Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

One-Week versus Two-Week Chemoradiotherapy Followed by Curative Surgery in Rectal Cancer: Long-Term Comparative Pooled Analysis of Two Prospective Multicenter Phase II Trials: Soo-Yoon Sung, Dae Yong Kim, Hong Seok Jang, Tae Hyun Kim, Hee Chul Park, Eui Kyu Chie, Taek-Keun Nam, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2023;55(3):918-926. Published online February 27, 2023; DOI: https://doi.org/10.4143/crt.2022.1646

Abstract PDF PubReader ePub: Purpose
The optimal short-course chemotherapeutic regimen for rectal cancer has not been clearly defined until now. KROG 10-01 and KROG 11-02 prospective trials investigated the efficacy and safety of 1- and 2-week chemoradiotherapy (CRT), respectively.
Materials and Methods
Patients eligible for KROG 10-01 and KROG 11-02 involved those with clinical T3-4N0-2M0 rectal cancers. They received preoperative CRT and total mesorectal excision. Patients in KROG 10-01 received radiation of 25 Gy in 5 fractions during 1 week with 5-fluorouracil/leucovorin. Patients in KROG 11-02 received radiation of 33 Gy in 10 fractions for 2 weeks with oral capecitabine.
Results
A total of 150 patients consisting of 70 patients from KROG 10-01 and 80 patients from KROG 11-02 were collectively analyzed. With a median follow-up time of 89.2 months, the 5-year overall survival rate was 86.5% in 1-week CRT and 85.3% in 2-week CRT (p=0.841). The 5-year recurrence-free survival rate was 83.5% in 1-week CRT and 77.1% in 2-week CRT (p=0.448). One patient (1.4%) in 1-week CRT and 11 patients (13.8%) in 2-week CRT exhibited pathologic complete regression (ypT0N0M0) after radiotherapy (p=0.006). One-week CRT had significantly higher acute hematologic (12.8% vs. 3.8%, p=0.040) and nonhematologic (38.6% vs. 16.3%, p=0.002) toxicity than 2-week CRT.
Conclusion
Both 1- and 2-week schedules of CRT showed favorable survival outcomes after 7 years of follow-up. But, 2-week course achieved more increased tumor response and decreased acute toxicity than 1-week course.

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A Phase II Study of Preoperative Chemoradiotherapy with Capecitabine Plus Simvastatin in Patients with Locally Advanced Rectal Cancer: Hyunji Jo, Seung Tae Kim, Jeeyun Lee, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Jeong Il Yu, Hee Chul Park, Doo Ho Choi, Yoonah Park, Yong Beom Cho, Jung Wook Huh, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Won Ki Kang; Cancer Res Treat. 2023;55(1):189-195. Published online June 8, 2022; DOI: https://doi.org/10.4143/crt.2021.1527

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Purpose
The purpose of this phase II trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, to preoperative chemoradiotherapy (CRT) with capecitabine confers a clinical benefit to patients with locally advanced rectal cancer (LARC).
Materials and Methods
Patients with LARC (defined by clinical stage T3/4 and/or lymph node positivity) received preoperative radiation (45-50.4 Gy in 25-28 daily fractions) with concomitant capecitabine (825 mg/m2 twice per day) and simvastatin (80 mg, daily). Curative surgery was planned 4-8 weeks after completion of the CRT regimen. The primary endpoint was pathologic complete response (pCR). The secondary endpoints included sphincter-sparing surgery, R0 resection, disease-free survival, overall survival, the pattern of failure, and toxicity.
Results
Between October 2014 and July 2017, 61 patients were enrolled; 53 patients completed CRT regimen and underwent total mesorectal excision. The pCR rate was 18.9% (n=10) by per-protocol analysis. Sphincter-sparing surgery was performed in 51 patients (96.2%). R0 resection was achieved in 51 patients (96.2%). One patient experienced grade 3 liver enzyme elevation. No patient experienced additional toxicity caused by simvastatin.
Conclusion
The combination of 80 mg simvastatin with CRT and capecitabine did not improve pCR in patients with LARC, although it did not increase toxicity.

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Effects of Hyperlipidemia on Osseointegration of Dental Implants and Its Strategies
Haiyang Sun, Shuhuai Meng, Junyu Chen, Qianbing Wan
Journal of Functional Biomaterials.2023; 14(4): 194. CrossRef

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Carcinoembryonic Antigen Improves the Performance of Magnetic Resonance Imaging in the Prediction of Pathologic Response after Neoadjuvant Chemoradiation for Patients with Rectal Cancer: Gyu Sang Yoo, Hee Chul Park, Jeong Il Yu, Doo Ho Choi, Won Kyung Cho, Young Suk Park, Joon Oh Park, Ho Yeong Lim, Won Ki Kang, Woo Yong Lee, Hee Cheol Kim, Seong Hyeon Yun, Yong Beom Cho, Yoon Ah Park, Kyoung Doo Song, Seok-Hyung Kim, Sang Yun Ha; Cancer Res Treat. 2020;52(2):446-454. Published online September 25, 2019; DOI: https://doi.org/10.4143/crt.2019.261

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to investigate the role of carcinoembryonic antigen (CEA) levels in improving the performance of magnetic resonance imaging (MRI) for the prediction of pathologic response after the neoadjuvant chemoradiation (NCRT) for patients with rectal cancer.
Materials and Methods
We retrospectively reviewed the medical records of 524 rectal cancer patients who underwent NCRT and total mesorectal excision between January 2009 and December 2014. The performances of MRI with or without CEA parameters (initial CEA and CEA dynamics) for prediction of pathologic tumor response grade (pTRG) were compared by receiver-operating characteristic analysis with DeLong’s method. Cox regression was used to identify the independent factors associated to pTRG and disease-free survival (DFS) after NCRT.
Results
The median follow-up was 64.0 months (range, 3.0 to 113.0 months). On multivariate analysis, poor tumor regression grade on MRI (mrTRG; p < 0.001), initial CEA (p < 0.001) and the mesorectal fascia involvement on MRI before NCRT (mrMFI; p=0.054) showed association with poor pTRG. The mrTRG plus CEA parameters showed significantly improved performances in the prediction of pTRG than mrTRG alone. All of mrTRG, mrMFI, and initial CEA were also identified as independent factors associated with DFS. The initial CEA further discriminated DFS in the subgroups with good mrTRG or that without mrMFI.
Conclusion
The CEA parameters significantly improved the performance of MRI in the prediction of pTRG after NCRT for patients with rectal cancer. The DFS was further discriminated by initial CEA level in the groups with favorable MRI parameters.

