therapy is also an effective treatment modality for recurrent conjunctival lymphoma. It generally requires more than three months to achieve complete response following radiation therapy, thus we recommend evaluating the response to radiation therapy at three months after completion of treatment.

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Clinical Features and Prognosis of Lung Cancer with Brain Metastasis: Kyung Eun Lee, Eun Mi Nam, He Jin Lee, Seung Hyun Nam, Do Yeun Kim, Seock Ah Im, Chu Myung Seong, Soon Nam Lee, Kyung Ja Lee; Cancer Res Treat. 2001;33(3):250-255. Published online June 30, 2001; DOI: https://doi.org/10.4143/crt.2001.33.3.250

Abstract PDF

PURPOSE
Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis.
MATERIALS AND METHODS
From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities.
RESULTS
The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01).
CONCLUSION
In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.

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Combination of EGFR-Directed Tyrosine Kinase Inhibitors (EGFR-TKI) with Radiotherapy in Brain Metastases from Non-Small Cell Lung Cancer: A 2010–2019 Retrospective Cohort Study
Vineeth Tatineni, Patrick J. O’Shea, Shreya Saxena, Atulya A. Khosla, Ahmad Ozair, Rupesh R. Kotecha, Xuefei Jia, Yasmeen Rauf, Erin S. Murphy, Samuel T. Chao, John H. Suh, David M. Peereboom, Manmeet S. Ahluwalia
Cancers.2023; 15(11): 3015. CrossRef

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Results of Definitive Radiation Therapy in Adenosquamous Cell Carcinoma of the Uterine Cervix: Sang Wook Lee, Chang Ok Suh, Eun Ji Chung, Gwi Eon Kim, Kyung Ran Park, Kang Kyoo Lee, Ik Jae Lee, Tchan Kyu Park, Jaewook Kim, Jong Taek Park, Jae Uk Shim, Joon Oh Park; J Korean Cancer Assoc. 2001;33(1):21-26.

Abstract PDF: PURPOSE
To define the clinical features and pattern of failure and to evaluate the results of radiation treatment in of adenosquamous cell carcinoma of the uterine cervix.
MATERIALS AND METHODS
From Jun. 1981 to Dec. 1997, 43 patients with adenosquamous cell carcinoma of the uterine cervix were retrospectively analyzed external radiation treatment and HDR-ICR from Yonsei cancer center and Wonju cristian hospital. The median age was 51. Stage distribution according to FIGO were stage 1b in 10, 2a in 5, 2b in 18, 3b in 9, 4a in 1. Median follow-up period was 41 months.
RESULTS
Overall survival rate and disease free survival rate were 57.2% and 60.2%. Complete response rate was 86.0%. Locoregional failure was observed in seven patients.
CONCLUSION
Major pattern of failure was locoregional failure. Adenosquamous cell carcinoma was not more aggressive than other pathologic types.

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Primary CHOP Chemotherapy Followed by Involved Field Radiation Therapy in Clinical Stage I or II Aggressive Non-Hodgkin's Lymphomas: Chang Hee Lee, Young Hyuck Im, Baek Yeol Ryoo, Seung Mo Nam, Mi Sook Kim, Yong Sik Lee, Kyung Kyun Oh, Yoon Sang Shim, Seong Yul Yoo, Jhin Oh Lee, Tae Woong Kang, Yoon Koo Kang; J Korean Cancer Assoc. 1998;30(4):809-817.

Abstract PDF: PURPOSE
Although radiation therapy had been the treatment of choice for localized non-Hodgkin's lymphoma(NHL), recent studies have revealed that treatment result after radiation therapy alone is not successful for localized aggressive NHL, if it is not pathologically but clinically staged. A prospective phase II trial was conducted to evaluate the therapeutic results of 4 cycles of CHOP chemotherapy followed by involved field radiation therapy in clinically staged localized aggressive NHL.
MATERIALS AND METHODS
Patients with a diagnosis of aggressive NHL(all intermediate grade and immunoblastic histology in NCI working formulation), Ann Arbor stage I or II without poor prognostic factors(presence of B symptoms, bulky diseases, or 2 or more extranodal involvement) were treated with 4 cycles of CHOP(cyclophosphamide, doxorubicin, vincristine, prednisolone) followed by involved field radiation therapy of 3,000~6,000(median: 4,500) cGy.
RESULTS
Between April 1990 and March 1995, 62 consecutive patients entered this trial. Forty six patients with measurable diseases were evaluable for response. Complete response was achieved in 41(89.1%) patients after CHOP chemotherapy and 4 more patients after subsequent radiation therapy, making total CR rate of 98%. Progression free survival(PFS) of all 62 patients were 2.2+~73+ months and 5 year PFS rate was 64.6%. Overall survival(OS) were 2.4+~75+ months and 5 year OS rate was 75.2%. Old age (> 60) was the only significant prognostic factor, which-affected overall survival negatively. Treatment was relatively well tolerated, but 3 patients died associated with treatment.
CONCLUSIONS
Four cycles of CHOP chemotherapy followed by involved field radiation therapy is highly curative and safe treatment for clinically staged, localized aggressive NHLs.

