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A Phase I/II Trial to Evaluate the Technical Feasibility of Partial Breast Irradiation with Three-Dimensional Conformal Radiation Therapy in Korean Women with Stage I Breast Carcinoma: An Initial Report of the Korean Radiation Therapy Oncology Group (KROG) Study 0804
Jae-Uk Jeong, Jung Han Yoon, Min Ho Park, Mee Sun Yoon, Ju-Young Song, Taek-Keun Nam, Woong-Ki Chung, Yong-Hyub Kim, Chang-Ok Suh, Sung-Ja Ahn
Cancer Res Treat. 2015;47(1):18-25.   Published online August 21, 2014
DOI: https://doi.org/10.4143/crt.2013.202
AbstractAbstract PDFPubReaderePub
Purpose
This prospective study was designed to verify the technical feasibility of partial breast irradiation in breast cancer patients with small breasts, which are commonly encountered in Korean women. Materials and Methods A total of 40 Gy, administered in 10 fractions on consecutive days (one fraction per day), was prescribed to the isocenters of the fields using three-dimensional conformal radiotherapy (3-DCRT). For all patients, treatment planning and dose parameters strictly adhered to the constraints set forth in the Radiation Therapy Oncology Group (RTOG) 0319 protocol. This study was designed such that if fewer than five of the first 42 evaluable patients received unacceptable scores, the treatment would be considered reproducible. Results Ten treatment plans (23.8%) were determined to have major variations. There was no major variation in planning target volume (PTV) coverage. The ipsilateral and contralateral breast dose limitations were not met in four (9.5%) and four cases (9.5%), respectively. Major variations in ipsilateral and contralateral lung dose limitations were observed in two cases (4.8%). Major variations in the heart and thyroid dose limitations were observed in one (2.4%) and one case (2.4%), respectively. In multivariate analysis, a ratio of PTV to ipsilateral breast volume (PTV/IB) > 0.16 was the only significant factor that statistically affected major variations. Conclusion We concluded that partial breast irradiation using 3-DCRT could not be reproduced in Korean breast cancer patients, particularly small-volumed breast surrogated as PTV/IB > 0.16. The dominant cause was the major variation in surrounding normal breast tissues.

Citations

Citations to this article as recorded by  
  • Assessment of Eligibility and Utilization of Accelerated Partial Breast Irradiation in Korean Breast Cancer Patients (KROG 22-15)
    Seok-Joo Chun, Ji Hwan Jo, Yong Bae Kim, Sangjoon Park, Sung-Ja Ahn, Su Ssan Kim, Kyubo Kim, Kyung Hwan Shin
    Cancer Research and Treatment.2024; 56(2): 549.     CrossRef
  • Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy in the Treatment of Breast Cancer: An Updated Review
    Jee Suk Chang, Ji Hyun Chang, Nalee Kim, Yong Bae Kim, Kyung Hwan Shin, Kyubo Kim
    Journal of Breast Cancer.2022; 25(5): 349.     CrossRef
  • Who are the optimal candidates for partial breast irradiation?
    Ji Hyeon Joo, Yongkan Ki, Hosang Jeon, Dong Woon Kim, Jinhong Jung, Su Ssan Kim
    Asia-Pacific Journal of Clinical Oncology.2021; 17(4): 305.     CrossRef
  • First Experience in Korea of Stereotactic Partial Breast Irradiation for Low-Risk Early-Stage Breast Cancer
    Won Hee Lee, Jee Suk Chang, Min Jung Kim, Vivian Youngjean Park, Jung Hyun Yoon, Se Young Kim, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, Young Up Cho, Byeong Woo Park, Yong Bae Kim
    Frontiers in Oncology.2020;[Epub]     CrossRef
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The Role of Radiotherapy in the Treatment of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
Taek-Keun Nam, Jae-Sook Ahn, Yoo-Duk Choi, Jae-Uk Jeong, Yong-Hyeob Kim, Mee Sun Yoon, Ju-Young Song, Sung-Ja Ahn, Woong-Ki Chung
Cancer Res Treat. 2014;46(1):33-40.   Published online January 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.1.33
AbstractAbstract PDFPubReaderePub
PURPOSE
To assess radiotherapy for patients with early stage gastric mucosa-associated lymphoid tissue (MALT) lymphoma with respect to survival, treatment response, and complications.
MATERIALS AND METHODS
Enrolled into this study were 48 patients diagnosed with gastric MALT lymphoma from January 2000 to September 2012. Forty-one patients had low grade and seven had mixed component with high grade. Helicobacter pylori eradication was performed in 33 patients. Thirty-four patients received radiotherapy alone. Ten patients received chemotherapy before radiotherapy, and three patients underwent surgery followed by chemotherapy and radiotherapy. One patient received surgery followed by radiotherapy. All patients received radiotherapy of median dose of 30.6 Gy.
RESULTS
The duration of follow-up ranged from 6 to 158 months (median, 48 months). Five-year overall survival and cause-specific survival rates were 90.3% and 100%. All patients treated with radiotherapy alone achieved pathologic complete remission (pCR) in 31 of the low-grade and in three of the mixed-grade patients. All patients treated with chemotherapy and/or surgery prior to radiotherapy achieved pCR except one patient who received chemotherapy before radiotherapy. During the follow-up period, three patients developed diffuse large B-cell lymphoma in the stomach, and one developed gastric adenocarcinoma after radiotherapy. No grade 3 or higher acute or late complications developed. One patient, who initially exhibited gastroptosis, developed mild atrophy of left kidney.
CONCLUSION
These findings indicate that a modest dose of radiotherapy alone can achieve a high cure rate for low-grade and even mixed-grade gastric MALT lymphoma without serious toxicity. Patients should be carefully observed after radiotherapy to screen for secondary malignancies.

