Cancer Research and Treatment

Original Articles

Pediatric cancer

Long-term Outcomes of Protocol-Based Treatment for Newly Diagnosed Medulloblastoma: Won Kee Ahn, Seung Min Hahn, Hong In Yoon, Jeongshim Lee, Eun Kyung Park, Kyu Won Shim, Dong Seok Kim, Chang-Ok Suh, Se Hoon Kim, Chuhl Joo Lyu, Jung Woo Han; Cancer Res Treat. 2024;56(2):652-664. Published online November 30, 2023; DOI: https://doi.org/10.4143/crt.2023.865

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Purpose
The Korean Society of Pediatric Neuro-Oncology (KSPNO) conducted treatment strategies for children with medulloblastoma (MB) by using alkylating agents for maintenance chemotherapy or tandem high-dose chemotherapy (HDC) with autologous stem cell rescue (ASCR) according to the risk stratification. The purpose of the study was to assess treatment outcomes and complications based on risk-adapted treatment and HDC.
Materials and Methods
Fifty-nine patients diagnosed with MB were enrolled in this study. Patients in the standard-risk (SR) group received radiotherapy (RT) after surgery and chemotherapy using the KSPNO M051 regimen. Patients in the high-risk (HR) group received two and four chemotherapy cycles according to the KSPNO S081 protocol before and after reduced RT for age following surgery and two cycles of tandem HDC with ASCR consolidation treatment.
Results
In the SR group, 24 patients showed 5-year event-free survival (EFS) and overall survival (OS) estimates of 86.7% (95% confidence interval [CI], 73.6 to 100) and 95.8% (95% CI, 88.2 to 100), respectively. In the HR group, more infectious complications and mortality occurred during the second HDC than during the first. In the HR group, the 5-year EFS and OS estimates were 65.5% (95% CI, 51.4 to 83.4) and 72.3% (95% CI, 58.4 to 89.6), respectively.
Conclusion
High intensity of alkylating agents for SR resulted in similar outcomes but with a high incidence of hematologic toxicity. Tandem HDC with ASCR for HR induced favorable EFS and OS estimates compared to those reported previously. However, infectious complications and treatment-related mortalities suggest that a reduced chemotherapy dose is necessary, especially for the second HDC.

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Neurocognitive outcomes following postoperative paediatric cerebellar mutism syndrome: A systematic review
Bethany M. Horne, Annisha A. Attanayake, Kristian Aquilina, Tara Murphy, Charlotte P. Malcolm
Developmental Medicine & Child Neurology.2026; 68(1): 29. CrossRef
Ferroptosis Transcriptional Regulation and Prognostic Impact in Medulloblastoma Subtypes Revealed by RNA-Seq
Christophe Desterke, Yuanji Fu, Jenny Bonifacio-Mundaca, Claudia Monge, Pascal Pineau, Jorge Mata-Garrido, Raquel Francés
Antioxidants.2025; 14(1): 96. CrossRef

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CNS cancer

Suggestions for Escaping the Dark Ages for Pediatric Diffuse Intrinsic Pontine Glioma Treated with Radiotherapy: Analysis of Prognostic Factors from the National Multicenter Study: Hyun Ju Kim, Joo Ho Lee, Youngkyong Kim, Do Hoon Lim, Shin-Hyung Park, Seung Do Ahn, In Ah Kim, Jung Ho Im, Jae Wook Chung, Joo-Young Kim, Il Han Kim, Hong In Yoon, Chang-Ok Suh; Cancer Res Treat. 2023;55(1):41-49. Published online March 4, 2022; DOI: https://doi.org/10.4143/crt.2021.1514

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Purpose
This multicenter retrospective study aimed to investigate clinical, radiologic, and treatment-related factors affecting survival in patients with newly diagnosed diffuse intrinsic pontine glioma (DIPG) treated with radiotherapy.
Materials and Methods
Patients aged <30 years who underwent radiotherapy as an initial treatment for DIPG between 2000 and 2018 were included; patients who did not undergo magnetic resonance imaging at diagnosis and those with pathologically diagnosed grade I glioma were excluded. We examined medical records of 162 patients collected from 10 participating centers in Korea. The patients’ clinical, radiological, molecular, and histopathologic characteristics, and treatment responses were evaluated to identify the prognosticators for DIPG and estimate survival outcomes.
Results
The median follow-up period was 10.8 months (interquartile range, 7.5 to 18.1). The 1- and 2-year overall survival (OS) rates were 53.5% and 19.0%, respectively, with a median OS of 13.1 months. Long-term survival rate (≥ 2 years) was 16.7%, and median OS was 43.6 months. Age (< 10 years), poor performance status, treatment before 2010, and post-radiotherapy necrosis were independently associated with poor OS in multivariate analysis. In patients with increased post-radiotherapy necrosis, the median OS estimates were 13.3 months and 11.4 months with and without bevacizumab, respectively (p=0.138).
Conclusion
Therapeutic strategy for DIPG has remained unchanged over time, and the associated prognosis remains poor. Our findings suggest that appropriate efforts are needed to reduce the occurrence of post-radiotherapy necrosis. Further well-designed clinical trials are recommended to improve the poor prognosis observed in DIPG patients.