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Effect of Oral Nutritional Support During Radiation Therapy in Patients with Thoracic and Gead/Neck Cancer: Mi Sun Chun, Seung Hee Kang, Hye Kyung Kwon, Young Taek Oh, Joo Ri Kim, Hyun Joo Lee, Soon Young Lee, Sun Jeong Choi; J Korean Cancer Assoc. 1998;30(4):781-789.

Abstract PDF: PURPOSE
This study was designed to evaluate the role of oral nutritional support and nutritional counseling by dietician during radiation therapy.
MATERIALS AND METHODS
This study included total 58 patients with head/neck, lung, or esophageal cancers who received radiation therapy with radical purpose between February and December, 1996. They were randomized either into nutrient supplement group (Group I) or control group (Group II). In Group I, the dietician advised patients to take high density nutrient supplement (NuCare, 250 kcal/can, Miwon co., LTD) based on dieticians initial evaluation for oral intake from initiation to completion of radiation therapy. In Group II, patients received nutritional support other than high density nutrient supplement only when patients lose weight more than 2 Kg during radiation treatment. All patients were evaluated for nutritional status and diet pattern and received nutritional counseling before radiation therapy and then weekly during treatment.
RESULTS
Total 45 patients (22 patients in group I, 23 patients in group II) were available. In group I, all patients received average 3 cans (2~4 cans) a day. The calory from nutrient supplement was 43.9% of their daily energy intake (25.9~68.7%). About 72.7% of patients in Group I could keep up with their oral intake over 80% of daily requirement energy comparing to only 12.3% for patients in Group II(p<0.05). The patients in Group I started to lose weight 2 weeks later and lost weight more than 3 Kg less often than patients in Group II (5/22 vs 8/23, p>0.05).
CONCLUSION
There was less significant weight loss in patients who started oral nutritional supplement based on the daily requirement energy early in radiation therapy. We think it is better to recommend nutritional supplement before weight loss started because radiation induced side effects such as esophagitis and oral mucositis prohibited patients to continue to take nutrient supplement.

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Fractionated Stereotactic Radiation Therapy for Intracranial Malignant Tumor: Preliminary Results of Clinical Application: Dae Young Kim, Yong Chan Ahn, Seung Jae Huh, Dong Rak Choi, Jung Il Lee, Jong Hyun Kim, Hyung Jin Shin, Do Hoon Lim, Hong Gyun Wu; J Korean Cancer Assoc. 1998;30(3):583-590.

Abstract PDF: PURPOSE
Fractionated stereotactic radiation therapy(FSRT) is a new modality that combines the accurate focal dose delivery of stereotactic radiosurgery with the biological advantages of conventional radiotherapy. We report our early experience using FSRT for intracranial malignant tumor.
MATERIALS AND METHODS
Between October 1995 and December 1996, 16 patients(9 males and 7 females aged between 10~64 years) with central nerve system malignancy were treated using FSRT. Sixteen patients had the following diagnosis: 6 high-grade gliomas, 1 pineoblastoma, 4 germinomas, 2 medulloblastomas, and 3 solitary brain metastases. Using the Gill-Thomas-Cosman relocatable head frame and multiple non-coplanar therapy, the daily dose of 2 Gy(3 Gy in metastasis) was irradiated at 85~100% isodose surface.
RESULTS
Although the follow-up period is relatively short(range; 2~18 months), post- treatment clinical courses in 16 patients have been consistent with changes similar to those found after conventional radiation therapy. No significant adverse effects were observed in our neurological and radiological studies. Four out of 5 patients with high grade glioma died from progressive disease, surviving from 7 to 17 months(median 14 months), but patients with pineoblastoma, germinoma and medulloblastoma showed no evidence of recurrence. All patients with metastasis obtained a neurologic response, but two among them died with extracranial progression and one die from multiple intracranial metastasis.In overall patient setup with scalp measurements, reproducibility was found to have mean of 1.1+/-0.6 mm from the baseline reading.
CONCLUSION
FSRT and relocatable stereotactic head frames were well tolerated with minimal transient acute side effects. Subacute or late complications were not observed, because the follow-up period was short. We expect that FSRT might be a good indication for; recurrent disease with previous radiation therapy history, tumors of relatively large volume, lesions adjacent to radiosensitive organs, and as a boost, following conventional radiation therapy.

