Cancer Research and Treatment

Sung-Ja Ahn

6 Articles

Breast cancer

Locoregional Recurrence in Adenoid Cystic Carcinoma of the Breast: A Retrospective, Multicenter Study (KROG 22-14): Sang Min Lee, Bum-Sup Jang, Won Park, Yong Bae Kim, Jin Ho Song, Jin Hee Kim, Tae Hyun Kim, In Ah Kim, Jong Hoon Lee, Sung-Ja Ahn, Kyubo Kim, Ah Ram Chang, Jeanny Kwon, Hae Jin Park, Kyung Hwan Shin; Cancer Res Treat. 2025;57(1):150-158. Published online July 12, 2024; DOI: https://doi.org/10.4143/crt.2024.201

Purpose
This study aims to evaluate the treatment approaches and locoregional patterns for adenoid cystic carcinoma (ACC) in the breast, which is an uncommon malignant tumor with limited clinical data.
Materials and Methods
A total of 93 patients diagnosed with primary ACC in the breast between 1992 and 2022 were collected from multi-institutions. All patients underwent surgical resection, including breast-conserving surgery (BCS) or total mastectomy (TM). Recurrence patterns and locoregional recurrence-free survival (LRFS) were assessed.
Results
Seventy-five patients (80.7%) underwent BCS, and 71 of them (94.7%) received post-operative radiation therapy (PORT). Eighteen patients (19.3%) underwent TM, with five of them (27.8%) also receiving PORT. With a median follow-up of 50 months, the LRFS rate was 84.2% at 5 years. Local recurrence (LR) was observed in five patients (5.4%) and four cases (80%) of the LR occurred in the tumor bed. Three of LR (3/75, 4.0%) had a history of BCS and PORT, meanwhile, two of LR (2/18, 11.1%) had a history of mastectomy. Regional recurrence occurred in two patients (2.2%), and both cases had a history of PORT with (n=1) and without (n=1) irradiation of the regional lymph nodes. Partial breast irradiation (p=0.35), BCS (p=0.96) and PORT in BCS group (p=0.33) had no significant association with LRFS.
Conclusion
BCS followed by PORT was the predominant treatment approach for ACC of the breast and LR mostly occurred in the tumor bed. The findings of this study suggest that partial breast irradiation might be considered for PORT in primary breast ACC.

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Adenoid Cystic Carcinoma of the Breast: A Narrative Review and Update on Management
Taylor Neilson, Zaibo Li, Christina Minami, Sara P. Myers
Cancers.2025; 17(7): 1079. CrossRef

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Assessment of Eligibility and Utilization of Accelerated Partial Breast Irradiation in Korean Breast Cancer Patients (KROG 22-15): Seok-Joo Chun, Ji Hwan Jo, Yong Bae Kim, Sangjoon Park, Sung-Ja Ahn, Su Ssan Kim, Kyubo Kim, Kyung Hwan Shin; Cancer Res Treat. 2024;56(2):549-556. Published online December 8, 2023; DOI: https://doi.org/10.4143/crt.2023.1109

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Purpose
We investigated the proportions of patients eligible for accelerated partial breast irradiation (APBI) among those with pT1-2N0 breast cancer, based on the criteria set by the American Society for Radiation Oncology (ASTRO), the Groupe Européen de Curiethérapie and the European Society for Radiotherapy and Oncology (GEC-ESTRO), the American Brachytherapy Society (ABS), and the American Society of Breast Surgeons (ASBS). Additionally, we analyzed the rate of APBI utilization among eligible patients.
Materials and Methods
Patients diagnosed with pT1-2N0 breast cancer in 2019 were accrued in four tertiary medical centers in Korea. All patients had undergone breast conserving surgery followed by radiotherapy, either whole breast irradiation or APBI. To determine which guideline best predicts the use of APBI in Korea, the F1 score and Matthews Correlation Coefficient (MCC) were determined for each guideline.
Results
A total of 1,251 patients were analyzed, of whom 196 (15.7%) underwent APBI. The percentages of eligible patients identified by the ASTRO, GEC-ESTRO, ABS, and ASBS criteria were 13.7%, 21.0%, 50.5%, and 63.5%, respectively. APBI was used to treat 54.4%, 37.2%, 27.1%, and 23.7% of patients eligible by the ASTRO, GEC-ESTRO, ABS, and ASBS criteria, respectively. The ASTRO guideline exhibited the highest F1 score (0.76) and MCC (0.67), thus showing the best prediction of APBI utilization in Korea.
Conclusion
The proportion of Korean breast cancer patients who are candidates for APBI is substantial. The actual rate of APBI utilization among eligible patients may suggest there is a room for risk-stratified optimization in offering radiation therapy.

