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Yong Chan Ahn 59 Articles
Gastrointestinal cancer
Salvage Radiotherapy for Loco-regional Recurrence of Esophageal Cancer Following Surgery
Won Kyung Cho, Jae Myoung Noh, Dongryul Oh, Yong Chan Ahn, Jong-Mu Sun, Hong Kwan Kim, Young Mog Shim
Cancer Res Treat. 2025;57(1):165-173.   Published online July 26, 2024
DOI: https://doi.org/10.4143/crt.2024.191
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
There is few evidence regarding the optimal salvage treatment options for loco-reginal recurrence of esophageal cancer. This study aimed to evaluate the clinical outcomes of salvage radiotherapy (RT) in patients with loco-regional recurrence (LRR) after surgery for esophageal cancer.
Materials and Methods
We retrospectively reviewed 147 esophageal cancer patients who received salvage RT for loco-regional recurrence between 1996 and December 2019. A total dose of 60 Gy in 20 fractions was used for RT alone and 60-70 Gy in 30-35 fractions for concurrent chemoradiotherapy (CCRT).
Results
The patients’ median age was 65 years (range, 41 to 86 years). The median disease-free interval was 13.5 months (1.0 to 97.4 months). After a median 18.8 months follow-up, the 2-year overall survival (OS) and progression-free survival (PFS) rates were 38.1% and 25.9%, respectively. The median OS and PFS were 18.8 and 8.4 months, respectively. The CCRT could not improve OS compared to RT (p=0.336), but there was a trend of better PFS in the CCRT group. Regarding toxicities, the rate of grade 3 or higher toxicity was 10.9% occurring in 16 patients, and it was higher in patients who received CCRT than in the RT alone group (19.6% vs. 6.3%, p=0.023).
Conclusion
Salvage RT alone as well as CCRT could be effective in patients with locoregionally recurrent esophageal cancer.

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  • Salvage Chemoradiotherapy for Loco-Regional Recurrence of Esophageal Squamous Cell Carcinoma After Esophagectomy
    Atsuto Katano, Tomoki Kiritoshi, Subaru Sawayanagi, Hideomi Yamashita
    Journal of Clinical Medicine.2025; 14(5): 1540.     CrossRef
  • 1,353 View
  • 90 Download
  • 1 Web of Science
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Identifying Trends in Oncology Research through a Bibliographic Analysis of Cancer Research and Treatment
Choong-kun Lee, Jeong Min Choo, Yong Chan Ahn, Jin Kim, Sun Young Rha, Chai Hong Rim, On behalf of the 50th Anniversary Committee of the Korean Cancer Association
Cancer Res Treat. 2025;57(1):11-18.   Published online December 5, 2024
DOI: https://doi.org/10.4143/crt.2024.688
AbstractAbstract PDFPubReaderePub
During the celebration of the 50th anniversary of the founding of the Korean Cancer Association, articles published in Cancer Research and Treatment from 2004 to 2023 were assessed based on the subject and design of each study. Based on this analysis, trends in domestic cancer research were inferred and directions were suggested for the future development of Cancer Research and Treatment.
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Lung and Thoracic cancer
Adjuvant Pembrolizumab in Patients with Stage IIIA/N2 Non–Small Cell Lung Cancer Completely Resected after Neoadjuvant Concurrent Chemoradiation: A Prospective, Open-Label, Single-Arm, Phase 2 Trial
Junghoon Shin, Sehhoon Park, Kyung Hwan Kim, Eui-Cheol Shin, Hyun Ae Jung, Jong Ho Cho, Jong-Mu Sun, Se-Hoon Lee, Yong Soo Choi, Jin Seok Ahn, Jhingook Kim, Keunchil Park, Young Mog Shim, Hong Kwan Kim, Jae Myoung Noh, Yong Chan Ahn, Hongryull Pyo, Myung-Ju Ahn
Cancer Res Treat. 2024;56(4):1084-1095.   Published online April 30, 2024
DOI: https://doi.org/10.4143/crt.2024.084
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Optimal treatment for stage IIIA/N2 non–small cell lung cancer (NSCLC) is controversial. We aimed to assess the efficacy and safety of adjuvant pembrolizumab for stage IIIA/N2 NSCLC completely resected after neoadjuvant concurrent chemoradiation therapy (CCRT).
Materials and Methods
In this open-label, single-center, single-arm phase 2 trial, patients with stage IIIA/N2 NSCLC received adjuvant pembrolizumab for up to 2 years after complete resection following neoadjuvant CCRT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS) and safety. As an exploratory biomarker analysis, we evaluated the proliferative response of blood CD39+PD-1+CD8+ T cells using fold changes in the percentage of proliferating Ki-67+ cells from days 1 to 7 of cycle 1 (Ki-67D7/D1).
Results
Between October 2017 and October 2018, 37 patients were enrolled. Twelve (32%) and three (8%) patients harbored EGFR and ALK alterations, respectively. Of 34 patients with programmed cell death ligand 1 assessment, 21 (62%), nine (26%), and four (12%) had a tumor proportion score of < 1%, 1%-50%, and ≥ 50%, respectively. The median follow-up was 71 months. The median DFS was 22.4 months in the overall population, with a 5-year DFS rate of 29%. The OS rate was 86% at 2 years and 76% at 5 years. Patients with tumor recurrence within 6 months had a significantly lower Ki-67D7/D1 among CD39+PD-1+CD8+ T cells than those without (p=0.036). No new safety signals were identified.
Conclusion
Adjuvant pembrolizumab may offer durable disease control in a subset of stage IIIA/N2 NSCLC patients after neoadjuvant CCRT and surgery.

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  • Adjuvant immunotherapy improves survival in completely resected stage IB–III NSCLC: a systematic review and meta-analysis
    Hong Huang, Pengchen Bao, Hongyu Jin, Wenyang Li, Hui Shen, Zhen Qin, Ying Pan, Xinming Su, Delei Kong
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • 2,861 View
  • 153 Download
  • 1 Web of Science
  • 1 Crossref
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Gastrointestinal cancer
The Clinical Efficacy of Colorectal Cancer Patients with Pulmonary Oligometastases by Sterotactic Body Ablative Radiotherapy: A Meta-Analysis
Jae-Uk Jeong, Chai Hong Rim, Gyu Sang Yoo, Won Kyung Cho, Eui Kyu Chie, Yong Chan Ahn, Jong Hoon Lee, on behalf of Korean Oligometastasis Working Group, Korean Cancer Association
Cancer Res Treat. 2024;56(3):809-824.   Published online December 14, 2023
DOI: https://doi.org/10.4143/crt.2023.920
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
There is increasing interest in the efficacy of stereotactic ablative radiotherapy (SABR) for treating colorectal cancer (CRC) patients with oligometastases (OM), recently. The purpose of this meta-analysis was to evaluate local control (LC), progression-free survival (PFS), and overall survival (OS) of CRC patients with pulmonary OM treated with SABR and toxicities.
Materials and Methods
Studies that reported SABR for CRC patients with pulmonary OM were searched from MEDLINE and Embase. Treatment outcomes including LC, PFS, OS, and toxicities of grade 3 or higher were assessed.
Results
A total of 19 studies with 1,668 patients were chosen for this meta-analysis. Pooled 1-, 2-, and 3-year LC rates were 83.1%, 69.3%, and 63.9%, respectively. PFS rates were 44.8%, 26.5%, and 21.5% at 1, 2, and 3 years, respectively. OS rates at 1-, 2-, and 3-year were 87.5%, 69.9%, and 60.5%, respectively. The toxicity rate of grade 3 or higher was 3.6%. The effect of dose escalation was meta-analyzed using available studies.
Conclusion
Application of SABR to CRC patients with pulmonary OM achieved modest local control with acceptable toxicity according to the present meta-analysis. Further studies establishing the clinical efficacy of SABR are guaranteed.

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  • Identifying Trends in Oncology Research through a Bibliographic Analysis of Cancer Research and Treatment
    Choong-kun Lee, Jeong Min Choo, Yong Chan Ahn, Jin Kim, Sun Young Rha, Chai Hong Rim
    Cancer Research and Treatment.2025; 57(1): 11.     CrossRef
  • 3,669 View
  • 163 Download
  • 1 Web of Science
  • 1 Crossref
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Editor’s Note on Recent Journal Impact Factor of Cancer Research and Treatment
Yong Chan Ahn
Cancer Res Treat. 2024;56(3):699-699.   Published online July 9, 2024
DOI: https://doi.org/10.4143/crt.2024.619
PDFPubReaderePub

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  • How to Achieve Further Progress of Journal of Korean Neurosurgical Society (JKNS) - Improve the Impact Factor (IF) and Maintain It Continuously
    Hee-Jin Yang
    Journal of Korean Neurosurgical Society.2024; 67(5): 489.     CrossRef
  • 7,759 View
  • 104 Download
  • 1 Web of Science
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General
Radiation Oncologists’ Perspectives on Oligometastatic Disease: A Korean Survey Study
Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Ah Ram Chang, Eui Kyu Chie, Yong Chan Ahn, on behalf of the Oligometastasis Working Group, Korean Cancer Association
Cancer Res Treat. 2024;56(2):414-421.   Published online November 22, 2023
DOI: https://doi.org/10.4143/crt.2023.876
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Perspectives of radiation oncologists on oligometastatic disease was investigated using multi-layered survey.
Materials and Methods
Online survey on the oligometastatic disease was distributed to the board-certified regular members of the Korean Society for Radiation Oncology. The questionnaire consisted of four domains: five questions on demographics; five on the definition of oligometastatic disease; four on the role of local therapy; and three on the oligometastatic disease classification, respectively.
Results
A total of 135 radiation oncologists participated in the survey. The median length of practice after board certification was 22.5 years (range, 1 to 44 years), and the vast majority (94.1%) answered affirmatively to the clinical experience in oligometastatic disease management. Nearly two-thirds of the respondents considered the number of involved organs as an independent factor in defining oligometastasis. Most frequently perceived upper limit on the numerical definition of oligometastasis was 5 (64.2%), followed by 3 (26.0%), respectively. Peritoneal and brain metastasis were nominated as the sites to be excluded from oligometastastic disease by 56.3% and 12.6% of the participants, respectively. Vast majority (82.1%) agreed on the role of local treatment in the management of oligometastatic disease. Majority (72%) of the participants acknowledged the European Society for Radiotherapy and Oncology (ESTRO)–European Organisation for Research and Treatment of Cancer (EORTC) classification of oligometastatic disease, however, only 43.3% answered that they applied this classification in their clinical practice. Underlying reasons against the clinical use were ‘too complicated’ (66.0%), followed by ‘insufficient supporting evidence’ (30.0%), respectively.
Conclusion
While most radiation oncologists supported the role of local therapy in oligometastatic disease, there were several inconsistencies in defining and categorizing oligometastatic disease. Continued education and training on oligometastatic disease would be also required to build consensus among participating caregivers.

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  • Efficacy Analysis of Hypofractionated Radiotherapy for Oligometastatic Tumors: A Retrospective Study
    Qian Sun, Hanqing Zhao, Xianwen Zhang, Suli Zhang, Zelai He, Gengming Wang, Hao Jiang, Aili Xuan, Xianming Li
    Technology in Cancer Research & Treatment.2025;[Epub]     CrossRef
  • A new proposal of simplified classification of non-small cell lung cancer oligometastases for easy applicability through systematic literature analysis and meta-analysis validation
    Hanseung Kang, Woohyeon Do, Yong Chan Ahn, Eui Kyu Chie, Chai Hong Rim
    European Journal of Cancer.2024; 212: 115043.     CrossRef
  • 3,207 View
  • 153 Download
  • 3 Web of Science
  • 2 Crossref
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Lung and Thoracic cancer
Sublobar Resection versus Stereotactic Body Radiation Therapy for Clinical Stage I Non–Small Cell Lung Cancer: A Study Using Data from the Korean Nationwide Lung Cancer Registry
Jeonghee Yun, Jong Ho Cho, Tae Hee Hong, Kyungmi Yang, Yong Chan Ahn, Hong Kwan Kim, Korean Association for Lung Cancer, Korea Central Cancer Registry
Cancer Res Treat. 2023;55(4):1171-1180.   Published online April 17, 2023
DOI: https://doi.org/10.4143/crt.2022.1581
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Stereotactic body radiotherapy (SBRT) had been increasingly recognized as a favorable alternative to surgical resection in patients with high risk for surgery. This study compared survival outcomes between sublobar resection (SLR) and SBRT for clinical stage I non–small cell lung cancer (NSCLC).
Materials and Methods
Data were obtained from the Korean Association of Lung Cancer Registry, a sampled nationwide database. This study retrospectively reviewed 382 patients with clinical stage I NSCLC who underwent curative SLR or SBRT from 2014 to 2016.
Results
Of the patients, 43 and 339 underwent SBRT and SLR, respectively. Patients in the SBRT group were older and had worse pulmonary function. The 3-year overall survival (OS) rate was significantly better in the SLR group compared with the SBRT group (86.6% vs. 57%, log-rank p < 0.001). However, after adjusting for age, sex, tumor size, pulmonary function, histology, smoking history, and adjuvant therapy, treatment modality was not an independent prognostic factor for survival (hazard ratio, 0.99; 95% confidence interval, 0.43 to 2.77; p=0.974). We performed subgroup analysis in the following high-risk populations: patients who were older than 75 years; patients who were older than 70 years and had diffusing capacity of lung for carbon monoxide ≤ 80%. In each subgroup, there were no differences in OS and recurrence-free survival between patients who underwent SLR and those who received SBRT.
Conclusion
In our study, there were no significant differences in terms of survival or recurrence between SBRT and SLR in medically compromised stage I NSCLC patients. Our findings suggest that SBRT could be considered as a potential treatment option for selected patients.
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Head and Neck cancer
Outcomes of Salvage Therapy for Oropharyngeal Cancer Recurrence Following Upfront Radiation Therapy and Prognostic Factors
Nayeon Choi, Hack Jung Kim, Heejun Yi, Heejung Kim, Tae Hwan Kim, Han-Sin Jeong, Young-Ik Son, Chung-Hwan Baek, Dongryul Oh, Yong Chan Ahn, Man Ki Chung
Cancer Res Treat. 2023;55(4):1123-1133.   Published online May 8, 2023
DOI: https://doi.org/10.4143/crt.2022.1046
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to investigate the oncologic outcomes and prognostic factors of salvage treatments in patients with recurrent oropharyngeal squamous cell carcinoma (OPSCC) after radiotherapy (RT)-based treatment.
Materials and Methods
A cancer registry was used to retrieve the records of 337 patients treated with definitive RT or concurrent chemoradiotherapy (CRT) from 2008 to 2018 at a single institution. The poor-responder group (PRG) was defined as patients with residual or recurrent disease after primary treatment, and the oncologic outcomes for each salvage treatment method were analyzed. In addition, prognostic indicators of recurrence-free survival (RFS) and overall survival (OS) were identified in patients who underwent salvage treatment.
Results
After initial (C)RT, the PRG comprised 71 of the 337 patients (21.1%): 18 patients had residual disease, and 53 had recurrence after primary treatment (mean time to recurrence 19.5 months). Of these, 63 patients received salvage treatment (surgery 57.2%, re-(C)RT 23.8%, and chemotherapy 19.0%), and the salvage success rate was 47.6% at the last follow-up. The overall 2-year OS for salvage treatments was 56.4% (60.8% for the salvage surgery group and 46.2% for the salvage re-(C)RT). Salvage surgery patients with negative resection margins had better oncologic outcomes than those with close/positive resection margins. Using multivariate analyses, locoregional recurrence and residual disease after primary surgery were associated with poor outcome after salvage treatment. In Kaplan-Meier analyses, p16 status was significantly associated with OS in the initial treatment setting but not in the salvage setting.
Conclusion
In recurrent OPSCC after RT-based treatment, successful salvage was achieved in 56.4% patients who had undergone salvage surgery and radiation treatment. Salvage treatment methods should be selected carefully, given recurrence site as a prognostic factor for RFS.