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Clinical outcomes of neoadjuvant chemoradiotherapy followed by total mesorectal excision in locally advanced rectal cancer with mesorectal fascia involvement
Jeong Ha Lee, Nalee Kim, Jeong Il Yu, Gyu Sang Yoo, Hee Chul Park, Woo-Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jung Kyong Shin, Joon Oh Park, Seung Tae Kim, Young Suk Park, Jeeyun Lee, Won Ki Kang
Radiation Oncology Journal.2024; 42(2): 130. CrossRef
Predicting the response to neoadjuvant chemoradiation for rectal cancer using nomograms based on MRI tumour regression grade
S. Qin, Y. Chen, K. Liu, Y. Li, Y. Zhou, W. Zhao, P. Xin, Q. Wang, S. Lu, H. Wang, N. Lang
Cancer/Radiothérapie.2024; 28(4): 341. CrossRef
Body composition parameters combined with blood biomarkers and magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Jianguo Yang, Qican Deng, Zhenzhou Chen, Yajun Chen, Zhongxue Fu
Frontiers in Oncology.2023;[Epub] CrossRef
Pretreatment blood biomarkers combined with magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Xinyu Shi, Min Zhao, Bo Shi, Guoliang Chen, Huihui Yao, Junjie Chen, Daiwei Wan, Wen Gu, Songbing He
Frontiers in Oncology.2022;[Epub] CrossRef
Clinical implication and management of rectal cancer with clinically suspicious lateral pelvic lymph node metastasis: A radiation oncologist’s perspective
Gyu Sang Yoo, Hee Chul Park, Jeong Il Yu
Frontiers in Oncology.2022;[Epub] CrossRef
High-Resolution T2-Weighted MRI to Evaluate Rectal Cancer: Why Variations Matter
Kirsten L Gormly
Korean Journal of Radiology.2021; 22(9): 1475. CrossRef
MRI Assessment of Complete Response to Preoperative Chemoradiation Therapy for Rectal Cancer: 2020 Guide for Practice from the Korean Society of Abdominal Radiology
Seong Ho Park, Seung Hyun Cho, Sang Hyun Choi, Jong Keon Jang, Min Ju Kim, Seung Ho Kim, Joon Seok Lim, Sung Kyoung Moon, Ji Hoon Park, Nieun Seo
Korean Journal of Radiology.2020; 21(7): 812. CrossRef

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Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05): Sun Hyun Bae, Hee Chul Park, Won Sup Yoon, Sang Min Yoon, In-Hye Jung, Ik Jae Lee, Jun Won Kim, Jinsil Seong, Tae Hyun Kim, Taek-Keun Nam, Youngmin Choi, Sun Young Lee, Hong Seok Jang, Dong Soo Lee, Jin Hee Kim; Cancer Res Treat. 2019;51(4):1589-1599. Published online April 10, 2019; DOI: https://doi.org/10.4143/crt.2018.687

Abstract PDF Supplementary Material PubReader ePub

Purpose
There is limited data on radiotherapy (RT) for hepatocellular carcinoma (HCC) in patients with Child-Pugh classification B (CP-B). This study aimed to evaluate the treatment outcomes of fractionated conformal RT in HCC patients with CP-B.
Materials and Methods
We retrospectively reviewed the data of HCC patients with CP-B treated with RT between 2009 and 2014 at 13 institutions in Korea. HCC was diagnosed by the Korea guideline of 2009, and modern RT techniques were applied. Fraction size was ≤ 5 Gy and the biologically effective dose (BED) ≥ 40 Gy10 (α/β = 10 Gy). A total of 184 patients were included in this study.
Results
Initial CP score was seven in 62.0% of patients, eight in 31.0%, and nine in 7.0%. Portal vein tumor thrombosis was present in 66.3% of patients. The BED ranged from 40.4 to 89.6 Gy10 (median, 56.0 Gy10). After RT completion, 48.4% of patients underwent additional treatment. The median overall survival (OS) was 9.4 months. The local progression-free survival and OS rates at 1 year were 58.9% and 39.8%, respectively. In the multivariate analysis, non-classic radiation-induced liver disease (RILD) (p < 0.001) and additional treatment (p < 0.001) were the most significant prognostic factors of OS. Among 132 evaluable patients without progressive disease, 19.7% experienced non-classic RILD. Normal liver volume was the most predictive dosimetric parameter of non-classic RILD.
Conclusion
Fractionated conformal RT showed favorable OS with a moderate risk non-classic RILD. The individual radiotherapy for CP-B could be cautiously applied weighing the survival benefits and the RILD risks.