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An Investigation of the Effect of Nimotuzumab Combined with Radiation Therapy on Gliomas
巍瀚张
Advances in Clinical Medicine.2025; 15(04): 3098. CrossRef
Advancements in Image-Based Models for High-Grade Gliomas Might Be Accelerated
Guido Frosina
Cancers.2024; 16(8): 1566. CrossRef
The relationship between imaging features, therapeutic response, and overall survival in pediatric diffuse intrinsic pontine glioma
Xiaojun Yu, Mingyao Lai, Juan Li, Lichao Wang, Kunlin Ye, Dong Zhang, Qingjun Hu, Shaoqun Li, Xinpeng Hu, Qiong Wang, Mengjie Ma, Zeyu Xiao, Jiangfen Zhou, Changzheng Shi, Liangping Luo, Linbo Cai
Neurosurgical Review.2024;[Epub] CrossRef
Current status and advances to improving drug delivery in diffuse intrinsic pontine glioma
Lauren M. Arms, Ryan J. Duchatel, Evangeline R. Jackson, Pedro Garcia Sobrinho, Matthew D. Dun, Susan Hua
Journal of Controlled Release.2024; 370: 835. CrossRef
Pediatric diffuse intrinsic pontine glioma radiotherapy response prediction: MRI morphology and T2 intensity-based quantitative analyses
Xiaojun Yu, Shaoqun Li, Wenfeng Mai, Xiaoyu Hua, Mengnan Sun, Mingyao Lai, Dong Zhang, Zeyu Xiao, Lichao Wang, Changzheng Shi, Liangping Luo, Linbo Cai
European Radiology.2024; 34(12): 7962. CrossRef

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The Role of Postoperative Radiotherapy in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma: A Multi-institutional Retrospective Study (KROG 18-11): Joo Ho Lee, Seung Hyuck Jeon, Chul-Kee Park, Sung-Hye Park, Hong In Yoon, Jong Hee Chang, Chang-Ok Suh, Su Jeong Kang, Do Hoon Lim, In Ah Kim, Jin Hee Kim, Jung Ho Im, Sung-Hwan Kim, Chan Woo Wee, Il Han Kim; Cancer Res Treat. 2022;54(1):65-74. Published online March 24, 2021; DOI: https://doi.org/10.4143/crt.2021.142

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to evaluate the role of postoperative radiotherapy (PORT) in intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC).
Materials and Methods
A total of 133 patients with histologically confirmed HPC were included from eight institutions. Gross total resection (GTR) and subtotal resection (STR) were performed in 86 and 47 patients, respectively. PORT was performed in 85 patients (64%). The prognostic effects of sex, age, performance, World Health Organization (WHO) grade, location, size, Ki-67, surgical extent, and PORT on local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) were estimated by univariate and multivariate analyses.
Results
The 10-year PFS, and OS rates were 45%, and 71%, respectively. The multivariate analysis suggested that PORT significantly improved LC (p < 0.001) and PFS (p < 0.001). The PFS benefit of PORT was maintained in the subgroup of GTR (p=0.001), WHO grade II (p=0.001), or STR (p < 0.001). In the favorable subgroup of GTR and WHO grade II, PORT was also significantly related to better PFS (p=0.028). WHO grade III was significantly associated with poor DMFS (p=0.029). In the PORT subgroup, the 0-0.5 cm margin of the target volume showed an inferior LC to a large margin with 1.0-2.0 cm (p=0.021). Time-dependent Cox proportion analysis showed that distant failures were significantly associated with poor OS (p=0.003).
Conclusion
This multicenter study supports the role of PORT in disease control of intracranial SFT/HPC, irrespective of the surgical extent and grade. For LC, PORT should enclose the tumor bed with sufficient margin.