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  • Toxicities and prognostic factors in elderly HPV‐associated oropharyngeal cancer patients treated with radiotherapy or chemoradiotherapy
    Erkan Topkan, Efsun Somay, Ugur Selek
    Journal of Medical Virology.2024;[Epub]     CrossRef
  • 3,373 View
  • 216 Download
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Phase II Trial of Combined Durvalumab Plus Tremelimumab with Proton Therapy for Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
Hana Kim, Sehhoon Park, Hyun Ae Jung, Se-Hoon Lee, Keunchil Park, Yong Chan Ahn, Dongryul Oh, Myung-Ju Ahn
Cancer Res Treat. 2023;55(4):1104-1112.   Published online May 17, 2023
DOI: https://doi.org/10.4143/crt.2023.502
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This phase II study investigated whether durvalumab/tremelimumab with proton therapy improves the objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) in heavily treated recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) patients.
Materials and Methods
Patients who previously received more than one chemotherapy, including at least one platinum-based regimen, and who had at least two measurable lesions were enrolled. Patients received 1,500 mg durvalumab intravenously combined with 75 mg tremelimumab intravenously every 4 weeks for four cycles followed by 1,500 mg durvalumab every 4 weeks. After one cycle of the durvalumab/tremelimumab treatment, proton therapy was given with a total dose of 25 Gy in 5 Gy daily fractions to one of the measurable lesions. We also assessed the ORR in the target lesion outside the radiation field to evaluate the abscopal effect.
Results
Thirty-one patients were enrolled between March 2018 and July 2020. With 8.6 months of follow-up, the ORR was 22.6% (7/31), including one complete response and six partial responses. The median OS was 8.4 months (95% confidence interval [CI], 2.5 to 14.3) and the median PFS was 2.4 months (95% CI, 0.6 to 4.2). Among the 23 evaluable patients who completed proton therapy, the ORR was 30.4% (7/23). The median OS was 11.1 months (95% CI, 6.5 to 15.8), and the median PFS was 3.7 months (95% CI, 1.6 to 5.7). Grade 3 or higher adverse events were observed in six patients (19.4%) as follows: anemia (n=1), constipation (n=1), electrolyte imbalances (n=2), hyperglycemia (n=1), and pneumonia (n=1).
Conclusion
The combination of durvalumab/tremelimuab with proton therapy was tolerated well and had encouraging anti-tumor efficacy in non-irradiated tumor lesions of heavily treated HNSCC patients.

Citations

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  • Abscopal Effects and Immunomodulation in Skin Cancer Therapy
    William J. Nahm, Goranit Sakunchotpanit, Vinod E. Nambudiri
    American Journal of Clinical Dermatology.2025;[Epub]     CrossRef
  • Abscopal effect in maxillary sinus cancer: Insights from two case reports and a literature review
    Akihiro Sakai, Koji Ebisumoto, Hiroaki Iijima, Mayu Yamauchi, Daisuke Maki, Tsuyoshi Fukuzawa, Kenji Okami
    Cancer Reports.2024;[Epub]     CrossRef
  • Solid tumours showing oligoprogression to immune checkpoint inhibitors have the potential for abscopal effects
    Makoto Ito, Souichiro Abe, Sou Adachi, Yukihiko Oshima, Arisa Takeuchi, Wataru Ohashi, Takashi Iwata, Tetsuya Ogawa, Akiko Ota, Yasuaki Kubota, Takahito Okuda, Kojiro Suzuki
    Japanese Journal of Radiology.2024; 42(4): 424.     CrossRef
  • Durvalumab with or without tremelimumab for patients with recurrent or metastatic squamous cell carcinoma of the head and neck: a systematic review and meta-analysis
    Xiao Han, Haidong Zhang, Kai Sun, Jing Li, Wanjuan Wu, Kai Liu, Zhenkun Yu
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • Kaplan lecture 2023: lymphopenia in particle therapy
    Marco Durante
    International Journal of Radiation Biology.2024; 100(5): 669.     CrossRef
  • Clinical application of high‐LET radiotherapy combined with immunotherapy in malignant tumors
    Kexin Meng, Haijun Lu
    Precision Radiation Oncology.2024; 8(1): 42.     CrossRef
  • Research progress of immunotherapy for advanced head and neck cancer
    Anchi Sun, Zhiwei Xing, Rongrong Lv, Pengyuan Niu, Bao Zhao, Shiyin Ma, Hui Li
    Medical Oncology.2024;[Epub]     CrossRef
  • A review and bibliometric analysis of global research on proton radiotherapy
    Ge Song, Zhi Zheng, Yingming Zhu, Yaoting Wang, Song Xue
    Medicine.2024; 103(19): e38089.     CrossRef
  • Cutaneous Squamous Cell Carcinoma: An Updated Review
    Rina Jiang, Mike Fritz, Syril Keena T. Que
    Cancers.2024; 16(10): 1800.     CrossRef
  • Radiotherapy and immunology
    Liangliang Wang, Connor Lynch, Sean P. Pitroda, András Piffkó, Kaiting Yang, Amy K. Huser, Hua Laura Liang, Ralph R. Weichselbaum
    Journal of Experimental Medicine.2024;[Epub]     CrossRef
  • The Evolving Paradigm of Immunotherapy in Head-and-neck Squamous Cell Cancers
    Riccardo Gili, Paolo Bossi
    Journal of Head & Neck Physicians and Surgeons.2024; 12(1): 13.     CrossRef
  • Neoadjuvant Immunotherapy in Head and Neck Cancers: A Paradigm Shift in Treatment Approach
    Alessia Zotta, Maria Luisa Marciano, Francesco Sabbatino, Alessandro Ottaiano, Marco Cascella, Monica Pontone, Massimo Montano, Ester Calogero, Francesco Longo, Morena Fasano, Teresa Troiani, Fortunato Ciardiello, Fabiana Raffaella Rampetta, Giovanni Salz
    Biomedicines.2024; 12(10): 2337.     CrossRef
  • Emerging Radiotherapy Technologies for Head and Neck Squamous Cell Carcinoma: Challenges and Opportunities in the Era of Immunotherapy
    Carmen Kut, Harry Quon, Xuguang Scott Chen
    Cancers.2024; 16(24): 4150.     CrossRef
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  • 13 Web of Science
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Gastrointestinal cancer
Differential Perspectives by Specialty on Oligometastatic Colorectal Cancer: A Korean Oligometastasis Working Group’s Comparative Survey Study
Won Kyung Cho, Gyu Sang Yoo, Chai Hong Rim, Jae-Uk Jeong, Eui Kyu Chie, Yong Chan Ahn, Hyeon-Min Cho, Jun Won Um, Yang-Gun Suh, Ah Ram Chang, Jong Hoon Lee, On behalf of the Oligometastasis Working Group, Korean Cancer Association
Cancer Res Treat. 2023;55(4):1281-1290.   Published online June 7, 2023
DOI: https://doi.org/10.4143/crt.2023.479
AbstractAbstract PDFPubReaderePub
Purpose
Despite numerous studies on the optimal treatments for oligometastatic disease (OMD), there is no established interdisciplinary consensus on its diagnosis or classification. This survey-based study aimed to analyze the differential opinions of colorectal surgeons and radiation oncologists regarding the definition and treatment of OMD from the colorectal primary.
Materials and Methods
A total of 141 participants were included in this study, consisting of 63 radiation oncologists (44.7%) and 78 colorectal surgeons (55.3%). The survey consisted of 19 questions related to OMD, and the responses were analyzed using the chi-square test to determine statistical differences between the specialties.
Results
The radiation oncologists chose “bone” more frequently compared to the colorectal surgeons (19.2% vs. 36.5%, p=0.022), while colorectal surgeons favored “peritoneal seeding” (26.9% vs. 9.5%, p=0.009). Regarding the number of metastatic tumors, 48.3% of colorectal surgeons responded that “irrelevant, if all metastatic lesions are amendable to local therapy”, while only 21.8% of radiation oncologist chose same answer. When asked about molecular diagnosis, most surgeons (74.8%) said it was important, but only 35.8% of radiation oncologists agreed.
Conclusion
This study demonstrates that although radiation oncologists and colorectal surgeons agreed on a majority of aspects such as diagnostic imaging, biomarker, systemic therapy, and optimal timing of OMD, they also had quite different perspectives on several aspects of OMD. Understanding these differences is crucial to achieving multidisciplinary consensus on the definition and optimal management of OMD.

Citations

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  • 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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Barriers in Oligometastasis Care in Korea: Radiation Oncologists’ Perspectives
Eui Kyu Chie, Chai Hong Rim, Won Kyung Cho, Yong Chan Ahn
Cancer Res Treat. 2023;55(4):1063-1064.   Published online June 27, 2023
DOI: https://doi.org/10.4143/crt.2023.780
PDFPubReaderePub

Citations

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  • The patterns of systemic metastasis in major salivary gland cancer and therapeutic implications
    Subi Oh, Younghac Kim, Hyojun Kim, Eunhye Kim, Sook-young Woo, Nayeon Choi, Junhun Cho, Dongryul Oh, Yong-Chan Ahn, Sehhoon Park, Myung-Ju Ahn, Han-Sin Jeong
    Oral Oncology.2025; 164: 107258.     CrossRef
  • Oligometastasis: Expansion of Curative Treatments in the Field of Oncology
    Ah Reum Lim, Chai Hong Rim
    Medicina.2023; 59(11): 1934.     CrossRef
  • 2,776 View
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Lung and Thoracic cancer
The Incidence and Risk Factors of Chronic Pulmonary Infection after Radiotherapy in Patients with Lung Cancer
Yeonseok Choi, Jae Myoung Noh, Sun Hye Shin, Kyungjong Lee, Sang-Won Um, Hojoong Kim, Hongryull Pyo, Yong Chan Ahn, Byeong-Ho Jeong
Cancer Res Treat. 2023;55(3):804-813.   Published online January 3, 2023
DOI: https://doi.org/10.4143/crt.2022.1305
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to investigate cumulative incidence and risk factors associated with chronic pulmonary infection (CPI) development after radiotherapy for lung cancer.
Materials and Methods
We retrospectively analyzed 1,872 patients with lung cancer who received radiotherapy for lung cancer from 2010-2014, had a follow-up period of ≥ 3 months after radiotherapy, and did not have CPI at the time of radiotherapy. CPI was defined as pulmonary tuberculosis, non-tuberculous mycobacterial pulmonary disease, chronic pulmonary aspergillosis, or pulmonary actinomycosis. The cumulative incidence of CPI and overall survival (OS) were estimated using the Kaplan-Meier method, and a multivariable Cox proportional hazards analysis was performed to identify risk factors associated with CPI development.
Results
The median follow-up period was 2.3 years with OS rates of 55.6% and 37.6% at 2 and 5 years, respectively. CPI developed in 59 patients at a median of 1.8 years after radiotherapy, with cumulative incidence rates of 1.1%, 3.4%, 5.0%, and 6.8% at 1, 3, 5, and 7 years, respectively. A lower body mass index, interstitial lung disease, prior pulmonary tuberculosis, larger clinical target volume, history of lung cancer surgery or radiation pneumonitis, and use of inhaled corticosteroids were independent risk factors for CPI development.
Conclusion
The long-term survival rate of lung cancer patients receiving radiotherapy was not low, but the cumulative incidence of CPI gradually increased to 6.8% at 7 years after radiotherapy. Therefore, close monitoring of CPI development is required in surviving patients with risk factors.

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  • Chronic progressive pulmonary aspergillosis within the irradiated field after stereotactic body radiotherapy: two case reports
    Nao Mamuro, Noriko Kishi, Yukinori Matsuo, Masahiro Yoneyama, Hiroyuki Inoo, Minoru Inoue, Takashi Mizowaki
    International Cancer Conference Journal.2025; 14(2): 113.     CrossRef
  • Predictive nomogram for risk of pulmonary infection in lung cancer patients undergoing radiochemotherapy: development and performance evaluation
    Yujie Huang
    American Journal of Cancer Research.2025; 15(2): 781.     CrossRef
  • The Inter-Relationships Among the Risk Factors for Pulmonary Infection and the Diagnostic Utility of Inflammatory Markers in Patients with Non-Small Cell Lung Cancer
    Wenwen Qin, Tiebin You, Tai Guo, Ruixin Tian, Xiaoman Cui, Ping Wang
    Infection and Drug Resistance.2025; Volume 18: 1111.     CrossRef
  • Invasive aspergillosis complicated in a patient with non-small cell lung cancer harboring RET fusion during treatment with RET-TKIs: a case report and literature review
    Kaidiriye Setiwalidi, Yimeng Li, Yuyan Ma, Zhanpeng Hao, Yujia Zhao, Yuxin Zhang, Xuan Liang, Tao Tian, Zhiping Ruan, Yu Yao, Xiao Fu
    Frontiers in Oncology.2024;[Epub]     CrossRef
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General
Recent Trends of Medical Expenses Associated with Radiation Therapy in Korea Based on HIRA Big Data
Jeong Eun Lee, Kyungmi Yang, Yong Chan Ahn, Won Park, Seung Jae Huh
Cancer Res Treat. 2023;55(3):758-765.   Published online January 30, 2023
DOI: https://doi.org/10.4143/crt.2022.389
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We aimed to determine the trends in the use of radiotherapy (RT) and the expenses associated with it in South Korea.
Materials and Methods
The statistical data of the claims and reimbursement records provided on the Health and Insurance Review and Assessment Service website were utilized. This included information such as the number of patients, fractions, medical expenses according to treatment codes, in/outpatient, sex, age, and regions of hospitals. We analyzed data from 2016 to 2020.
Results
With a growing RT infrastructure and an increase in the number of radiation oncologists, the expenses for RT were 605.5 million USD in 2020, which had increased 1.5 times from 394.7 million USD in 2016. This growth was mainly because of the increased usage of advanced RT techniques. Furthermore, the proportion of intensity-modulated radiation therapy (IMRT) expenses in the total expenses increased by 1.6 times from 48.8% in 2016 to 76.9% in 2020. Advanced techniques were used more commonly in older individuals or children. However, the proportion of IMRT expenses increased mostly in young women. Additionally, geographical differences in RT use and expense were observed, although the gap in the IMRT fractions decreased among the regions.
Conclusion
Recent medical expenses associated with RT in Korea have increased in tandem with technological advances and changes in demographics.