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Impact of the ASTRO 2024 Guideline on Partial Breast Irradiation Eligibility in Breast Cancer Patients (KROG 24-01)
Seok-Joo Chun, Sangjoon Park, Yong Bae Kim, Sung-Ja Ahn, Kyubo Kim, Kyung Hwan Shin
Practical Radiation Oncology.2025; 15(3): e230. CrossRef

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A Phase I/II Trial to Evaluate the Technical Feasibility of Partial Breast Irradiation with Three-Dimensional Conformal Radiation Therapy in Korean Women with Stage I Breast Carcinoma: An Initial Report of the Korean Radiation Therapy Oncology Group (KROG) Study 0804: Jae-Uk Jeong, Jung Han Yoon, Min Ho Park, Mee Sun Yoon, Ju-Young Song, Taek-Keun Nam, Woong-Ki Chung, Yong-Hyub Kim, Chang-Ok Suh, Sung-Ja Ahn; Cancer Res Treat. 2015;47(1):18-25. Published online August 21, 2014; DOI: https://doi.org/10.4143/crt.2013.202

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Purpose
This prospective study was designed to verify the technical feasibility of partial breast irradiation in breast cancer patients with small breasts, which are commonly encountered in Korean women. Materials and Methods A total of 40 Gy, administered in 10 fractions on consecutive days (one fraction per day), was prescribed to the isocenters of the fields using three-dimensional conformal radiotherapy (3-DCRT). For all patients, treatment planning and dose parameters strictly adhered to the constraints set forth in the Radiation Therapy Oncology Group (RTOG) 0319 protocol. This study was designed such that if fewer than five of the first 42 evaluable patients received unacceptable scores, the treatment would be considered reproducible. Results Ten treatment plans (23.8%) were determined to have major variations. There was no major variation in planning target volume (PTV) coverage. The ipsilateral and contralateral breast dose limitations were not met in four (9.5%) and four cases (9.5%), respectively. Major variations in ipsilateral and contralateral lung dose limitations were observed in two cases (4.8%). Major variations in the heart and thyroid dose limitations were observed in one (2.4%) and one case (2.4%), respectively. In multivariate analysis, a ratio of PTV to ipsilateral breast volume (PTV/IB) > 0.16 was the only significant factor that statistically affected major variations. Conclusion We concluded that partial breast irradiation using 3-DCRT could not be reproduced in Korean breast cancer patients, particularly small-volumed breast surrogated as PTV/IB > 0.16. The dominant cause was the major variation in surrounding normal breast tissues.

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Assessment of Eligibility and Utilization of Accelerated Partial Breast Irradiation in Korean Breast Cancer Patients (KROG 22-15)
Seok-Joo Chun, Ji Hwan Jo, Yong Bae Kim, Sangjoon Park, Sung-Ja Ahn, Su Ssan Kim, Kyubo Kim, Kyung Hwan Shin
Cancer Research and Treatment.2024; 56(2): 549. CrossRef
Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy in the Treatment of Breast Cancer: An Updated Review
Jee Suk Chang, Ji Hyun Chang, Nalee Kim, Yong Bae Kim, Kyung Hwan Shin, Kyubo Kim
Journal of Breast Cancer.2022; 25(5): 349. CrossRef
Who are the optimal candidates for partial breast irradiation?
Ji Hyeon Joo, Yongkan Ki, Hosang Jeon, Dong Woon Kim, Jinhong Jung, Su Ssan Kim
Asia-Pacific Journal of Clinical Oncology.2021; 17(4): 305. CrossRef
First Experience in Korea of Stereotactic Partial Breast Irradiation for Low-Risk Early-Stage Breast Cancer
Won Hee Lee, Jee Suk Chang, Min Jung Kim, Vivian Youngjean Park, Jung Hyun Yoon, Se Young Kim, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, Young Up Cho, Byeong Woo Park, Yong Bae Kim
Frontiers in Oncology.2020;[Epub] CrossRef

