Cancer Research and Treatment

Original Articles

Breast cancer

Postmastectomy Radiation Therapy for Node-Negative Breast Cancer of 5 cm or Larger Tumors: A Multicenter Retrospective Analysis (KROG 20-03): Kyubo Kim, Jinhong Jung, Haeyoung Kim, Wonguen Jung, Kyung Hwan Shin, Ji Hyun Chang, Su Ssan Kim, Won Park, Jee Suk Chang, Yong Bae Kim, Sung Ja Ahn, Ik Jae Lee, Jong Hoon Lee, Hae Jin Park, Jihye Cha, Juree Kim, Jin Hwa Choi, Taeryool Koo, Jeanny Kwon, Jin Hee Kim, Mi Young Kim, Shin-Hyung Park, Yeon-Joo Kim; Cancer Res Treat. 2022;54(2):497-504. Published online August 25, 2021; DOI: https://doi.org/10.4143/crt.2021.933

Purpose
To evaluate the role of postmastectomy radiation therapy (PMRT) in patients with node-negative breast cancer of 5cm or larger tumors undergoing mastectomy
Materials and Methods
Medical records of 274 patients from 18 institutions treated with mastectomy between January 2000 and December 2016 were retrospectively reviewed. Among these, 202 patients underwent PMRT, while 72 did not. Two hundred and forty-one patients (88.0%) received systemic chemotherapy, and 172 (62.8%) received hormonal therapy. Patients receiving PMRT were younger, more likely to have progesterone receptor-positive tumors, and received adjuvant chemotherapy more frequently compared with those without PMRT (p <0.001, 0.018, and <0.001, respectively). Other characteristics were not significantly different between the two groups.
Results
With a median follow-up of 95 months (range, 1-249), there were 9 locoregional recurrences, and 20 distant metastases. The 8-year locoregional recurrence-free survival rates were 98.0% with PMRT and 91.3% without PMRT (p=0.133), and the 8-year disease-free survival (DFS) rates were 91.8% with PMRT and 73.9% without PMRT (p=0.008). On multivariate analysis incorporating age, histologic grade, lymphovascular invasion, hormonal therapy, chemotherapy, and PMRT, the absence of lymphovascular invasion and the receipt of PMRT were associated with improved DFS (p=0.025 and 0.009, respectively).
Conclusion
Locoregional recurrence rate was very low in node-negative breast cancer of 5cm or larger tumors treated with mastectomy regardless of the receipt of PMRT. However, PMRT was significantly associated with improved DFS. Further investigation is needed to confirm these findings.

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Outcomes with and without postmastectomy radiotherapy for pT3N0‐1M0 breast cancer: An institutional experience
Xinxin Rao, Xuanyi Wang, Kairui Jin, Yilan Yang, Xu Zhao, Zhe Pan, Weiluo Lv, Zhen Zhang, Li Zhang, Xiaoli Yu, Xiaomao Guo
Cancer Medicine.2024;[Epub] CrossRef
The effect of radiotherapy on patients with pathological stage IIB breast cancer after breast-conserving surgery or mastectomy: A cohort study
Yi-Ying Pan, Tzu-Yu Lai, Cheng-Ying Shiau, Ling-Ming Tseng, I-Chun Lai, Yu-Ming Liu, Pin-I Huang
Journal of the Chinese Medical Association.2024; 87(2): 202. CrossRef
Post-mastectomy radiation therapy after breast reconstruction: from historic dogmas to practical expert agreements based on a large literature review of surgical and radiation therapy considerations
Yazid Belkacemi, Meena S. Moran, Burcu Celet Ozden, Yazan Masannat, Fady Geara, Mohamed Albashir, Nhu Hanh To, Kamel Debbi, Mahmoud El Tamer
Critical Reviews in Oncology/Hematology.2024; 200: 104421. CrossRef
Impact of the 21-gene recurrence score testing on chemotherapy selection and clinical outcomes in T3N0 luminal breast cancer
Ke Liu, Jia-Yi Li, Guan-Qiao Li, Zhen-Yu He, San-Gang Wu
Expert Review of Anticancer Therapy.2024; : 1. CrossRef
Post-Mastectomy Radiation Therapy: Applications and Advancements
Jessica L. Thompson, Steven G. Allen, Cecilia Pesavento, Corey W. Speers, Jacqueline S. Jeruss
Current Breast Cancer Reports.2022; 14(3): 75. CrossRef