Citations

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The role of radiotherapy in intracranial hemangiopericytoma/solitary fibrous tumors
Nuri Kaydıhan, Gözde Yazıcı, Petek Erpolat, Serra Kamer, Burak Erdemci, Emine Canyılmaz, Beste Melek Atasoy, Dicle Aslan, Ela Delikgöz Soykut, Enis Özyar, Fatih Demircioğlu, Fazilet Öner Dinçbaş, Meltem Kirli Bolukbas, Ramazan Aksu, Selvi Tabak Dinçer, Ya
Strahlentherapie und Onkologie.2025; 201(4): 431. CrossRef
Does Adjuvant Radiotherapy Enhance Survival in Intracranial Solitary Fibrous Tumor Patients?
Sakhr Alshwayyat, Haya Kamal, Tala Abdulsalam Alshwayyat, Mustafa Alshwayyat, Mesk Alkhatib, Ayah Erjan
World Neurosurgery.2025; 194: 123545. CrossRef
Application and effect evaluation of microsurgical resection combined with intensity-modulated radiation therapy in the treatment of intracranial solitary fibrous tumor/hemangiopericytoma
Jingcheng Jiang, Xiaoqin Qu, Han Wang, Chao Zhang, Qingshan Deng, Xiaoping Xu, Jun Qiu, Lihua Qu, Yong Yi
Medicine.2025; 104(6): e41336. CrossRef
Mesenchymal Nonmeningothelial Tumors of the CNS: Evolving Molecular Landscape and Implications for Neuroradiologists
Neetu Soni, Manish Ora, Denes Szekeres, Girish Bathla, Amit Desai, Vivek Gupta, Aparna Singhal, Amit Agarwal
American Journal of Neuroradiology.2025; 46(5): 868. CrossRef
Meningeal malignant solitary fibrous tumor with multiple recurrence, extracranial extension, cervical lymph node metastases: case report and review of the literature
Rong He, Peng Zhong, Juntao Hu, Guangkuo Guo, He Xiao, Lin Lei, Yun Liu, Mingying Geng, Jungang Ma
Discover Oncology.2025;[Epub] CrossRef
A systematic review and meta-analysis on the efficacy of postoperative radiotherapy after gross total resection of intracranial solitary fibrous tumors
Min Kyun Na, Kyu-Sun Choi, Tae Ho Lim, Hyungoo Shin, Juncheol Lee, Heekyung Lee, Wonhee Kim, Jae Guk Kim, Youngsuk Cho, Chiwon Ahn, Jae Hwan Kim, Bo-Hyoung Jang, Myeong Namgung, Sae Min Kwon
Scientific Reports.2025;[Epub] CrossRef
Pediatric Spinal Solitary Fibrous Tumor: A Systematic Review of a Rare Condition
Andrea Trezza, Chiara B. Rui, Stefano Chiaravalli, Veronica Biassoni, Elisabetta Schiavello, Sabina Vennarini, Ester Orlandi, Giorgio G. Carrabba, Maura Massimino, Carlo G. Giussani
Children.2025; 12(9): 1214. CrossRef
Solitary fibrous tumour: histological discoveries, behavioural aspects, risk assessment and therapeutical approaches
Claudia Di Prata, Paolo Del Fiore, Chiara Trevisiol, Saveria Tropea, Maria-Samaritana Buzzaccarini, Marco Krengli, Giovanni Scarzello, Ilaria Cosci, Marta Sbaraglia, Benedetta Chiusole, Fabio Murtas, Marcodomenico Mazza, Antonella Brunello, Marco Rastrell
Therapeutic Advances in Medical Oncology.2025;[Epub] CrossRef
Hypo-Fractionated versus Standard Fractionation Radiotherapy in Frail and Elderly Patients with Central Nervous System Solitary Fibrous Tumors
Ory Haisraely, Marcia Jaffe, Alisa Taliansky, Zvi R. Cohen, Yaakov R. Lawerence
Oncology.2025; 103(12): 1080. CrossRef
Development of an MRI‐Based Comprehensive Model Fusing Clinical, Radiomics and Deep Learning Models for Preoperative Histological Stratification in Intracranial Solitary Fibrous Tumor
Xiaohong Liang, Kaiqiang Tang, Xiaoai Ke, Jian Jiang, Shenglin Li, Caiqiang Xue, Juan Deng, Xianwang Liu, Cheng Yan, Mingzi Gao, Junlin Zhou, Liqin Zhao
Journal of Magnetic Resonance Imaging.2024; 60(2): 523. CrossRef
Surgical Management of Craniospinal Axis Solitary Fibrous Tumors: A Single-Institution Case Series and Comprehensive Review of the Literature
Anthony J. Piscopo, A. J. Chowdhury, Nahom Teferi, Sarah Lee, Meron Challa, Michael Petronek, Kathryn Eschbacher, Girish Bathla, John M. Buatti, Patrick Hitchon
Neurosurgery.2024; 94(2): 358. CrossRef
Meningeal Solitary Fibrous Tumor: A Single-Center Retrospective Cohort Study
Siyer Roohani, Yasemin Alberti, Maximilian Mirwald, Felix Ehret, Carmen Stromberger, Soleiman Fabris Roohani, Katja Bender, Anne Flörcken, Sven Märdian, Daniel Zips, David Kaul, Manish Charan
Sarcoma.2024; 2024: 1. CrossRef
Repeated Radiation Therapy of Recurrent Solitary Fibrous Tumors of the Brain: A Medical Case History Over 20 Years
Anna Carla Piccardo, Sabrina Gurdschinski, Sybille Spieker, Christof Renner, Piotr Czapiewski, Markus Wösle, I. Frank Ciernik
Advances in Radiation Oncology.2024; 9(4): 101426. CrossRef
Intracranial solitary fibrous tumors: Clinical, radiological, and histopathological insights along with review of literature
Adil Aziz Khan, Sana Ahuja, Dipanker Singh Mankotia, Sufian Zaheer
Pathology - Research and Practice.2024; 260: 155456. CrossRef
Central nervous system solitary fibrous tumors: Case series in accordance with the WHO 2021 reclassification. Framework for patient surveillance
V. Matthijs, R. Beckers, C. Vanden Broecke, F. Dedeurwaerdere, J. Van Dorpe, D. Vanhauwaert, G. Hallaert
Acta Neurochirurgica.2024;[Epub] CrossRef
Recurrence of Solitary Fibrous Tumor in the Spinal Cord Following Gross Total and Subtotal Resection: A Case Report of Recurrence 19 Years of Post-total Resection and Systematic Literature Review
Satoka SHIDOH, Kazutoshi HIDA, Yoshitaka ODA, Toru SASAMORI, Prabin SHRESTHA, Jangbo LEE, Satoshi YAMAGUCHI
NMC Case Report Journal.2024; 11: 297. CrossRef
The Role of Radical Radiotherapy in Sinonasal Myopericytoma: A Case Report and Literature Overview
Anna Merlotti, Stefania Martini, Riccardo Vigna Taglianti, Alessia Reali, Giuseppe Signorini, Silvana Parisi, Francesca De Felice
EMJ Oncology.2023;[Epub] CrossRef
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Marine Lottin, Alexandre Escande, Luc Bauchet, Marie Albert-Thananayagam, Maël Barthoulot, Matthieu Peyre, Mathieu Boone, Sonia Zouaoui, Jacques Guyotat, Guillaume Penchet, Johan Pallud, Henry Dufour, Evelyne Emery, Michel Lefranc, Sébastien Freppel, Houm
Cancers.2023; 15(3): 704. CrossRef
Solitary fibrous tumor of the central nervous system invading and penetrating the skull: A case report
Qiyan Lin, Jiabin Zhu, Xiaofeng Zhang
Oncology Letters.2023;[Epub] CrossRef
Impact of extent of resection and postoperative radiotherapy on survival outcomes in intracranial solitary fibrous tumors: a systematic review and meta-analysis
Sae Min Kwon, Min Kyun Na, Kyu-Sun Choi, Tae Ho Lim, Hyungoo Shin, Juncheol Lee, Heekyung Lee, Wonhee Kim, Youngsuk Cho, Jae Guk Kim, Chiwon Ahn, Bo-Hyoung Jang
Neurosurgical Review.2023;[Epub] CrossRef
Radiotherapy for rare primary brain tumors
E. Mesny, P. Lesueur
Cancer/Radiothérapie.2023; 27(6-7): 599. CrossRef
Complete Resection of a Torcular Herophili Hemangiopericytoma without Sinus Reconstruction: A Case Report and Review of the Literature
Salah-Edine Safi, Julie Godfrain, Herbert Rooijakkers, Frederic Collignon, Mario Ganau
Case Reports in Surgery.2023; 2023: 1. CrossRef
Clinical Features, Management, and Prognostic Factors of Intracranial Solitary Fibrous Tumor
Jingdian Liu, Sisi Wu, Kai Zhao, Junwen Wang, Kai Shu, Ting Lei
Frontiers in Oncology.2022;[Epub] CrossRef
Toward Better Understanding and Management of Solitary Fibrous Tumor
Karineh Kazazian, Elizabeth G. Demicco, Marc de Perrot, Dirk Strauss, Carol J. Swallow
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Effect of Different Treatments for Intracranial Solitary Fibrous Tumors: Retrospective Analysis of 31 Patients
Qinghua Li, Wenshuai Deng, Peng Sun
World Neurosurgery.2022; 166: e60. CrossRef
Sixteen-Year Follow-Up in a Cavernous Sinus Hemangiopericytoma: Improved Outcomes over Radiotherapy Advances
Beatrice Detti, Lilia Bardoscia, Antonio Rosario Pisani, Salvatore Cozzi, Manuele Roghi, Paolo Mammucci, Angela Sardaro
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Mallory Raymond, Philip Ryan Elvis, Tiffany Baker, William Alexander Vandergrift, Theodore McRackan
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A Comprehensive Review on Solitary Fibrous Tumor: New Insights for New Horizons
Javier Martin-Broto, Jose L. Mondaza-Hernandez, David S. Moura, Nadia Hindi
Cancers.2021; 13(12): 2913. CrossRef
Intradural Extramedullary Solitary Fibrous Tumor of the Thoracic Spinal Cord
Zachary T Olmsted, Joanna Tabor, Omer Doron, Hossein Hosseini, Daniel Schneider, Ross Green, Samuel J Wahl, Daniel M Scuibba, Randy S D'Amico
Cureus.2021;[Epub] CrossRef