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The Role of Radiotherapy in the Treatment of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: Taek-Keun Nam, Jae-Sook Ahn, Yoo-Duk Choi, Jae-Uk Jeong, Yong-Hyeob Kim, Mee Sun Yoon, Ju-Young Song, Sung-Ja Ahn, Woong-Ki Chung; Cancer Res Treat. 2014;46(1):33-40. Published online January 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.1.33

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PURPOSE
To assess radiotherapy for patients with early stage gastric mucosa-associated lymphoid tissue (MALT) lymphoma with respect to survival, treatment response, and complications.
MATERIALS AND METHODS
Enrolled into this study were 48 patients diagnosed with gastric MALT lymphoma from January 2000 to September 2012. Forty-one patients had low grade and seven had mixed component with high grade. Helicobacter pylori eradication was performed in 33 patients. Thirty-four patients received radiotherapy alone. Ten patients received chemotherapy before radiotherapy, and three patients underwent surgery followed by chemotherapy and radiotherapy. One patient received surgery followed by radiotherapy. All patients received radiotherapy of median dose of 30.6 Gy.
RESULTS
The duration of follow-up ranged from 6 to 158 months (median, 48 months). Five-year overall survival and cause-specific survival rates were 90.3% and 100%. All patients treated with radiotherapy alone achieved pathologic complete remission (pCR) in 31 of the low-grade and in three of the mixed-grade patients. All patients treated with chemotherapy and/or surgery prior to radiotherapy achieved pCR except one patient who received chemotherapy before radiotherapy. During the follow-up period, three patients developed diffuse large B-cell lymphoma in the stomach, and one developed gastric adenocarcinoma after radiotherapy. No grade 3 or higher acute or late complications developed. One patient, who initially exhibited gastroptosis, developed mild atrophy of left kidney.
CONCLUSION
These findings indicate that a modest dose of radiotherapy alone can achieve a high cure rate for low-grade and even mixed-grade gastric MALT lymphoma without serious toxicity. Patients should be carefully observed after radiotherapy to screen for secondary malignancies.