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Effect of Postoperative Radiotherapy after Primary Tumor Resection in De Novo Stage IV Breast Cancer: A Multicenter Retrospective Study (KROG 19-02): Yeon Joo Kim, Yeon-Joo Kim, Yong Bae Kim, Ik Jae Lee, Jeanny Kwon, Kyubo Kim, Jihye Cha, Myungsoo Kim, In Young Jo, Jung Hoon Kim, Jaehyeon Park, Jin Hee Kim, Juree Kim, Kyung Hwan Shin, Su Ssan Kim; Cancer Res Treat. 2022;54(2):478-487. Published online July 12, 2021; DOI: https://doi.org/10.4143/crt.2021.632

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to investigate the impact of postoperative radiotherapy (PORT) in de novo metastatic breast cancer (dnMBC) patients undergoing planned primary tumor resection (PTR) and to identify the subgroup of patients who would most benefit from PORT.
Materials and Methods
This study enrolled 426 patients with dnMBC administered PTR alone or with PORT. The primary and secondary outcomes were overall and progression-free survival (OS and PFS), respectively.
Results
The median follow-up time was 53.7 months (range, 3.1 to 194.4). The 5-year OS and PFS rates were 73.2% and 32.0%, respectively. For OS, clinical T3/4 category, triple-negative breast cancer (TNBC), postoperative chemotherapy alone were significantly poor prognostic factors, and administration of PORT failed to show its significance. Regarding PFS, PORT was a favorable prognostic factor (hazard ratio, 0.64; 95% confidence interval, 0.50 to 0.82; p < 0.001), in addition to T1/2 category, ≤ 5 metastases, and non-TNBC. According to the multivariate analyses of OS in the PORT group, we divided the patients into three groups (group 1, T1/2 and non-TNBC [n=193]; group 2, T3/4 and non-TNBC [n=171]; and group 3, TNBC [n=49]), and evaluated the effect of PORT. Although PORT had no significance for OS in all subgroups, it was a significant factor for good prognosis regarding PFS in groups 1 and 2, not in group 3.
Conclusion
PORT was associated with a significantly better PFS in patients with dnMBC who underwent PTR. Patients with clinical T1/2 category and non-TNBC benefited most from PORT, while those with TNBC showed little benefit.

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Letter to the editor for the article“Tumor margin irregularity degree is an important preoperative predictor of adverse pathology for clinical T1/2 renal cell carcinoma and the construction of predictive model”
Yaping Miao, Lexin Wang, Ping Chen, Jiaan Lu, Guanhu Yang, Hao Chi
World Journal of Urology.2024;[Epub] CrossRef
The prognostic differences and the effect of postmastectomy radiotherapy between post‐chemotherapy ypT1‐2ypN1 and de novo pT1‐2N1 breast cancer
Tian Yang, Xiaorong Zhong, Jun Wang, Zhongzheng Xiang, Yuanyuan Zeng, Siting Yu, Zelei Dai, Ningyue Xu, Ting Luo, Lei Liu
Cancer Medicine.2023; 12(7): 8112. CrossRef
Impact of high dose radiotherapy for breast tumor in locoregionally uncontrolled stage IV breast cancer: a need for a risk-stratified approach
Nalee Kim, Haeyoung Kim, Won Park, Won Kyung Cho, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim
Radiation Oncology.2023;[Epub] CrossRef
Machine learning predicts the prognosis of breast cancer patients with initial bone metastases
Chaofan Li, Mengjie Liu, Jia Li, Weiwei Wang, Cong Feng, Yifan Cai, Fei Wu, Xixi Zhao, Chong Du, Yinbin Zhang, Yusheng Wang, Shuqun Zhang, Jingkun Qu
Frontiers in Public Health.2022;[Epub] CrossRef
Factors Influencing Prognosis in Patients with De Novo Stage IV Breast Cancer: A Systematic Review and Meta-Analysis
Meilin Zhang, Zining Jin, Yingying Xu, Bo Chen, Jian Song, Muyao Li, Feng Jin, Ang Zheng
SSRN Electronic Journal .2022;[Epub] 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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Optimal Adjuvant Treatment for Curatively Resected Thoracic Esophageal Squamous Cell Carcinoma: A Radiotherapy Perspective: Kyung Hwan Kim, Jee Suk Chang, Ji Hye Cha, Ik Jae Lee, Dae Joon Kim, Byoung Chul Cho, Kyung Ran Park, Chang Geol Lee; Cancer Res Treat. 2017;49(1):168-177. Published online June 23, 2016; DOI: https://doi.org/10.4143/crt.2016.142