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  • Volumetric Modulated Arc Therapy for 26 Gy in 5 Fractions Whole Breast Irradiation for Breast Cancer
    Seo Hee Choi, Jin Sung Kim, Ho Jin Kim, Ryeong Hwang Park, Ik Jae Lee, Yong Bae Kim, Jee Suk Chang
    Advances in Radiation Oncology.2025; 10(4): 101733.     CrossRef
  • Large institutional experience of early outcomes and dosimetric findings with postoperative stereotactic partial breast irradiation in breast cancer
    Jee Suk Chang, Jeongshim Lee, Frank A. Vicini, Jin Sung Kim, Jihun Kim, Seo Hee Choi, Ik Jae Lee, Yong Bae Kim
    Radiotherapy and Oncology.2024; 191: 110066.     CrossRef
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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, on behalf of Korean Cancer Association Oligometastasis Working Group
Cancer Res Treat. 2023;55(3):707-719.   Published online March 15, 2023
DOI: https://doi.org/10.4143/crt.2022.1599
AbstractAbstract PDFPubReaderePub
Introduction of the concept for oligometastasis led to wide application of metastasis-directed local ablative therapies for metastatic colorectal cancer (CRC). By application of the metastasis-directed local ablative therapies including surgical resection, radiofrequency ablation (RFA), and stereotactic ablative body radiotherapy (SABR), the survival outcomes of patients with metastatic CRC have improved. The liver is the most common distant metastatic site in CRC patients, and recently various metastasis-directed local therapies for hepatic oligometastasis from CRC (HOCRC) are widely used. Surgical resection is the first line of metastatic-directed local therapy for HOCRC, but its eligibility is very limited. Alternatively, RFA can be applied to patients who are ineligible for surgical resection of liver metastasis. However, there are some limitations such as inferior local control (LC) compared with surgical resection and technical feasibility based on location, size, and visibility on ultrasonography of the liver metastasis. Recent advances in radiation therapy technology have led to an increase in the use of SABR for liver tumors. SABR is considered complementary to RFA for patients with HOCRC who are ineligible for RFA. Furthermore, SABR can potentially result in better LC for liver metastases > 2-3 cm compared with RFA. In this article, the previous studies regarding curative metastasis-directed local therapies for HOCRC based on the radiation oncologist’s and surgeon’s perspective are reviewed and discussed. In addition, future perspectives regarding SABR in the treatment of HOCRC are suggested.

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  • Identifying Trends in Oncology Research through a Bibliographic Analysis of Cancer Research and Treatment
    Choong-kun Lee, Jeong Min Choo, Yong Chan Ahn, Jin Kim, Sun Young Rha, Chai Hong Rim
    Cancer Research and Treatment.2025; 57(1): 11.     CrossRef
  • Evidence-based clinical recommendations for hypofractionated radiotherapy: exploring efficacy and safety - Part 4: Liver and locally recurrent rectal cancer
    Hwa Kyung Byun, Gyu Sang Yoo, Soo-Yoon Sung, Jin-Ho Song, Byoung Hyuck Kim, Yoo-Kang Kwak, Yeon Joo Kim, Yeon-Sil Kim, Kyung Su Kim
    Radiation Oncology Journal.2024; 42(4): 247.     CrossRef
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Oligometastasis: More Lessons to Be Learned
Kyung Hwan Kim, Yong Chan Ahn, Oligometastasis Working Group, Korea Cancer Association
Cancer Res Treat. 2023;55(1):1-4.   Published online January 3, 2023
DOI: https://doi.org/10.4143/crt.2023.265
PDFPubReaderePub

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  • Photonic Hyperthermia Synergizes with Immune‐Activators to Augment Tumor‐Localized Immunotherapy
    Tiankuan Li, Zhongqian Hu, Feifei Song, Chenyao Wu, Qizeng Miao, Zhongmin Wang, Wei Feng, Jinhe Guo, Yu Chen
    Small Methods.2023;[Epub]     CrossRef
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General
Role of Local Treatment for Oligometastasis: A Comparability-Based Meta-Analysis
Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Eui Kyu Chie, Yong Chan Ahn, The Oligometastasis Working Group, Korea Cancer Association
Cancer Res Treat. 2022;54(4):953-969.   Published online August 16, 2022
DOI: https://doi.org/10.4143/crt.2022.329
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We intend to investigate the oncological efficacy and feasibility of local consolidative therapy (LCT) through a meta-analysis method.
Materials and Methods
Four databases including PubMed, MEDLINE, Embase, and Cochrane library were searched. Target studies are controlled trials comparing outcomes of LCT versus a control group. Primary endpoints are overall survival (OS) and progression-free survival (PFS).
Results
A total of 54 studies involving 7,242 patients were included. Pooled analyses showed that the LCT arm could achieve improved OS with pooled odds ratio of 2.896 (95% confidence interval [CI], 2.377 to 3.528; p < 0.001). Regarding PFS, pooled analyses showed pooled odds ratio of 3.045 (95% CI, 2.356 to 3.937; p < 0.001) in favor of the LCT arm. In the subgroup analyses including the studies with reliable comparability (e.g. randomized studies or intentionally matched studies without significant favorable prognosticator in LCT arms), pooled odds ratio was 2.548 (95% CI, 1.808 to 3.591; p < 0.001) favoring the LCT arm regarding OS. Regarding PFS, pooled OR was 2.656 (95% CI, 1.713 to 4.120; p < 0.001) which also favored the LCT arm. Subgroup analyses limited to the randomized controlled trials (RCT) were also performed and pooled odds ratios on OS and PFS were 1.535 (95% CI, 1.082 to 2.177; p=0.016) and 1.668 (95% CI, 1.187 to 2.344; p=0.003). The rates of grade ≥ 3 complications related to LCT was mostly low (< 10%) and not significantly higher compared to the control arm.
Conclusion
Pooled analyses results of all included studies, selected studies with reliable comparability, and RCT’s demonstrated the survival benefit of LCT. These consistent results suggest that LCT was beneficial to the patients with oligometastasis.

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    Current Oncology.2024; 31(6): 3239.     CrossRef
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  • A new proposal of simplified classification of non-small cell lung cancer oligometastases for easy applicability through systematic literature analysis and meta-analysis validation
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    Kyung Hwan Kim, Yong Chan Ahn
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  • 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
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  • Barriers in Oligometastasis Care in Korea: Radiation Oncologists’ Perspectives
    Eui Kyu Chie, Chai Hong Rim, Won Kyung Cho, Yong Chan Ahn
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    Nalee Kim, Haeyoung Kim, Won Park, Won Kyung Cho, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim
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Head and Neck cancer
Oncological and Functional Outcomes of Larynx-preserving Surgery for Hypopharyngeal Cancer: A Comparison with Definitive Radiation-based Treatment
Donghyeok Kim, Nalee Kim, Sungmin Koh, Man Ki Chung, Young-Ik Son, Dongryul Oh, Han-Sin Jeong, Yong Chan Ahn
Cancer Res Treat. 2022;54(1):84-95.   Published online March 26, 2021
DOI: https://doi.org/10.4143/crt.2020.1197
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Larynx-preserving surgery (LPS) have recently gained popularity and achieved comparable oncologic outcomes to conventional radical surgery for localized hypopharyngeal cancer (HPC). In the current study, the role of LPS has been assessed thoroughly in comparison with upfront radiation therapy (RT).
Materials and Methods
We retrospectively reviewed 185 candidates for LPS with cT1-2 disease; 59 patients underwent upfront LPS while 126 patients received upfront RT, respectively. Oncological and functional outcomes were investigated and compared.
Results
Following LPS, safe margin (≥ 5 mm) was achieved in 37.3% of patients. Overall, better clinical outcomes at 5 years were achieved following upfront LPS than those following upfront RT: overall survival (OS) (72.7% vs. 59.0%, p=0.045), disease-free survival (DFS) (59.8% vs. 45.0%, p=0.039), and functional laryngeal preservation (100% vs. 89.7%, p=0.010). Although similar outcomes were observed in patients with cT1 disease, better 5-year DFS was achieved following upfront LPS in patients with cT2 disease (57.0% vs. 36.4%, p=0.023) by virtue of better local control. Despite frequent cN2-3 disease in upfront LPS group, comparable outcomes were observed between upfront RT and LPS group. However, multivariable analyses revealed that performance status and double primary cancer diagnosed within 6 months of HPC diagnosis affected OS significantly, while treatment modality per se did not.
Conclusion
Although upfront LPS could provide better local control than upfront RT in patients with cT2 disease, overall outcomes were comparable following either modality. Treatment selection of larynx-preserving approach for HPC should be individualized based on tumor and patient factors.

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  • In Reply to Liu and Luo
    Kangpyo Kim, Yong Chan Ahn
    International Journal of Radiation Oncology*Biology*Physics.2024; 118(1): 308.     CrossRef
  • The role and clinical significance of microRNA-29a-3p in the development of hypopharyngeal carcinoma
    Tao Liu, Detao Ding, Wei Wang, Yungang Wu, Dengdian Ma, Miaomiao Liu, Ziqiao Tan, Jing Yao, Xiaoyu Li
    Brazilian Journal of Otorhinolaryngology.2023; 89(3): 401.     CrossRef
  • Survival and swallowing function outcome impact factors analysis of surgery-oriented comprehensive treatment for hypopharyngeal cancer in a series of 122 patients
    Wan-Xin Li, Yan-Bo Dong, Cheng Lu, Patrick J. Bradley, Liang-Fa Liu
    Ear, Nose & Throat Journal.2022; 101(8): 532.     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
AbstractAbstract PDFPubReaderePub
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.

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  • Case Report: Unresectable recurrent nasopharyngeal cancer treated with immuno oncology
    Fabiano Flauto, Rosa Maria Di Crescenzo, Vincenzo Damiano
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Envisioning an Italian Head and Neck Proton Therapy Model-Based Selection: Challenge and Opportunity
    Giulia Fontana, Matteo Pepa, Anna Maria Camarda, Mimoza Strikchani, Michela Meregaglia, Alessandro Vai, Alfredo Mirandola, Barbara Vischioni, Andrea Pella, Guido Baroni, Barbara Alicja Jereczek-Fossa, Marta Scorsetti, Marco Cianchetti, Elisa D’Angelo, Pie
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    Helena Levyn, Fan Yang, Nancy Y. Lee
    Current Opinion in Otolaryngology & Head & Neck Surgery.2024; 32(1): 5.     CrossRef
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  • 202 Download
  • 7 Web of Science
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The Rise of Particle Beam Therapy: Are We Ready for The Potential Game-Changer?
Eui Kyu Chie, Yong Chan Ahn
Cancer Res Treat. 2021;53(3):609-610.   Published online June 16, 2021
DOI: https://doi.org/10.4143/crt.2021.707
PDFPubReaderePub
  • 5,365 View
  • 184 Download
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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
AbstractAbstract PDFPubReaderePub
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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    Seung Gyu Park, Yong Chan Ahn, Dongryul Oh, Kyungmi Yang, Sang Gyu Ju, Jin Man Kim, Dongyeol Kwon, Euncheol Choi, Han Gyul Yoon
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    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
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Dummy Run of Quality Assurance Program before Prospective Study of Hippocampus-Sparing Whole-Brain Radiotherapy and Simultaneous Integrated Boost for Multiple Brain Metastases from Non-small Cell Lung Cancer: Korean Radiation Oncology Group (KROG) 17-06 Study
Eunah Chung, Jae Myoung Noh, Kyu Chan Lee, Jin Hee Kim, Weon Kuu Chung, Yang-Gun Suh, Jung Ae Lee, Ki Ho Seol, Hong Gyun Wu, Yeon Sil Kim, O Kyu Noh, Jae Won Park, Dong Soo Lee, Jihae Lee, Young Suk Kim, Woo-Yoon Park, Min Kyu Kang, Sunmi Jo, Yong Chan Ahn
Cancer Res Treat. 2019;51(3):1001-1010.   Published online October 15, 2018
DOI: https://doi.org/10.4143/crt.2018.415
AbstractAbstract PDFPubReaderePub
Purpose
Lung Cancer Subcommittee of Korean Radiation Oncology Group (KROG) has recently launched a prospective clinical trial (KROG 17-06) of hippocampus-sparing whole brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in treating multiple brain metastases from non-small cell lung cancer. In order to improve trial quality, dummy run studies among the participating institutions were designed. This work reported the results of two-step dummy run procedures of the KROG 17-06 study.
Materials and Methods
Two steps tested hippocampus contouring variability and radiation therapy planning compliance. In the first step, the variation of the hippocampus delineation was investigated for two representative cases using the Dice similarity coefficients. In the second step, the participating institutions were requested to generate a HS-WBRT with SIB treatment plan for another representative case. The compliance of the treatment plans to the planning protocol was evaluated.
Results
In the first step, the median Dice similarity coefficients of the hippocampus contours for two other dummy run cases changed from 0.669 (range, 0.073 to 0.712) to 0.690 (range, 0.522 to 0.750) and from 0.291 (range, 0.219 to 0.522) to 0.412 (range, 0.264 to 0.598) after providing the hippocampus contouring feedback. In the second step, with providing additional plan priority and extended dose constraints to the target volumes and normal structures, we observed the improved compliance of the treatment plans to the planning protocol.
Conclusion
The dummy run studies demonstrated the notable inter-institutional variability in delineating the hippocampus and treatment plan generation, which could be decreased through feedback from the trial center.

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  • Radiotherapy trial quality assurance processes: a systematic review
    Chloe Brooks, Elizabeth Miles, Peter J Hoskin
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EGFR Mutation Is Associated with Short Progression-Free Survival in Patients with Stage III Non-squamous Cell Lung Cancer Treated with Concurrent Chemoradiotherapy
Song Ee Park, Jae Myoung Noh, You Jin Kim, Han Sang Lee, Jang Ho Cho, Sung Won Lim, Yong Chan Ahn, Hongryull Pyo, Yoon-La Choi, Joungho Han, Jong-Mu Sun, Se Hoon Lee, Jin Seok Ahn, Keunchil Park, Myung-Ju Ahn
Cancer Res Treat. 2019;51(2):493-501.   Published online June 18, 2018
DOI: https://doi.org/10.4143/crt.2018.125
AbstractAbstract PDFPubReaderePub
Purpose
This study was conducted to evaluate the relationship between epidermal growth factor receptor (EGFR) mutation and clinical outcomes in patients with stage III non-squamous cell lung cancer treated with definitive concurrent chemoradiotherapy (CCRT).
Materials and Methods
From January 2008 to December 2013, the medical records of 197 patients with stage III non- squamous non-small cell lung cancer treated with definitive CCRT were analyzed to determine progression-free survival (PFS) and overall survival (OS) according to EGFR mutation status.
Results
Among 197 eligible patients, 81 patients were EGFR wild type, 36 patients had an EGFR mutation (exon 19 Del, n=18; L858R, n=9, uncommon [G719X, L868, T790M], n=9), and 80 patients had unknown EGFR status. The median age was 59 years (range, 28 to 80 years) and 136 patients (69.0%) were male. The median follow-up duration was 66.5 months (range, 1.9 to 114.5 months). One hundred sixty-four patients (83.2%) experienced disease progression. Median PFS was 8.9 months for the EGFR mutation group, 11.8 months for EGFR wild type, and 10.5 months for the unknown EGFR group (p=0.013 and p=0.042, respectively). The most common site of metastasis in the EGFR mutant group was the brain. However, there was no significant difference in OS among the three groups (34.6 months for EGFR mutant group vs. 31.9 months for EGFR wild type vs. 22.6 months for EGFR unknown group; p=0.792 and p=0.284). A total of 29 patients (80.6%) with EGFR mutation were treated with EGFR tyrosine kinase inhibitor (gefitinib, n=24; erlotinib, n=3; afatinib, n=2) upon progression.
Conclusion
EGFR mutation is associatedwith short PFS and the brain is the most common site of distant metastasis in patients with stage III non- squamous cell lung cancer treated with CCRT.

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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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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.