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Development and validation of a nomogram for radiation-induced hepatic toxicity after intensity modulated radiotherapy for hepatocellular carcinoma: a retrospective study
Qiaoyuan Wu, Yudan Wang, Yuxin Wei, Zhengqiang Yang, Kai Chen, Jianxu Li, Liqing Li, Tingshi Su, Shixiong Liang
Japanese Journal of Clinical Oncology.2024; 54(6): 699. CrossRef
Managing hepatocellular carcinoma across the stages: efficacy and outcomes of stereotactic body radiotherapy
Ahmed Allam Mohamed, Marie-Luise Berres, Philipp Bruners, Sven Arke Lang, Christian Trautwein, Georg Wiltberger, Alexandra Barabasch, Michael Eble
Strahlentherapie und Onkologie.2024; 200(8): 715. CrossRef
Clinical outcomes and safety of external beam radiotherapy with extensive intrahepatic targets for advanced hepatocellular carcinoma: A single institutional clinical experience
Sunmin Park, Chai Hong Rim, Won Sup Yoon
Saudi Journal of Gastroenterology.2024;[Epub] CrossRef
Role of rapid arc-image-guided radiotherapy in hepatocellular carcinoma with portal vein tumor thrombosis: A study from tertiary care center in Punjab, India
Manjinder Singh Sidhu, Ramandeep, Sandhya Sood, Ritu Aggarwal, Kulbir Singh, Divyanshi Sood
Journal of Cancer Research and Therapeutics.2023; 19(3): 639. CrossRef
Non-classic radiation-induced liver disease after intensity-modulated radiotherapy for Child–Pugh grade B patients with locally advanced hepatocellular carcinoma
Jian-Xu Li, Rui-Jun Zhang, Mo-Qin Qiu, Liu-Ying Yan, Mei-Ling He, Mei-Ying Long, Jian-Hong Zhong, Hai-Yan Lu, Hong-Mei Zhou, Bang-De Xiang, Shi-Xiong Liang
Radiation Oncology.2023;[Epub] CrossRef
Long-term characterization of MRI-morphologic alterations after active motion-compensated liver SBRT: a multi-institutional pooled analysis
Constantin Dreher, Gustavo R. Sarria, Georgia Miebach, Christel Weiss, Daniel Buergy, Paulina Wojtal, Anoshirwan A. Tavakoli, David Krug, Hans Oppitz, Frank A. Giordano, Marcus Both, Frank Lohr, Jürgen Dunst, Oliver Blanck, Judit Boda-Heggemann
Acta Oncologica.2023; 62(3): 281. CrossRef
Radiotherapy trend in elderly hepatocellular carcinoma: retrospective analysis of patients diagnosed between 2005 and 2017
Bong Kyung Bae, Jeong Il Yu, Hee Chul Park, Myung Ji Goh, Yong-Han Paik
Radiation Oncology Journal.2023; 41(2): 98. CrossRef
Radiotherapy plus anti-PD1 versus radiotherapy for hepatic toxicity in patients with hepatocellular carcinoma
Rui-Jun Zhang, Hong-Mei Zhou, Hai-Yan Lu, Hong-Ping Yu, Wei-Zhong Tang, Mo-Qin Qiu, Liu-Ying Yan, Mei-Ying Long, Ting-Shi Su, Bang-De Xiang, Mei-Ling He, Xiao-Ting Wang, Shi-Xiong Liang, Jian-Xu Li
Radiation Oncology.2023;[Epub] CrossRef
Low-dose radiotherapy combined with dual PD-L1 and VEGFA blockade elicits antitumor response in hepatocellular carcinoma mediated by activated intratumoral CD8+ exhausted-like T cells
Siqi Li, Kun Li, Kang Wang, Haoyuan Yu, Xiangyang Wang, Mengchen Shi, Zhixing Liang, Zhou Yang, Yongwei Hu, Yang Li, Wei Liu, Hua Li, Shuqun Cheng, Linsen Ye, Yang Yang
Nature Communications.2023;[Epub] CrossRef
Stereotactic ablative radiotherapy for pulmonary oligometastases from primary hepatocellular carcinoma: a multicenter and retrospective analysis (KROG 17-08)
In Young Jo, Hee Chul Park, Eun Seog Kim, Seung-Gu Yeo, Myungsoo Kim, Jinsil Seong, Jun Won Kim, Tae Hyun Kim, Won Sup Yoon, Bae Kwon Jeong, Sung Hwan Kim, Jong Hoon Lee
Japanese Journal of Clinical Oncology.2022; 52(6): 616. CrossRef
Efficacy and feasibility of surgery and external radiotherapy for hepatocellular carcinoma with portal invasion: A meta-analysis
Han Ah Lee, Yeon Seok Seo, In-Soo Shin, Won Sup Yoon, Hye Yoon Lee, Chai Hong Rim
International Journal of Surgery.2022; 104: 106753. CrossRef
Trend Analysis and Prediction of Hepatobiliary Pancreatic Cancer Incidence and Mortality in Korea
Hyeong Min Park, Young-Joo Won, Mee Joo Kang, Sang-Jae Park, Sun-Whe Kim, Kyu-Won Jung, Sung-Sik Han
Journal of Korean Medical Science.2022;[Epub] CrossRef
Radiofrequency ablation and stereotactic body radiotherapy for hepatocellular carcinoma: should they clash or reconcile?
Chai Hong Rim, Hye Yoon Lee, Jung Sun Kim, Hakyoung Kim
International Journal of Radiation Biology.2021; 97(2): 111. CrossRef
Therapeutic Decision Making in Hepatocellular Carcinoma According to Age and Child–Pugh Class: A Nationwide Cohort Analysis in South Korea
Sunmin Park, Chai Hong Rim, Young Kul Jung, Won Sup Yoon, Alessandro Granito
Canadian Journal of Gastroenterology and Hepatology.2021; 2021: 1. CrossRef
Benefits of Local Treatment Including External Radiotherapy for Hepatocellular Carcinoma with Portal Invasion
Han Lee, Sunmin Park, Yeon Seo, Won Yoon, Chai Rim
Biology.2021; 10(4): 326. CrossRef
Phase I Radiation Dose-Escalation Study to Investigate the Dose-Limiting Toxicity of Concurrent Intra-Arterial Chemotherapy for Unresectable Hepatocellular Carcinoma
Yeona Cho, Jun Won Kim, Ja Kyung Kim, Kwan Sik Lee, Jung Il Lee, Hyun Woong Lee, Kwang-Hun Lee, Seung-Moon Joo, Jin Hong Lim, Ik Jae Lee
Cancers.2020; 12(6): 1612. CrossRef
Do Biliary Complications after Proton Beam Therapy for Perihilar Hepatocellular Carcinoma Matter?
Gyu Sang Yoo, Jeong Il Yu, Hee Chul Park, Dongho Hyun, Woo Kyoung Jeong, Ho Yeong Lim, Moon Seok Choi, Sang Yun Ha
Cancers.2020; 12(9): 2395. CrossRef
Combinational Immunotherapy for Hepatocellular Carcinoma: Radiotherapy, Immune Checkpoint Blockade and Beyond
Yun Hua Lee, David Tai, Connie Yip, Su Pin Choo, Valerie Chew
Frontiers in Immunology.2020;[Epub] CrossRef

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The Impact of Surgical Timing on Pathologic Tumor Response after Short Course and Long Course Preoperative Chemoradiation for Locally Advanced Rectal Adenocarcinoma: Sea-Won Lee, Jong Hoon Lee, In Kyu Lee, Seong Taek Oh, Dae Yong Kim, Tae Hyun Kim, Jae Hwan Oh, Ji Yeon Baek, Hee Jin Chang, Hee Chul Park, Hee Cheol Kim, Eui Kyu Chie, Taek-Keun Nam, Hong Seok Jang; Cancer Res Treat. 2018;50(3):1039-1050. Published online November 21, 2017; DOI: https://doi.org/10.4143/crt.2017.252

Abstract PDF PubReader ePub

Purpose
A pooled analysis of multi-institutional trials was performed to analyze the effect of surgical timing on tumor response by comparing short course concurrent chemoradiotherapy (CCRT) with long course CCRT followed by delayed surgery in locally advanced rectal cancer.
Materials and Methods
Three hundred patients with cT3-4N0-2 rectal adenocarcinoma were included. Long course patients from KROG 14-12 (n=150) were matched 1:1 to 150 short course patients from KROG 10-01 (NCT01129700) and KROG 11-02 (NCT01431599) according to stage, age, and other risk factors. The primary endpoint was to determine the interval between surgery and the last day of neoadjuvant CCRT which yields the best tumor response after the short course and long course CCRT. Downstaging was defined as ypT0-2N0M0 and pathologic complete response (ypCR) was defined as ypT0N0M0, respectively.
Results
Both the long and short course groups achieved lowest downstaging rates at < 6 weeks (long 20% vs. short 8%) and highest downstaging rates at 6-7 weeks (long 44% vs. short 40%). The ypCR rates were lowest at < 6 weeks (both long and short 0%) and highest at 6-7 weeks (long 21% vs. short 11%) in both the short and long course arms. The downstaging and ypCR rates of long course group gradually declined after the peak at 6-7 weeks and those of the short course group trend to constantly increase afterwards.
Conclusion
It is optimal to perform surgery at least 6 weeks after both the short course and long course CCRT to obtain maximal tumor regression in locally advanced rectal adenocarcinoma.