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Proportion and Characteristics of Helicobacter Pylori-Negative Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: A Systematic Review and Meta-Analysis
Xiu-He Lv, Qing Lu, Jia-Huan Liu, Bi-Han Xia, Zi-Jing Wang, Zhu Wang, Jin-Lin Yang
Clinical and Translational Gastroenterology.2025; 16(4): e00781. CrossRef
Clinical Management of Patients with Gastric MALT Lymphoma: A Gastroenterologist’s Point of View
Tamara Matysiak-Budnik, Kateryna Priadko, Céline Bossard, Nicolas Chapelle, Agnès Ruskoné-Fourmestraux
Cancers.2023; 15(15): 3811. CrossRef
Magnetic Resonance Imaging-Guided Radiation Therapy for Early-Stage Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
Neris Dincer, Gamze Ugurluer, Gorkem Gungor, Teuta Zoto Mustafayev, Banu Atalar, Enis Ozyar
Cureus.2022;[Epub] CrossRef
Development and Validation of a Prognostic Nomogram for Gastric Marginal Zone Lymphoma: a Surveillance, Epidemiology and End Results-based population Study
Mingliang Wang, Cheng Wu, Yida Lu, Xin Xu, Huizhen Wang, Youliang Wu, Xiaodong Wang, Yongxiang Li
Future Oncology.2021; 17(5): 529. CrossRef
Radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma
Laurent Quéro, Mouna Labidi, Marc Bollet, Côme Bommier, Sophie Guillerm, Christophe Hennequin, Catherine Thieblemont
World Journal of Gastrointestinal Oncology.2021; 13(10): 1453. CrossRef
Second Cancers in a Patient with Gastric MALT Lymphoma
Lucy Navsaria, Alfonso Badillo, Michael Wang
Case Reports in Medicine.2020; 2020: 1. CrossRef
The Treatment of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma using Radiotherapy
Aswin Nagarajan, Arun Sakthivelu, Alexander John, Ramya Ravichandar
Indian Journal of Medical and Paediatric Oncology.2020; 41(04): 559. CrossRef
Favorable radiation field decrease in gastric marginal zone lymphoma
Gabriele Reinartz, Regina P. Pyra, Georg Lenz, Rüdiger Liersch, Georg Stüben, Oliver Micke, Kay Willborn, Clemens F. Hess, Andreas Probst, Rainer Fietkau, Ralf Jany, Jürgen Schultze, Christian Rübe, Carsten Hirt, Wolfgang Fischbach, Martin Bentz, Severin
Strahlentherapie und Onkologie.2019; 195(6): 544. CrossRef
Long-term course of precancerous lesions arising in patients with gastric MALT lymphoma
Anne-Laure Rentien, Michaël Lévy, Christiane Copie-Bergman, Charlotte Gagniere, Jehan Dupuis, Yann Le Baleur, Karim Belhadj, Iradj Sobhani, Corinne Haioun, Jean-Charles Delchier, Aurelien Amiot
Digestive and Liver Disease.2018; 50(2): 181. CrossRef
Gastrointestinal lymphomas: French Intergroup clinical practice recommendations for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFH)
Tamara Matysiak-Budnik, Bettina Fabiani, Christophe Hennequin, Catherine Thieblemont, Georgia Malamut, Guillaume Cadiot, Olivier Bouché, Agnès Ruskoné-Fourmestraux
Digestive and Liver Disease.2018; 50(2): 124. CrossRef
Place de la radiothérapie pour les lymphomes du mucosa-associated lymphoid tissue gastriques : résultats d’une étude rétrospective
L. Ghorbal, A. Hdiji, H. Ben Salah, F. Elloumi, M. Frikha, M. Elloumi, J. Daoud
Cancer/Radiothérapie.2018; 22(8): 763. CrossRef
Les lymphomes gastro-intestinaux
P. Jamet, T. Matysiak-Budnik, L. Brichet, A. Ruskoné-Fourmestraux
Oncologie.2018; 20(5-6): 107. CrossRef
Radiotherapy for localized gastric mucosa–associated lymphoid tissue lymphoma: long-term outcomes over 10 years
Yu Ohkubo, Yoshihiro Saito, Hiroki Ushijima, Masahiro Onishi, Tomoko Kazumoto, Jun-ichi Saitoh, Nobuko Kubota, Hirofumi Kobayashi, Nobuo Maseki, Yu Nishimura, Masafumi Kurosumi
Journal of Radiation Research.2017; 58(4): 537. CrossRef
Place de la radiothérapie dans la prise en charge des lymphomes malins non hodgkiniens
L. Gastaud, B. Rossignol, F. Peyrade, D. Ré, J. Thariat, A. Thyss, J. Doyen
Cancer/Radiothérapie.2016; 20(3): 236. CrossRef
Differential somatostatin and CXCR4 chemokine receptor expression in MALT-type lymphoma of gastric and extragastric origin
Susann Stollberg, Daniel Kämmerer, Elisa Neubauer, Stefan Schulz, Ingrid Simonitsch-Klupp, Barbara Kiesewetter, Markus Raderer, Amelie Lupp
Journal of Cancer Research and Clinical Oncology.2016; 142(11): 2239. CrossRef
Radiation therapy for gastric mucosa-associated lymphoid tissue lymphoma: dose-volumetric analysis and its clinical implications
Hyeon Woo Lim, Tae Hyun Kim, Il Ju Choi, Chan Gyoo Kim, Jong Yeul Lee, Soo Jeong Cho, Hyeon Seok Eom, Sung Ho Moon, Dae Yong Kim
Radiation Oncology Journal.2016; 34(3): 193. CrossRef
Refractory peptic ulceration following radiation therapy in primary gastric lymphoma: A report of two cases
CHUNYAN ZENG, SHIWEN LUO, NONGHUA LV, YOUXIANG CHEN
Oncology Letters.2015; 9(1): 63. CrossRef
Exclusive moderate-dose radiotherapy in gastric marginal zone B-cell MALT lymphoma: Results of a prospective study with a long term follow-up
Agnès Ruskoné-Fourmestraux, Tamara Matysiak-Budnik, Bettina Fabiani, Pascale Cervera, Hedia Brixi, Karine Le Malicot, Isabelle Nion-Larmurier, Jean-Fançois Fléjou, Christophe Hennequin, Laurent Quéro
Radiotherapy and Oncology.2015; 117(1): 178. CrossRef