Citations

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Feasibility of Selective Neck Irradiation with Lower Elective Radiation Dose in Treating Nasopharynx Cancer Patients
Won Kyung Cho, Dongryul Oh, Eonju Lee, Tae Gyu Kim, Hyebin Lee, Heerim Nam, Jae Myoung Noh, Yong Chan Ahn
Cancer Res Treat. 2019;51(2):603-610.   Published online July 18, 2018
DOI: https://doi.org/10.4143/crt.2018.240
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to report the clinical outcomes following selective neck irradiation (SNI) with lower elective radiation therapy (RT) dose in treating nasopharyngeal cancer (NPC) patients.
Materials and Methods
A total of 347 NPC patients received definitive RT according to our SNI policy and were retrospectively analyzed. The clinical target volumes (CTVs) were subdivided into CTV at high risk (CTV-HR) and CTV at low risk (CTV-LR). The typical doses to gross tumor volume (GTV), CTV-HR, and CTV-LR were 68.4-70.0 Gy, 54.0-60.0 Gy, and 36.0 Gy.
Results
With the median follow-up of 68.1 months (range, 2.3 to 197.1 months), the 5-year rates of loco-regional control and progression-free survival in all the patients were 85.0% and 70.8%, respectively. Thirty patients developed regional failure and the regional control rates at 3 and 5 years were 92.6% and 91.4%, respectively. The sites of regional failure in relation to the target volume were exclusively inside GTV/CTV-HR in 20, inside and outside GTV/CTVHR in three, and exclusively outside GTV/CTV-HR in seven, which were 5.7%, 0.9%, and 2.0% of total patients, respectively.
Conclusion
The clinical outcomes by the current SNI policy were feasible and comparable to those following classic elective nodal irradiation policy.

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  • Clinical features of post-radiation nasopharyngeal necrosis and their outcomes following surgical intervention in nasopharyngeal cancer patients
    Kyungmi Yang, Yong Chan Ahn, Heerim Nam, Sang Duk Hong, Dongryul Oh, Jae Myoung Noh
    Oral Oncology.2021; 114: 105180.     CrossRef
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    Han Gyul Yoon, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Seung Gyu Park, Heerim Nam, Sang Gyu Ju, Dongyeol Kwon, Seyjoon Park
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  • Development and Validation of Web-Based Nomograms to Precisely Predict Survival Outcomes of Non-metastatic Nasopharyngeal Carcinoma in an Endemic Area
    Ji-Jin Yao, Li Lin, Tian-Sheng Gao, Wang-Jian Zhang, Wayne R. Lawrence, Jun Ma, Ying Sun
    Cancer Research and Treatment.2021; 53(3): 657.     CrossRef
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    Johannes H.A.M. Kaanders, Sven van den Bosch, Tim Dijkema, Abrahim Al-Mamgani, Cornelis P.J. Raaijmakers, Wouter V. Vogel
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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
AbstractAbstract PDFPubReaderePub
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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The Effect of Hospital Case Volume on Clinical Outcomes in Patients with Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Analysis (KROG-1106)
Boram Ha, Kwan Ho Cho, Sung Ho Moon, Chang-Geol Lee, Ki Chang Keum, Yeon-Sil Kim, Hong-Gyun Wu, Jin Ho Kim, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Jong Hoon Lee, Sung Hwan Kim, Won Taek Kim, Young-Taek Oh, Min Kyu Kang, Jin Hee Kim, Ji-Yoon Kim, Moon-June Cho, Chul Seoung Kay, Jin Hwa Choi
Cancer Res Treat. 2019;51(1):12-23.   Published online February 5, 2018
DOI: https://doi.org/10.4143/crt.2017.273
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to investigate the effect of hospital case volume on clinical outcomes in patients with nasopharyngeal carcinoma (NPC).
Materials and Methods
Data on 1,073 patients with cT1-4N0-3M0 NPC were collected from a multi-institutional retrospective database (KROG 11-06). All patients received definitive radiotherapy (RT) either with three-dimensional-conformal RT (3D-CRT) (n=576) or intensity-modulated RT (IMRT) (n=497). The patients were divided into two groups treated at high volume institution (HVI) (n=750) and low volume institution (LVI) (n=323), defined as patient volume ≥ 10 (median, 13; range, 10 to 18) and < 10 patients per year (median, 3; range, 2 to 6), respectively. Endpoints were overall survival (OS) and loco-regional progression-free survival (LRPFS).
Results
At a median follow-up of 56.7 months, the outcomes were significantly better in those treated at HVI than at LVI. For the 614 patients of propensity score-matched cohort, 5-year OS and LRPFS were consistently higher in the HVI group than in the LVI group (OS: 78.4% vs. 62.7%, p < 0.001; LRPFS: 86.2% vs. 65.8%, p < 0.001, respectively). According to RT modality, significant difference in 5-year OS was observed in patients receiving 3D-CRT (78.7% for HVI vs. 58.9% for LVI, p < 0.001) and not in those receiving IMRT (77.3% for HVI vs. 75.5% for LVI, p=0.170).
Conclusion
A significant relationship was observed between HVI and LVI for the clinical outcomes of patients with NPC. However, the difference in outcome becomes insignificant in the IMRT era, probably due to the standardization of practice by education.

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    Wenyan Yao, Jiang Hu, Peixun Xu, Mengxue He, Yongwen Fang, Mingzhi Liu, Zongtai Li, Huilang He, Hui Liu, Wenzhao Sun, Senkui Xu
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Low-Dose Radiation Therapy for Primary Conjunctival Marginal Zone B-Cell Lymphoma
Ga-In Lee, Dongryul Oh, Won Seog Kim, Seok Jin Kim, Young Hyeh Ko, Kyung In Woo, Yoon-Duck Kim, Yong Chan Ahn
Cancer Res Treat. 2018;50(2):575-581.   Published online June 16, 2017
DOI: https://doi.org/10.4143/crt.2017.182
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to evaluate the clinical features and the long-term outcomes of primary conjunctival marginal zone B-cell lymphoma (MZBCL) patients who were treated with radiation therapy (RT).
Materials and Methods
Retrospective data of 79 patients with 121 primary conjunctival MZBCL lesions were collected from January 1, 2001 till June 30, 2014. All lesions were treated by local RT (26 Gy) with patient-specific customized lens-shielding device.
Results
The current Korean patients’ cohort showed younger median age at diagnosis (38 years), great female preponderance (78.5%) and more frequent bilateral involvement (53.2%) than the previous studies. Following 26 Gy’s RT, excellent clinical outcomes were achieved: 5-year rates of overall survival, local relapse-free survival, and contralateral relapse-free survival were 100%, 98.1%, and 91.5%, respectively. Two patients (2.5%) developed local relapse and five (6.3%) developed relapse at initially uninvolved contralateral conjunctiva with median interval of 52.9 months, and late adverse events of grade 2 and 3 occurred in seven (8.8%) and two (2.5%) patients, respectively.
Conclusion
26 Gy’s RT was highly effective and safe, with the use of lens-shielding device, in treating patients with primary conjunctival MZBCL.

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Role of Adjuvant Thoracic Radiation Therapy and Full Dose Chemotherapy in pN2 Non-small Cell Lung Cancer: Elucidation Based on Single Institute Experience
Hyojung Park, Dongryul Oh, Yong Chan Ahn, Hongryull Pyo, Jae Myung Noh, Jong-Mu Sun, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim
Cancer Res Treat. 2017;49(4):880-889.   Published online December 12, 2016
DOI: https://doi.org/10.4143/crt.2016.442
AbstractAbstract PDFPubReaderePub
Purpose
The optimal adjuvant therapy modality for treating pN2 non-small cell lung cancer patients has not yet been established. In this study, the authors investigated clinical outcomes following three different adjuvant therapy modalities.
Materials and Methods
From January 2006 to December 2012, 240 patients with cN0/1 disease were found to have pN2 disease following curative resection and received one of three adjuvant therapy modalities:thoracic radiation therapy (TRT) and concurrent chemotherapy (CTx) (CCRT) (group I), CCRT plus consolidation CTx (group II), and CTx alone (group III). TRT was delivered to 155 patients (groups I/II), and full dose CTxwas delivered to 172 patients either as a consolidative or a sole modality (group II/III).
Results
During 30 months of median follow-up, 44 patients died and 141 developed recurrence. The 5-year overall survival (OS), locoregional control (LRC), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates of all patients were 76.2%, 80.7%, 36.4%, and 29.6%, respectively. There was no difference in OS among groups. TRT (groups I/II) significantly improved LRC, full dose CTx (groups II/III) did DMFS, and CCRT plus consolidation CTx (group II) did DFS, respectively.
Conclusion
The current study could support that TRT could improve LRC and full dose CTx could improve DMFS and that CCRT plus consolidation CTx could improve DFS.

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    Dailong Li, Wanqiang Li, Yaqi Pang, Lu Xu, Xinhua Xu
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    Zexu Wang, Baixia Yang, Ping Zhan, Li Wang, Bing Wan
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Comparison of the Clinical Outcomes of Patients with Squamous Cell Carcinoma of the Tonsil Receiving Postoperative Ipsilateral Versus Bilateral Neck Radiotherapy: A Propensity Score Matching Analysis (KROG 11-07)
Youngkyong Kim, Kwan Ho Cho, Sung Ho Moon, Chang Geol Lee, Ki Chang Keum, Sang-wook Lee, Yong Chan Ahn, Dongryul Oh, Yeon-Sil Kim, Yong Kyun Won, Hong-Gyun Wu, J. Hun Hah, Young-Taek Oh
Cancer Res Treat. 2017;49(4):1097-1105.   Published online February 9, 2017
DOI: https://doi.org/10.4143/crt.2016.425
AbstractAbstract PDFPubReaderePub
Purpose
The impact of postoperative ipsilateral neck radiotherapy (INRT) versus bilateral neck radiotherapy (BNRT) on the clinical outcomes of patients with tonsillar squamous cell carcinoma was analyzed retrospectively.
Materials and Methods
Between October 2001 and June 2012, 241 patients with T1-2 and N0-N2b tonsillar carcinoma from 16 institutes underwent postoperative INRT (n=84) or BNRT (n=157) following a tonsillectomy. Seventy patientswere identified from each group by propensity score matching and compared in terms of the overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates calculated using the Kaplan-Meier method with a log-rank test.
Results
The median follow-up was 55 months (range, 3 to 133 months). The survival outcomes in the INRT and BNRT groupswere similar: 5-year OS (92.8% vs. 94.0%, p=0.985), DFS (80.5% vs. 94.2%. p=0.085), LRRFS (88.1% vs. 97.1%, p=0.083), and DMFS (92.7% vs. 97.0%, p=0.370). Subgroup analysis revealed no contralateral neck recurrence in 61 patients with T1-2N0-2a regardless of the treatment groups. For 79 patients with N2b, contralateral neck recurrence was more common in the INRT group than in the BNRT group (7.9% vs. 0.0%), but the difference was not significant (p=0.107). The overall grade ≥ 2 toxicities were lower in the INRT group: acute (45.7% vs. 74.3%, p=0.001) and late (4.3% vs. 31.4%, p < 0.001), respectively.
Conclusion
INRT is an attractive strategy for patients with T1-2N0-2a tonsillar carcinoma compared to BNRT. For patients with N2b, there was a small risk of contralateral neck recurrence when treated with INRT, but its impact on the OS was limited with successful salvage treatment.

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    Claire M. Rooney, Shao Hui Huang, Jie Su, Scott Bratman, John Cho, John de Almeida, Michael Glogauer, David Goldstein, Ezra Hahn, Ali Hosni, Andrew Hope, Jonathan Irish, John Kim, Brian O'Sullivan, Jolie Ringash, Anna Spreafico, Jillian Tsai, John Waldron
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    Divya Natesan, Christina K. Cramer, Taofik Oyekunle, Donna Niedzwiecki, David M. Brizel, Yvonne M. Mowery
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Survey of the Patterns of Using Stereotactic Ablative Radiotherapy for Early-Stage Non-small Cell Lung Cancer in Korea
Sanghyuk Song, Ji Hyun Chang, Hak Jae Kim, Yeon Sil Kim, Jin Hee Kim, Yong Chan Ahn, Jae-Sung Kim, Si Yeol Song, Sung Ho Moon, Moon June Cho, Seon Min Youn
Cancer Res Treat. 2017;49(3):688-694.   Published online October 31, 2016
DOI: https://doi.org/10.4143/crt.2016.219
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Stereotactic ablative radiotherapy (SABR) is an effective emerging technique for early-stage non-small cell lung cancer (NSCLC). We investigated the current practice of SABR for early-stage NSCLC in Korea.
Materials and Methods
We conducted a nationwide survey of SABR for NSCLC by sending e-mails to all board-certified members of the Korean Society for Radiation Oncology. The survey included 23 questions focusing on the technical aspects of SABR and 18 questions seeking the participants’ opinions on specific clinical scenarios in the use of SABR for early-stage NSCLC. Overall, 79 radiation oncologists at 61/85 specialist hospitals in Korea (71.8%) responded to the survey.
Results
SABR was used at 33 institutions (54%) to treat NSCLC. Regarding technical aspects, the most common planning methods were the rotational intensity-modulated technique (59%) and the static intensity-modulated technique (49%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained using 4-dimensional computed tomography. In the clinical scenarios, the most commonly chosen fractionation schedule for peripherally located T1 NSCLC was 60 Gy in four fractions. For centrally located tumors and T2 NSCLC, the oncologists tended to avoid SABR for radiotherapy, and extended the fractionation schedule.
Conclusion
The results of our survey indicated that SABR is increasingly being used to treat NSCLC in Korea. However, there were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions. Standardization of SABR is necessary before implementing nationwide, multicenter, randomized studies.

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Radiation Therapy Alone in cT1-3N0 Non-small Cell Lung Cancer Patients Who Are Unfit for Surgical Resection or Stereotactic Radiation Therapy: Comparison of Risk-Adaptive Dose Schedules
Won Kyung Cho, Jae Myoung Noh, Yong Chan Ahn, Dongryul Oh, Hongryull Pyo
Cancer Res Treat. 2016;48(4):1187-1195.   Published online March 9, 2016
DOI: https://doi.org/10.4143/crt.2015.391
AbstractAbstract PDFPubReaderePub
Purpose
High dose definitive radiation therapy (RT) alone is recommended to patients with cT1-3N0 non-small cell lung cancer, who are unfit for surgery or stereotactic RT. This study was conducted to evaluate the clinical outcomes and cost-effectiveness following RT alone using two different modest hypofractionation dose schemes. Materials and Methods Between 2001 and 2014, 124 patients underwent RT alone. From 2001 till 2010, 60 Gy in 20 fractions was delivered to 79 patients (group 1). Since 2011, 60 Gy in 20 fractions (group 2, 20 patients), and 60 Gy in 15 fractions (group 3, 25 patients) were selectively chosen depending on estimated risk of esophagitis.
Results
At follow-up of 16.7 months, 2-year rates of local control, progression-free survival, and overall survival were 62.6%, 39.1%, and 59.1%, respectively. Overall survival was significantly better in group 3 (p=0.002). In multivariate analyses, cT3 was the most powerful adverse factor affecting clinical outcomes. Incidence and severity of radiation pneumonitis were not different among groups, while no patients developed grade 2 esophagitis in group 3 (p=0.003). Under current Korean Health Insurance Policy, RT cost per person was 22.5% less in group 3 compared with others. Conclusion The current study demonstrated that 60 Gy in 15 fractions instead of 60 Gy in 20 fractions resulted in comparable clinical outcomes with excellent safety, direct cost saving, and improved convenience to the patients with tumors located at ≥ 1.5 cm from the esophagus.

