Cancer Research and Treatment

Original Article

General

Development and Feasibility Evaluation of Smart Cancer Care 2.0 Based on Patient-Reported Outcomes for Post-Discharge Management of Patients with Cancer: Jin Ah Kwon, Songsoo Yang, Su-Jin Koh, Young Ju Noh, Dong Yoon Kang, Sol Bin Yang, Eun Ji Kwon, Jeong-Wook Seo, Jin sung Kim, Minsu Ock; Cancer Res Treat. 2024;56(4):1040-1049. Published online April 9, 2024; DOI: https://doi.org/10.4143/crt.2024.003

Abstract PDF Supplementary Material PubReader ePub: Purpose
A “Smart Cancer Care” platform that integrates patient-reported outcomes (PROs) with management has been established in Korea. This study focused on improving health behaviors and connecting patients to welfare services by introducing and assessing the feasibility of “Smart Cancer Care 2.0,” an enhanced version designed for monitoring complications post-cancer treatment.
Materials and Methods
Smart Cancer Care 2.0 was developed by conducting a literature review and consulting with expert panels to identify symptoms or variables requiring monitoring and management guidelines based on the treatment type. Qualitative and quantitative surveys were conducted to assess the feasibility of the app and web system based on the experiences of patients with cancer and healthcare workers.
Results
A total of 81 symptoms or variables (chemotherapy-, surgery-, radiotherapy-, rehabilitation-, and health management-related) were selected for management in Smart Cancer Care 2.0. PROs for these symptoms were basically categorized into three severity grades: preventive management, self-treatment, and consultation with a healthcare worker or visit to a healthcare institution. The overall mean scores in the feasibility evaluation by patients and healthcare workers were 3.83 and 3.90 points, respectively, indicating high usefulness.
Conclusion
Smart Cancer Care 2.0 leverages the existing information and communication technologies–based platform, Smart Cancer Care, and further includes health behaviors and welfare services. Smart Cancer Care 2.0 may play a crucial role in establishing a comprehensive post-discharge management system for patients with cancer as it provides suitable interventions based on patients’ responses and allows the regularly collected PROs to be easily viewed for streamlined care.

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Special Article

Physical and Biological Characteristics of Particle Therapy for Oncologists: Hwa Kyung Byun, Min Cheol Han, Kyungmi Yang, Jin Sung Kim, Gyu Sang Yoo, Woong Sub Koom, Yong Bae Kim; Cancer Res Treat. 2021;53(3):611-620. Published online June 16, 2021; DOI: https://doi.org/10.4143/crt.2021.066

Abstract PDF PubReader ePub

Particle therapy is a promising and evolving modality of radiotherapy that can be used to treat tumors that are radioresistant to conventional photon beam radiotherapy. It has unique biological and physical advantages compared with conventional radiotherapy. The characteristic feature of particle therapy is the “Bragg peak,” a steep and localized peak of dose, that enables precise delivery of the radiation dose to the tumor while effectively sparing normal organs. Especially, the charged particles (e.g., proton, helium, carbon) cause a high rate of energy loss along the track, thereby leading to high biological effectiveness, which makes particle therapy attractive. Using this property, the particle beam induces more severe DNA double-strand breaks than the photon beam, which is less influenced by the oxygen level. This review describes the general biological and physical aspects of particle therapy for oncologists, including non-radiation oncologists and beginners in the field.

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Seo Hee Choi, Woong Sub Koom, Hong In Yoon, Kyung Hwan Kim, Chan Woo Wee, Jaeho Cho, Yong Bae Kim, Ki Chang Keum, Ik Jae Lee
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Farzad Taghizadeh-Hesary, Mohammad Houshyari, Mohammad Farhadi
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Original Articles

Carotid-Sparing TomoHelical 3-Dimensional Conformal Radiotherapy for Early Glottic Cancer: Chae-Seon Hong, Dongryul Oh, Sang Gyu Ju, Yong Chan Ahn, Jae Myoung Noh, Kwangzoo Chung, Jin Sung Kim, Tae-Suk Suh; Cancer Res Treat. 2016;48(1):63-70. Published online March 6, 2015; DOI: https://doi.org/10.4143/crt.2014.265