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to evaluate the benefits of adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma (ESCC) and determine the optimal adjuvant treatments.
Materials and Methods
One hundred ninety-five patients who underwent a curative resection for thoracic ESCC between 1994 and 2014 were reviewed retrospectively. Postoperatively, the patients received no adjuvant treatment (no-adjuvant group, n=68), adjuvant chemotherapy (AC group, n=62), radiotherapy (RT group, n=41), or chemoradiotherapy (CRT group, n=24). Chemotherapy comprised cisplatin and 5-fluorouracil administration every 3 weeks. The median RT dose was 45.0 Gy (range, 34.8 to 59.4 Gy). The overall survival (OS), disease-free survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) rates were estimated.
Results
At a median follow-up duration of 42.2 months (range, 6.3 to 215.2 months), the 5-year OS and DFS were 37.6% and 31.4%, respectively. After adjusting for other clinicopathologic variables, the AC and CRT groups had a significantly better OS and DFS compared to the no-adjuvant group (p < 0.05). The LRR rate was significantly lower in the RT and CRT groups than in the no-adjuvant group (p < 0.05), whereas no significant difference was observed in the AC group. In the no-adjuvant and AC groups, 25% of patients received high-dose salvage RT due to LRR. The DM rates were similar. The anastomotic stenosis and leakage were similar in the treatment groups.
Conclusion
Adjuvant treatment might prolong survival after an ESCC resection, and RT contributes to a reduction of the LRR. Overall, the risks and benefits should be weighed properly when selecting the optimal adjuvant treatment.

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The Society of Thoracic Surgeons/American Society for Radiation Oncology Updated Clinical Practice Guidelines on Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction
Stephanie G. Worrell, Karyn A. Goodman, Nasser K. Altorki, Jonathan B. Ashman, Traves D. Crabtree, Jennifer Dorth, Scott Firestone, David H. Harpole, Wayne L. Hofstetter, Theodore S. Hong, Kalie Kissoon, Geoffrey Y. Ku, Daniela Molena, Joel E. Tepper, Tho
Practical Radiation Oncology.2024; 14(1): 28. CrossRef
The Society of Thoracic Surgeons/American Society for Radiation Oncology Updated Clinical Practice Guidelines on Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction
Stephanie G. Worrell, Karyn A. Goodman, Nasser K. Altorki, Jonathan B. Ashman, Traves D. Crabtree, Jennifer Dorth, Scott Firestone, David H. Harpole, Wayne L. Hofstetter, Theodore S. Hong, Kalie Kissoon, Geoffrey Y. Ku, Daniela Molena, Joel E. Tepper, Tho
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Esophageal cancer: Treatment challenges and controversies
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Journal of Current Oncology.2021; 4(1): 41. CrossRef
Radical esophagectomy for stage II and III thoracic esophageal squamous cell carcinoma followed by adjuvant radiotherapy with or without chemotherapy: Which is more beneficial?
Bingwen Zou, Yan Tu, Duwen Liao, Yong Xu, Jin Wang, Meijuan Huang, Li Ren, Jiang Zhu, Youling Gong, Yongmei Liu, Lin Zhou, Xiaojuan Zhou, Feng Peng, You Lu
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A meta-analysis on surgery with or without postoperative radiotherapy to treat squamous cell esophageal carcinoma
Hao-Nan Lin, Long-Qi Chen, Qi-Xin Shang, Yong Yuan, Yu-Shang Yang
International Journal of Surgery.2020; 80: 184. CrossRef
Homeobox D10, a tumor suppressor, inhibits the proliferation and migration of esophageal squamous cell carcinoma
Jin Zhang, Shiyuan Liu, Danjie Zhang, Zhenchuan Ma, Liangzhang Sun
Journal of Cellular Biochemistry.2019; 120(8): 13717. CrossRef
Adjuvant radiotherapy for stage pN1M0 esophageal squamous cell carcinoma: Results from a Chinese two‐center study
Wenjie Ni, Junqiang Chen, Zefen Xiao, Shufei Yu, Wencheng Zhang, Zongmei Zhou, Dongfu Chen, Qinfu Feng, Xiaohui Chen, Yu Lin, Kunshou Zhu, Shugeng Gao, Qi Xue, Yousheng Mao, Guiyu Cheng, Kelin Sun, Xiangyang Liu, Dekang Fang
Thoracic Cancer.2019; 10(6): 1431. CrossRef
Comparison of the effect of postoperative radiotherapy with surgery alone for esophagus squamous cell carcinoma patients
Xiao-han Zhao, Duo Wang, Fang Wang, Shu-chai Zhu
Medicine.2018; 97(47): e13168. CrossRef
The impact of adjuvant therapies on patient survival and the recurrence patterns for resected stage IIa–IVa lower thoracic oesophageal squamous cell carcinoma
Yichun Wang, Liyang Zhu, Wanli Xia, Liming Wu, Fan Wang
World Journal of Surgical Oncology.2018;[Epub] CrossRef
A retrospective study of pattern of recurrence after radical surgery for thoracic esophageal carcinoma with or without postoperative radiotherapy
Yichun Wang, Li Zhang, Dongmei Ye, Wanli Xia, Jun Jiang, Xiumei Wang, Mingxia Zhang, Fan Wang
Oncology Letters.2018;[Epub] CrossRef
Pattern of lymph node metastasis in thoracic esophageal squamous cell carcinoma with poor differentiation
Jinling Zhang, Yuanyuan Liu, Fengyuan Che, Yi Luo, Wei Huang, Xueyuan Heng, Baosheng Li
Molecular and Clinical Oncology.2018;[Epub] CrossRef
Negative lymph node at station 108 is a strong predictor of overall survival in esophageal cancer
Jinling Zhang, Xueyuan Heng, Yi Luo, Luning Li, Haiyan Zhang, Fengyuan Che, Baosheng Li
Oncology Letters.2018;[Epub] CrossRef