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    Zixuan Lyu, Chiming Wei
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Variation in Practice Patterns of Korean Radiation Oncologists for Spine Metastasis between 2009 and 2014
Jeong Il Yu, Hee Chul Park, Yong Chan Ahn, Yoonsun Chung, Woong Sub Koom, Si Yeol Song
Cancer Res Treat. 2016;48(3):1102-1109.   Published online December 2, 2015
DOI: https://doi.org/10.4143/crt.2015.207
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The Korean Society of Radiation Oncologists (KOSRO) conducted the Patterns of Care Study (PCS) of radiotherapy (RT) for spine metastases in 2009. The current study was conducted to investigate current practice patterns and compare them with the results of the PCS.
Materials and Methods
The survey questionnaire was composed of 10 questions regarding general information and seven questions for each of two clinical scenarios.
Results
Fifty-four members of the KOSRO answered at least one question on the web-based questionnaire. The yearly number of patients treated who underwent palliative spine RT was greater than 200 in 14 (25.9%), 51 to 100 in 13 (24.1%), and 31 to 50 in 11 respondents (20.4%). Scenario 1 described a patient presenting with cord compressive spine metastasis in multiple bones and liver metastasis from non-small cell lung cancer. Thirty gray (Gy) in 10 fractions was chosen by 35 respondents (64.8%). Scenario 2 described a case of a single spine metastasis without progression after targeted therapy. Thirty Gy in 10 fractions was chosen by 19 respondents (35.2%), and a single fraction or less than four fractions of stereotactic ablative radiotherapy (SABR) were selected by 18 respondents (33.3%). When compared with the 2009 PCS, practice patterns of Korean radiation oncologists had not changed significantly over 5 years, except that SABR emerged as a new treatment modality in the selected population.
Conclusion
The 2014 PCS demonstrated that multiple fraction RT is still preferred in a considerable proportion of Korean radiation oncologists.

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The Role of Neoadjuvant Chemotherapy in the Treatment of Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Study (KROG 11-06) Using Propensity Score Matching Analysis
Jin Ho Song, Hong-Gyun Wu, Bhum Suk Keam, Jeong Hun Hah, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Hyo Jung Park, Chang Geol Lee, Ki Chang Keum, Jihye Cha, Kwan Ho Cho, Sung Ho Moon, Ji-Yoon Kim, Woong-Ki Chung, Young Taek Oh, Won Taek Kim, Moon-June Cho, Chul Seung Kay, Yeon-Sil Kim
Cancer Res Treat. 2016;48(3):917-927.   Published online December 28, 2015
DOI: https://doi.org/10.4143/crt.2015.265
AbstractAbstract PDFPubReaderePub
Purpose
We compared the treatment results and toxicity in nasopharyngeal carcinoma (NPC) patients treated with concurrent chemotherapy (CCRT) alone (the CRT arm) or neoadjuvant chemotherapy followed by CCRT (the NCT arm). Materials and Methods A multi-institutional retrospective study was conducted to review NPC patterns of care and treatment outcome. Data of 568 NPC patients treated by CCRT alone or by neoadjuvant chemotherapy followed by CCRT were collected from 15 institutions. Patients in both treatment arms were matched using the propensity score matching method, and the clinical outcomes were analyzed.
Results
After matching, 300 patients (150 patients in each group) were selected for analysis. Higher 5-year locoregional failure-free survival was observed in the CRT arm (85% vs. 72%, p=0.014). No significant differences in distant failure-free survival (DFFS), disease-free survival (DFS), and overall survival were observed between groups. In subgroup analysis, the NCT arm showed superior DFFS and DFS in stage IV patients younger than 60 years. No significant difference in compliance and toxicity was observed between groups, except the radiation therapy duration was slightly shorter in the CRT arm (50.0 days vs. 53.9 days, p=0.018). Conclusion This study did not show the superiority of NCT followed by CCRT over CCRT alone. Because NCT could increase the risk of locoregional recurrences, it can only be considered in selected young patients with advanced stage IV disease. The role of NCT remains to be defined and should not be viewed as the standard of care.

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Tumor Volume Reduction Rate during Adaptive Radiation Therapy as a Prognosticator for Nasopharyngeal Cancer
Hyebin Lee, Yong Chan Ahn, Dongryul Oh, Heerim Nam, Jae Myoung Noh, Su Yeon Park
Cancer Res Treat. 2016;48(2):537-545.   Published online July 14, 2015
DOI: https://doi.org/10.4143/crt.2015.081
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to evaluate the prognostic significance of the tumor volume reduction rate (TVRR) measured during adaptive definitive radiation therapy (RT) for nasopharyngeal cancer (NPC).
Materials and Methods
We reviewed the RT records of 159 NPC patients treated with definitive RT with or without concurrent chemotherapy between January 2006 and February 2013. Adaptive re-planning was performed in all patients at the third week of RT. The pre- and mid-RT gross tumor volumes (GTVs) of the primary tumor and the metastatic lymph nodes were measured and analyzed for prognostic implications.
Results
After a median follow-up period of 41.5 months (range, 11.2 to 91.8 months) for survivors, there were 43 treatment failures. The overall survival and progression-free survival (PFS) rates at 5 years were 89.6% and 69.7%, respectively. The mean pre-RT GTV, mid-RT GTV, and TVRR were 45.9 cm3 (range, 1.5 to 185.3 cm3), 26.7 cm3 (1.0 to 113.8 cm3), and –41.9% (range, –87% to 78%), respectively. Patients without recurrence had higher TVRR than those with recurrence (44.3% in the no recurrence group vs. 34.0% in the recurrence group, p=0.004), and those with TVRR > 35% achieved a significantly higher rate of PFS at 5 years (79.2% in TVRR > 35% vs. 53.2% in TVRR ≤ 35%; p < 0.001). In multivariate analysis, TVRR was a significant factor affecting PFS (hazard ratio, 2.877; 95% confidence interval, 1.555 to 5.326; p=0.001).
Conclusion
TVRR proved to be a significant prognostic factor in NPC patients treated with definitive RT, and could be used as a potential indicator for early therapeutic modification during the RT course.

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Association between PD-L1 and HPV Status and the Prognostic Value of PD-L1 in Oropharyngeal Squamous Cell Carcinoma
Hae Su Kim, Ji Yun Lee, Sung Hee Lim, Keunchil Park, Jong-Mu Sun, Young Hyeh Ko, Chung-Hwan Baek, Young-ik Son, Han Sin Jeong, Yong Chan Ahn, Min-Young Lee, Mineui Hong, Myung-Ju Ahn
Cancer Res Treat. 2016;48(2):527-536.   Published online September 15, 2015
DOI: https://doi.org/10.4143/crt.2015.249
AbstractAbstract PDFPubReaderePub
Purpose
Oropharyngeal squamous cell carcinoma (OSCC) has been recognized as an immunosuppressive disease. Various mechanisms have been proposed for immune escape, including dysregulation of immune checkpoints such as the PD-1:PD-L1 pathway. We investigated the expression of programmed cell death-ligand 1 (PD-L1) in HPV-negative and HPV-positive OSCC to determine its prevalence and prognostic relevance.
Materials and Methods
Using immunohistochemistry, 133 cases of OSCC were evaluated for expression of PD-L1. Formalin-fixed paraffin-embedded tumor samples were stained with monoclonal antibody (clone 5H1) to PD-L1. PD-L1 positivity was defined as membrane staining in ≥20% of tumor cells. Correlations between PD-L1 expression and HPV status and survival parameters were analyzed.
Results
Of the 133 patients, 68% showed PD-L1 expression, and 67% of patients were positive for p16 expression by immunohistochemistry. No significant difference in PD-L1 expression was observed between HPV(-) and HPV(+) tumors (61% vs. 71%, p=0.274). No significant difference in age, gender, smoking history, location of tumor origin, or stage was observed according to PD-L1 status. With a median follow-up period of 44 months, older age (≥65) (p=0.017) and T3-4 stage (p<0.001) were associated with poor overall survival (OS), whereas PD-L1 expression did not affect OS in univariate and multivariate analysis.
Conclusion
PD-L1 expression was observed in the majority of OSCC patients regardless of HPV status. Further large prospective studies are required to determine the role of PD-L1 expression as a prognostic or predictive biomarker, and clinical studies of immune checkpoint inhibitors in OCSS are warranted regardless of HPV status.

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Effect of Radiation Therapy Techniques on Outcome in N3-positive IIIB Non-small Cell Lung Cancer Treated with Concurrent Chemoradiotherapy
Jae Myoung Noh, Jin Man Kim, Yong Chan Ahn, Hongryull Pyo, BoKyong Kim, Dongryul Oh, Sang Gyu Ju, Jin Sung Kim, Jung Suk Shin, Chae-Seon Hong, Hyojung Park, Eonju Lee
Cancer Res Treat. 2016;48(1):106-114.   Published online February 12, 2015
DOI: https://doi.org/10.4143/crt.2014.131
AbstractAbstract PDFPubReaderePub
Purpose
This study was conducted to evaluate clinical outcomes following definitive concurrent chemoradiotherapy (CCRT) for patients with N3-positive stage IIIB (N3-IIIB) non-small cell lung cancer (NSCLC), with a focus on radiation therapy (RT) techniques. Materials and Methods From May 2010 to November 2012, 77 patients with N3-IIIB NSCLC received definitive CCRT (median, 66 Gy). RT techniques were selected individually based on estimated lung toxicity, with 3-dimensional conformal RT (3D-CRT) and intensity-modulated RT (IMRT) delivered to 48 (62.3%) and 29 (37.7%) patients, respectively. Weekly docetaxel/paclitaxel plus cisplatin (67, 87.0%) was the most common concurrent chemotherapy regimen.
Results
The median age and clinical target volume (CTV) were 60 years and 288.0 cm3, respectively. Patients receiving IMRT had greater disease extent in terms of supraclavicular lymph node (SCN) involvement and CTV ≥ 300 cm3. The median follow-up time was 21.7 months. Fortyfive patients (58.4%) experienced disease progression, most frequently distant metastasis (39, 50.6%). In-field locoregional control, progression-free survival (PFS), and overall survival (OS) rates at 2 years were 87.9%, 38.7%, and 75.2%, respectively. Although locoregional control was similar between RT techniques, patients receiving IMRT had worse PFS and OS, and SCN metastases from the lower lobe primary tumor and CTV ≥ 300 cm3were associated with worse OS. The incidence and severity of toxicities did not differ significantly between RT techniques. Conclusion IMRT could lead to similar locoregional control and toxicity, while encompassing a greater disease extent than 3D-CRT. The decision to apply IMRT should be made carefully after considering oncologic outcomes associated with greater disease extent and cost.

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Carotid-Sparing TomoHelical 3-Dimensional Conformal Radiotherapy for Early Glottic Cancer
Chae-Seon Hong, Dongryul Oh, Sang Gyu Ju, Yong Chan Ahn, Jae Myoung Noh, Kwangzoo Chung, Jin Sung Kim, Tae-Suk Suh
Cancer Res Treat. 2016;48(1):63-70.   Published online March 6, 2015
DOI: https://doi.org/10.4143/crt.2014.265
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to investigate the dosimetric benefits and treatment efficiency of carotid-sparing TomoHelical 3-dimensional conformal radiotherapy (TH-3DCRT) for early glottic cancer. Materials and Methods Ten early-stage (T1N0M0) glottic squamous cell carcinoma patients were simulated, based on computed tomography scans. Two-field 3DCRT (2F-3DCRT), 3-field intensity-modulated radiation therapy (3F-IMRT), TomoHelical-IMRT (TH-IMRT), and TH-3DCRT plans were generated with a 67.5-Gy total prescription dose to the planning target volume (PTV) for each patient. In order to evaluate the plan quality, dosimetric characteristics were compared in terms of conformity index (CI) and homogeneity index (HI) for PTV, dose to the carotid arteries, and maximum dose to the spinal cord. Treatment planning and delivery times were compared to evaluate treatment efficiency.
Results
The median CI was substantially better for the 3F-IMRT (0.65), TH-IMRT (0.64), and TH-3DCRT (0.63) plans, compared to the 2F-3DCRT plan (0.32). PTV HI was slightly better for TH-3DCRT and TH-IMRT (1.05) compared to 2F-3DCRT (1.06) and 3F-IMRT (1.09). TH-3DCRT, 3F-IMRT, and TH-IMRT showed an excellent carotid sparing capability compared to 2F-3DCRT (p < 0.05). For all plans, the maximum dose to the spinal cord was < 45 Gy. The median treatment planning times for 2F-3DCRT (5.85 minutes) and TH-3DCRT (7.10 minutes) were much lower than those for 3F-IMRT (45.48 minutes) and TH-IMRT (35.30 minutes). The delivery times for 2F-3DCRT (2.06 minutes) and 3F-IMRT (2.48 minutes) were slightly lower than those for TH-IMRT (2.90 minutes) and TH-3DCRT (2.86 minutes). Conclusion TH-3DCRT showed excellent carotid-sparing capability, while offering high efficiency and maintaining good PTV coverage.

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    Journal of Cancer Research and Therapeutics.2024; 20(1): 327.     CrossRef
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    Quan Chen, Yi Rong, Jay W. Burmeister, Edward H. Chao, Nathan A. Corradini, David S. Followill, X. Allen Li, An Liu, X. Sharon Qi, Hairong Shi, Jennifer B. Smilowitz
    Medical Physics.2023;[Epub]     CrossRef
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    Heesoon Sheen, Han-Back Shin, Hojae Kim, Changhwan Kim, Jihun Kim, Jin Sung Kim, Chae-Seon Hong
    Scientific Reports.2023;[Epub]     CrossRef
  • Comparison of Carotid Artery Dose in Early-Stage Glottic Cancer Treated with 3D-Conformal, Helical-IMRT and VMAT
    B Pires, D Rothwell, I Guimarães, J Sousa, R Magalhães, T Serra, L Khouri, P Alves
    Forum of Clinical Oncology.2022; 13(3): 23.     CrossRef
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    Yurday Ozdemir, Ibrahim Acibuci, Ugur Selek, Erkan Topkan
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    Razzagh Abedi Firouzjah, Amin Banaei, Bagher Farhood, Mohsen Bakhshandeh
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    D.M. Gujral, M. Long, J.W.G. Roe, K.J. Harrington, C.M. Nutting
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ERRATUM: Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy
Min Kyu Kang, Dongryul Oh, Kwan Ho Cho, Sung Ho Moon, Hong-Gyun Wu, Dae-Seog Heo, Yong Chan Ahn, Keunchil Park, Hyo Jung Park, Jun Su Park, Ki Chang Keum, Jihye Cha, Jun Won Kim, Yeon-Sil Kim, Jin Hyoung Kang, Young-Taek Oh, Ji-Yoon Kim, Sung Hwan Kim, Jin-Hee Kim, Chang Geol Lee
Cancer Res Treat. 2016;48(1):425-425.   Published online January 10, 2016
DOI: https://doi.org/10.4143/crt.2014.141.2
Corrects: Cancer Res Treat 2015;47(4):871
PDFPubReaderePub
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Dosimetric and Clinical Influence of 3D Versus 2D Planning in Postoperative Radiation Therapy for Gastric Cancer
Jung Ae Lee, Yong Chan Ahn, Do Hoon Lim, Hee Chul Park, Margarita S. Asranbaeva
Cancer Res Treat. 2015;47(4):727-737.   Published online December 2, 2014
DOI: https://doi.org/10.4143/crt.2014.018
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to investigate the dosimetric and clinical influence of computed tomography–based (3-dimensional [3D]) simulation versus conventional 2-dimensional (2D)–based simulation in postoperative chemoradiotherapy (CRT) for patients with advanced gastric cancer in terms of parallel opposed anteroposterior-posteroanterior field arrangement. Materials and Methods A retrospective stage-matched cohort study was conducted in 158 patients treated with adjuvant CRT following curative surgery and D2 dissection from 2006 to 2008 at Samsung Medical Center: 98 patients in the 3D group; and 60 patients in the 2D group. For comparison of the dosimetric parameters between 3D plan and 2D plan, second sets of radiation treatment plans were generated according to the same target delineation method used in the 2D group for each patient in the 3D group (V2D). Acute toxicity, recurrence, and survival were analyzed. The median follow-up period was 28 months (range, 5 to 51 months). Results The 3D group showed better dose-volume histogram (DVH) profiles than the V2D group for all dosimetric parameters, including the kidneys, liver, spinal cord, duodenum, pancreas, and bowel. However, no difference in acute gastrointestinal toxicity and survival outcomes was observed between the 3D group and the 2D group. Conclusion The 3D plan enabled precise delineation of the target volume and organs at risk by visualization of geometric changes in the internal organs after surgery. The DVH of normal tissues in the 3D plan was superior to that of the V2D plan, but similar clinical features were observed between the 3D group and the 2D group.