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Results of Postoperative Radiation Therapy in 77 Patients of Breast Cancer: Yeon Shil Kim, Hong Seok Jang, Mi Ryeong Ryu, Sung Hwan Kim, Sang Sul Chung, Sei Chul Yoon, In Chul Kim, Kyung Sub Shinn; J Korean Cancer Assoc. 1997;29(6):1049-1060.

Abstract PDF: PURPOSE
This retrospective study was performed to evaluate the effect of postoperative adjuvant radiation therapy of breast cancer on survival, failure patterns and to identify unfavorable prognostic factors.
MATERIALS AND METHODS
Seventy-seven patients were analysed retrospectively. Median follow up period was 72 months. According to AJCC system, fifty-eight patients (75%) were advanced than Stage IIb. Among 77 patients, 66 patients (86%) received mastectomy and axillary LN dissection and the other 11 patients (14%) received partial mastectomy and axillary LN dissection. Postoperative radiation therapy with 6 MV X-ray was given to the chest wall and regional lymphatics with total dose of 50 to 55 Gy. Fifty-five patients (71%) received CMF or CAF chemotherapy prior to or after radiation therapy.
RESULTS
The 5 year and 10 year survival rate were 64.4% and 51.3%, respectively and 5 year and 10 year disease free survival rate were 57.6% and 47.5%, respectively. Median survival duration was 91 months. Of the 77 patients, 59 patients were evaluable for pattern of failure. Of these, eighteen patients (31%) failed. Initial failure pattern was as follow: 7 (12%) at locoregional, 3 (5%) in distant metastasis, 8 (14%) with locoregional and distant metastasis. But the pattern of final failure at the time of last follow up was contrasted. Distanf failure was the predominant pattern of failure with 29% of patients. Overall survival and disease free survival was significantly influenced by 6 factors with univariated analysis (p<0.05): AJC Stage, T stage, N Stage, number of involved axilliary LN, SCL LN mets, failure pattern. By multivariate analysis the survival difference continued to be significant in 3 factors : T stage, number of involved axillary LN, failure pattern.
CONCLUSION
These data demonstrate high locoregional control and survival rate using the combination of surgery and radiotherapy for the patients with locally advanced breast cancer. But predominant failure pattern was distant dissemination. Therefore more effective systemic therapy is needed to improve overall survival.

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The Results of Postoperative Radiation Therapy in the Rectal Cancer: Mi Ryeong Ryu, Hong Seok Jang, Sei Chul Yoon, Su Mi Chung, Yeon Shil Kim, Se Kyung Kim, In Chul Kim, Kyung Sub Shinn; J Korean Cancer Assoc. 1997;29(1):111-116.

Abstract PDF: PURPOSE
This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the patients with rectal cancer who received postoperative radiation therapy.
METHODS
& MATERIALS: Seventy patients with rectal cancer received postoperative radiation therapy after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medial College between May 1984 and April 1993. Of the seventy patients, sixty-four evaluable patients were analysed retrospectively. There were 34 men and 28 women. Age at diagnosis ranged from 23 to 74 years. The distribution of stage according to the modified Astler-Coller (MAC) system was as follow: 12 in B2+3, 2 in C1, and 50 in C2+3. Postoperative adjuvant therapy included pelvic radiotherapy in all cases and chemotherapy in addition in 55 cases. A total dose of 45 to 60 Gy (median dose: 55.8Gy) was delivered in a period of 5 to 6 weeks and the follow-up period ranged from 26 to 133 months with a median of 55 months.
RESULTS
Overall two-year and five-year actuarial survival rate were 70.3% and 51.4%, 90.9% and 90.9% in stage B2+3, and 68.2% and 53.6% in stage C. Local failure occurred in 13 (20.3%) of the 64 patients and distant failure rate was 18.8% (12/64). Severe late complication was small bowel obstruction in 4 patients and surgery was required in 3 patients (5%). The significant prognostic factors were stage (p=0.0019) and histologic differentiation (p=0.0046).
CONCLUSION
This study suggested a potential adjuvant role for radiation. However, the possible reduction in local failure rates in this study compared with historic control groups must be verified in randomized trial.

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Treatment Results of Radiation Therapy in Laryngeal Cancer: Hong Seok Jang, Sei Chul Yoon, Sei Chul Yoon, Ki Mun Kang, Chul Seung Kay, Min Sik Kim, Byung Do Suh, Hoon Kyo Kim, Kyung Shik Lee, Kyung Sub Shinn; J Korean Cancer Assoc. 1994;26(6):950-959.

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