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Association between personality types and low anterior resection syndrome in rectal cancer patients following surgery
Ting‐Yu Chiang, Yu‐Jen Hsu, Yih‐Jong Chern, Chun‐Kai Liao, Wen‐Sy Tsai, Pao‐Shiu Hsieh, Hung‐Chih Hsu, Yu‐Fen Lin, Hsiu‐Lan Lee, Jeng‐Fu You
Cancer Medicine.2024;[Epub] CrossRef
Lateral Lymph Node Size and Tumor Distance From Anal Verge Accurately Predict Positive Lateral Pelvic Lymph Nodes in Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Diseases of the Colon & Rectum.2023; 66(6): 785. CrossRef
Robotic Lateral Pelvic Lymph Node Dissection Could Harvest More Lateral Pelvic Lymph Nodes over Laparoscopic Approach for Mid-to-Low Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ri Na Yoo, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Biomedicines.2023; 11(6): 1556. CrossRef
Does a long interval between neoadjuvant chemoradiotherapy and surgery benefit the clinical outcomes of locally advanced rectal cancer? A systematic review and meta analyses
Miao Yu, Deng-Chao Wang, Sheng Li, Li-Yan Huang, Jian Wei
International Journal of Colorectal Disease.2022; 37(4): 855. CrossRef
Predicting Factors of Complete Pathological Response in Locally Advanced Rectal Cancer
AmirHossein Latif, Mohammad Shirkhoda, Mohammad Reza Rouhollahi, Saeed Nemati, Seyed Hossein Yahyazadeh, Kazem Zendehdel, Ahmad Reza Soroush, Aidin Yaghoobi Notash
Middle East Journal of Digestive Diseases.2022; 14(4): 443. CrossRef
Practical recommendation for treatment of patients with colon cancer during covid-19 pandemic
M. Yu. Fedyanin
Meditsinskiy sovet = Medical Council.2020; (9): 213. CrossRef
Meta-analysis of the effect of extending the interval after long-course chemoradiotherapy before surgery in locally advanced rectal cancer
É J Ryan, D P O'Sullivan, M E Kelly, A Z Syed, P C Neary, P R O'Connell, D O Kavanagh, D C Winter, J M O'Riordan
British Journal of Surgery.2019; 106(10): 1298. CrossRef
Preoperative short-course radiotherapy (5 × 5 Gy) with delayed surgery versus preoperative long-course radiotherapy for locally resectable rectal cancer: a meta-analysis
Wang Qiaoli, Huang Yongping, Xiong Wei, Xu Guoqiang, Ju Yunhe, Liu Qiuyan, Li Cheng, Guo Mengling, Li Jiayi, Xiong Wei, Yang Yi
International Journal of Colorectal Disease.2019; 34(12): 2171. CrossRef
Comparison of long course and short course preoperative radiotherapy in the treatment of locally advanced rectal cancer: a systematic review and meta-analysis
Yongjun Yu, Yuwei Li, Chen Xu, Zhao Zhang, Xipeng Zhang
Revista Española de Enfermedades Digestivas.2018;[Epub] CrossRef

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Redefining the Positive Circumferential Resection Margin by Incorporating Preoperative Chemoradiotherapy Treatment Response in Locally Advanced Rectal Cancer: A Multicenter Validation Study: Joo Ho Lee, Eui Kyu Chie, Seung-Yong Jeong, Tae-You Kim, Dae Yong Kim, Tae Hyun Kim, Sun Young Kim, Ji Yeon Baek, Hee Jin Chang, Min Ju Kim, Sung Chan Park, Jae Hwan Oh, Sung Hwan Kim, Jong Hoon Lee, Doo Ho Choi, Hee Chul Park, Sung-Bum Kang, Jae-Sung Kim; Cancer Res Treat. 2018;50(2):506-517. Published online May 24, 2017; DOI: https://doi.org/10.4143/crt.2016.607

Abstract PDF PubReader ePub

Purpose
This study was conducted to validate the prognostic influence of treatment response among patients with positive circumferential resection margin for locally advanced rectal cancer.
Materials and Methods
Clinical data of 197 patientswith positive circumferentialresection margin defined as ≤ 2 mm after preoperative chemoradiotherapy followed by total mesorectal excision between 2004 and 2009were collected forthis multicenter validation study. All patients underwent median 50.4Gy radiationwith concurrentfluoropyrimidine based chemotherapy. Treatmentresponse was dichotomized to good response, including treatmentresponse of grade 2 or 3, and poor response, including grade 0 or 1.
Results
After 52 months median follow-up, 5-year overall survival (OS) for good responders and poor responders was 79.1% and 48.4%, respectively (p < 0.001). In multivariate analysis, circumferential resection margin involvement and treatment response were a prognosticator for OS and locoregional recurrence-free survival. In subgroup analysis, good responders with close margin showed significantly better survival outcomes for survival. Good responders with involved margin and poor responders with close margin shared similar results, whereas poorresponderswith involved margin hadworst survival (5-year OS, 81.2%, 57.0%, 50.0%, and 32.4%, respectively; p < 0.001).
Conclusion
Among patients with positive circumferential resection margin after preoperative chemoradiotherapy, survival of the good responders was significantly better than poor responders. Subgroup analysis revealed that definition of positive circumferential resection margin may be individualized as involvement for good responders, whereas ≤ 2 mm for poor responders.

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Tailored Strategy for Locally Advanced Rectal Carcinoma (GRECCAR 4): Long-term Results From a Multicenter, Randomized, Open-Label, Phase II Trial
Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stephanie Nougaret
Diseases of the Colon & Rectum.2022; 65(8): 986. CrossRef
Colorectal Cancer Surgery Quality in Manitoba: A Population-Based Descriptive Analysis
Iresha Ratnayake, Jason Park, Natalie Biswanger, Allison Feely, Grace Musto, Kathleen Decker
Current Oncology.2021; 28(3): 2239. CrossRef

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Clinical Practice Patterns of Radiotherapy in Patients with Hepatocellular Carcinoma: A Korean Radiation Oncology Group Study (KROG 14-07): Hyejung Cha, Hee Chul Park, Jeong Il Yu, Tae Hyun Kim, Taek-Keun Nam, Sang Min Yoon, Won Sup Yoon, Jun Won Kim, Mi Sook Kim, Hong Seok Jang, Youngmin Choi, Jin Hee Kim, Chul Seung Kay, Inkyung Jung, Jinsil Seong; Cancer Res Treat. 2017;49(1):61-69. Published online June 13, 2016; DOI: https://doi.org/10.4143/crt.2016.097

Abstract PDF PubReader ePub

Purpose
The aim of this study was to examine patterns of radiotherapy (RT) in Korean patients with hepatocellular carcinoma (HCC) according to the evolving guideline for HCC established by the Korean Liver Cancer Study Group-National Cancer Center (KLCSG-NCC).
Materials and Methods
We reviewed 765 patients with HCC who were treated with RT between January 2011 and December 2012 in 12 institutions.
Results
The median follow-up period was 13.3 months (range, 0.2 to 51.7 months). Compared with previous data between 2004 and 2005, the use of RT as a first treatment has increased (9.0% vs. 40.8%). Increased application of intensity-modulated RT resulted in an increase in radiation dose (fractional dose, 1.8 Gy vs. 2.5 Gy; biologically effective dose, 53.1 Gy₁₀ vs. 56.3 Gy₁₀). Median overall survival was 16.2 months, which is longer than that reported in previous data (12 months). In subgroup analysis, treatments were significantly different according to stage (p < 0.001). Stereotactic body RT was used in patients with early HCC, and most patients with advanced stage were treated with three-dimensional conformal RT.
Conclusion
Based on the evolving KLCSG-NCC practice guideline for HCC, clinical practice patterns of RT have changed. Although RT is still used mainly in advanced HCC, the number of patients with good performance status who were treated with RT as a first treatment has increased. This change in practice patterns could result in improvement in overall survival.