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to investigate the dosimetric benefits and treatment efficiency of carotid-sparing TomoHelical 3-dimensional conformal radiotherapy (TH-3DCRT) for early glottic cancer. Materials and Methods Ten early-stage (T1N0M0) glottic squamous cell carcinoma patients were simulated, based on computed tomography scans. Two-field 3DCRT (2F-3DCRT), 3-field intensity-modulated radiation therapy (3F-IMRT), TomoHelical-IMRT (TH-IMRT), and TH-3DCRT plans were generated with a 67.5-Gy total prescription dose to the planning target volume (PTV) for each patient. In order to evaluate the plan quality, dosimetric characteristics were compared in terms of conformity index (CI) and homogeneity index (HI) for PTV, dose to the carotid arteries, and maximum dose to the spinal cord. Treatment planning and delivery times were compared to evaluate treatment efficiency.
Results
The median CI was substantially better for the 3F-IMRT (0.65), TH-IMRT (0.64), and TH-3DCRT (0.63) plans, compared to the 2F-3DCRT plan (0.32). PTV HI was slightly better for TH-3DCRT and TH-IMRT (1.05) compared to 2F-3DCRT (1.06) and 3F-IMRT (1.09). TH-3DCRT, 3F-IMRT, and TH-IMRT showed an excellent carotid sparing capability compared to 2F-3DCRT (p < 0.05). For all plans, the maximum dose to the spinal cord was < 45 Gy. The median treatment planning times for 2F-3DCRT (5.85 minutes) and TH-3DCRT (7.10 minutes) were much lower than those for 3F-IMRT (45.48 minutes) and TH-IMRT (35.30 minutes). The delivery times for 2F-3DCRT (2.06 minutes) and 3F-IMRT (2.48 minutes) were slightly lower than those for TH-IMRT (2.90 minutes) and TH-3DCRT (2.86 minutes). Conclusion TH-3DCRT showed excellent carotid-sparing capability, while offering high efficiency and maintaining good PTV coverage.

Citations

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Accelerated three‐dimensional conformal radiotherapy for early‐stage glottic cancer in reducing dose to the internal carotid artery and pharyngeal constrictor muscles
Kento Tomizawa, Atsushi Motegi, Hidekazu Oyoshi, Takeshi Fujisawa, Sadamoto Zenda, Yuzheng Zhou, Masaki Nakamura, Hidenari Hirata, Hidehiro Hojo, Shun‐ichiro Kageyama, Kouta Hirotaki, Kazuto Matsuura, Tetsuo Akimoto
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Dosimetric comparison between carotid-sparing IMRT and 3DCRT in early glottic cancer patients treated with definitive radiation therapy
Harkirat Kaur, Niketa Thakur, Ramita Sharma, Meena Sudan, Neeraj Jain, Supreet Kaur, Priyanka Lehal
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Effect of Radiation Therapy Techniques on Outcome in N3-positive IIIB Non-small Cell Lung Cancer Treated with Concurrent Chemoradiotherapy: Jae Myoung Noh, Jin Man Kim, Yong Chan Ahn, Hongryull Pyo, BoKyong Kim, Dongryul Oh, Sang Gyu Ju, Jin Sung Kim, Jung Suk Shin, Chae-Seon Hong, Hyojung Park, Eonju Lee; Cancer Res Treat. 2016;48(1):106-114. Published online February 12, 2015; DOI: https://doi.org/10.4143/crt.2014.131

Abstract PDF PubReader ePub

Purpose
This study was conducted to evaluate clinical outcomes following definitive concurrent chemoradiotherapy (CCRT) for patients with N3-positive stage IIIB (N3-IIIB) non-small cell lung cancer (NSCLC), with a focus on radiation therapy (RT) techniques. Materials and Methods From May 2010 to November 2012, 77 patients with N3-IIIB NSCLC received definitive CCRT (median, 66 Gy). RT techniques were selected individually based on estimated lung toxicity, with 3-dimensional conformal RT (3D-CRT) and intensity-modulated RT (IMRT) delivered to 48 (62.3%) and 29 (37.7%) patients, respectively. Weekly docetaxel/paclitaxel plus cisplatin (67, 87.0%) was the most common concurrent chemotherapy regimen.
Results
The median age and clinical target volume (CTV) were 60 years and 288.0 cm3, respectively. Patients receiving IMRT had greater disease extent in terms of supraclavicular lymph node (SCN) involvement and CTV ≥ 300 cm3. The median follow-up time was 21.7 months. Fortyfive patients (58.4%) experienced disease progression, most frequently distant metastasis (39, 50.6%). In-field locoregional control, progression-free survival (PFS), and overall survival (OS) rates at 2 years were 87.9%, 38.7%, and 75.2%, respectively. Although locoregional control was similar between RT techniques, patients receiving IMRT had worse PFS and OS, and SCN metastases from the lower lobe primary tumor and CTV ≥ 300 cm3were associated with worse OS. The incidence and severity of toxicities did not differ significantly between RT techniques. Conclusion IMRT could lead to similar locoregional control and toxicity, while encompassing a greater disease extent than 3D-CRT. The decision to apply IMRT should be made carefully after considering oncologic outcomes associated with greater disease extent and cost.

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