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Central nervous system

Survival, Prognostic Factors, and Volumetric Analysis of Extent of Resection for Anaplastic Gliomas: Je Beom Hong, Tae Hoon Roh, Seok-Gu Kang, Se Hoon Kim, Ju Hyung Moon, Eui Hyun Kim, Sung Soo Ahn, Hye Jin Choi, Jaeho Cho, Chang-Ok Suh, Jong Hee Chang; Cancer Res Treat. 2020;52(4):1041-1049. Published online April 23, 2020; DOI: https://doi.org/10.4143/crt.2020.057

Abstract PDF PubReader ePub

Purpose
The aim of this study is to evaluate the survival rate and prognostic factors of anaplastic gliomas according to the 2016 World Health Organization classification, including extent of resection (EOR) as measured by contrast-enhanced T1-weighted magnetic resonance imaging (MRI) and the T2-weighted MRI.
Materials and Methods
The records of 113 patients with anaplastic glioma who were newly diagnosed at our institute between 2000 and 2013 were retrospectively reviewed. There were 62 cases (54.9%) of anaplastic astrocytoma, isocitrate dehydrogenase (IDH) wild-type (AAw), 18 cases (16.0%) of anaplastic astrocytoma, IDH-mutant, and 33 cases (29.2%) of anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted.
Results
The median overall survival (OS) was 48.4 months in the whole anaplastic glioma group and 21.5 months in AAw group. In multivariate analysis, age, preoperative Karnofsky Performance Scale score, O⁶-methylguanine-DNA methyltransferase (MGMT) methylation status, postoperative tumor volume, and EOR measured from the T2 MRI sequence were significant prognostic factors. The EOR cut-off point for OS measured in contrast-enhanced T1-weighted MRI and T2-weighted MRI were 99.96% and 85.64%, respectively.
Conclusions
We found that complete resection of the contrast-enhanced portion (99.96%) and more than 85.64% resection of the non-enhanced portion of the tumor have prognostic impacts on patient survival from anaplastic glioma.

Citations

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Maximizing outcomes in diffusely infiltrative gliomas: A systematic review of surgical innovations and molecular predictors
Jheremy Sebastian Reyes Barreto, Cristian Sebastian Cabezas Varela, Juan Sebastian Aguirre Patiño, David Fernando Estupiñan Pepinosa, Nikolas Correa Molina, Paola Andrea Niño Muñoz, Juan Pablo Quintero Ruiz, Maria Fernanda Cordoba Gallego, Raul Fernando V
Acta Neurológica Colombiana.2025;[Epub] CrossRef
AQP1 as a novel biomarker to predict prognosis and tumor immunity in glioma patients
Xiang Gao, Wenqu Jiang, Guofeng Zhu, Zelong Xing, Pengbo Zhu, Zunliang Ke, Qiwei Huang
Oncologie.2024; 26(1): 117. CrossRef
Decapping enzyme 2 is a novel immune-related biomarker that predicts poor prognosis in glioma
Yuran Mei, Qiaoli Lv, Zilong Tan, Zhe Zhang, Yulong Ji, Shuhui Chen, Xiaoli Shen
Biotechnology and Genetic Engineering Reviews.2024; 40(4): 4262. CrossRef
Decision system for extent of resection in WHO grade 3 gliomas: a Chinese Glioma Genome Atlas database analysis
Ziming Hou, Jie Hu, Xing Liu, Zeya Yan, Kenan Zhang, Shengyu Fang, Tao Jiang, Yinyan Wang
Journal of Neuro-Oncology.2023; 164(2): 461. CrossRef
The Impact of Extent of Resection on the Prognosis of Glioblastoma Multiforme: A Systematic Review and Meta-analysis
Dipak Chaulagain, Volodymyr Smolanka, Andriy Smolanka, Sunil Munakomi
Open Access Macedonian Journal of Medical Sciences.2022; 10(F): 345. CrossRef
Relative T2-FLAIR signal intensity surrounding residual cavity is associated with survival prognosis in patients with lower-grade gliomas
Tao Yuan, Zhen Gao, Fei Wang, Jia-Liang Ren, Tianda Wang, Hongbo Zhong, Guodong Gao, Guanmin Quan
Frontiers in Oncology.2022;[Epub] CrossRef
SLC39A1 contribute to malignant progression and have clinical prognostic impact in gliomas
Peng Wang, Jingjing Zhang, Shuai He, Boan Xiao, Xiaobin Peng
Cancer Cell International.2020;[Epub] CrossRef