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Korean Journal of Radiology.2019; 20(7): 1042. CrossRef
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Sun Hyun Bae, Hee Chul Park, Won Sup Yoon, Sang Min Yoon, In-Hye Jung, Ik Jae Lee, Jun Won Kim, Jinsil Seong, Tae Hyun Kim, Taek-Keun Nam, Youngmin Choi, Sun Young Lee, Hong Seok Jang, Dong Soo Lee, Jin Hee Kim
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Peter R. Galle, Alejandro Forner, Josep M. Llovet, Vincenzo Mazzaferro, Fabio Piscaglia, Jean-Luc Raoul, Peter Schirmacher, Valérie Vilgrain
Journal of Hepatology.2018; 69(1): 182. CrossRef

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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

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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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Different decision-making in spine metastasis management among radiation oncologists and orthopedic surgeons: a Korean online survey study
Hwa Kyung Byun, Woong Sub Koom, Se-Jun Park, Sang-Il Kim, Jin Ho Kim, Young-Hoon Kim, Bong-Soon Chang, Yong Chan Ahn
Frontiers in Neurology.2024;[Epub] CrossRef
The Feasibility of Spinal Stereotactic Radiosurgery for Spinal Metastasis with Epidural Cord Compression
Yi-Jun Kim, Jin Ho Kim, Kyubo Kim, Hak Jae Kim, Eui Kyu Chie, Kyung Hwan Shin, Hong-Gyun Wu, Il Han Kim
Cancer Research and Treatment.2019; 51(4): 1324. CrossRef
Evaluation of predictive factors of vertebral compression fracture after conventional palliative radiotherapy for spinal metastasis from colorectal cancer
Jeongshim Lee, Woo Joong Rhee, Jee Suk Chang, Sei Kyung Chang, Woong Sub Koom
Journal of Neurosurgery: Spine.2018; 28(3): 333. CrossRef
Spine Metastasis Practice Patterns among Korean, Chinese, and Japanese Radiation Oncologists: A Multinational Online Survey Study
Jeong Il Yu, Hee Chul Park, Yong Chan Ahn, Xian-Shu Gao, Jun-Jie Wang, Zhao-Chong Zeng, Yoshinori Ito, Tatsuya Ohno, Yasumasa Nishimura
Journal of Radiation Research.2017; 58(1): 155. CrossRef
Nephrologists' likelihood of referring patients for kidney transplant based on hypothetical patient scenarios
Ankita Tandon, Ming Wang, Kevin C. Roe, Surju Patel, Nasrollah Ghahramani
Clinical Kidney Journal.2016; 9(4): 611. CrossRef
The Effect of Perioperative Radiation Therapy on Spinal Bone Fusion Following Spine Tumor Surgery
Tae-Kyum Kim, Wonik Cho, Sang Min Youn, Ung-Kyu Chang
Journal of Korean Neurosurgical Society.2016; 59(6): 597. CrossRef

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Do Biliary Complications after Hypofractionated Radiation Therapy in Hepatocellular Carcinoma Matter?: Jeong Il Yu, Hee Chul Park, Do Hoon Lim, Seung Woon Paik; Cancer Res Treat. 2016;48(2):574-582. Published online July 17, 2015; DOI: https://doi.org/10.4143/crt.2015.076

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study is to evaluate the efficacy of hypofractionated radiation therapy (RT) in the treatment of unresectable hepatocellular carcinoma (HCC) after failure of transarterial chemoembolization (TACE) or in cases of refractory HCC, and to investigate biliary complications after hypofractionated RT. Materials and Methods We retrospectively enrolled patients with unresectable, TACE-unresponsive, or refractory HCC treated with hypofractionated RT between July 2006 and December 2012. The perihilar region was defined as the 1-cm area surrounding the right, left, and the common hepatic duct, including the gallbladder and the cystic duct. Significant elevation of total bilirubin was defined as an increase of more than 3.0 mg/dL, and more than two times that of the previous level after completion of RT.
Results
Fifty patients received hypofractionated RT and 27 (54%) had a tumor located within the perihilar region. The median follow-up period was 24.7 months (range, 4.3 to 95.5 months). None of the patients developed classic radiation disease symptoms, but four patients (8%) showed significant elevation of total bilirubin within 1 year after RT. During follow-up, 12 patients (24%) developed radiologic biliary abnormalities, but only two patients had toxicities requiring intervention. Estimated local progression-free survival, progression-free survival, and overall survival of the patients at 3-year post-hypofractionated RT were 89.7%, 11.2%, and 57.4%, respectively. Conclusion Biliary complications associated with a higher dose exposure of hypofractionated RT were minimal, even in the perihilar region. Hypofractionated RT provided excellent local control and may be a valuable option for treatment of unresectable cases of TACE-unresponsive or refractory HCC.

