Cancer Research and Treatment

Original Articles

Stereotactic Ablative Radiotherapy Versus Surgery in Patients with Pulmonary Metastases from Colorectal Cancer: Byung min Lee, Ha Eun Kim, Young Ho Yang, Seung Yoon Yang, Han Sang Kim, Seo Hee Choi, Woong Sub Koom, Byung Jo Park, Jee Suk Chang; Received October 29, 2024 Accepted February 5, 2025 Published online February 6, 2025; DOI: https://doi.org/10.4143/crt.2024.1040 [Accepted]

Abstract PDF: Purpose
We compared the local control rate and toxicity of stereotactic ablative radiotherapy (SABR) versus wedge resection for colorectal pulmonary metastases.
Materials and Methods
We retrospectively reviewed medical charts and imaging of patients treated with SABR or wedge resection between 2010 and 2017 at a single institution.
Results
There were 404 patients who were treated with local therapy for 528 pulmonary metastatic lesions. While surgery was frequently used upfront for smaller, solitary metastases without other site involvement, SABR was often used for larger, multiple lesions and disease burdens beyond the lungs. The 3-year local control rate was 88.6% following surgery, which was not significantly different from that with SABR at 86.7% (p=0.174). No major postoperative complications or mortality were observed in the surgery group, and 2.8% of patients in the SABR group experienced grade 3-4 radiation pneumonitis.
Conclusion
SABR was used in patients with a higher risk of progression compared to those undergoing surgery, yet it has similar local control rates to wedge resection.

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Breast cancer

The Pattern of Care for Brain Metastasis from Breast Cancer over the Past 10 Years in Korea: A Multicenter Retrospective Study (KROG 16-12): Jae Sik Kim, Kyubo Kim, Wonguen Jung, Kyung Hwan Shin, Seock-Ah Im, Hee-Jun Kim, Yong Bae Kim, Jee Suk Chang, Jee Hyun Kim, Doo Ho Choi, Yeon Hee Park, Dae Yong Kim, Tae Hyun Kim, Byung Ock Choi, Sea-Won Lee, Suzy Kim, Jeanny Kwon, Ki Mun Kang, Woong-Ki Chung, Kyung Su Kim, Ji Ho Nam, Won Sup Yoon, Jin Hee Kim, Jihye Cha, Yoon Kyeong Oh, In Ah Kim; Cancer Res Treat. 2022;54(4):1121-1129. Published online December 31, 2021; DOI: https://doi.org/10.4143/crt.2021.1083

Abstract PDF Supplementary Material PubReader ePub

Purpose
We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea.
Materials and Methods
We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients).
Results
Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance.
Conclusion
The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years.

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Comparison of initial and sequential salvage brain-directed treatment in patients with 1–4 vs. 5–10 brain metastases from breast cancer (KROG 16–12)
Jae Sik Kim, Kyubo Kim, Wonguen Jung, Kyung Hwan Shin, Seock-Ah Im, Hee-Jun Kim, Yong Bae Kim, Jee Suk Chang, Jee Hyun Kim, Doo Ho Choi, Yeon Hee Park, Dae Yong Kim, Tae Hyun Kim, Byung Ock Choi, Sea-Won Lee, Suzy Kim, Jeanny Kwon, Ki Mun Kang, Woong-Ki C
Breast Cancer Research and Treatment.2023; 200(1): 37. CrossRef

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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

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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; 24(12): 1283. 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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General

Increased Radiosensitivity of Solid Tumors Harboring ATM and BRCA1/2 Mutations: Kyung Hwan Kim, Han Sang Kim, Seung-seob Kim, Hyo Sup Shim, Andrew Jihoon Yang, Jason Joon Bock Lee, Hong In Yoon, Joong Bae Ahn, Jee Suk Chang; Cancer Res Treat. 2022;54(1):54-64. Published online June 4, 2021; DOI: https://doi.org/10.4143/crt.2020.1247