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Results of Curative Radiation Therapy with or without Chemotherapy for Stage III Unresectable Non-Small Cell Lung Cancer: Sung-Ja Ahn, Young-Chul Kim, Kyu-Sik Kim, Kyung-Ok Park, Woong-Ki Chung, Taek-Keun Nam, Byung-Sik Nah, Ju-Young Song, Mi-Sun Yoon; Cancer Res Treat. 2005;37(5):268-272. Published online October 31, 2005; DOI: https://doi.org/10.4143/crt.2005.37.5.268

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Purpose

We retrospectively analyzed the patients who received curative radiotherapy for unresectable stage III NSCLC to investigate the impact of chemotherapy.

Materials and Methods

From 1998 to 2001, the records of 224 patients who completed curative radiotherapy for NSCLC were reviewed. There were 210 males and 14 females, and their median age was 64 years (range 38~83). 54 patients had stage IIIA disease and 170 patients had stage IIIB disease. Conventional radiotherapy was given and the radiation dose ranged from 50~70 Gy with a median of 60 Gy, and chemotherapy was combined for 116 patients (52%).

Results

The median survival, the 2-year, and 5-year actuarial survival rates of all 224 patients were 15 months, 30%, and 7%, respectively. The median survival of the patients with stage IIIA and IIIB disease were 21 months and 13 months, respectively (p=0.14). The median survival of patients who received chemoradiation was 18 months compared to 14 months for the patients who received RT alone (p=0.02). Among the chemoradiation group of patients, the median survival time of the patients who received 1 to 3 cycles of chemotherapy was 16 months and that for the patients who received more than 3 cycles was 22 months (p=0.07). We evaluated the effects of the timing of chemoradiation in 57 patients who received more than 3 cycles of chemotherapy. The median survival of the patients with the concurrent sequence was 25 months and that for the patients with the sequential chemotherapy was 19 months (p=0.81).

Conclusions

For advanced stage III non-small cell lung cancer patients who completed the curative radiotherapy, the addition of chemotherapy improved the survival compared to the patients who received radiotherapy alone.

Citations

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Treatment for Non-Small-Cell Lung Cancer and Circulating Tumor Cells
Joel Mason, Benjamin Blyth, Michael P MacManus, Olga A Martin
Lung Cancer Management.2017; 6(4): 129. CrossRef
Clinical Responses and Prognostic Indicators of Concurrent Chemoradiation for Non-small Cell Lung Cancer
Dong-Soo Lee, Yeon-Sil Kim, Jin-Hyoung Kang, Sang-Nam Lee, Young-Kyoun Kim, Myung-Im Ahn, Dae-Hee Han, Ie-Ryung Yoo, Young-Pil Wang, Jae-Gil Park, Sei-Chul Yoon, Hong-Seok Jang, Byung-Oak Choi
Cancer Research and Treatment.2011; 43(1): 32. CrossRef