Citations

Citations to this article as recorded by  
  • Clinical Management of Patients with Gastric MALT Lymphoma: A Gastroenterologist’s Point of View
    Tamara Matysiak-Budnik, Kateryna Priadko, Céline Bossard, Nicolas Chapelle, Agnès Ruskoné-Fourmestraux
    Cancers.2023; 15(15): 3811.     CrossRef
  • Magnetic Resonance Imaging-Guided Radiation Therapy for Early-Stage Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
    Neris Dincer, Gamze Ugurluer, Gorkem Gungor, Teuta Zoto Mustafayev, Banu Atalar, Enis Ozyar
    Cureus.2022;[Epub]     CrossRef
  • Development and Validation of a Prognostic Nomogram for Gastric Marginal Zone Lymphoma: a Surveillance, Epidemiology and End Results-based population Study
    Mingliang Wang, Cheng Wu, Yida Lu, Xin Xu, Huizhen Wang, Youliang Wu, Xiaodong Wang, Yongxiang Li
    Future Oncology.2021; 17(5): 529.     CrossRef
  • Radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma
    Laurent Quéro, Mouna Labidi, Marc Bollet, Côme Bommier, Sophie Guillerm, Christophe Hennequin, Catherine Thieblemont
    World Journal of Gastrointestinal Oncology.2021; 13(10): 1453.     CrossRef
  • Second Cancers in a Patient with Gastric MALT Lymphoma
    Lucy Navsaria, Alfonso Badillo, Michael Wang
    Case Reports in Medicine.2020; 2020: 1.     CrossRef
  • The Treatment of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma using Radiotherapy
    Aswin Nagarajan, Arun Sakthivelu, Alexander John, Ramya Ravichandar
    Indian Journal of Medical and Paediatric Oncology.2020; 41(04): 559.     CrossRef
  • Favorable radiation field decrease in gastric marginal zone lymphoma
    Gabriele Reinartz, Regina P. Pyra, Georg Lenz, Rüdiger Liersch, Georg Stüben, Oliver Micke, Kay Willborn, Clemens F. Hess, Andreas Probst, Rainer Fietkau, Ralf Jany, Jürgen Schultze, Christian Rübe, Carsten Hirt, Wolfgang Fischbach, Martin Bentz, Severin
    Strahlentherapie und Onkologie.2019; 195(6): 544.     CrossRef
  • Long-term course of precancerous lesions arising in patients with gastric MALT lymphoma
    Anne-Laure Rentien, Michaël Lévy, Christiane Copie-Bergman, Charlotte Gagniere, Jehan Dupuis, Yann Le Baleur, Karim Belhadj, Iradj Sobhani, Corinne Haioun, Jean-Charles Delchier, Aurelien Amiot
    Digestive and Liver Disease.2018; 50(2): 181.     CrossRef
  • Gastrointestinal lymphomas: French Intergroup clinical practice recommendations for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFH)
    Tamara Matysiak-Budnik, Bettina Fabiani, Christophe Hennequin, Catherine Thieblemont, Georgia Malamut, Guillaume Cadiot, Olivier Bouché, Agnès Ruskoné-Fourmestraux
    Digestive and Liver Disease.2018; 50(2): 124.     CrossRef
  • Place de la radiothérapie pour les lymphomes du mucosa-associated lymphoid tissue gastriques : résultats d’une étude rétrospective
    L. Ghorbal, A. Hdiji, H. Ben Salah, F. Elloumi, M. Frikha, M. Elloumi, J. Daoud