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Purpose
Preclinical data indicate that response to radiotherapy (RT) depends on DNA damage repair. In this study, we investigated the role of mutations in genes related to DNA damage repair in treatment outcome after RT.
Materials and Methods
Patients with solid tumor who participated in next generation sequencing panel screening using biopsied tumor tissue between October 2013 and February 2019 were reviewed and 97 patients that received RT were included in this study. Best response to RT and the cumulative local recurrence rate (LRR) were compared according to absence or presence of missense, nonsense, and frameshift mutations in ATM and/or BRCA1/2.
Results
Of the 97 patients, five patients harbored mutation only in ATM, 22 in only BRCA1/2, and six in both ATM and BRCA1/2 (ATM^mtBRCA^mt). Propensity score matching was performed to select the control group without mutations (ATM^wtBRCA^wt, n=33). In total, 90 RT-treated target lesions were evaluated in 66 patients. Highest objective response rate of 80% was observed in ATM^mtBRCA^mt lesions (p=0.007), which was mostly durable. Furthermore, the cumulative 1-year LRR was the lowest in ATM^mtBRCA^mt lesions and the highest in ATM^wtBRCA^wt lesions (0% vs. 47.9%, p=0.008). RT-associated toxicities were observed in 10 treatments with no significant difference among the subgroups (p=0.680).
Conclusion
Tumors with ATM and BRCA1/2 mutations exhibited superior tumor response and local control after RT compared to tumors without these mutations. The results are hypothesis generating and suggest the need for integrating the tumor mutation profile of DNA repair genes during treatment planning.