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Altered Biological Potential and Radioresponse of Murine Tumors in Different Microenvironments: Ik Jae Lee, Eun Jeong Lee, Hyojin Park, Wonwoo Kim, Sang-Jun Ha, You Keun Shin, Jinsil Seong; Cancer Res Treat. 2016;48(2):727-737. Published online July 28, 2015; DOI: https://doi.org/10.4143/crt.2014.350

Abstract PDF PubReader ePub

Purpose
This study was conducted to evaluate the biological features of murine hepatocarcinoma according to different tumor microenvironmental models and to determine the change in molecular and immunologic responses after radiation.
Materials and Methods
Tumor models were established in the liver (orthotopic) and thigh (heterotopic) of male C3H/HeN mice. Tumor growth and lung metastasis were assessed in these models. To evaluate the radiation effect, the tumors were irradiated with 10 Gy. Factors associated with tumor microenvironment including vascular endothelial growth factor (VEGF), cyclooxygenase- 2 (COX-2), transforming growth factor beta1 (TGF-β1), CD31, and serum interleukin- 6 (IL-6) were evaluated. Tumor-infiltrating regulatory immune cells, regulatory T cells (Tregs), and myeloid-derived suppressor cells (MDSCs) were also analyzed.
Results
A higher number of lung metastases were observed in the orthotopic tumor model than in the heterotopic tumor model. VEGF, CD31, COX-2, and TGF-β1 expression was more prominent in the orthotopic tumor model than in the heterotopic tumor model. Expression of the angiogenic factor VEGF and key regulatory molecules (TGF-β1 and COX-2) decreased following radiation in the orthotopic tumor model, while the serum IL-6 level increased after radiation. In the orthotopic tumor model, the number of both Tregs and MDSCs in the tumor burden decreased after radiation.
Conclusion
The orthotopic tumor model showed higher metastatic potential and more aggressive molecular features than the heterotopic tumor model. These findings suggest that the orthotopic tumor mouse model may be more reflective of the tumor microenvironment and suitable for use in the translational research of radiation treatment.