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Definitive Bimodality Concurrent Chemoradiotherapy in Patients with Inoperable N2-positive Stage IIIA Non-small Cell Lung Cancer
Jae Myoung Noh, Yong Chan Ahn, Hyebin Lee, Hongryull Pyo, BoKyong Kim, Dongryul Oh, Hyojung Park, Eonju Lee, Keunchil Park, Jin Seok Ahn, Myung-Ju Ahn, Jong-Mu Sun
Cancer Res Treat. 2015;47(4):645-652.   Published online February 12, 2015
DOI: https://doi.org/10.4143/crt.2014.144
AbstractAbstract PDFPubReaderePub
Purpose
This study was conducted to evaluate the treatment outcomes following definitive bimodality concurrent chemoradiotherapy (CCRT) in patients with inoperable N2-positive stage IIIA (N2- IIIA) non-small cell lung cancer (NSCLC). Materials and Methods From May 1997 to December 2012, 65 out of 633 patients with N2-IIIA NSCLC received bimodality therapy. The treatment modality was selected during/after neoadjuvant CCRT in 21 patients or primarily at diagnosis in 44 through a multidisciplinary consensus meeting. The median age was 65 years (range, 36 to 76 years). Sixty patients (92.3%) had clinically evident N2 disease, while 22 (33.8%) had multi-station N2 involvement. The median radiation therapy dose was 66 Gy in 33 fractions, while the dose was elevated to 72 Gy in 13 patients who had a treatment break due to delayed decision regarding resectability. The most frequent chemotherapy regimen was weekly paclitaxel or docetaxel plus cisplatin or carboplatin (54, 83.1%).
Results
During the median follow-up of 18.8 months (range, 1.6 to 173.1 months), 34 patients (52.3%) experienced disease progression, with distant metastasis being the most common first treatment failure pattern (23, 34.8%). The median and 2-year rates of progression-free survival were 18.8 months and 45.9%, respectively. The median and 2-year rates of overall survival were 28.6 months and 50.1%, respectively. Conclusion Definitive bimodality therapy in patients with N2-IIIA NSCLC demonstrated favorable outcomes, while trimodality therapy could be considered for candidates for less than pneumonectomy.

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    Junghee Lee, Yun Soo Hong, Jin Lee, Genehee Lee, Danbee Kang, Jiyoun Park, Yeong Jeong Jeon, Seong Yong Park, Jong Ho Cho, Yong Soo Choi, Jhingook Kim, Young Mog Shim, Eliseo Guallar, Juhee Cho, Hong Kwan Kim
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    Choi Eunsook, Park Sunhee
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Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy
Min Kyu Kang, Dongryul Oh, Kwan Ho Cho, Sung Ho Moon, Hong-Gyun Wu, Dae-Seog Heo, Yong Chan Ahn, Keunchil Park, Hyo Jung Park, Jun Su Park, Ki Chang Keum, Jihye Cha, Jun Won Kim, Yeon-Sil Kim, Jin Hyoung Kang, Young-Taek Oh, Ji-Yoon Kim, Sung Hwan Kim, Jin-Hee Kim, Chang Geol Lee
Cancer Res Treat. 2015;47(4):871-878.   Published online February 13, 2015
DOI: https://doi.org/10.4143/crt.2014.141
Correction in: Cancer Res Treat 2016;48(1):425
AbstractAbstract PDFPubReaderePub
Purpose
To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngeal carcinoma, we compared the treatment outcomes of patients treated with curative radiotherapy with or without chemotherapy. Materials and Methods From 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002 stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitals in South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvant chemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in 80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gy to 74.2 Gy (median, 70 Gy).
Results
Median follow-up was 48 months (range, 7 to 97 months) for all patients. At the last followup, 13 patients had died and 32 had experienced treatment failure; locoregional failure occurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival, and overall survival were 86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that the significant prognostic factors were concurrent chemotherapy and N stage for locoregional relapse-free survival, concurrent chemotherapy for progression-free survival, and age and N stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improved distant metastasis-free survival. Conclusion Concurrent chemotherapy significantly improved 5-year locoregional relapse-free survival and progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvant chemotherapy failed to improve either.

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Potential Role of Adjuvant Radiation Therapy in Cervical Thymic Neoplasm Involving Thyroid Gland or Neck
Jae Myoung Noh, Sang Yun Ha, Yong Chan Ahn, Dongryul Oh, Seung Won Seol, Young Lyun Oh, Joungho Han
Cancer Res Treat. 2015;47(3):436-440.   Published online November 17, 2014
DOI: https://doi.org/10.4143/crt.2013.184
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to assess the clinicopathologic features, treatment outcomes, and role of adjuvant radiation therapy (RT) in cervical thymic neoplasm involving the thyroid gland or neck. Materials and Methods The medical and pathologic records of eight patients with cervical thymic neoplasm were reviewed retrospectively. All patients underwent surgical resection, including thyroidectomy or mass excision. Adjuvant RT was added in five patients with adverse clinicopathologic features. The radiation doses ranged from 54 Gy/27 fractions to 66 Gy/30 fractions delivered to the primary tumor bed and pathologically involved regional lymphatics using a 3-dimensional conformal technique. Results Eight cases of cervical thymic neoplasm included three patients with carcinoma showing thymus-like differentiation (CASTLE) and five with ectopic cervical thymoma. The histologic subtypes of ectopic cervical thymoma patients were World Health Organization (WHO) type B3 thymoma in one, WHO type B1 thymoma in two, WHO type AB thymoma in one, and metaplastic thymoma in one, respectively. The median age was 57 years (range, 40 to 76 years). Five patients received adjuvant RT: three with CASTLE; one with WHO type B3; and one with WHO type AB with local invasiveness. After a median follow-up period of 49 months (range, 11 to 203 months), no recurrence had been observed, regardless of adjuvant RT. Conclusion Adjuvant RT after surgical resection might be worthwhile in patients with CASTLE and ectopic cervical thymoma with WHO type B2-C and/or extraparenchymal extension, as similarly indicated for primary thymic epithelial tumors. A longer follow-up period may be needed in order to validate this strategy.

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    Maryam Vajihinejad, Ali Ataei, Mohammad Pashmchi, Ali Aledavoud, Vahid Zand, Mohammad Ali Broomand, Mohammad Mohammadi, Niloofar Zare Reshkuiyeh
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Impact on Loco-regional Control of Radiochemotherapeutic Sequence and Time to Initiation of Adjuvant Treatment in Stage II/III Rectal Cancer Patients Treated with Postoperative Concurrent Radiochemotherapy
Haeyoung Kim, Eui Kyu Chie, Yong Chan Ahn, Kyubo Kim, Won Park, Won Sup Yoon, Seung Jae Huh, Sung W. Ha
Cancer Res Treat. 2014;46(2):148-157.   Published online April 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.2.148
AbstractAbstract PDFPubReaderePub
Purpose

This study was designed to evaluate the impact of radiochemotherapeutic sequence and time to initiation of adjuvant treatment on loco-regional control for resected stage II and III rectal cancer.

Materials and Methods

Treatment outcomes for rectal cancer patients from two hospitals with different sequencing strategies regarding adjuvant concurrent radiochemotherapy (CRCT) were compared retrospectively. Pelvic radiotherapy was administered concurrently on the first (early CRCT, n=180) or the third cycle of chemotherapy (late CRCT, n=180). During radiotherapy, two cycles of fluorouracil were provided to patients in both groups. In the early CRCT group, median six cycles of fluorouracil and leucovorin were prescribed during the post-CRCT period. In the late CRCT group, two cycles of fluorouracil were administered in the pre- and post-CRCT periods.

Results

No significant differences in the 5-year loco-regional recurrence-free survival (LRRFS) (92.5% vs. 95.6%, p=0.43) or overall survival and disease-free survival were observed between groups. Patients who began receiving adjuvant treatment later than five weeks after surgery had lower LRRFS than patients who received adjuvant treatment within five weeks following surgery (79% vs. 91%, p<0.01). The risk of loco-regional recurrence increased as the time to initiation of adjuvant treatment was delayed.

Conclusion

In the current study, treatment outcomes were not significantly influenced by the sequence of adjuvant treatment but by the delay of adjuvant treatment for more than five weeks. Timely administration of adjuvant treatment is deemed important in achieving loco-regional tumor control for stage II/III rectal cancer patients.

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    Yan-Ru Feng, Jing Jin, Hua Ren, Xin Wang, Shu-Lian Wang, Wei-Hu Wang, Yong-Wen Song, Yue-Ping Liu, Yuan Tang, Ning Li, Xin-Fan Liu, Hui Fang, Zi-Hao Yu, Ye-Xiong Li
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    Jin Ho Song, Sung Hwan Kim, Jong Hoon Lee, Hyeon Min Cho, Dae Yong Kim, Tae Hyun Kim, Sun Young Kim, Ji Yeon Baek, Jae Hwan Oh, Taek Keun Nam, Mee Sun Yoon, Jae Uk Jeong, Kyubo Kim, Eui Kyu Chie, Hong Seok Jang, Jae Sung Kim, Jin Hee Kim, Ki Mun Kang
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  • Impact of Lymph Node Ratio on Oncologic Outcomes in ypStage III Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy followed by Total Mesorectal Excision, and Postoperative Adjuvant Chemotherapy
    Taeryool Koo, Changhoon Song, Jae-Sung Kim, Kyubo Kim, Eui Kyu Chie, Sung-Bum Kang, Keun-Wook Lee, Jee Hyun Kim, Seung-Yong Jeong, Tae-You Kim, Ramon Andrade de Mello
    PLOS ONE.2015; 10(9): e0138728.     CrossRef
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Response Evaluation after Neoadjuvant Chemoradiation by Positron Emission Tomography-Computed Tomography for Esophageal Squamous Cell Carcinoma
Joon Suk Park, Joon Young Choi, Seung Hwan Moon, Yong Chan Ahn, Jeeyun Lee, Dohun Kim, Kwhanmien Kim, Young Mog Shim
Cancer Res Treat. 2013;45(1):22-30.   Published online March 31, 2013
DOI: https://doi.org/10.4143/crt.2013.45.1.22
AbstractAbstract PDFPubReaderePub
PURPOSE
Parameters of positron emission tomography-computed tomography (PET-CT) were compared with the results of histopathologic examination in order to determine which can provide an objective indication of response after neoadjuvant chemoradiation for treatment of thoracic esophageal squamous cell carcinoma (SCC).
MATERIALS AND METHODS
Between August 2003 and January 2010, data on 25 patients who underwent neoadjuvant chemoradiation and subsequent resection for treatment of esophageal SCC were retrospectively reviewed. Changes in maximum standardized uptake value (DeltaSUVmax), metabolic tumor volume (DeltaMTV), and total lesion glycolysis (DeltaTLG) were analyzed by comparison with the histopathologic findings.
RESULTS
Pathologic complete remission (CR) for the main tumor was achieved in 11 patients. Postradiation esophagitis was observed in 10 patients. DeltaSUVmax of the main tumor was significantly greater in the CR group than in the partial response (PR) group (p=0.039), while DeltaMTV and DeltaTLG of the main tumor were not (p=0.141 and p=0.349, respectively). The cut-off DeltaSUVmax value for CR was estimated as 72.1%, indicating significantly better accuracy than visual interpretation (p=0.045). Of the 48 involved lymph nodes, DeltaSUVmax and DeltaMTV of lymph nodes were significantly greater in the CR group than in the PR group (p=0.045 and p=0.014, respectively), while DeltaTLG was not (p=0.063). The cut-off value of DeltaSUVmax for prediction of CR in lymph nodes was calculated as 50.67%.
CONCLUSION
PET-CT could be used for prediction of response to neoadjuvant treatment in thoracic esophageal SCC. DeltaSUVmax may be a more significant predictor for CR after neoadjuvant chemoradiation than DeltaTLG and DeltaMTV.