Citations

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The art of war: using genetic insights to understand and harness radiation sensitivity in hematologic malignancies
N. Ari Wijetunga, Joachim Yahalom, Brandon S. Imber
Frontiers in Oncology.2025;[Epub] CrossRef
Effects of Ataxia-Telangiectasia Mutated Variants on Radionecrosis and Local Control After Stereotactic Radiation Surgery for Non-Small Cell Lung Cancer Brain Metastases
Warren Floyd, David Carpenter, Eugene Vaios, Rachel Shenker, Peter Hendrickson, Justus D. Adamson, William M. Giles, Chunhao Wang, Karen Allen, Trey Mullikin, Scott R. Floyd, John P. Kirkpatrick, Michelle Green, Zachary J. Reitman
Advances in Radiation Oncology.2024; 9(1): 101320. CrossRef
Long-term survival after systemic chemotherapy, chemoradiotherapy, and maintenance therapy for an older adult patient with recurrent pancreatic acinar cell carcinoma
Makiko Urabe, Kenji Ikezawa, Kazuhiro Kozumi, Yugo Kai, Ryoji Takada, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Hirofumi Akita, Kazuyoshi Ohkawa
Clinical Journal of Gastroenterology.2024; 17(4): 771. CrossRef
Robustness of carbon‐ion radiotherapy against DNA damage repair associated radiosensitivity variation based on a biophysical model
Hans Liew, Thomas Tessonnier, Stewart Mein, Giuseppe Magro, Lars Glimelius, Elias Coniavitis, Thomas Held, Thomas Haberer, Amir Abdollahi, Jürgen Debus, Ivana Dokic, Andrea Mairani
Medical Physics.2024; 51(5): 3782. CrossRef
Use of Radiation Therapy for Ataxia-Telangiectasia Mutated (ATM)-Mutation Metastatic Renal Cell Carcinoma: A Case Report
Steven N Seyedin, Garrett Harada, Eleen Garemanian, Desiree Rafizadeh, Dalia Kaakour, Sami Dwabe, Michael Daneshvar, Nataliya Mar
Cureus.2024;[Epub] CrossRef
Star wars against leukemia: attacking the clones
Monika M. Toma, Tomasz Skorski
Leukemia.2024; 38(11): 2293. CrossRef
Predicting tumour radiosensitivity to deliver precision radiotherapy
James M. Price, Asmithaa Prabhakaran, Catharine M. L. West
Nature Reviews Clinical Oncology.2023; 20(2): 83. CrossRef
Locoregional Chemoradiation for a Patient with BRCA1 Stage IV Pancreatic Adenocarcinoma
Pranit Singh, Jacob Adams, Sylvia Choo, Matthew Adams, Jordan McDonald, Laura Barton, Richard Levine, Dae Won Kim, Russell Palm, Jessica Frakes, Sarah Hoffe
Applied Radiation Oncology.2023;[Epub] CrossRef
A genomic score to predict local control among patients with brain metastases managed with radiation
Nayan Lamba, Daniel N Cagney, Paul J Catalano, Dewey Kim, Hesham Elhalawani, Daphne A Haas-Kogan, Patrick Y Wen, Nikhil Wagle, Ayal A Aizer
Neuro-Oncology.2023; 25(10): 1815. CrossRef
Lineage plasticity and treatment resistance in prostate cancer: the intersection of genetics, epigenetics, and evolution
Jarrell Imamura, Shinjini Ganguly, Andrew Muskara, Ross S. Liao, Jane K. Nguyen, Christopher Weight, Christopher E. Wee, Shilpa Gupta, Omar Y. Mian
Frontiers in Endocrinology.2023;[Epub] CrossRef
Ex Vivo Chromosomal Radiosensitivity Testing in Patients with Pathological Germline Variants in Breast Cancer High-Susceptibility Genes BReast CAncer 1 and BReast CAncer 2
Tara Zuhair Kassem, Marius Wunderle, Lukas Kuhlmann, Matthias Ruebner, Hanna Huebner, Juliane Hoyer, André Reis, Peter A. Fasching, Matthias W. Beckmann, Carolin C. Hack, Rainer Fietkau, Luitpold Distel
Current Issues in Molecular Biology.2023; 45(8): 6618. CrossRef
Moving the Needle Forward in Genomically-Guided Precision Radiation Treatment
Andrew Tam, Benjamin D. Mercier, Reeny M. Thomas, Eemon Tizpa, Irene G. Wong, Juncong Shi, Rishabh Garg, Heather Hampel, Stacy W. Gray, Terence Williams, Jose G. Bazan, Yun R. Li
Cancers.2023; 15(22): 5314. CrossRef
Case Report: MR-Guided Adaptive Radiotherapy, Some Room to Maneuver
Winnie Li, Jeff Winter, Jerusha Padayachee, Jennifer Dang, Vickie Kong, Peter Chung
Frontiers in Oncology.2022;[Epub] CrossRef
Dramatic response to local radiotherapy in a refractory metastatic mediastinal yolk sac tumor patient harboring a germline BRCA2 frameshift mutation: a case report
Xi Cheng, Haiming Yu, Jinying Li, Xiaona Han, Erhong Meng, Houqing Zhou, Dongliang Wang, Beifang Niu, Xiaotao Zhang
Cancer Biology & Therapy.2022; 23(1): 393. CrossRef
Ovarian Cancer Radiosensitivity: What Have We Understood So Far?
Amelia Barcellini, Alexandra Charalampopoulou, Loris De Cecco, Andrei Fodor, Emanuela Rabaiotti, Giorgio Candotti, Simona Secondino, Angelica Facoetti, Laura Deborah Locati, Sandro Pignata, Ester Orlandi, Giorgia Mangili
Life.2022; 13(1): 6. CrossRef

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Clinical Outcomes of Immune Checkpoint Blocker Therapy for Malignant Melanoma in Korean Patients: Potential Clinical Implications for a Combination Strategy Involving Radiotherapy: Jeongshim Lee, Jee Suk Chang, Mi Ryung Roh, Minkyu Jung, Choong-Kun Lee, Byung Ho Oh, Kee Yang Chung, Woong Sub Koom, Sang Joon Shin; Cancer Res Treat. 2020;52(3):730-738. Published online February 13, 2020; DOI: https://doi.org/10.4143/crt.2019.598