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The Effect of Radiation Treatment of Solid Tumors on Neutrophil Infiltration and Function: A Systematic Review
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International Journal of Radiation Oncology*Biology*Physics.2024; 120(3): 845. CrossRef
Polymorphonuclear-MDSCs Facilitate Tumor Regrowth After Radiation by Suppressing CD8+ T Cells
Jieying Zhang, MD, Liling Zhang, MD, Yuhui Yang, MD, Qing Liu, MD, Hong Ma, MD, Ai Huang, MD, Yanxia Zhao, MD, Zihan Xia, MD, Tao Liu, MD, Gang Wu, MD
International Journal of Radiation Oncology*Biology*Physics.2021; 109(5): 1533. CrossRef
Preclinical Quantification of Prostate Cancer-Associated Vascular Alterations in the Bone Microenvironment in vivo
Malte Schroeder, Lennart Viezens, Jördis Sündermann, Svenja Hettenhausen, Gerrit Hauenherm, Jasmin Wellbrock, Haider Mussawy, Kai Kossow, Christian Schaefer
European Surgical Research.2020; 61(6): 188. CrossRef
The bone microenvironment promotes tumor growth and tissue perfusion compared with striated muscle in a preclinical model of prostate cancer in vivo
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BMC Cancer.2018;[Epub] CrossRef

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Surgery Alone Versus Surgery Followed by Chemotherapy and Radiotherapy in Resected Extrahepatic Bile Duct Cancer: Treatment Outcome Analysis of 336 Patients: Jung Ho Im, Jinsil Seong, Ik Jae Lee, Joon Seong Park, Dong Sup Yoon, Kyung Sik Kim, Woo Jung Lee, Kyung Ran Park; Cancer Res Treat. 2016;48(2):583-595. Published online July 22, 2015; DOI: https://doi.org/10.4143/crt.2015.091

Abstract PDF PubReader ePub

Purpose
This study analyzed the outcomes of patients with resected extrahepatic bile duct cancer (EHBDC) in order to clarify the role of adjuvant treatments in these patients.
Materials and Methods
A total of 336 patients with EHBDC who underwent curative resection between 2001 and 2010 were analyzed retrospectively. The treatment types were as follows: surgery alone (n=168), surgery with chemotherapy (CTx, n=90), surgery with radiotherapy (RT) alone (n=29), and surgery with chemoradiotherapy (CRT, n=49).
Results
The median follow-up period was 63 months. The 5-year rates of locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) for all patients were 56.5%, 59.7%, 36.6%, and 42.0%, respectively. In multivariate analysis, surgery with RT and CRT was a significant prognostic factor for LRFFS, and surgery with CTx was a significant prognostic factor for DMFS, and surgery with CTx, RT, and CRT was a significant prognostic factor for PFS (p < 0.05). Surgery with CTx and CRT showed association with superior OS (p < 0.05), and surgery with RT had marginal significance (p=0.078). In multivariate analysis of the R1 resection patients, surgery with CRT showed significant association with OS (p < 0.05).
Conclusion
Adjuvant RT and CTx may be helpful in improving clinical outcomes of patients with resected EHBDC who have a high risk of disease recurrence, particularly R1 resection patients. Conduct of additional prospective, larger-scale studies will be required in order to confirm the benefit of adjuvant RT and CTx in these patients.

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Clinical Benefit of Hepatic Arterial Infusion Concurrent Chemoradiotherapy in Locally Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis: Hong In Yoon, Ki Jun Song, Ik Jae Lee, Do Young Kim, Kwang-Hyub Han, Jinsil Seong; Cancer Res Treat. 2016;48(1):190-197. Published online March 5, 2015; DOI: https://doi.org/10.4143/crt.2014.276