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Impact of Regional Nodal Irradiation for Breast Cancer Patients with Supraclavicular and/or Internal Mammary Lymph Node Involvement: A Multicenter, Retrospective Study (KROG 16-14): Kyubo Kim, Yuri Jeong, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Su Ssan Kim, Chang-Ok Suh, Yong Bae Kim, Doo Ho Choi, Won Park, Jihye Cha, Mison Chun, Dong Soo Lee, Sun Young Lee, Jin Hee Kim, Hae Jin Park, Wonguen Jung; Cancer Res Treat. 2019;51(4):1500-1508. Published online March 15, 2019; DOI: https://doi.org/10.4143/crt.2018.575

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to evaluate the treatment outcomes of radiotherapy (RT) for breast cancer with ipsilateral supraclavicular (SCL) and/or internal mammary (IMN) lymph node involvement.
Materials and Methods
A total of 353 patients from 11 institutions were included. One hundred and thirty-six patients had SCL involvement, 148 had IMN involvement, and 69 had both. All patients received neoadjuvant systemic therapy followed by breast-conserving surgery or mastectomy, and postoperative RT to whole breast/chest wall. As for regional lymph node irradiation, SCL RT was given to 344 patients, and IMN RT to 236 patients. The median RT dose was 50.4 Gy.
Results
The median follow-up duration was 61 months (range, 7 to 173 months). In-field progression was present in SCL (n=20) and/or IMN (n=7). The 5-year disease-free survival (DFS) and overall survival rates were 57.8% and 75.1%, respectively. On multivariate analysis, both SCL/IMN involvement, number of axillary lymph node ≥ 4, triple-negative subtype, and mastectomy were significant adverse prognosticators for DFS (p=0.022, p=0.001, p=0.001, and p=0.004, respectively). Regarding the impact of regional nodal irradiation, SCL RT dose ≥ 54 Gy was not associated with DFS (5-year rate, 52.9% vs. 50.9%; p=0.696) in SCL-involved patients, and the receipt of IMN RT was not associated with DFS (5-year rate, 56.1% vs. 78.1%; p=0.099) in IMN-involved patients.
Conclusion
Neoadjuvant chemotherapy followed by surgery and postoperative RT achieved an acceptable in-field regional control rate in patients with SCL and/or IMN involvement. However, a higher RT dose to SCL or IMN RT was not associated with the improved DFS in these patients.

Citations

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Xiaofang Wang, Xiaomeng Zhang, Li Zhang, Jin Meng, Wei Shi, Xingxing Chen, Zhaozhi Yang, Xin Mei, Xiaoli Yu, Zhen Zhang, Zhimin Shao, Xiaomao Guo, Jinli Ma
Breast Cancer.2025; 32(1): 144. CrossRef
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Julia M. Selfridge, Zachary Schrank, Chris B. Agala, David W. Ollila, Kristalyn K. Gallagher, Dana L. Casey, Philip M. Spanheimer
Annals of Surgical Oncology.2025; 32(3): 2070. CrossRef
Radiotherapy Boost to Clinically Positive Internal Mammary Lymph Nodes: An Effective Non-Surgical Alternative?
Caglayan Selenge Beduk Esen, Yasin Ozyurek, Sezin Yuce Sari, Melis Gultekin, Gokhan Ozyigit, Ferah Yildiz
Journal of Breast Cancer.2025; 28(4): 228. CrossRef
Comparison of the efficacy between radiotherapy alone and surgery plus radiotherapy for ipsilateral supraclavicular lymph node metastasis in breast cancer based on propensity score matching analysis: a retrospective study with 8-year follow-up
Chao Wei, Shuhua Zhou, Longyu Zhu, Jie Kong, Zimeng Gao, Danyang Wang, Deyou Kong, Andu Zhang, Shuo Pan, Kaiye Du, Dongxing Shen, Jun Zhang, Zhikun Liu
BMC Cancer.2025;[Epub] CrossRef
Internal mammary regional management after neoadjuvant therapy in breast cancer
Zhao Bi, Chun-Hui Zheng, Tong-Yue Ren, Yong-Sheng Wang
International Journal of Surgery.2024; 110(5): 2508. CrossRef
Oncological outcomes in patients with residual triple-negative breast cancer after preoperative chemotherapy
Hyunki Park, Haeyoung Kim, Won Park, Won Kyung Cho, Nalee Kim, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Jonghan Yu, Byung Joo Chae, Sei Kyung Lee, Jai-Min Ryu
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Garima Shrivastav, Debanjali Datta, Tabassum Wadasadawala, Pallavi Rane, Subhajit Panda, Rima Pathak, Libin Scaria, Revathy Krishnamurthy, Rajiv Sarin
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The optimal regional irradiation volume for breast cancer patients: A comprehensive systematic review and network meta-analysis of published studies
Wei-Xiang Qi, Lu Cao, Cheng Xu, Gang Cai, Jiayi Chen
Frontiers in Oncology.2023;[Epub] CrossRef
Contemporary Outcomes After Multimodality Therapy in Patients With Breast Cancer Presenting With Ipsilateral Supraclavicular Node Involvement
Kevin Diao, Lauren M. Andring, Carlos H. Barcenas, Puneet Singh, Huong (Carisa) Le-Petross, Valerie K. Reed, Jay P. Reddy, Elizabeth S. Bloom, Neelofur R. Ahmad, Lauren L. Mayo, George H. Perkins, Melissa P. Mitchell, Kevin T. Nead, Welela Tereffe, Benjam
International Journal of Radiation Oncology*Biology*Physics.2022; 112(1): 66. CrossRef
Locoregional Management and Prognostic Factors in Breast Cancer With Ipsilateral Internal Mammary and Axillary Lymph Node Involvement
Lauren M. Andring, Kevin Diao, Susie Sun, Miral Patel, Gary J. Whitman, Pamela Schlembach, Isadora Arzu, Melissa M. Joyner, Simona F. Shaitelman, Karen Hoffman, Michael C. Stauder, Benjamin D. Smith, Wendy A. Woodward
International Journal of Radiation Oncology*Biology*Physics.2022; 113(3): 552. CrossRef
Yesterday, Today and Tomorrow – Are We Any Closer to Knowing Which Patients Will Benefit from Adjuvant Internal Mammary Nodal Irradiation?
C.A. Johnson, J. Evans
Clinical Oncology.2022; 34(8): 534. CrossRef
Dynamics of circulating tumor DNA during postoperative radiotherapy in patients with residual triple-negative breast cancer following neoadjuvant chemotherapy: a prospective observational study
Haeyoung Kim, Yeon Jeong Kim, Donghyun Park, Woong-Yang Park, Doo Ho Choi, Won Park, Won kyung Cho, Nalee Kim
Breast Cancer Research and Treatment.2021; 189(1): 167. CrossRef
Cervical Lymph Node Involvement above the Supraclavicular Fossa in Breast Cancer: Comparison with Stage IIIC (KROG 18-02)
Jae Sik Kim, Kyubo Kim, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Su Ssan Kim, Yong Bae Kim, Jee Suk Chang, Doo Ho Choi, Won Park, Tae Hyun Kim, Mison Chun, Jihye Cha, Jin Hee Kim, Dong Soo Lee, Sun Young Lee, Hae Jin Park
Journal of Breast Cancer.2020; 23(2): 194. CrossRef
Aggressive Surgical Excision of Supraclavicular Lymph Node Did Not Improve the Outcomes of Breast Cancer With Supraclavicular Lymph Node Involvement (KROG 16-14)
Kyubo Kim, Su Ssan Kim, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Doo Ho Choi, Won Park, Sun Young Lee, Mison Chun, Jin Hee Kim, Yong Bae Kim, Jihye Cha, Hae Jin Park, Dong Soo Lee, Wonguen Jung
Clinical Breast Cancer.2020; 20(1): 51. CrossRef
Combined Therapy Can Improve the Outcomes of Breast Cancer with Isolated Supraclavicular Lymph Node Involvement