Abstract PDF Supplementary Material PubReader ePub

Purpose
We investigated the clinical efficacy of immune checkpoint blocker (ICB) therapy for metastatic or advanced melanoma in Korean patients. As well, we assessed whether the effects of ICBs can be enhanced by combination therapy with palliative radiotherapy (RT).
Materials and Methods
We retrospectively reviewed the records of 127 patients with metastatic melanoma who received ICB with or without palliative RT between 2014 and 2018. The melanoma subtypes were classified as follows: chronic sun-damaged (CSD), acral, mucosal, and uveal. The primary endpoint was the objective response rate (ORR).
Results
The overall ORR was 15%, with 11 complete and eight partial responses. ORRs for CSD, acral/mucosal, and uveal melanomas were 50%, 16.5%, and 0%, respectively (p=0.009). In addition to the subtype, stage at treatment, total tumor burden at treatment, and ICB type were significantly associated with ORR (all p < 0.05). Palliative RT was administered in 44% of patients during the treatment, and it did not affect ORR. Clinical responders to ICB therapy exhibited significantly higher 1-year progression-free and overall survival rates than nonresponders.
Conclusion
ORR for ICB monotherapy in Korean patients with melanoma is relatively modest compared with that in Western patients because the non-CSD subtypes are predominant in the Korean population. Our findings regarding combination therapy with ICB provided a rationale for the initiation of our phase II study (NCT04017897).

Citations

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Hydrogels as a Potential Biomaterial for Multimodal Therapeutic Applications
Harpreet Kaur, Bishmita Gogoi, Ira Sharma, Deepak Kumar Das, Mohd Ashif Azad, Devlina Das Pramanik, Arindam Pramanik
Molecular Pharmaceutics.2024; 21(10): 4827. CrossRef
Injectable hydrogels for personalized cancer immunotherapies
Neda Mohaghegh, Amir Ahari, Fatemeh Zehtabi, Claire Buttles, Saya Davani, Hanna Hoang, Kaylee Tseng, Benjamin Zamanian, Safoora Khosravi, Ariella Daniali, Negar Hosseinzadeh Kouchehbaghi, Isabel Thomas, Hamed Serati Nouri, Danial Khorsandi, Reza Abbasghol
Acta Biomaterialia.2023; 172: 67. CrossRef
Efficacy of radiotherapy combined with immune checkpoint inhibitors in patients with melanoma: a systemic review and meta-analysis
Gaofei Yin, Wei Guo, Zhigang Huang, Xiaohong Chen
Melanoma Research.2022; 32(2): 71. CrossRef
The pharmacotherapeutic management of nail unit and acral melanomas
Julianne M. Falotico, Shari R. Lipner
Expert Opinion on Pharmacotherapy.2022; 23(11): 1273. CrossRef
A Comparison of 2 Disease Burden Assessment Methods (3D Volume Versus the Number of Lesions) for Prognostication of Survival in Metastatic Melanoma: Implications for the Characterization of Oligometastatic Disease
Jina Kim, Jee Suk Chang, Wonmo Sung, Jin Sung Kim, Tae Hyung Kim, Seo Hee Choi, Kyung Hwan Kim, Heejoo Ko, Hye Sun Lee, Soyoung Jeon, Sang Joon Shin, Mitchell Liu, Robert Olson
International Journal of Radiation Oncology*Biology*Physics.2022; 114(5): 883. CrossRef
Prediction of Immune-Checkpoint Blockade Monotherapy Response in Patients With Melanoma Based on Easily Accessible Clinical Indicators
Hwa Kyung Byun, Jee Suk Chang, Minkyu Jung, Woong Sub Koom, Kee Yang Chung, Byung Ho Oh, Mi Ryung Roh, Kyung Hwan Kim, Choong-Kun Lee, Sang Joon Shin
Frontiers in Oncology.2021;[Epub] CrossRef
Effectiveness and safety of immune checkpoint inhibitors in combination with palliative radiotherapy in advanced melanoma: A systematic review
Jennifer Ben Shimol, Yuli Guzman-Prado, Maria Karlinskaya, Tima Davidson
Critical Reviews in Oncology/Hematology.2021; 167: 103499. CrossRef