Citations

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  • PET-Uptake Reduction into Lymph Nodes After Neoadjuvant Therapy is Highly Predictive of Prognosis for Patients Who have Thoracic Esophageal Squamous Cell Carcinoma Treated with Chemoradiotherapy Plus Esophagectomy
    Yushi Nagaki, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Hiromu Fujita, Kohei Kemuriyama, Yoshihiro Sasaki, Kazuhiro Imai, Eri Maeda, Yoshihiro Minamiya
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  • Prognostic factors associated with 18FDG-PET/CT in esophageal squamous cell carcinoma after trimodality treatment
    Wei-Hsiang Feng, Ying-Yi Chen, Yen‐Shou Kuo, Kuan-Hsun Lin, Yuan-Ming Tsai, Ti-Hui Wu, Hsu-Kai Huang, Tsai-Wang Huang
    BMC Cancer.2022;[Epub]     CrossRef
  • SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma
    Yushi Nagaki, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Hiromu Fujita, Yoshihiro Sasaki, Kazuhiro Imai, Yoshihiro Minamiya
    World Journal of Surgical Oncology.2021;[Epub]     CrossRef
  • 18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy
    Seokmo Lee, Yunseon Choi, Geumju Park, Sunmi Jo, Sun Seong Lee, Jisun Park, Hye-Kyung Shim
    Technology in Cancer Research & Treatment.2021;[Epub]     CrossRef
  • Accuracy of Detecting Residual Disease After Neoadjuvant Chemoradiotherapy for Esophageal Cancer
    Ben M. Eyck, Barbera D. Onstenk, Bo J. Noordman, Daan Nieboer, Manon C. W. Spaander, Roelf Valkema, Sjoerd M. Lagarde, Bas P. L. Wijnhoven, J. Jan B. van Lanschot
    Annals of Surgery.2020; 271(2): 245.     CrossRef
  • Utility of positron emission–computed tomography for predicting pathological response in resectable oesophageal squamous cell carcinoma after neoadjuvant chemoradiation
    Jiyun Lee, Joon Young Choi, Sung Won Lim, Myung-Ju Ahn, Keunchil Park, Jae Il Zo, Young Mog Shim, Dongryul Oh, Jong-Mu Sun
    European Journal of Cardio-Thoracic Surgery.2020; 58(5): 1019.     CrossRef
  • Detecting Pathological Complete Response in Esophageal Cancer after Neoadjuvant Therapy Based on Imaging Techniques: A Diagnostic Systematic Review and Meta-Analysis
    Didi J.J.M. de Gouw, Bastiaan R. Klarenbeek, Mitchell Driessen, Stefan A.W. Bouwense, Frans van Workum, Jurgen J. Fütterer, Maroeska M. Rovers, Richard P.G. ten Broek, Camiel Rosman
    Journal of Thoracic Oncology.2019; 14(7): 1156.     CrossRef
  • Supraclavicular and/or celiac lymph node metastases from thoracic esophageal squamous cell carcinoma did not compromise survival following neoadjuvant chemoradiotherapy and surgery
    Won Kyung Cho, Dongryul Oh, Yong Chan Ahn, Young Mog Shim, Jae Ill Zo, Jong-Mu Sun, Myung-Ju Ahn, Keunchil Park
    Oncotarget.2017; 8(2): 3542.     CrossRef
  • Prognostic and Predictive Value of FDG-PET as an Aid in Oesophageal Cancer Management
    Mian Xi, Steven H. Lin
    EMJ Oncology.2017; : 78.     CrossRef
  • Ability of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography to Predict Outcomes of Neoadjuvant Chemoradiotherapy Followed by Surgical Treatment for Esophageal Squamous Cell Carcinoma
    Yoichi Hamai, Jun Hihara, Manabu Emi, Takaoki Furukawa, Ichiko Yamakita, Tomoaki Kurokawa, Morihito Okada
    The Annals of Thoracic Surgery.2016; 102(4): 1132.     CrossRef
  • PET/CT in the evaluation of treatment response to neoadjuvant chemoradiotherapy and prognostication in patients with locally advanced esophageal squamous cell carcinoma
    Hui Yuan, Daniel K.H. Tong, Varut Vardhanabhuti, Simon Y.K. Law, Keith W.H. Chiu, Pek-Lan Khong
    Nuclear Medicine Communications.2016; 37(9): 947.     CrossRef
  • Understanding Complete Pathologic Response in Oesophageal Cancer: Implications for Management and Survival
    K. E. O’Sullivan, E. T. Hurley, J. P. Hurley
    Gastroenterology Research and Practice.2015; 2015: 1.     CrossRef
  • Prognostic significance of PET assessment of metabolic response to therapy in oesophageal squamous cell carcinoma
    Arpit Chhabra, Leonard T Ong, Deborah Kuk, Geoffrey Ku, David Ilson, Yelena Y Janjigian, Abraham Wu, Heiko Schöder, Karyn A Goodman
    British Journal of Cancer.2015; 113(12): 1658.     CrossRef
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Is There a Role of Postoperative Radiation Therapy in Completely Resected Stage I/II Thymic Epithelial Tumor?
Dongryul Oh, Yong Chan Ahn, Kwhanmien Kim, Jhingook Kim, Young Mog Shim, Jungho Han
Cancer Res Treat. 2012;44(3):166-172.   Published online September 30, 2012
DOI: https://doi.org/10.4143/crt.2012.44.3.166
AbstractAbstract PDFPubReaderePub
PURPOSE
Retrospective analyses of patients with stage I-II thymic epithelial tumors (TET) who were treated with either surgery alone (S) or surgery plus postoperative radiation therapy (SRT) were conducted to evaluate the role of adjuvant radiation therapy (RT).
MATERIALS AND METHODS
A total of 110 stage I-II TET patients following complete resection were included in this study. Postoperative radiation therapy was recommended for those with aggressive histologic type and/or invasive features according to the surgeons' judgment during the operation. A median dose of 54.0 Gy (range, 44 to 60 Gy) focused on the primary tumor bed was administered to 57 patients (51.8%).
RESULTS
In all patients, the rates of overall survival, disease-specific survival, and disease-free survival at 10 years were 91.7%, 97.1%, and 95.8%, respectively. No significant differences in disease-specific survival (100% in the S group and 93.5% in the SRT group at 10 years, p=0.12) and disease-free survival (98.1% in the S group and 94.5% in the SRT group at 10 years, p=0.41) were observed between the treatment groups, although a significantly larger number of World Health Organization (WHO)-type B2-C (p<0.001) and Masaoka stage II (p=0.03) tumors were observed in the SRT group than in the S group. No local recurrence was observed in the SRT group. No grade 2 or greater RT-related toxicities were observed in the SRT group.
CONCLUSION
Excellent outcomes were achieved in patients with stage I-II TET who underwent complete resection. Considering excellent local control and low morbidity, adjuvant RT may be considered in high risk patients with WHO-type B2-C histology and Masaoka stage II.

Citations

Citations to this article as recorded by  
  • Comparison of radiotherapy techniques in patients with thymic epithelial tumor who underwent postoperative radiotherapy
    Hyunseok Lee, Dongryul Oh, Yong Chan Ahn, Hongryull Pyo, Kyungmi Yang, Jae Myoung Noh
    Radiation Oncology Journal.2024; 42(1): 43.     CrossRef
  • American Radium Society Appropriate Use Criteria for Radiation Therapy in the Multidisciplinary Management of Thymic Carcinoma
    Stephen G. Chun, Andreas Rimner, Arya Amini, Joe Y. Chang, Jessica Donington, Martin J. Edelman, Yimin Geng, Matthew A. Gubens, Kristin A. Higgins, Puneeth Iyengar, Benjamin Movsas, Matthew S. Ning, Henry S. Park, George Rodrigues, Andrea Wolf, Charles B.
    JAMA Oncology.2023; 9(7): 971.     CrossRef
  • Case Reports: A role of postoperative radiation therapy in completely resected early stage intrathyroid thymic carcinoma: a case report and literature review of the diagnosis and treatment
    Ailin Cui, Yaoqiang Du, Chunjie Hou, Lin Zhang, Litao Sun, Hongfeng He
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Patterns of Failure Following Postoperative Radiation Therapy Based on “Tumor Bed With Margin” for Stage II to IV Type C Thymic Epithelial Tumor
    Kyung Hwa Lee, Jae Myoung Noh, Yong Chan Ahn, Dongryul Oh, Jhingook Kim, Young Mog Shim, Jung-ho Han
    International Journal of Radiation Oncology*Biology*Physics.2018; 102(5): 1505.     CrossRef
  • Survival Impact of Adjuvant Radiation Therapy in Masaoka Stage II to IV Thymomas: A Systematic Review and Meta-analysis
    Yu Jin Lim, Eunji Kim, Hak Jae Kim, Hong-Gyun Wu, Jinchun Yan, Qin Liu, Shilpen Patel
    International Journal of Radiation Oncology*Biology*Physics.2016; 94(5): 1129.     CrossRef
  • A Review of the Place and Role of Radiotherapy in Thymoma
    Dorothy C. Lombe, Branislav Jeremic
    Clinical Lung Cancer.2015; 16(6): 406.     CrossRef
  • Predictive SNPs for radiation-induced damage in lung cancer patients with radiotherapy: a potential strategy to individualize treatment
    Qian Huang, Fangwei Xie, Xuenong Ouyang
    The International Journal of Biological Markers.2015; 30(1): 1.     CrossRef
  • Potential Role of Adjuvant Radiation Therapy in Cervical Thymic Neoplasm Involving Thyroid Gland or Neck
    Jae Myoung Noh, Sang Yun Ha, Yong Chan Ahn, Dongryul Oh, Seung Won Seol, Young Lyun Oh, Joungho Han
    Cancer Research and Treatment.2014; 47(3): 436.     CrossRef
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Treatment Outcome of Limited Stage Hodgkin's Disease
Jung Hun Kang, Yong Chan Ahn, Won Seog Kim, Won Ki Kang
Cancer Res Treat. 2005;37(1):31-36.   Published online February 28, 2005
DOI: https://doi.org/10.4143/crt.2005.37.1.31
AbstractAbstract PDFPubReaderePub
Purpose

The 10-year overall survival rate following conventional treatments for patients with limited-stage Hodgkin's disease (HD) exceeds 90%. However, the clinical features and treatment outcome of HD in Korea have not been extensively characterized due to its low incidence. In this study, we attempted to analyze the treatment outcome of different modalities in limited stage HD patients.

Materials and Methods

Twenty one Hodgkin's disease patients, referred to the Samsung Medical Center between January 1997 and December 2003, were enrolled in this study. Limited stage Hodgkin's disease was subdivided into low and high risk groups. All evaluable patients received treatment.

Results

There were 13 and 8 patients in the low and high risk groups, respectively. Eighteen patients (86%) obtained complete response (CR) and 3 patients (14%) achieved an undetermined complete response (CRu). Fourteen (67%), 4 (19%) and 3 (14%) cases received combination chemotherapy, radiotherapy alone and chemotherapy alone, respectively. Four cases relapsed and 2 obtained a second CR. The 5-year overall and disease-free survival rates were 90 and 72%, respectively, for all patients. The median follow-up duration was 31 months. There was no difference in disease free survival (DFS) between the low and high risk groups. Although 12 cases had neutropenia greater than grade III, none experienced neutropenic fever.

Conclusion

The treatment outcome of limited-stage HD was excellent, regardless to the initial treatment modality.

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Radical Radiotherapy for Locally Advanced Cancer of Uterine Cervix
Jeung Eun Lee, Seung Jae Huh, Won Park, Do Hoon Lim, Yong Chan Ahn, Chang Soo Park, Byoung Gie Kim, Duk Soo Bae, Je Ho Lee, Chong Taik Park, Tae Jin Kim, Kyung Taek Lim, Hwan Wook Chung, Ki Heon Lee, Jae Uk Shim
Cancer Res Treat. 2004;36(4):222-227.   Published online August 31, 2004
DOI: https://doi.org/10.4143/crt.2004.36.4.222
AbstractAbstract PDFPubReaderePub
Purpose

This study was performed to evaluate the treatment results, prognostic factors and complication rates in patients with locally advanced cancer of uterine cervix after radiotherapy with high-dose rate (HDR) brachytherapy.

Materials and Methods

One hundred and twenty patients with a locally advanced (stages IIB~IVA according to FIGO classification) carcinoma of the uterine cervix were treated with radiotherapy at the Department of Radiation Oncology, Samsung Medical Center between September 1994 and December 2001. The median age of the patients was 61 years (range 29 to 81). Sixty-one, 56 and 3 patients had FIGO stage IIB, III, and IV diseases, respectively. All patients were given external beam radiotherapy over the whole pelvis (median 50.4 Gy) and HDR intracavitary brachytherapy, with a median of 4 Gy per fraction, to point A. Twenty-one patients received chemotherapy, of which 13 and 21 received neoadjuvant chemotherapy and concurrent chemotherapy, respectively, during the first and fourth weeks of external beam radiotherapy. The chemotherapy was not randomly assigned and the median follow-up time was 28.5 months (range: 6~100 months).

Results

The three- and 5-year overall survival (OS) and disease-free survival (DFS) rates were 64.4 and 57.0%, and 63.7 and 60.2%, respectively. The 5-year OS and DFS rates of the patients at stages IIB, III and IV were 60.2, 57.9 and 33.3%, and 57.4, 65.4 and 33.3%, respectively. Univariate analysis indicated that the FIGO stage, overall treatment time (OTT) and treatment response were significant variables for the OS (p=0.035, p=0.0649 and p=0.0009) and of the DFS (p=0.0009, p=0.0359 and p=0.0363). Multivariate analysis showed that the treatment response was the only significant variable for the OS (p=0.0018) and OTT for the DFS (p=0.0360). The overall incidence of late complications in the rectum and bladder were 11.7 and 6.7%, respectively. In addition, insufficiency fractures were observed in 7 patients (5.8%).

Conclusion

The results of this study suggest that radical radiotherapy with HDR brachytherapy was appropriate for the treatment of locally advanced uterine cervix cancer. Also, the response after treatment and OTT are significant prognostic factors.

