Cancer Research and Treatment

Original Articles

Hematologic malignancy

Assessment of Bone Marrow Involvement in Extranodal NK/T-Cell Lymphoma: Positron Emission Tomography versus Bone Marrow Biopsy, and the Significance of Minimal Involvement by EBV+ Cells (KROG 18-09): Tae Hoon Lee, Hyun Ju Kim, Jong Hoon Lee, Jeongshim Lee, Jin Hee Kim, Dongryul Oh, Keun-Yong Eom; Cancer Res Treat. 2024;56(2):688-696. Published online December 11, 2023; DOI: https://doi.org/10.4143/crt.2023.1049

Abstract PDF PubReader ePub: Purpose
This study aims to investigate the diagnostic significance of positron emission tomography/computed tomography (PET/CT) in assessing bone marrow (BM) involvement through a comparison of PET/CT findings with BM biopsy in extranodal natural killer/T-cell lymphoma.
Materials and Methods
The medical records of 193 patients were retrospectively reviewed. Patients were categorized as having early-stage (PET-ES) or advanced-stage (PET-AS) disease based on PET/CT results. The BM involvement was classified into three groups according to BM biopsy: gross BM involvement, minimal BM involvement (defined as the presence of a limited number of Epstein-Barr virus–positive cells in BM), and no involvement. Calculations of the accuracy of PET/CT in detecting BM involvement and analysis of the clinical outcomes (progression-free survival [PFS] and overall survival [OS]) according to the BM biopsy status were performed.
Results
PET/CT exhibited a sensitivity of 64.7% and a specificity of 96.0% in detecting gross BM involvement. For detecting any (both gross and minimal) BM involvement, the sensitivity was 30.4%, while the specificity was 99.0%. Only one patient (0.7%) demonstrated gross BM involvement among the PET-ES group. Survival outcomes of the PET-ES group with minimal BM involvement (3-year PFS, 55.6%; OS, 77.0%) were closer to those of the PET-ES group with no BM involvement (3-year PFS, 62.2%; OS, 80.6%) than to those of the PET-AS group (3-year PFS, 20.1%; OS, 29.9%).
Conclusion
PET/CT exhibits high specificity, but moderate and low sensitivity in detecting gross and minimal BM involvement, respectively. The clinical significance of minimal BM involvement for patients in the PET-ES group may be limited.

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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

Abstract PDF Supplementary Material PubReader ePub

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.

Citations

Citations to this article as recorded by

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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Head/neck cancer

Intensity-Modulated Radiotherapy-Based Reirradiation for Head and Neck Cancer: A Multi-institutional Study by Korean Radiation Oncology Group (KROG 1707): Jeongshim Lee, Tae Hyung Kim, Yeon-Sil Kim, Myungsoo Kim, Jae Won Park, Sung Hyun Kim, Hyun Ju Kim, Chang Geol Lee; Cancer Res Treat. 2020;52(4):1031-1040. Published online July 7, 2020; DOI: https://doi.org/10.4143/crt.2020.310

Abstract PDF Supplementary Material PubReader ePub

Purpose
The benefits of reirradiation for head and neck cancer (HNC) have not been determined. This study evaluated the efficacy of reirradiation using intensity-modulated radiotherapy (IMRT) for recurrent or second primary HNC (RSPHNC) and identified subgroups for whom reirradiation for RSPHNC is beneficial.
Materials and Methods
A total of 118 patients from seven Korean institutions with RSPHNC who underwent IMRT-based reirradiation between 2006 and 2015 were evaluated through retrospective review of medical records. We assessed overall survival (OS) and local control (LC) within the radiotherapy (RT) field following IMRT-based reirradiation. Additionally, the OS curve according to the recursive partitioning analysis (RPA) suggested by the Multi-Institution Reirradiation (MIRI) Collaborative was determined.
Results
At a median follow-up period of 18.5 months, OS at 2 years was 43.1%. In multivariate analysis, primary subsite, recurrent tumor size, interval between RT courses, and salvage surgery were associated with OS. With regard to the MIRI RPA model, the class I subgroup had a significantly higher OS than class II or III subgroups. LC at 2 years was 53.5%. Multivariate analyses revealed that both intervals between RT courses and salvage surgery were prognostic factors affecting LC. Grade 3 or more toxicity and grade 5 toxicity rates were 8.5% and 0.8%, respectively.
Conclusion
IMRT-based reirradiation was an effective therapeutic option for patients with RSPHNC, especially those with resectable tumors and a long interval between RT courses. Further, our patients' population validated the MIRI RPA classification by showing the difference of OS according to MIRI RPA class.