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Ruthenium-106 Brachytherapy with or without Additional Local Therapy Shows Favorable Outcome for Variable-Sized Choroidal Melanomas in Korean Patients: Yeona Cho, Jee Suk Chang, Jin Sook Yoon, Sung Chul Lee, Yong Bae Kim, Joo Ho Kim, Ki Chang Keum; Cancer Res Treat. 2018;50(1):138-147. Published online March 24, 2017; DOI: https://doi.org/10.4143/crt.2016.391

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to report clinical outcomes of ruthenium-106 (¹⁰⁶Ru) brachytherapy with or without additional local therapy for choroidal melanomas in Korean patients.
Materials and Methods
A total of 88 patients diagnosed with choroidal melanomas were treated with ¹⁰⁶Ru brachytherapy between 2006 and 2012. Patients were divided into two groups according to their tumor height: a large group (≥ 6 mm, n=50) and a small group (< 6 mm, n=38). Most patients in the large group received combined therapy with local excision and/or transpupillary thermotherapy. In general, 85-95 Gy was administered to the apex of the tumor, while 100 Gy was administered to the point 2-6 mm from the outer surface of the sclera for patients undergoing combined therapy.
Results
The median follow-up duration was 30 months. The 3-year local control rate was significantly higher in the small group than in the large group (94% vs. 70%, p=0.047). The free from distant metastasis (FFDM) rate and the overall survival (OS) rate were also higher in patients in the small group (3-year FFDM, 97% vs. 76%; p=0.031 and 3-year OS, 97% vs. 72%; p=0.036). A total of 13 patients underwent enucleation. The eye-preservation rate was also higher in the small group (3-year eye-preservation rate, 94% vs. 70%; p=0.050), and tumor height was a significant prognostic factor for eye-preservation.
Conclusion
¹⁰⁶Ru brachytherapy showed favorable outcomes in small choroidal melanomas in Korean patients. Although additional local treatment could improve eye-preservation rate for large tumors, other strategies should be considered for disease control.

Citations

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Incidence, risk factors and outcomes of cataract surgery after plaque brachytherapy for posterior uveal melanoma
Viktor T. Gill, Gustav Stålhammar
Heliyon.2024; 10(1): e23447. CrossRef
Brachytherapy With 15- Versus 20-mm Ruthenium 106 Plaques Without Verification of Plaque Position Is Associated With Local Tumor Recurrence and Death in Posterior Uveal Melanoma
Gustav Stålhammar
International Journal of Radiation Oncology*Biology*Physics.2023; 117(5): 1125. CrossRef
The Role of Ruthenium Compounds in Neurologic Diseases: A Minireview
Fátima Virgínia Gama Justi, Gabriella Araújo Matos, Juan de Sá Roriz Caminha, Cássia Rodrigues Roque, Edinilton Muniz Carvalho, Márcio Wilker Soares Campelo, Ludmila Belayev, Luiz Gonzaga de França Lopes, Reinaldo Barreto Oriá
The Journal of Pharmacology and Experimental Therapeutics.2022; 380(1): 47. CrossRef
Long-Term Outcomes in Uveal Melanoma After Ruthenium-106 Brachytherapy
Gilda Cennamo, Daniela Montorio, Luca D’ Andrea, Antonio Farella, Elide Matano, Mario Giuliano, Raffaele Liuzzi, Maria Angelica Breve, Sabino De Placido, Giovanni Cennamo
Frontiers in Oncology.2022;[Epub] CrossRef
Uveal Melanoma: A Review of the Literature and Personal Experiences
Yong Joon Kim, Christopher Seungkyu Lee, Sung Chul Lee
Journal of Retina.2021; 6(2): 65. CrossRef
Prognostic Factors and Decision Tree for Long-Term Survival in Metastatic Uveal Melanoma
Daniel Lorenzo, María Ochoa, Josep Maria Piulats, Cristina Gutiérrez, Luis Arias, Jaume Català, María Grau, Judith Peñafiel, Estefanía Cobos, Pere Garcia-Bru, Marcos Javier Rubio, Noel Padrón-Pérez, Bruno Dias, Joan Pera, Josep Maria Caminal
Cancer Research and Treatment.2018; 50(4): 1130. CrossRef