Citations

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  • Bilateral cervical cancer in a complete septate uterus with a double cervix and vagina: a case report
    Li Wang, Zi Liu
    Journal of International Medical Research.2023;[Epub]     CrossRef
  • Pooled Analysis of external-beam RADiotherapy parameters in phase II and phase III trials in radiochemotherapy in Anal Cancer (PARADAC)
    Eleonor Rivin del Campo, Oscar Matzinger, Karin Haustermans, Didier Peiffert, Robert Glynne-Jones, Kathryn A. Winter, Andre A. Konski, Jaffer A. Ajani, Jean-François Bosset, Jean-Michel Hannoun-Levi, Marc Puyraveau, A. Bapsi Chakravarthy, Helen Meadows, J
    European Journal of Cancer.2019; 121: 130.     CrossRef
  • Predictors of Radiation Field Failure After Definitive Chemoradiation in Patients With Locally Advanced Cervical Cancer
    Hyo Sook Bae, Yeon-Joo Kim, Myong Cheol Lim, Sang-Soo Seo, Sang-yoon Park, Sokbom Kang, Sun Ho Kim, Joo-Young Kim
    International Journal of Gynecological Cancer.2016; 26(4): 737.     CrossRef
  • High expression of mTOR is associated with radiation resistance in cervical cancer
    Min-Kyu Kim, Tae-Joong Kim, Chang Ok Sung, Chel Hun Choi, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae
    Journal of Gynecologic Oncology.2010; 21(3): 181.     CrossRef
  • Increased expression of pAKT is associated with radiation resistance in cervical cancer
    T-J Kim, J-W Lee, S Y Song, J-J Choi, C H Choi, B-G Kim, J-H Lee, D-S Bae
    British Journal of Cancer.2006; 94(11): 1678.     CrossRef
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The Relation between Histopathologic Findings on Surgical Specimen and Outcomes in Patients with N2 Positive Stage IIIA Non-Small Cell Lung Cancer Receiving Preoperative Concurrent Radiochemotherapy and Surgery
Bo Kyong Kim, Kyoung Ju Kim, Yong Chan Ahn, Do Hoon Lim, Won Park, Joungho Han, Keunchil Park, Kwan Min Kim, Jhingook Kim, Young Mog Shim
Cancer Res Treat. 2003;35(6):497-501.   Published online December 31, 2003
DOI: https://doi.org/10.4143/crt.2003.35.6.497
AbstractAbstract PDF
PURPOSE
To evaluate the prognostic implication of histopathologic findings on the surgical specimens of N2 positive stage IIIA non-small cell lung cancer (NSCLC) patients who were treated with preoperative concurrent radiochemotherapy (CRCT) and surgery. MATERIALS AND METHODS: From May 1997 to April 2000, 48 patients with N2 positive stage IIIA NSCLC were treated with preoperative CRCT and surgery. Retrospective analyses were performed on 33 patients who underwent surgical resection. The thoracic radiation therapy (TRT) dose was 45 Gy over 5 weeks with a 1.8 Gy daily fraction using 10 MV X-rays. Chemotherapy consisted of two cycles of intravenous cisplatin (100 mg/m2, on days 1 and 29) and oral etoposide (50 mg/m2/day, on days 1~14 and 29~42), concurrently delivered with TRT. Surgery was performed around 4 weeks of the completion of CRCT. The median follow up was 18 months. The histopathologic findings, including the proportions of viable tumor cells, fibrosis, and necrosis, as well as the tumor and nodal statuses on the surgical specimens following the preoperative CRCT, were analyzed. RESULTS: The 3-year overall survival, disease-free survival, and local control rates were 46.1%, 49.5%, and 85.5%, respectively. Post-surgical stages decreased in 18 patients (54.5%), including 3 pathologic complete responses, were unchanged in 13 (39.4%), and increased in two (6.1%). On univariate analyses, the low proportion of the viable tumor cells was the only factor favorably affecting the overall survival rate (p=0.0386), and the histologic type of squamous cell carcinoma was a favorable factor affecting disease free survival rate (p=0.0452). On multivariate analyses, however, no factor affected the overall survival, disease free survival, or local control rates. CONCLUSION: The histopathologic findings of the proportion of viable tumor cells, fibrosis, and necrosis on the surgical specimens following preoperative CRCT had few prognostic implications on uni-and multi-variate analyses. Furthermore, the primary tumor and nodal responses to preoperative CRCT did not influence the outcomes. Longer-term follow-up with a larger number of patients, however, is awaited.
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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
AbstractAbstract 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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Combined Chemotherapy and Radiotherapy for Primary CNS Lymphoma
Jeong Eun Lee, Dae Yong Kim, Yong Chan Ahn, Do Hoon Lim, Seung Jae Huh, Seong Soo Shin, Won Seok Kim, Won Ki Kang, Do Hyun Nam, Jung Il Lee, Jong Hyun Kim
Cancer Res Treat. 2001;33(5):398-403.   Published online October 31, 2001
DOI: https://doi.org/10.4143/crt.2001.33.5.398
AbstractAbstract PDF
PURPOSE
This study was performed in order to evaluate the effectiveness of combined chemotherapy and radiotherapy (RT) in primary central nervous system lymphoma (PCNSL).
MATERIALS AND METHODS
From January 1995 to August 1999, 21 patients with a diagnosis of PCNSL were treated with combined chemotherapy and radiotherapy. Their median age was 47 years with range of 19 to 78 years. Twelve patients were male and nine patients were female. All patients were immunocompetent and they had no evidence of systemic lymphoma. All patients underwent placement of an Ommaya reservoir and recieved a combination regimen using pre-RT systemic and intra-Ommaya methotrexate (MTX), 40 Gy whole-brain RT with a 14.4 Gy boost, and 2 courses of post-RT high-dose cytarabine. The median follow-up period of all patients and survived patients were 22 months and 36 months, respectively.
RESULTS
The median overall survival duration was 21 months and the overall two- and four-year survival rates were 51% and 43%, respectively. Complete response (CR), partial response, stable disease, and progressive disease were achieved in 12, 3, 1, and 5 patients, respectively. All nine patients without CR expired within 1-31 months (median 6 months). Two patients among the patients with CR developed recurrence after 13 and 14 months, respectively. The location of recurrent disease was within the port of radiation boost. Survival was influenced by age, performance status, and CR. There was one episode of MTX neurotoxicity and hepatotoxicity,respectively.
CONCLUSION
Combined chemotherapy and radiotherapy was an effective treatment for PCNSL, and was associated with a minimum toxicity. However, we must pay attention to the recurrence and late toxicity, particularly within two years following treatment.
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Stereotactic Radiosurgery and Fractionated Stereotactic Radiotherapy for Intracranial Schwannoma
Dae Yong Kim, Yong Chan Ahn, Jung Il Lee, Do Hyun Nam, Jeong Eun Lee, Do Hoon Lim, Inhwan J Yeo, Seung Jae Huh, Young Joo Noh, Hyung Jin Shin, Kwan Park, Jong Hyun Kim
J Korean Cancer Assoc. 2001;33(1):27-33.
AbstractAbstract PDF
PURPOSE
To assess the radiologic response and cranial nerve morbidity in intracranial schwannoma patients treated with stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT).
MATERIALS AND METHODS
Twenty-six patients with intracranial schwannoma were treated with linear accelerator- based SRS or FSRT between February 1995 and October 1999. The origin of schwannoma was acoustic nerve in twenty-one patients, facial nerve in two, trigeminal nerve in two, and glossopharyngeal nerve in one. SRS were performed with the median peripheral dose of 14 Gy (range 12-16), and FSRT were done with the median peripheral dose of 25 2 Gy (range 50-60).
RESULTS
With a median follow-up period of 33 months (range 12-67), the local control rate was 100%. Tumorregression was noted in eleven patients, and tumor stabilization was found in the remaining fifteen. Useful hearing preservation was achieved in two of three patients. Facial nerve neuropathy was shown in two patients and one patients developed trigeminal nerve neuropathy.
CONCLUSION
Stereotactic radiotherapy including SRS and FSRT provided excellent local control in intracranial schwannoma. It shows the possibility of a high rate of hearing preservation and an acceptable neurotoxicity, although the number of patients are small and follow-up is relatively short.
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Dose-Response Relationship of Radiotherapy for Locally Advanced Hepatocellular Carcinoma
Dae Yong Kim, Joon Hyoek Lee, Kwang Cheol Koh, Seung Woon Paik, Yong Chan Ahn, Seung Jae Huh, Inhwan J Yeo, Suk Won Park, Seung Hee Chang
J Korean Cancer Assoc. 2000;32(5):918-924.
AbstractAbstract PDF
PURPOSE
Recently radiotherapy is applied alone or in conjunction with transcatheter arterial chemoembolizaion (TACE) or percutaneous ethanol injection therapy (PEIT) for locally advanced hepatocellular carcinoma (HCC). The purpose of this study was to evaluate dose-response relationship of radiotherapy for local control and toxicity in inoperable HCC.
MATERIALS AND METHODS
Twenty-eight patients who were not eligible for TACE and PEIT or had showed no response to these treatment were treated with a total dose of 40 Gy with 2 Gy per fraction or 30 Gy with 3 Gy per fraction (low dose group, 18 patients) or 45 Gy with 3 Gy per fraction (high dose group, 10 patients).
RESULTS
The median survival duration was 8 months and 1-year survival rate was 37%. The treatment results were as follows; partial response in 11% and 70% (p=0.001), stable disease in 56% and 30%, and progressive disease in 33% and 0% in low dose group and high dose group, respectively. The incidence of gastrointestinal (G-I) toxicity by the criteria of Southwest Oncology Group was as follows; grade 1 in 22% and 40%, grade 2 in 17% and 10%, respectively (p=0.56). There was no patient with severe G-I toxicity above grade 3. The incidence of G-I toxicity by site was as follows; grade 1 in 24% and 29%, and grade 2 in 0% and 57% in patients with right lobe and left lobe lesion, respectively (p=0.001).
CONCLUSION
This study indicates that there is clear dose-response relationship in local control. The G-I toxicity does not increase significantly with increment of radiation dose within the dose range tested in this study. And careful attention should be paid for G-I toxicity when the tumor is located in left lobe.
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Preliminary Results of Postoperative Radiotherapy after Breast Conserving Surgery in Early Breast Cancer
Seung Hee Chang, Seung Jae Huh, Jung Hyun Yang, Do Hoon Lim, Seok Jin Nam, Sung Soo Yoon, Yong Chan Ahn, Dae Yong Kim, Suk Won Park, Moon Kyung Kim
J Korean Cancer Assoc. 2000;32(4):775-782.
AbstractAbstract PDF
PURPOSE
To evaluate treatment results of breast conserving surgery and radiation therapy including survival rates, patterns of failure, and complication and to analyze prognostic factors.
MATERIALS AND METHODS
Retrospective analysis was carried out for 111 (112 cases) consecutive patients with breast cancer treated by radiation therapy after breast conserving surgery from October 1994 to April 1997. The median follow up was 45 months (range 10~66). AJCC staging was as follows: 16 cases (14%) for ductal carcinoma in situ, 46 cases (41%) for stage I, 33 cases (30%) for stage IIa, and 17 cases (15%) for stage IIb. Radiation therapy after breast conserving surgery was delivered to whole breast with 50.4 Gy and additional 10 Gy electron beam boost to tumor bed. Adjuvant CMF or CAF chemotherapy was performed in 61 patients.
RESULTS
Overall three- and five-year survivals were 99% and 95%, and progression-free survival were 93%, 87%, respectively. Treatment failure occurred in 11 cases (10%); loco-regional recur rence in six; distant metastasis in five. Univariate analysis showed prognostic factor affecting survival was only T-stage. Acute radiation dermatitis were found in five cases (4%), and chronic complications were found in five (4%); one case with amputation of nipple, two cases with lymphedema requiring rehabilitation therapy and two cases with symptomatic radiation pneu monitis requiring steroid therapy.
CONCLUSION
Breast conserving therapy of early breast cancer including ductal carcinoma in situ showed high survival rates and low complications, and T stage was prognostic factor for survival. But further follow-up should be needed.
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Stereotactic Radiotherapy for the Treatment of Brain Metastases
Dae Yong Kim, Yong Chan Ahn, Seung Jae Huh, Jung Il Lee, Do Hyun Nam, Seung Chyul Hong, Hyung Jin Shin, Kwan Park, Jong Hyun Kim
J Korean Cancer Assoc. 2000;32(1):148-155.
AbstractAbstract PDF
PURPOSE
To evaluate the clinical results of stereotactic radiosurgery (SRS) and frac- tionated stereotactic radiotherapy (FSRT) for metastatic brain tumors.
MATERIALS AND METHODS
Nineteen patients with brain metastases (34 lesions) were treated with LINAC-based SRS or FSRT with or without whole brain radiotherapy between October 1995 and February 1998. SRS was preferred to FSRT in cases with three or more lesions and poor performance status. FSRT was preferred to SRS in cases with lesions larger than 3 cm and lesions located near or at the eloquent areas such as thalamus, brain stem, and optic apparatus. Single isocenter was used both in SRS and FSRT, and the median peripheral dose in SRS was 15 Gy (range 13~20 Gy), while that in FSRT was 21 Gy (range 15~24 Gy) by 3 Gy per fraction.
RESULTS
Local control was achieved in 79% (27/34 treated lesions) and 1-year over- all survival rate was 58% with the median survival of 12 months. Lethal progressive brain metastases, both local and regional, were in four patients (27% of all deaths). No significant differences in local control and survival was observed with histology, age, sex, performance status, tumor volume, number of lesions, or treatment modality. Unacceptable acute or late complications did not occur.
CONCLUSION
Stereotactic radiotherapy including SRS and FSRT is effective, non-invasive therapy for brain metastases. This study suggests that stereotactic radiotherapy might be an alternative to surgical resection in selected patients of brain metastases.
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p 53 Expression in Non - Small Cell Lung Cancer: Its relationship to the clinical prognostic factor and smoking history
Moon Kyung Kim, Han Kyeom Kim, In Sun Kim, Joung Ho Han, Seung Jae Huh, Yong Chan Ahn, Dae Yong Kim, Young Mok Shim
J Korean Cancer Assoc. 1999;31(6):1219-1226.
AbstractAbstract PDF
PURPOSE
p53 mutations are one of the most common genetic alterations in human lung cancer. Although the prognostic value of mutant p53 is still debated, it is widely accepted as a relatively early genetic event in the development and progression of lung cancer. Moreover, there are growing reports about an association between smoking and p53 mutation, suggesting that the p53 gene could be a target of the smoking associated carcino- genesis in the lung cancer.
MATERIALS AND METHODS
Surgically resected 89 primary non-small cell lung cancers were obtained from May of 1995 to May of 1997. p53 expression and Ki-67 expression were measured by immunohistochemistry, and each p53 expression and smoking amount were compared with Ki-67 expression and other clinical prognostic factors.
RESULTS
Positive p53 expressions were found in 52 (58%) specimens, including 38 (69%) squamous cell carcinomas, 11 (39%) adenocarcinomas, and 3 (50%) large cell carcinomas, and closely associated with male and squamous cell carcinoma. Also close correlation was observed between smoking amount and p53 expression by the regression analysis. But p53 and Ki-67 expression showed no associations in pathologic stage and survival, and there was no association between p53 expression and survival after adjuvant radiotherapy.
CONCLUSION
Smoking seems to affect p53 mutations in non-small cell lung cancer, and additional efforts are needed to evaluate the carcinogesis of lung cancer.
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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.
AbstractAbstract 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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Limb - Conserving Surgery and Interstitial Brachytherapy Plus External Radiation Therapy in Extremity Soft Tissue Sarcoma
Yong Chan Ahn, Do Hoon Lim, Jai Gon Seo, Moon Kyung Kim, Hong Gyun Wu, Dae Young Kim, Seung Jae Huh
J Korean Cancer Assoc. 1998;30(3):599-607.
AbstractAbstract PDF
PURPOSE
In order to avoid functional disability that may be caused by radical excision or amputation in extremity soft tissue sarcomas, authors employed limb-conserving surgery together with extemal radiation therapy plus interstitial brachytherapy.
MATERIALS AND METHODS
From June 1995 to Febrary 1997, 10 extremity soft tissue sarcoma patients were treated with limb-conserving surgery and external radiation therapy plus interstitial brachytherapy. In six patients, whose histologic diagnoses were made at the time of surgery, wide or marginal excision and interstitial brachytherapy was done 4 weeks before postoperative external radiation therapy. In four patients whose histologic confinnations were done before definitive treatment, preoperative external radiation therapy was given 4 weeks before surgery and interstitial brachytherapy. The types of surgery were wide excision in five patients, and marginal excision in five patients. Gross or microscopic residual was left at the surgical resection margins in four patients. The brachytherapy dose ranged from 17.5 Gy to 24 Gy and external beam radiation did from 40 Gy to 45 Gy.
RESULTS
With the median follow-up duration of 21.5 months(range: 13 to 29 months); one local recurrence, and three new distant metastases were observed. There were three patients with wound complications attributable to the current treatment regimen.
CONCLUSION
Satisfactory local tumor control may be achievable with limb-conserving surgery and external radiation therapy plus brachytherapy in patients with extremity soft tissue sarcomas, while more caution should be used to avoid wound problems.
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Radiation Therapy of Carcinoma of the Cervical Stump
Seung Jae Huh, Won Dong Kim, Yong Chan Ahn, Sung Whan Ha, Il Han Kim, Charn Il Park
J Korean Cancer Assoc. 1995;27(6):986-990.
AbstractAbstract PDF
We have reviewed 19 cases of cervical stump cancer treated at the Seoul National and Soonchunhyang University Hospital from 1983 to 1993. Patients were treated with external beam radiation and/or intracavitary radiation. Median follow up period is 39 months. The absolute disease free, and overall survival rate for all patients are 51% and 70%, respectively. Six pelvic failures and two distant metastasis were observed. Recurrences were more common in external radiotherapy only or external radiotherapy plus colpostat application group than in the external radiotherapy plus tandem and colpostat treatment group. The grade 2 complication rate was 21%(4/l9) but there were no life threatening complications. Radiation therapy is effective for the treatment of cervical stump cancer.
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Reduced Dose and Selective Neck Irradiation Policy in Treating Oropharynx Cancer: Excellent Oncological Outcomes with very Low Risk of Locoregional Failure
Eunyeong Yang, Seung Gyu Park, Kyungmi Yang, Dongryul Oh, Yong Chan Ahn
Received December 13, 2024  Accepted April 9, 2025  Published online April 10, 2025  
DOI: https://doi.org/10.4143/crt.2024.1204    [Accepted]
AbstractAbstract PDF
Purpose
To evaluate the risk of locoregional failure after reduced dose selective neck irradiation (RD-SNI) in patients with oropharyngeal cancer (OPC).
Materials and Methods
Between 2008 and 2022, 342 OPC patients underwent definitive radiation therapy (with or without concurrent systemic therapy). The doses of 67.2–68.4 Gy to gross tumor volume (GTV), 56–60 Gy to high risk clinical target volumes (CTV-HR), and 32–36 Gy to low risk clinical target volumes (CTV-LR) were irradiated. The same target delineation and dosing policy were applied to all patients regardless of human papillomavirus (HPV) status. Oncological outcomes including failure patterns were also investigated.
Results
With a median follow-up of 60.3 months (range: 1.4-196.6 months), the 3- and 5-year locoregional control, distant metastasis-free survival (DMFS), disease-free survival, and overall survival rates were 91.6%/90.7%, 83.7%/80.7%, 78.7%/74.8%, and 91.0%/85.8%, respectively. The HPV-positive patients exhibited significantly better outcomes. Treatment failure occurred in 61 patients (17.8%); 37 (10.8%) had distant metastasis, 22 (6.4%) had local failure, and 8 (2.3%) had regional failure. GTV failure was significantly more common in HPV-negative patients (p=0.003). Among the 27 patients with locoregional failure, either GTV and/or CTV-HR failure occurred in 22 (81.5%), with CTV-LR failure in 1 (3.7%), and out-target regional (OTR) failure in 5 (18.5%). Only five failures (1.5%) could be attributed to the current RD-SNI policy: one CTV-LR failure (0.3%) reflecting the RD policy and four OTR failures (1.2%) reflecting the SNI policy.
Conclusion
Excellent oncological outcomes were achieved with the current RD-SNI policy.
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