Tianyi Ma, Yan Mao, Haibo Wang
Cancer Management and Research.2020; Volume 12: 11857. CrossRef

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Effects of Postoperative Radiotherapy on Leptomeningeal Carcinomatosis or Dural Metastasis after Resection of Brain Metastases in Breast Cancer Patients: Boram Ha, Seung Yeun Chung, Yeon-Joo Kim, Ho-Shin Gwak, Jong Hee Chang, Sang Hyun Lee, In Hae Park, Keun Seok Lee, Seeyoun Lee, Tae Hyun Kim, Dae Yong Kim, Seok-Gu Kang, Chang-Ok Suh; Cancer Res Treat. 2017;49(3):748-758. Published online October 31, 2016; DOI: https://doi.org/10.4143/crt.2016.303

Abstract PDF Supplementary Material PubReader ePub

Purpose
In this retrospective study, we compared the incidence of leptomeningeal carcinomatosis or dural metastasis (LMCDM) in patients who received whole brain radiotherapy (WBRT), partial radiotherapy (PRT), or no radiotherapy (RT) following resection of brain metastases from breast cancer.
Materials and Methods
Fifty-one patients with breast cancer underwent surgical resection for newly diagnosed brain metastases in two institutions between March 2001 and March 2015. Among these, 34 received postoperative WBRT (n=24) or PRT (n=10) and 17 did not.
Results
With a median follow-up of 12.4 months (range, 2.3 to 83.6 months), 22/51 patients developed LMCDM at a median of 8.6 months (range, 4.8 to 51.2 months) after surgery. The 18-months LMCDM-free survival (LMCDM-FS) rates were 77.5%, 30.0%, and 13.6%, in the WBRT, PRT, and no RT groups, respectively (p=0.013). The presence of a tumor adjacent to cerebrospinal fluid flow and no systemic treatment after treatment for brain metastases were also associated with poor LMCDM-FS rate. Multivariate analysis showed that WBRT compared to PRT (p=0.009) and systemic treatment (p < 0.001) were independently associated with reduced incidence of LMCDM.
Conclusion
WBRT improved LMCDM-FS rate after resection of brain metastases compared to PRT in breast cancer patients.

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Maria Alice Franzoi, Gabriel N. Hortobagyi
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Leptomeningeal Metastases
Jerome J. Graber, Santosh Kesari
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Optimal dose and volume for postoperative radiotherapy in brain oligometastases from lung cancer: a retrospective study
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Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea: Byung Sup Kim, Ho Jun Seol, Do-Hyun Nam, Chul-Kee Park, Il Han Kim, Tae Min Kim, Jeong Hoon Kim, Young Hyun Cho, Sang Min Yoon, Jong Hee Chang, Seok-Gu Kang, Eui Hyun Kim, Chang-Ok Suh, Tae-Young Jung, Kyung-Hwa Lee, Chae-Yong Kim, In Ah Kim, Chang-Ki Hong, Heon Yoo, Jin Hee Kim, Shin-Hyuk Kang, Min Kyu Kang, Eun-Young Kim, Sun-Hwan Kim, Dong-Sup Chung, Sun-Chul Hwang, Joon-Ho Song, Sung Jin Cho, Sun-Il Lee, Youn-Soo Lee, Kook-Jin Ahn, Se Hoon Kim, Do Hun Lim, Ho-Shin Gwak, Se-Hoon Lee, Yong-Kil Hong; Cancer Res Treat. 2017;49(1):193-203. Published online June 27, 2016; DOI: https://doi.org/10.4143/crt.2015.473

Abstract PDF PubReader ePub

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

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¹⁸F-FDG/PET May Help to Identify a Subgroup of Patients with T1-T2 Breast Cancer and 1-3 Positive Lymph Nodes Who Are at a High Risk of Recurrence after Mastectomy: Jee Suk Chang, Jeongshim Lee, Hyun Jung Kim, Kyung Hwan Kim, Mijin Yun, Seung Il Kim, Ki Chang Keum, Chang-Ok Suh, Yong Bae Kim; Cancer Res Treat. 2016;48(2):508-517. Published online September 9, 2015; DOI: https://doi.org/10.4143/crt.2015.172