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Sunmin Park, Chai Hong Rim, Won Sup Yoon
Saudi Journal of Gastroenterology.2024;[Epub] CrossRef
Comparative analysis of clinical treatment outcomes: Breath‐hold vs. free‐breathing techniques in liver stereotactic body radiotherapy
Kosuke Morishima, Hideomi Yamashita, Tomoyuki Noyama, Atsuto Katano
Journal of Medical Imaging and Radiation Oncology.2024;[Epub] CrossRef
Pencil Beam Scanning Carbon Ion Radiotherapy for Hepatocellular Carcinoma
Wenna Zhang, Xin Cai, Jiayao Sun, Weiwei Wang, Jingfang Zhao, Qing Zhang, Guoliang Jiang, Zheng Wang
Journal of Hepatocellular Carcinoma.2023; Volume 10: 2397. CrossRef
Hypofractionation in Hepatocellular Carcinoma – The Effect of Fractionation Size
S. Lewis, A. Barry, M.A. Hawkins
Clinical Oncology.2022; 34(5): e195. CrossRef
Potential of novel colchicine dosage schedule for the palliative treatment of advanced hepatocellular carcinoma
Zu‐Yau Lin, Ming‐Lun Yeh, Ching‐I Huang, Shinn‐Cherng Chen, Chung‐Feng Huang, Jee‐Fu Huang, Chia‐Yen Dai, Ming‐Lung Yu, Wan‐Long Chuang
The Kaohsiung Journal of Medical Sciences.2021; 37(7): 616. CrossRef
The feasibility of transcatheter arterial chemoembolization following radiation therapy for hepatocellular carcinoma
Mostafa Hamada, Eisuke Ueshima, Takeaki Ishihara, Yutaka Koide, Takuya Okada, Hiroki Horinouchi, Jun Ishida, Hiroshi Mayahara, Koji Sasaki, Tomoyuki Gentsu, Keitaro Sofue, Masato Yamaguchi, Ryohei Sasaki, Koji Sugimoto, Takamichi Murakami
Acta Radiologica Open.2021;[Epub] CrossRef
Stereotactic body radiation therapy vs. radiofrequency ablation in Asian patients with hepatocellular carcinoma
Nalee Kim, Jason Cheng, Inkyung Jung, Ja Der Liang, Yu Lueng Shih, Wen-Yen Huang, Tomoki Kimura, Victor H.F. Lee, Zhao Chong Zeng, Ren Zhenggan, Chul Seung Kay, Seok Jae Heo, Jong Yoon Won, Jinsil Seong
Journal of Hepatology.2020; 73(1): 121. CrossRef
Do Biliary Complications after Proton Beam Therapy for Perihilar Hepatocellular Carcinoma Matter?
Gyu Sang Yoo, Jeong Il Yu, Hee Chul Park, Dongho Hyun, Woo Kyoung Jeong, Ho Yeong Lim, Moon Seok Choi, Sang Yun Ha
Cancers.2020; 12(9): 2395. CrossRef
Clinical significance of radiotherapy before and/or during nivolumab treatment in hepatocellular carcinoma
Jeong Il Yu, Su Jin Lee, Jeeyun Lee, Ho Yeong Lim, Seung Woon Paik, Gyu Sang Yoo, Changhoon Choi, Hee Chul Park
Cancer Medicine.2019; 8(16): 6986. CrossRef
Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?
Kyung Hwa Lee, Jeong Il Yu, Hee Chul Park, Su Yeon Park, Jung Suk Shin, Eun Hyuk Shin, Sungkoo Cho, Sang Hoon Jung, Young Yih Han, Do Hoon Lim
Radiation Oncology Journal.2018; 36(2): 129. CrossRef
Proton therapy for hepatocellular carcinoma: Current knowledges and future perspectives
Gyu Sang Yoo, Jeong Il Yu, Hee Chul Park
World Journal of Gastroenterology.2018; 24(28): 3090. CrossRef
The possibility of radiotherapy as downstaging to living donor liver transplantation for hepatocellular carcinoma with portal vein tumor thrombus
Jin Y. Choi, Jeong I. Yu, Hee C. Park, C. H. David Kwon, Jong M. Kim, Jae‐Won Joh, Gyu‐Seong Choi, Jae B. Park, Sung J. Kim, Seung H. Lee, Won‐Tae Cho, Kyo W. Lee, Byeong‐Gon Na, Dong Kyu Oh, Nuri Lee, Chan W. Cho, Sanghoon Lee, Suk‐Koo Lee
Liver Transplantation.2017; 23(4): 545. CrossRef
Prevention and treatment of complications of selective internal radiation therapy: Expert guidance and systematic review
Bruno Sangro, Diego Martínez‐Urbistondo, Lourens Bester, Jose I. Bilbao, Douglas M. Coldwell, Patrick Flamen, Andrew Kennedy, Jens Ricke, Ricky A. Sharma
Hepatology.2017; 66(3): 969. CrossRef

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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

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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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Advances in targeted therapy for human epidermal growth factor receptor 2 positive in advanced gastric cancer
Ya-Kun Jiang, Wei Li, Ying-Yang Qiu, Meng Yue
World Journal of Gastrointestinal Oncology.2024; 16(6): 2318. CrossRef
Evaluation the benefits of additional radiotherapy for gastric cancer patients after D2 resection using CT based radiomics
Haoze Zheng, Qiao Zheng, Mengmeng Jiang, Didi Chen, Ce Han, Jinling Yi, Yao Ai, Jingyi Yan, Xiance Jin
La radiologia medica.2023; 128(6): 679. CrossRef
The impact of radiation treatment planning technique on unplanned hospital admissions
Sanders Chang, Meng Ru, Erin L. Moshier, Madhu Mazumdar, Doran Ricks, Nathan E. Goldstein, Juan P. Wisnivesky, Kavita V. Dharmarajan
Advances in Radiation Oncology.2018; 3(4): 647. CrossRef
Effects of adjuvant radiotherapy on completely resected gastric cancer: A radiation oncologist’s view of the ARTIST randomized phase III trial
Jeong Il Yu, Do Hoon Lim, Yong Chan Ahn, Jeeyun Lee, Won Ki Kang, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Seung Tae Kim, Sung Kim, Tae Sung Sohn, Min Gew Choi, Jae Moon Bae, Heerim Nam
Radiotherapy and Oncology.2015; 117(1): 171. CrossRef

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Changes in Arterioportal Shunts in Hepatocellular Carcinoma Patients with Portal Vein Thrombosis Who Were Treated with Chemoembolization Followed by Radiotherapy: Dongryul Oh, Sung Wook Shin, Hee Chul Park, Sung Ki Cho, Do Hoon Lim, Seung Woon Paik; Cancer Res Treat. 2015;47(2):251-258. Published online October 27, 2014; DOI: https://doi.org/10.4143/crt.2014.011

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Purpose
In this study, we retrospectively investigated the prevalence of arterioportal (AP) shunts in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) and evaluated the changes in AP shunts after chemoembolization followed by external beam radiation therapy (EBRT).
Materials and Methods
We analyzed 54 HCC patients with PVTT who were treated with chemoembolization followed by EBRT. EBRT was uniformly delivered at a total dose of 30 to 45 Gy (median, 35 Gy), with a daily dose of 2 to 4.5 Gy. Angiographic images of chemoembolization before and after radiation therapy (RT) were reviewed to investigate the AP shunt.
Results
During the initial session of chemoembolization, 33 of 54 patients (61%) had an AP shunt. After EBRT, 32 out of 33 patients had an additional session of chemoembolization and were evaluated for a change in the AP shunt. The AP shunt decreased in 20 of 32 patients (63%) after chemoembolization followed by EBRT. The 1-year calculated overall survival (OS) rate for all patients was 52.6% and the 2-year OS was 36.4%. The median OS in all patients was 13 months. Patients with AP shunt showed poorer median OS than those without AP shunt, but there was no statistically significant difference (median, 12 months vs. 17 months).
Conclusion
The AP shunt frequently occurs in HCC patients with PVTT. This study suggests that a poor prognosis is associated with an AP shunt. Chemoembolization followed by RT may produce a decrease in AP shunts.