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Assessment of Tumor Regression by Consecutive Pelvic Magnetic Resonance Imaging and Dose Modification during High-Dose-Rate Brachytherapy for Carcinoma of the Uterine Cervix: Taek-Keun Nam, Byung-Sik Nah, Ho-Sun Choi, Woong-Ki Chung, Sung-Ja Ahn, Seok-Mo Kim, Ju-Young Song, Mi-Seon Yoon; Cancer Res Treat. 2005;37(3):157-164. Published online June 30, 2005; DOI: https://doi.org/10.4143/crt.2005.37.3.157

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Purpose

To assess tumor regression, as determined by pelvic magnetic resonance imaging (MRI), and evaluate the efficacies and toxicities of the interim brachytherapy (BT) modification method, according to tumor regression during multi-fractionated high-dose-rate (HDR) BT for uterine cervical cancer.

Materials and Methods

Consecutive MRI studies were performed pre-radiotherapy (RT), pre-BT and during interfraction of BT (inter-BT) in 69 patients with cervical cancer. External beam radiotherapy (EBRT) was performed, using a 10 MV X-ray, in daily fraction of 1.8 Gy with 4-fields, 5 d/wk. Radiation was delivered up to 50.4 Gy, with midline shielding at around 30.6 Gy. Of all 69 patients, 50 received modified interim BT after checking the inter-BT MRI. The BT was delivered in two sessions; the first was composed of several 5 Gy fractions to point A, twice weekly, using three channel applicators. According to the three measured orthogonal diameters of the regressed tumor, based on inter-BT MR images, the initial BT plan was modified, with the second session consisting of a few fractions of less than 5 Gy to point A, using a cervical cylinder applicator.

Results

The numbers of patients in FIGO stages Ib, IIa, IIb and IIIb+IVa were 19 (27.5%), 18 (26.1%), 27 (39.2%) and 5 (7.2%), respectively. Our treatment characteristics were comparable to those from the literatures with respect to the biologically effective dose (BED) to point A, rectum and bladder as reference points. In the regression analysis a significant correlation was observed between tumor regression and the cumulative dose to point A on the follow-up MRI. Nearly 80% regression of the initial tumor volume occurred after 30.6 Gy of EBRT, and this increased to 90% after an additional 25 Gy in 5 fractions of BT, which corresponds to 73.6 Gy of cumulative BED₁₀ to point A. The median total fraction number, and those at the first and second sessions of BT were 8 (5~10), 5 (3~7) and 3 (1~5), respectively. The median follow-up time was 53 months (range, 9~66 months). The 4-year disease-free survival rate of all patients was 86.8%. Six (8.7%) patients developed pelvic failures, but major late complications developed in only two (2.9%).

Conclusion

Our study shows that effective tumor control, equivalent survival and low rates of major complications can be achieved by modifying the fraction size during BT according to tumor regression, as determined by consecutive MR images. We recommend checking the follow-up MRI at a cumulative BED₁₀ of around 65 Gy to point A, with the initial BT modified at a final booster BT session.

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Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer
Florian Arend, Markus Oechsner, Clara B. Weidenbächer, Stephanie E. Combs, Kai J. Borm, Marciana N. Duma
Tumori Journal.2021; 107(2): 139. CrossRef
Target volume changes through high-dose-rate brachytherapy for cervical cancer when evaluated on high resolution (3.0 Tesla) magnetic resonance imaging
Wenqing Sun, Sudershan K. Bhatia, Geraldine M. Jacobson, Ryan T. Flynn, Yusung Kim
Practical Radiation Oncology.2012; 2(4): e101. CrossRef
Metabolic Response of Lymph Nodes Immediately After RT Is Related With Survival Outcome of Patients With Pelvic Node-Positive Cervical Cancer Using Consecutive [18F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography
Mee Sun Yoon, Sung-Ja Ahn, Byung-Sik Nah, Woong-Ki Chung, Ho-Chun Song, Su Woong Yoo, Ju-Young Song, Jae-Uk Jeong, Taek-Keun Nam
International Journal of Radiation Oncology*Biology*Physics.2012; 84(4): e491. CrossRef

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