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to assess the utility of positron emission tomography (PET) for predicting recurrence among patients with T1-T2/N1 breast cancer who were treated with mastectomy. Materials and Methods Of 712 consecutive patients with T1-T2/N1 breast cancer treated during 2003-2012, 109 had undergone preoperative 18F-fluorodeoxyglucose/PET and were included. Metabolic (maximum standardized uptake value [SUVmax]), volumetric (metabolic tumor volume [MTV]), and combined (total lesion glycolysis [TLG]) indices were measured. The resulting values were analyzed and compared with clinical outcome.
Results
At the median follow-up of 46.7 months, the 3-year relapse-free survival (RFS) rate was 95.2%. SUVmax (area under curve, 0.824) was more useful than MTV or TLG as a means of identifying patients at high risk for any recurrence. In multivariate analysis, SUVmax remained an independent risk factor for RFS (p=0.006). Using the method of Contal and O’Quigley, a SUVmax threshold of 5.36 showed the best predictive performance. The PET-based highrisk group (≥ 5.36 in either breast or nodes) had more T1c-T2, high-grade, hormone-receptor negative, and invasive ductal carcinoma tumors than the low-risk group (< 5.36 in both breast and nodes). The prognosis was much worse when high SUVmax (≥ 5.36) was detected in nodes (p < 0.001). In the no-radiotherapy cohort, the PET-based high-risk group had increased risk of locoregional recurrence when compared to the low-risk group (p=0.037). Conclusion High SUVmax on preoperative PET showed association with elevated risk of locoregional recurrence and any recurrence. Pre-treatment PET may improve assessments of recurrence risk and clarify indications for post-mastectomy radiotherapy in this subset of patients.

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Yurika Kitano, Kanae K. Miyake, Tomomi W. Nobashi, Takayoshi Ishimori, Ryusuke Nakamoto, Sho Koyasu, Masako Kataoka, Yasuhide Takeuchi, Masakazu Toi, Yuji Nakamoto
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Tomoko Higuchi, Yukie Fujimoto, Hiromi Ozawa, Ayako Bun, Reiko Fukui, Yoshimasa Miyagawa, Michiko Imamura, Kazuhiro Kitajima, Koichiro Yamakado, Yasuo Miyoshi
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Burcak Yilmaz, Sedef Dağ, Nurhan Ergul, Tevfik Fikret Çermik
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Wei Diao, Fangfang Tian, Zhiyun Jia
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American Journal of Clinical Oncology.2018; 41(11): 1049. CrossRef
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Yong-il Kim, Yong Joong Kim, Jin Chul Paeng, Gi Jeong Cheon, Dong Soo Lee, June-Key Chung, Keon Wook Kang
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Tumor size and proliferative marker geminin rather than Ki67 expression levels significantly associated with maximum uptake of 18F-deoxyglucose levels on positron emission tomography for breast cancers
Arisa Nishimukai, Natsuko Inoue, Ayako Kira, Masashi Takeda, Koji Morimoto, Kazuhiro Araki, Kazuhiro Kitajima, Takahiro Watanabe, Seiichi Hirota, Toyomasa Katagiri, Shoji Nakamori, Kouhei Akazawa, Yasuo Miyoshi, Renato Franco
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Ryusuke Murakami, Yoshimitsu Fukushima, Hitomi Tani, Kotomi Iwata, Shinichiro Kumita, Maki Nakai, Tomoko Kurita, Keiko Yanagihara, Hiroyuki Takei, Miyuki Matsubara
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Young-Sil An, Doo Kyoung Kang, Yongsik Jung, Tae Hee Kim
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Trends in the Application of Postmastectomy Radiotherapy for Breast Cancer With 1 to 3 Positive Axillary Nodes and Tumors ≤5 cm in the Modern Treatment Era
Jee Suk Chang, Jung Eun Choi, Min Ho Park, Sung Hoo Jung, Byung Ock Choi, Hyung Seok Park, Seho Park, Yong Bae Kim
Medicine.2016; 95(19): e3592. CrossRef
Prognostic significance of preoperative 18F-FDG PET/CT for breast cancer subtypes
Tomoko Higuchi, Arisa Nishimukai, Hiromi Ozawa, Yukie Fujimoto, Ayako Yanai, Yoshimasa Miyagawa, Keiko Murase, Michiko Imamura, Yuichi Takatsuka, Kazuhiro Kitajima, Kazuhito Fukushima, Yasuo Miyoshi
The Breast.2016; 30: 5. CrossRef

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Case Report

Effective Treatment of Solitary Pituitary Metastasis with Panhypopituitarism in HER2-Positive Breast Cancer by Lapatinib: Youngmok Park, Hyemin Kim, Eui-Hyun Kim, Chang-Ok Suh, Soohyeon Lee; Cancer Res Treat. 2016;48(1):403-408. Published online February 16, 2015; DOI: https://doi.org/10.4143/crt.2014.165

Abstract PDF PubReader ePub

Brain metastasis affects one third of patients with HER2-positive breast cancer after treatment with trastuzumab. Surgical resection and radiation therapy are often unsuccessful at accomplishing complete control of metastasis. Lapatinib is presumed to cross the blood-brain barrier, and exhibits clinical activities for treatment of HER2- positive breast cancer. A 43-year-old woman was treated for early breast carcinoma with total mastectomy, axillary lymph-node dissection, and adjuvant chemotherapy with cyclophosphamide plus doxorubicin. After the end of adjuvant trastuzumab therapy, she was diagnosed with panhypopituitarism due to pituitary metastasis. Surgical removal and whole brain radiation therapy were performed, but a portion of viable tumor remained. Only taking lapatinib, the size of the metastatic lesion began to shrink. Trastuzumab may have controlled the micro-metastasis of breast cancer, but it was unable to control its progression to the central nervous system. Lapatinib is a possible option for HER2-positive metastatic breast cancer patients with brain metastasis.