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Sorafenib plus drug-eluting bead transarterial chemoembolization for early intrahepatic stage-progressed advanced hepatocellular carcinoma refractory to conventional transarterial chemoembolization
Wenzhe Fan, Bowen Zhu, Xinlin Zheng, Shufan Yue, Mingjian Lu, Huishuang Fan, Liangliang Qiao, Fuliang Li, Guosheng Yuan, Yanqin Wu, Xinhua Zou, Hongyu Wang, Miao Xue, Jiaping Li
Journal of Cancer Research and Clinical Oncology.2023; 149(5): 1873. CrossRef
Drug-eluting beads TACE is safe and non-inferior to conventional TACE in HCC patients with TIPS
Wenzhe Fan, Jian Guo, Bowen Zhu, Shutong Wang, Lei Yu, Wanchang Huang, Huishuang Fan, Fuliang Li, Yanqin Wu, Yue Zhao, Yu Wang, Miao Xue, Hongyu Wang, Jiaping Li
European Radiology.2021; 31(11): 8291. CrossRef
Diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging after radiation therapy for bone metastases in patients with hepatocellular carcinoma
Ji Hyun Lee, Gyu Sang Yoo, Young Cheol Yoon, Hee Chul Park, Hyun Su Kim
Scientific Reports.2021;[Epub] CrossRef
Multidisciplinary treatment of advanced hepatocellular carcinoma with severe arterioportal shunt: a case report
Yao-chang Luo, Hai-lin Lu, Wen-ling Song, Fei-fei Xuan
Journal of International Medical Research.2021;[Epub] CrossRef
Efficacy and safety of transjugular intrahepatic portosystemic shunt combined with transcatheter embolization/chemoembolization in hepatocellular carcinoma with portal hypertension and arterioportal shunt
Hai-lin Lu, Fei-fei Xuan, Yao-chang Luo, Xiao Qin
Abdominal Radiology.2021; 46(11): 5417. CrossRef
Portal stent with endovascular brachytherapy improves the efficacy of TACE for hepatocellular carcinoma with main portal vein tumor thrombus
Tian Li, Chong Liu, Jin-Tong He, Kai-Da Sui, Zhou-Bo Zhang, Duo Hong, Hong-Ying Su, Hai-Bo Shao
Hepatobiliary & Pancreatic Diseases International.2020; 19(2): 187. CrossRef
Sorafenib Reduced Significantly Heptopulmonary Shunt in a Large Hepatocelullar Carcinoma
Philippe d'Abadie, Ivan Borbath, Pierre Goffette, Nadia Amini, Renaud Lhommel
Clinical Nuclear Medicine.2019; 44(1): 70. CrossRef
Hepatopulmonary shunting on Tc99m-MAA liver mapping: correlation with dynamic cross-sectional imaging and description of different shunting patterns
Mohammed Bermo, Manuela C. Matesan, Malak Itani, Fatemeh Behnia, Hubert J. Vesselle
Abdominal Radiology.2018; 43(11): 3001. CrossRef
Chemoembolisation with polyvinyl alcohol for advanced hepatocellular carcinoma with portal vein tumour thrombosis and arterioportal shunts: efficacy and prognostic factors
L. Xiao, Q. Liu, W. Zhao, H. Pang, Q. Zeng, Y. Chen, J. Zhao, Q. Mei, X. He
Clinical Radiology.2018; 73(12): 1056.e17. CrossRef
Polyvinyl alcohol terminal chemoembolization for hepatocellular carcinoma with hepatic arteriovenous shunts: Safety, efficacy, and prognostic factors
Qiu-song Liu, Que-lin Mei, Yan-hao Li
European Journal of Radiology.2017; 89: 277. CrossRef
Is a Technetium-99m Macroaggregated Albumin Scan Essential in the Workup for Selective Internal Radiation Therapy with Yttrium-90? An Analysis of 532 Patients
Lidia Sancho, Macarena Rodriguez-Fraile, Jose Ignacio Bilbao, Carmen Beorlegui Arteta, Mercedes Iñarrairaegui, Veronica Moran, Bruno Sangro
Journal of Vascular and Interventional Radiology.2017; 28(11): 1536. CrossRef
Clinical impact of combined transarterial chemoembolization and radiotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: An external validation study
Jeong Il Yu, Jae Won Park, Hee Chul Park, Sang Min Yoon, Do Hoon Lim, Joon Hyeok Lee, Han Chu Lee, Seon Woo Kim, Jong Hoon Kim
Radiotherapy and Oncology.2016; 118(2): 408. CrossRef

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Multicenter Validation Study of a Prognostic Index for Portal Vein Tumor Thrombosis in Hepatocellular Carcinoma: Jeong Il Yu, Sang Min Yoon, Hee Chul Park, Jong Hoon Kim, Tae Hyun Kim, Joong-Won Park, Jinsil Seong, Ik Jae Lee, Hong Seok Jang, Chul Seung Kay, Chul Yong Kim, Eui Kyu Chie, Jin Hee Kim, Mi-Sook Kim, Young Min Choi; Cancer Res Treat. 2014;46(4):348-357. Published online July 16, 2014; DOI: https://doi.org/10.4143/crt.2013.142

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Purpose
We previously reported on a staging system and prognostic index (PITH) for portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) patients treated with radiotherapy (RT) at a single institution. The aim of this study is to validate the PITH staging system using data from patients at other institutions and to compare it with other published staging systems. Materials and Methods A total of 994 HCC patients with PVTT who were treated with RT between 1998 and 2011 by the Korean Radiation Oncology Group were analyzed retrospectively. All patients were staged using the Cancer of the Liver Italian Program (CLIP), Japanese Integrated Staging (JIS), Okuda, and PITH staging systems, and survival data were analyzed. The likelihood ratio, Akaike information criteria (AIC), time-dependent receiver operating characteristics, and prediction error curve analysis were used to determine discriminatory ability for comparison of staging systems. Results The median survival was 9.2 months. Compared with the other staging systems, the PITH score gave the highest values for likelihood ratio and lowest AIC values, demonstrating that PITH may be a better prognostic model. Although the values were not significant and differences were not exceptional, the PITH score showed slightly better performance with respect to time-dependent area under curve and integrated Brier score of prediction error curve. Conclusion The PITH staging system was validated in this multicenter retrospective study and showed better stratification ability in HCC patients with PVTT than other systems.