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Patterns of Care for Radiotherapy in the Neoadjuvant and Adjuvant Treatment of Gastric Cancer: A Twelve-Year Nationwide Cohort Study in Korea: Jee Suk Chang, Young Choi, Jaeyong Shin, Kyung Hwan Kim, Ki Chang Keum, Hyo Song Kim, Woong Sub Koom, Eun-Cheol Park; Cancer Res Treat. 2018;50(1):118-128. Published online March 8, 2017; DOI: https://doi.org/10.4143/crt.2016.575

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Purpose
Although Korea has the highest incidence of gastric cancer worldwide and D2-lymphadenectomies are routinely performed, radiotherapy (RT) practice patterns have not been well studied. Therefore, we examined RT usage trends for neoadjuvant/adjuvant patients and identified factors associated with RT. We also examined survival benefits and net medical cost advantages of adding RT.
Materials and Methods
Patients diagnosed with gastric cancer who underwent gastrectomy from 2002-2013 were identified using National Health Insurance Service-National Sample Cohort.
Results
Annually, 30.9 cases per 100,000 population in crude rate underwent gastrectomy in 230 hospitals and 49.8% received neoadjuvant/adjuvant therapy in 182 hospitals. For neoadjuvant/adjuvant patients, postoperative chemo-RT was administered in 4% of cases in 26 hospitals. No significant trends regarding treatment type were observed over time. Having undergone RT was inversely associated with being ≥ 60 years old and having a low income. Having undergone RT was positively related to having a Charlson comorbidity index ≥ 4, hospital location and hospital volume (≥ 2,000 beds). Significant portions of patients treated with RT in this nation (52%) were concentrated in one large-volume hospital. Use of RT linked to increased cost of primary treatment, yet not to reduced overall medical expense. RT did not influence both on overall and disease-specific survivals after adjusting for potential confounders (p > 0.05).
Conclusion
RT was uncommonly utilized as adjuvant or neoadjuvant treatment by physicians in Korea. Despite intrinsic drawback in this data, we did not find either survival benefit or net medical cost advantage by adding RT in adjuvant treatment.

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Observational Study Comparing Efficacy and Safety between Neoadjuvant Concurrent Chemoradiotherapy and Chemotherapy for Patients with Unresectable Locally Advanced or Metastatic Gastric Cancer
Yung-Sung Yeh, Ming-Yii Huang, Cheng-Jen Ma, Ching-Wen Huang, Hsiang-Lin Tsai, Yen-Cheng Chen, Ching-Chun Li, Fang-Jung Yu, Hsiang-Yao Shih, Jaw-Yuan Wang
Journal of Oncology.2020; 2020: 1. CrossRef
Opportunities and limitations of CT - assessment of neoadjuvant chemoradiation therapy of gastric cancer
T. A. Agababyan, N. K. Silanteva, V. Yu. Skoropad, S. A. Ivanov, A. D. Kaprin, Yu. A. Komin, A. Yu. Usacheva, D. D. Kudryavtsev
Research and Practical Medicine Journal.2019; 6(4): 92. CrossRef
Outcomes of radiation therapy for resectable M0 gastric cancer
Weipeng Gong, Hongwei Zhao, Shanshan Liu, Jie Guan, Xin Liu, Qingsheng Hou, Zhenyu Zhu, Hongliang Guo
Oncotarget.2018; 9(2): 1726. 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

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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.

Citations

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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
The Annals of Thoracic Surgery.2024; 117(1): 15. CrossRef
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¹⁸F-FDG/PET May Help to Identify a Subgroup of Patients with T1-T2 Breast Cancer and 1-3 Positive Lymph Nodes Who Are at a High Risk of Recurrence after Mastectomy: Jee Suk Chang, Jeongshim Lee, Hyun Jung Kim, Kyung Hwan Kim, Mijin Yun, Seung Il Kim, Ki Chang Keum, Chang-Ok Suh, Yong Bae Kim; Cancer Res Treat. 2016;48(2):508-517. Published online September 9, 2015; DOI: https://doi.org/10.4143/crt.2015.172

Abstract PDF PubReader ePub

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

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