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Re-irradiation for head and neck cancer: outcome and toxicity analysis using a prospective single institution database
Chiara Scolari, André Buchali, Achim Franzen, Robert Förster, Paul Windisch, Stephan Bodis, Daniel R. Zwahlen, Christina Schröder
Frontiers in Oncology.2023;[Epub] CrossRef
Double trouble: A cohort study of re-irradiation and laryngectomy – Severity of and risk for pharyngocutaneous fistula
Jeffrey M. Weinberger, Narmeen abd el Qadir, Nir Hirshoren
Oral Oncology.2022; 134: 106069. CrossRef
Current radiotherapy for recurrent head and neck cancer in the modern era: a state-of-the-art review
Yue Li, Yuliang Jiang, Bin Qiu, Haitao Sun, Junjie Wang
Journal of Translational Medicine.2022;[Epub] CrossRef
Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies
Franco Ionna, Paolo Bossi, Agostino Guida, Andrea Alberti, Paolo Muto, Giovanni Salzano, Alessandro Ottaiano, Fabio Maglitto, Davide Leopardo, Marco De Felice, Francesco Longo, Salvatore Tafuto, Giuseppina Della Vittoria Scarpati, Francesco Perri
Cancers.2021; 13(10): 2371. CrossRef
Re-irradiation for recurrent or second primary head and neck cancer
Hye In Lee, Jin Ho Kim, Soon-Hyun Ahn, Eun-Jae Chung, Bhumsuk Keam, Keun-Yong Eom, Woo-Jin Jeong, Ji-Won Kim, Chan Woo Wee, Hong-Gyun Wu
Radiation Oncology Journal.2021; 39(4): 279. CrossRef

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Dose-Response Relationship between Radiation Dose and Loco-regional Control in Patients with Stage II-III Esophageal Cancer Treated with Definitive Chemoradiotherapy: Hyun Ju Kim, Yang-Gun Suh, Yong Chan Lee, Sang Kil Lee, Sung Kwan Shin, Byung Chul Cho, Chang Geol Lee; Cancer Res Treat. 2017;49(3):669-677. Published online October 6, 2016; DOI: https://doi.org/10.4143/crt.2016.354

Abstract PDF PubReader ePub

Purpose
The correlation between radiation dose and loco-regional control (LRC) was evaluated in patients with stage II-III esophageal cancer treated with definitive concurrent chemoradiotherapy (CRT).
Materials and Methods
Medical records of 236 stage II-III esophageal cancer patients treated with definitive CRT at Yonsei Cancer Center between 1994 and 2013were retrospectively reviewed. Among these, 120 received a radiation dose of < 60 Gy (standard-dose group), while 116 received ≥ 60 Gy (high-dose group). The median doses of radiation in the standard- and high-dose groups were 50.4 and 63 Gy, respectively. Concurrent 5-fluorouracil/cisplatin chemotherapy was administered to most patients.
Results
There were no differences in patient characteristics between the two groups except for high Karnofsky performance status and lower-thoracic lesions being more prevalent in the standard-dose group. The median progression-free survival (PFS) and overall survival (OS) times were 13.2 months and 26.2 months, respectively. Patients in the high-dose group had significantly better 2-year LRC (69.1% vs. 50.3%, p=0.002), median PFS (16.7 months vs. 11.7 months, p=0.029), and median OS (35.1 months vs. 22.3 months, p=0.043). Additionally, LRC exhibited a dose-response relationship and the complete response rate was significantly higher in the high-dose group (p=0.006). There were no significant differences in treatment-related toxicities between the groups.
Conclusion
A higher radiation dose (> 60 Gy) is associated with increased LRC, PFS, and OS in patients with stage II-III esophageal cancer treated with definitive CRT.