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Efficacy and safety of radiotherapy combined with atezolizumab plus bevacizumab in treating hepatocellular carcinoma with portal vein tumour thrombus: a study protocol
Kang Wang, Hong-Ming Yu, Yan-Jun Xiang, Yu-Qiang Cheng, Qian-Zhi Ni, Wei-Xing Guo, Jie Shi, Shuang Feng, Jian Zhai, Shu-Qun Cheng
BMJ Open.2022; 12(12): e064688. CrossRef
Comparison of Transcatheter Arterial Chemoembolization-Radiofrequency Ablation and Transcatheter Arterial Chemoembolization Alone for Advanced Hepatocellular Carcinoma with Macrovascular Invasion Using Propensity Score Analysis: A Retrospective Cohort Stu
Yao Liu, Yuxin Li, Fangyuan Gao, Qun Zhang, Xue Yang, Bingbing Zhu, Shuaishuai Niu, Yunyi Huang, Ying Hu, Wei Li, Xianbo Wang
Journal of Oncology.2020; 2020: 1. CrossRef
2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma
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Outcome of transarterial chemoembolization in Egyptian patients with hepatocellular carcinoma and branch portal vein thrombosis
H. Abdella, M. K. Shaker, Iman Fawzy Montasser, M. Sobhi, H. Aly, A. Sayed, S. Saleh, A. El Dorry
Indian Journal of Gastroenterology.2018; 37(2): 127. CrossRef
Strategic application of radiotherapy for hepatocellular carcinoma
Seo Hee Choi, Jinsil Seong
Clinical and Molecular Hepatology.2018; 24(2): 114. CrossRef
Proton therapy for hepatocellular carcinoma: Current knowledges and future perspectives
Gyu Sang Yoo, Jeong Il Yu, Hee Chul Park
World Journal of Gastroenterology.2018; 24(28): 3090. CrossRef
Radiotherapy as valid modality for hepatocellular carcinoma with portal vein tumor thrombosis
Jeong Il Yu, Hee Chul Park
World Journal of Gastroenterology.2016; 22(30): 6851. CrossRef
Radiotherapy for liver tumors
Florence K Keane, Shyam K Tanguturi, Andrew X Zhu, Laura A Dawson, Theodore S Hong
Hepatic Oncology.2015; 2(2): 133. CrossRef
New perspectives on the management of hepatocellular carcinoma with portal vein thrombosis
Hyun Young Woo, Jeong Heo
Clinical and Molecular Hepatology.2015; 21(2): 115. CrossRef
Current management of hepatocellular carcinoma: An Eastern perspective
Hyung Joon Yim
World Journal of Gastroenterology.2015; 21(13): 3826. CrossRef
Portal vein thrombosis: What is new?
María del Carmen Manzano-Robleda, Beatriz Barranco-Fragoso, Misael Uribe, Nahum Méndez-Sánchez
Annals of Hepatology.2015; 14(1): 20. CrossRef

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Outcome of Local Excision Following Preoperative Chemoradiotherapy for Clinically T2 Distal Rectal Cancer: A Multicenter Retrospective Study (KROG 12-06): Jae Myoung Noh, Won Park, Jae-Sung Kim, Woong Sub Koom, Jin Hee Kim, Doo Ho Choi, Hee Chul Park; Cancer Res Treat. 2014;46(3):243-249. Published online July 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.3.243

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Purpose
The aim of this study was to examine the clinical implications of a pathologically complete response after neoadjuvant chemoradiotherapy (CRT) followed by local excision for patients with cT2 rectal cancer who refused radical surgery. Materials and Methods Seventeen patients with cT2 primary rectal cancer within 6 cm from the anal verge who received neoadjuvant CRT and local excision because of patient refusal of radical surgery or poor performance status were included. Two patients had clinical involvement of a regional lymph node. Preoperative radiotherapy was delivered to the whole pelvis at a dose of 44 to 50.4 Gy in 22 to 28 fractions. All patients underwent transanal excision and eight patients (47%) received postoperative chemotherapy. Results Ten patients (59%) achieved ypT0. At a median follow-up period of 75 months (range, 22 to 126 months), four (24%) patients developed recurrence (two locoregional and two distant). The 5-year disease-free survival of all patients was 82%, and was higher in patients with ypT0 (90%) than in patients with ypT1-2 (69%, p=0.1643). Decreased disease-free survival was also observed in patients receiving capecitabine compared with 5-fluorouracil (54% vs. 100%, p=0.0298). Conclusion Local excision could be a feasible alternative to radical surgery in patients with ypT0 after neoadjuvant CRT for cT2 distal rectal cancer without further radical surgery.

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Efficacy of Local Radiotherapy as a Salvage Modality for Hepatocellular Carcinoma Which is Refractory to TACE ( Transcatheter Arterial Chemoembolization ): Hee Chul Park, Jinsil Seong, John Jihoon Lim, Gwi Eon Kim, Kwang Hyub Han, Chae Yoon Chon, Young Myoung Moon, Do Yun Lee, Jong Tae Lee, Chang Ok Suh; J Korean Cancer Assoc. 2000;32(1):220-228.

Abstract: PURPOSE
Transcatheter arterial chemoembolization (TACE) has been actively performed for the treatment of unresectable or inoperable hepatocellular carcinoma. However, for the patients with treatment failure after TACE, few options are available for salvage. The purpose of this study was to investigate the efficacy of local radiotherapy as a salvage moda- lity for treatment failure after TACE.
MATERIALS AND METHODS
From January 1993 to December 1997, 27 patients were included in this study. Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Childs class C, tumors occupying more than two thirds of the entire liver, and performance status on the ECOG scale of more than 3. Mean tumor size was 7.2+/- 2.9 cm. Liver cirrhosis was associated in 10 patients. Portal vein thrombosis was presented in 5 patients. Serum alpha-fetoprotein was positive in 8 patients. According to VICC staging, the number of patients in III and IVA were 17 and 10, respectively. Treatment failure to TACE was evaluated by CT scan and angiography. Radiotherapy was given to the field including tumor with generous margin using 10-MV X-ray. Mean tumor dose was 51.8+-7.9 Gy in daily 1.8 Gy fractions. Tumor response was based on CT scans 4~6 weeks following completion of treatment.
RESULTS
An objective response was observed in 16 of 24 patients who were possible to be evaluated, giving a response rate of 66.7%. Survival rates after salvage radiotherapy at 1, 2, 3 years were 55.9%, 35.7%, and 21.4%, respectively. The median survival was 14 months. Six patients among responders are surviving at present. Acute toxicity included G1 elevation of AST/ALT in 4 patients, G2 thrombocytopenia in 2, G2 hyperbilirubinemia in 5, and G2 hypoalbuminemia in 3. During follow-up, 4 patients developed ascites. At 6 months after treatment, gastric ulcers and duodenal ulcer were developed in 2 and 1 patient, respectively.
CONCLUSION
Local radiotherapy for treatment failure after TACE in hepatocellular carci- noma appears to be a feasible and effective salvage modality. It gives a 66.7% response rate with a median survival of 14 months. Acute toxicity was self-limiting and manageable. Gastric and duodenal ulcer were significant toxicities after treatment. Further studies are required to find optimal methods of radiotherapy to minimize toxicity.

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