Abstract PDF PubReader ePub

Purpose
The aim of this study was to evaluate whether hepatic arterial infusion concurrent chemoradiotherapy (CCRT) could improve overall survival (OS) in patients with locally advanced hepatocellular carcinoma (LAHCC). Materials and Methods Two databases were reviewed from Yonsei Cancer Center (YCC) and Korean Liver Cancer Study Group (KLCSG) nationwide multi-center hepatocellular carcinoma (HCC) cohort. The CCRT group included 106 patients, with stage III-IV, Child-Pugh classification A, Eastern Cooperative Oncology Group performance status 0 or 1, who underwent definitive CCRT as the initial treatment at YCC. We used propensity score matching to adjust for seven clinical factors, including age, tumor size, TNM stage by the Liver Cancer Study Group of Japan, T stage, Barcelona Clinic Liver Cancer (BCLC) staging system, etiology of HCC, and portal vein invasion, which all differed significantly in the two databases. From the KLCSG cohort enrolled at 32 institutions, 106 patients for the non-CCRT group were defined. Results After propensity score matching, all patient characteristics were balanced between the two groups. The CCRT group had better OS (median, 11.4) than the non-CCRT group (6.6 months; p=0.02). In multivariate analyses for all patients, CCRT (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.11 to 1.97; p=0.007), tumor size (HR, 1.08; 95% CI, 1.04 to 1.12; p < 0.001), and BCLC stage (HR, 0.54; 95% CI, 0.36 to 0.8; p=0.003) were independent prognostic factors for OS. Conclusion CCRT showed better OS for LAHCC patients. In LAHCC patients with a good performance and normal liver function, CCRT could be a feasible treatment option. All of these findings need to be validated in prospective clinical trials.

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Liver-Directed Concurrent Chemoradiotherapy versus Sorafenib in Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis
Jina Kim, Hwa Kyung Byun, Tae Hyung Kim, Sun Il Kim, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Jinsil Seong
Cancers.2022; 14(10): 2396. CrossRef
Selection Strategy of Chemoradiotherapy in Patients with Unoperated Hepatocellular Carcinoma
华温
Advances in Clinical Medicine.2022; 12(08): 7520. CrossRef
Progress in Transformation Therapy of Hepatocellular Carcinoma with Portal Vein Cancer Thrombus
雍博周
Advances in Clinical Medicine.2022; 12(12): 11521. CrossRef
Efficacy and Safety of Liver-Directed Concurrent Chemoradiotherapy and Sequential Sorafenib for Advanced Hepatocellular Carcinoma: A Prospective Phase 2 Trial
Beom Kyung Kim, Do Young Kim, Hwa Kyung Byun, Hye Jin Choi, Seung-Hoon Beom, Hye Won Lee, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Jinsil Seong, Kwang-Hyub Han
International Journal of Radiation Oncology*Biology*Physics.2020; 107(1): 106. CrossRef
Successful palliative radiation therapy for hemobilia and obstructive jaundice due to bile duct invasion of hepatocellular carcinoma: a case report
Shinya Endo, Shinya Kawaguchi, Kazuhisa Asahara, Ryosuke Itai, Shuzo Terada, Naofumi Shirane, Kengo Kuriyama
Kanzo.2020; 61(9): 447. CrossRef
Dose escalation by intensity modulated radiotherapy in liver-directed concurrent chemoradiotherapy for locally advanced BCLC stage C hepatocellular carcinoma
Hwa Kyung Byun, Hyun Ju Kim, Yoo Ri Im, Do Young Kim, Kwang-Hyub Han, Jinsil Seong
Radiotherapy and Oncology.2019; 133: 1. CrossRef
Strategic application of radiotherapy for hepatocellular carcinoma
Seo Hee Choi, Jinsil Seong
Clinical and Molecular Hepatology.2018; 24(2): 114. CrossRef
Factors affecting survival after concurrent chemoradiation therapy for advanced hepatocellular carcinoma: a retrospective study
Ja Kyung Kim, Jun Won Kim, Ik Jae Lee, Seung-Moon Joo, Kwang-Hun Lee, Eun-Suk Cho, Jeong-Sik Yu, Tae Joo Jeon, Yonsoo Kim, Jung Il Lee, Kwan Sik Lee
Radiation Oncology.2017;[Epub] CrossRef
Transarterial Radioembolization Versus Concurrent Chemoradiation Therapy for Locally Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis
Jeong Eun Song, Kyu Sik Jung, Do Young Kim, Kijun Song, Jong Yun Won, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Jinsil Seong, Kwang-Hyub Han
International Journal of Radiation Oncology*Biology*Physics.2017; 99(2): 396. CrossRef
Conditional survival estimate in patients with Barcelona Clinic Liver Cancer stage B/C hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy with/without concurrent radiotherapy
In Rae Cho, Hye Won Lee, Ki Jun Song, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Jinsil Seong, Kwang-Hyub Han, Jun Yong Park
Oncotarget.2017; 8(45): 79914. 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
The effect of radiotherapy in liver-confined but non-resectable Barcelona Clinic Liver Cancer stage C large hepatocellular carcinoma
Hong In Yoon, Inkyung Jung, Kwang-Hyub Han, Jinsil Seong
Oncotarget.2016; 7(38): 62715. CrossRef
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Jeong Won Lee, Jin Kyoung Oh, Yong An Chung, Sae Jung Na, Seung Hyup Hyun, Il Ki Hong, Jae Seon Eo, Bong-Il Song, Tae-sung Kim, Do Young Kim, Seung Up Kim, Dae Hyuk Moon, Jong Doo Lee, Mijin Yun
Journal of Nuclear Medicine.2016; 57(4): 509. 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