Citations

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Current and future on definitive concurrent chemoradiotherapy for inoperable locally advanced esophageal squamous cell carcinoma
Renxian Xie, Qingxin Cai, Tong Chen, Hongxin Huang, Chuangzhen Chen
Frontiers in Oncology.2024;[Epub] CrossRef
Expert consensus on radiotherapy for elderly patients with esophageal cancer in China (2024 edition)

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Involved‐field high‐dose chemoradiotherapy with respiratory motion management for esophageal squamous cell carcinoma
Masaki Matsuda, Takafumi Komiyama, Kan Marino, Shinichi Aoki, Tomoko Akita, Naoki Sano, Hidekazu Suzuki, Masahide Saito, Hikaru Nemoto, Hiroshi Onishi
Thoracic Cancer.2024; 15(33): 2365. CrossRef
The impact of radiation dose on the efficacy of definitive chemoradiotherapy in patients with locally advanced esophageal carcinoma: a systematic review and meta-analysis
Danjing Luo, Qiulu Zhong, Xiaodong Zhu
Cancer Biology & Therapy.2023;[Epub] CrossRef
High-Dose Versus Standard-Dose Intensity-Modulated Radiotherapy With Concurrent Paclitaxel Plus Carboplatin for Patients With Thoracic Esophageal Squamous Cell Carcinoma: A Randomized, Multicenter, Open-Label, Phase 3 Superiority Trial
Jing You, Shuchai Zhu, Jiancheng Li, Jie Li, Junyue Shen, Yidian Zhao, Xiaomin Li, Lin Jia, Qingshan Li, Jun Yang, Yiqun Wu, Wenbin Shen, Haishan Wu, Xueqin Wu, Xiaomin Wang, Yaqiong Ren, Jun He, Pingping Lin, Guangying Zhu, Anhui Shi
International Journal of Radiation Oncology*Biology*Physics.2023; 115(5): 1129. CrossRef
Chemoradiotherapy Combined with Brachytherapy for the Definitive Treatment of Esophageal Carcinoma
Julian Mangesius, Katharina Hörmandinger, Robert Jäger, Sergej Skvortsov, Marlen Plankensteiner, Martin Maffei, Thomas Seppi, Daniel Dejaco, Matthias Santer, Manuel Sarcletti, Ute Ganswindt
Cancers.2023; 15(14): 3594. CrossRef
Do higher radiation doses improve survival for cervical esophageal squamous cell cancer patients treated with definitive chemoradiotherapy using intensity-modulated radiotherapy? A propensity-score matched analysis
Feihong Xie, Tingting Liu, Xinran Wang, Jinling Dong, Wei Huang, Hongfu Sun
Journal of Cancer Research and Therapeutics.2023; 19(6): 1582. CrossRef
Intensity-modulated radiotherapy with more than 60 Gy improved the survival of inoperable patients with locally advanced esophageal squamous cell carcinoma
Wei Zhang, Qing Xie, Bifa Zhu, Xiaokang Wang, Ling He, Yong Zhang
Medicine.2022; 101(16): e29166. CrossRef
A Phase III Multicenter Randomized Clinical Trial of 60 Gy versus 50 Gy Radiation Dose in Concurrent Chemoradiotherapy for Inoperable Esophageal Squamous Cell Carcinoma
Yujin Xu, Baiqiang Dong, Weiguo Zhu, Jiancheng Li, Rong Huang, Zongwen Sun, Xinmei Yang, Liping Liu, Han He, Zhongxing Liao, Ni Guan, Yue Kong, Wanwei Wang, Jianxiang Chen, Huijuan He, Guoqin Qiu, Ming Zeng, Juan Pu, Wangyuan Hu, Yong Bao, Zhigang Liu, Ju
Clinical Cancer Research.2022; 28(9): 1792. CrossRef
Comparative clinical studies of primary chemoradiotherapy versus S-1 and nedaplatin chemotherapy against stage IVb oesophageal squamous cell carcinoma: a multicentre open-label randomised controlled trial
Yun Liu, Narasimha M Beeraka, Junqi Liu, Kuo Chen, Bo Song, Zhang Song, Jianchao Luo, Yang Liu, Anping Zheng, Yanhui Cui, Yang Wang, Zhenhe Jia, Xiangyu Song, Xiaohong Wang, Hongqi Wang, Xuefeng Qi, Jinshan Ren, Liping Wu, Jixing Cai, Xainying Fang, Xin W
BMJ Open.2022; 12(4): e055273. CrossRef