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Original Articles

Role of Radiotherapy in the Multimodal Treatment of Ewing Sarcoma Family Tumors: Yunseon Choi, Do Hoon Lim, Soo Hyun Lee, Chuhl Joo Lyu, Jung Ho Im, Yun-Han Lee, Chang-Ok Suh; Cancer Res Treat. 2015;47(4):904-912. Published online February 16, 2015; DOI: https://doi.org/10.4143/crt.2014.158

Abstract PDF PubReader ePub

Purpose
The aim of this study was to evaluate the role of radiotherapy (RT) in the management of Ewing sarcoma family tumors (ESFT). Materials and Methods Retrospective analysiswas performed on 91 patientswith localized ESFT treated from 1988 to 2012. Primary tumor size was ≥ 8 cm in 33 patients. Surgery, RT, and combined surgery with RT were applied in 37, 15, and 33 patients, respectively.
Results
Median follow-up was 43.8 months. Forty-three patients (47.3%) showed recurrence or progressive disease. Twelve patients (13.2%) showed local failure after initial treatment. Thirty-nine patients (42.9%) experienced distant metastases. The 5-year overall survival (OS), progression-free survival, and local control (LC) were 60.5%, 58.2%, and 85.1%, respectively. According to treatment, 5-year LCwas 64.8% with RT and 90.2% with combined surgery and RT (p=0.052). Prognostic factors for OS were tumor size (≥ 8 cm, p < 0.001) and surgical resection (p < 0.001). In large tumors (≥ 8 cm), combined surgery and RT produced better LC compared to RT (p=0.033). However, in smaller tumors (< 8 cm), RT without surgery resulted in a similar LC rate as RT with surgery (p=0.374). Conclusion RT used for patients with unfavorable risk factors resulted in worse outcome than for patientswho received surgery. Smallertumors could be controlled locallywith chemotherapy and RT. For large tumors, combined surgery and RT is needed. Proper selection of local treatment modality, RT, surgery, or both is crucial in the management of ESFT.

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Patterns of Failure Following Multimodal Treatment for Medulloblastoma: Long-Term Follow-up Results at a Single Institution: Dong Soo Lee, Jaeho Cho, Se Hoon Kim, Dong-Seok Kim, Kyu Won Shim, Chuhl Joo Lyu, Jung Woo Han, Chang-Ok Suh; Cancer Res Treat. 2015;47(4):879-888. Published online December 8, 2014; DOI: https://doi.org/10.4143/crt.2014.067

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Purpose
The purpose of this study is to investigate the long-term results and appropriateness of radiation therapy (RT) for medulloblastoma (MB) at a single institution. Materials and Methods We analyzed the clinical outcomes of 106 patients with MB who received RT between January 1992 and October 2009. The median age was 7 years (range, 0 to 50 years), and the proportion of M0, M1, M2, and M3 stages was 60.4%, 8.5%, 4.7%, and 22.6%, respectively. The median total craniospinal irradiation (CSI) and posterior fossa tumor bed dose in 102 patients (96.2%) treated with CSI was 36 Gy and 54 Gy, respectively. Results The median follow-up period in survivors was 132 months (range, 31 to 248 months). A gradual improvement in survival outcomes was observed, with 5-year overall survival rates of 61.5% in 1990s increasing to 73.6% in 2000s. A total of 29 recurrences (27.4%) developed at the following sites: five (17.2%) in the tumor bed; five (17.2%) in the posterior fossa other than the tumor bed; nine (31%) in the supratentorium; and six (20.7%) in the spinal subarachnoid space only. The four remaining patients showed multiple site recurrences. Among 12 supratentorial recurrences, five cases recurred in the subfrontal areas. Although the frequency of posterior fossa/tumor bed recurrences was significantly high among patients treated with subtotal resection, other site (other intracranial/spinal) recurrences were more common among patients treated with gross tumor removal (p=0.016). There was no case of spinal subarachnoid space relapse from desmoplastic/extensive nodular histological subtypes. Conclusion Long-term follow-up results and patterns of failure confirmed the importance of optimal RT dose and field arrangement. More tailored multimodal strategies and proper CSI technique may be the cornerstones for improving treatment outcomes in MB patients.

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Remote Supratentorial Recurrent Medulloblastoma: Case Study and Literature Review
Asimina Dominari, Elias Antoniades, Antonio Capiccelo, Emmanuil Hatzipantelis, Nikolaos Foroglou
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Sequential improvement in paediatric medulloblastoma outcomes in a low-and-middle-income country setting over three decades
Johann Riedemann, Anthony Figaji, Alan Davidson, Clare Stannard, Komala Pillay, Tracy Kilborn, Jeannette Parkes
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L. Padovani, G. Horan, T. Ajithkumar
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Craniospinal irradiation using helical tomotherapy for central nervous system tumors
Sanziana R.I. Schiopu, Gregor Habl, Matthias Häfner, Sonja Katayama, Klaus Herfarth, Juergen Debus, Florian Sterzing
Journal of Radiation Research.2017;[Epub] CrossRef
Highly Conformal Craniospinal Radiotherapy Techniques Can Underdose the Cranial Clinical Target Volume if Leptomeningeal Extension through Skull Base Exit Foramina is not Contoured
D.J. Noble, T. Ajithkumar, J. Lambert, I. Gleeson, M.V. Williams, S.J. Jefferies
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Long-term toxic effects of proton radiotherapy for paediatric medulloblastoma: a phase 2 single-arm study
Torunn I Yock, Beow Y Yeap, David H Ebb, Elizabeth Weyman, Bree R Eaton, Nicole A Sherry, Robin M Jones, Shannon M MacDonald, Margaret B Pulsifer, Beverly Lavally, Annah N Abrams, Mary S Huang, Karen J Marcus, Nancy J Tarbell
The Lancet Oncology.2016; 17(3): 287. CrossRef

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

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

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Journal of Breast Cancer.2022; 25(5): 349. CrossRef
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Ji Hyeon Joo, Yongkan Ki, Hosang Jeon, Dong Woon Kim, Jinhong Jung, Su Ssan Kim
Asia-Pacific Journal of Clinical Oncology.2021; 17(4): 305. CrossRef
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Frontiers in Oncology.2020;[Epub] CrossRef

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