Abstract PDF PubReader ePub

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
KLCA Korean Liver Cancer Association, NCC National Cancer Center
Gut and Liver.2019; 13(3): 227. CrossRef
2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

Korean Journal of Radiology.2019; 20(7): 1042. CrossRef
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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Effect of Oral Supplementation with Branched-chain Amino Acid (BCAA) during Radiotherapy in Patients with Hepatocellular Carcinoma: A Double-Blind Randomized Study: Ik Jae Lee, Jinsil Seong, Jung Im Bae, Sei Hwan You, Yumie Rhee, Jong Ho Lee; Cancer Res Treat. 2011;43(1):24-31. Published online March 31, 2011; DOI: https://doi.org/10.4143/crt.2011.43.1.24

Abstract PDF PubReader ePub

PURPOSE
The present study evaluated whether oral supplementation with a branched-chain amino acid (BCAA) improves the biochemical and amino acid profiles of liver tumor patients undergoing radiotherapy.
MATERIALS AND METHODS
Patients were randomly assigned to one of 2 groups: a group given oral supplementation with BCAA granules (LIVACT granules; Samil Pharm Co., Korea, each granule containing L-isoleucine 952 mg, L-leucine 1,904 mg, and L-valine 1,144 mg) during radiotherapy, or a placebo group. Physical and biochemical examinations and measurements, including subjective symptoms, Child-Pugh class, body mass index, plasma albumin concentration, and plasma amino acid profiles were monitored.
RESULTS
Fifty were enrolled between November 2005 and November 2006. We also analyzed data from 37 hepatocellular carcinoma (HCC) patients in order to evaluate a more homogenous group. The two groups of patients were comparable in terms of age, gender, Child-Pugh score, and underlying hepatitis virus type. Serum albumin, total protein, liver enzymes, and cholesterol showed a tendency to increase in the BCAA group. In this group, the percentage of cases that reverted to normal serum albumin levels between 3 and 10 weeks after administration of BCAA was significantly higher (41.18%) than in the placebo group (p=0.043).
CONCLUSION
Oral supplementation with a BCAA preparation seems to help HCC patients undergoing radiotherapy by increasing the BCAA concentration.

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Georgios A. Sideris, Savvas Tsaramanidis, Aikaterini T. Vyllioti, Njogu Njuguna
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Results of Definitive Radiation Therapy in Adenosquamous Cell Carcinoma of the Uterine Cervix: Sang Wook Lee, Chang Ok Suh, Eun Ji Chung, Gwi Eon Kim, Kyung Ran Park, Kang Kyoo Lee, Ik Jae Lee, Tchan Kyu Park, Jaewook Kim, Jong Taek Park, Jae Uk Shim, Joon Oh Park; J Korean Cancer Assoc. 2001;33(1):21-26.

Abstract PDF: PURPOSE
To define the clinical features and pattern of failure and to evaluate the results of radiation treatment in of adenosquamous cell carcinoma of the uterine cervix.
MATERIALS AND METHODS
From Jun. 1981 to Dec. 1997, 43 patients with adenosquamous cell carcinoma of the uterine cervix were retrospectively analyzed external radiation treatment and HDR-ICR from Yonsei cancer center and Wonju cristian hospital. The median age was 51. Stage distribution according to FIGO were stage 1b in 10, 2a in 5, 2b in 18, 3b in 9, 4a in 1. Median follow-up period was 41 months.
RESULTS
Overall survival rate and disease free survival rate were 57.2% and 60.2%. Complete response rate was 86.0%. Locoregional failure was observed in seven patients.
CONCLUSION
Major pattern of failure was locoregional failure. Adenosquamous cell carcinoma was not more aggressive than other pathologic types.

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