A Novel Model Combining Tumor Length, Tumor Thickness, TNM_Stage, Nutritional Index, and Inflammatory Index Might Be Superior to the 8th TNM Staging Criteria in Predicting the Prognosis of Esophageal Squamous Cell Carcinoma Patients Treated With Definitiv
Xiaohui Chen, Yilin Yu, Haishan Wu, Jianjian Qiu, Dongmei Ke, Yahua Wu, Mingqiang Lin, Tianxiu Liu, Qunhao Zheng, Hongying Zheng, Jun Yang, Zhiping Wang, Hui Li, Lingyun Liu, Qiwei Yao, Jiancheng Li, Wenfang Cheng
Frontiers in Oncology.2022;[Epub] CrossRef
Comparison of involved-field intensity-modulated radiotherapy combined with S-1 vs radiotherapy alone for elderly patients with esophageal cancer
Li-Hua Liu, Mao-Hui Yan, Yu-Peng Di, Zhi-Guang Fu, Xiao-Dan Zhang, Hong-Qi Li
World Journal of Clinical Cases.2022; 10(21): 7365. CrossRef
A combined predicting model for benign esophageal stenosis after simultaneous integrated boost in esophageal squamous cell carcinoma patients (GASTO1072)
Weitong Liu, Chengbing Zeng, Siyan Wang, Yizhou Zhan, Ruihong Huang, Ting Luo, Guobo Peng, Yanxuan Wu, Zihan Qiu, Derui Li, Fangcai Wu, Chuangzhen Chen
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Definitive chemoradiotherapy for clinical T4b esophageal cancer – Treatment outcomes, failure patterns, and prognostic factors
Tzu-Ting Huang, Shau-Hsuan Li, Yen-Hao Chen, Hung-I Lu, Chien-Ming Lo, Fu-Min Fang, Shang-Yu Chou, Yi-Chun Chiu, Yeh-Pin Chou, Yu-Ming Wang
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He-San Luo, He-Cheng Huang, Lian-Xing Lin
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JAMA Oncology.2019; 5(11): 1597. CrossRef
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Hongyao Xu, Shengxi Wu, Hesan Luo, Chuyun Chen, Lianxing Lin, Hecheng Huang, Renliang Xue
Cancer Medicine.2019; 8(14): 6326. CrossRef
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Masaru Hayami, Masayuki Watanabe, Naoki Ishizuka, Shinji Mine, Yu Imamura, Akihiko Okamura, Takanori Kurogochi, Kotaro Yamashita
Journal of Surgical Oncology.2018; 117(6): 1251. CrossRef
Definite intensity‐modulated radiotherapy with concurrent chemotherapy more than 4 cycles improved survival for patients with locally‐advanced or inoperable esophageal squamous cell carcinoma
He‐Yuan Hsieh, Chung‐Ping Hsu, Hui‐Ling Yeh, Cheng‐Yen Chuang, Jai‐Fu Lin, Chen‐Fa Chang
The Kaohsiung Journal of Medical Sciences.2018; 34(5): 281. CrossRef
Comparison of definite chemoradiation therapy with carboplatin/paclitaxel or cisplatin/5-fluoruracil in patients with squamous cell carcinoma of the esophagus
Stefan Münch, Steffi U. Pigorsch, Michal Devečka, Hendrik Dapper, Wilko Weichert, Helmut Friess, Rickmer Braren, Stephanie E. Combs, Daniel Habermehl
Radiation Oncology.2018;[Epub] CrossRef
Definitive radiotherapy dose escalation with chemotherapy for treating non-metastatic oesophageal cancer
Chao-Yueh Fan, Yu-Fu Su, Wen-Yen Huang, Hsing-Lung Chao, Kuen-Tze Lin, Chun-Shu Lin
Scientific Reports.2018;[Epub] CrossRef
The role of definitive chemoradiation in patients with non-metastatic oesophageal cancer
Paul M. Jeene, Hanneke W.M. van Laarhoven, Maarten C.C.M. Hulshof
Best Practice & Research Clinical Gastroenterology.2018; 36-37: 53. CrossRef
Nedaplatin‑based chemotherapy regimens combined with concurrent radiotherapy as first‑line treatment for stage II‑III esophageal squamous cell carcinoma
Huiping Zhu, Xiaolin Ge, Yufeng Lu, Yun Zuo, Qin Qin, Xinchen Sun, Min Yang
Oncology Letters.2018;[Epub] CrossRef
Improved survival with higher radiation dose for esophageal squamous cell carcinoma patients treated with definitive chemoradiotherapy
Yuxia Deng, Chao Bian, Hua Tao, Haijun Zhang
Oncotarget.2017; 8(45): 79662. CrossRef

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