    Cancer/Radiothérapie.2018; 22(8): 763.     CrossRef
  • Les lymphomes gastro-intestinaux
    P. Jamet, T. Matysiak-Budnik, L. Brichet, A. Ruskoné-Fourmestraux
    Oncologie.2018; 20(5-6): 107.     CrossRef
  • Radiotherapy for localized gastric mucosa–associated lymphoid tissue lymphoma: long-term outcomes over 10 years
    Yu Ohkubo, Yoshihiro Saito, Hiroki Ushijima, Masahiro Onishi, Tomoko Kazumoto, Jun-ichi Saitoh, Nobuko Kubota, Hirofumi Kobayashi, Nobuo Maseki, Yu Nishimura, Masafumi Kurosumi
    Journal of Radiation Research.2017; 58(4): 537.     CrossRef
  • Place de la radiothérapie dans la prise en charge des lymphomes malins non hodgkiniens
    L. Gastaud, B. Rossignol, F. Peyrade, D. Ré, J. Thariat, A. Thyss, J. Doyen
    Cancer/Radiothérapie.2016; 20(3): 236.     CrossRef
  • Differential somatostatin and CXCR4 chemokine receptor expression in MALT-type lymphoma of gastric and extragastric origin
    Susann Stollberg, Daniel Kämmerer, Elisa Neubauer, Stefan Schulz, Ingrid Simonitsch-Klupp, Barbara Kiesewetter, Markus Raderer, Amelie Lupp
    Journal of Cancer Research and Clinical Oncology.2016; 142(11): 2239.     CrossRef
  • Radiation therapy for gastric mucosa-associated lymphoid tissue lymphoma: dose-volumetric analysis and its clinical implications
    Hyeon Woo Lim, Tae Hyun Kim, Il Ju Choi, Chan Gyoo Kim, Jong Yeul Lee, Soo Jeong Cho, Hyeon Seok Eom, Sung Ho Moon, Dae Yong Kim
    Radiation Oncology Journal.2016; 34(3): 193.     CrossRef
  • Refractory peptic ulceration following radiation therapy in primary gastric lymphoma: A report of two cases
    CHUNYAN ZENG, SHIWEN LUO, NONGHUA LV, YOUXIANG CHEN
    Oncology Letters.2015; 9(1): 63.     CrossRef
  • Exclusive moderate-dose radiotherapy in gastric marginal zone B-cell MALT lymphoma: Results of a prospective study with a long term follow-up
    Agnès Ruskoné-Fourmestraux, Tamara Matysiak-Budnik, Bettina Fabiani, Pascale Cervera, Hedia Brixi, Karine Le Malicot, Isabelle Nion-Larmurier, Jean-Fançois Fléjou, Christophe Hennequin, Laurent Quéro
    Radiotherapy and Oncology.2015; 117(1): 178.     CrossRef
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Results of Curative Radiation Therapy with or without Chemotherapy for Stage III Unresectable Non-Small Cell Lung Cancer
Sung-Ja Ahn, Young-Chul Kim, Kyu-Sik Kim, Kyung-Ok Park, Woong-Ki Chung, Taek-Keun Nam, Byung-Sik Nah, Ju-Young Song, Mi-Sun Yoon
Cancer Res Treat. 2005;37(5):268-272.   Published online October 31, 2005
DOI: https://doi.org/10.4143/crt.2005.37.5.268
AbstractAbstract PDFPubReaderePub
Purpose

We retrospectively analyzed the patients who received curative radiotherapy for unresectable stage III NSCLC to investigate the impact of chemotherapy.

Materials and Methods

From 1998 to 2001, the records of 224 patients who completed curative radiotherapy for NSCLC were reviewed. There were 210 males and 14 females, and their median age was 64 years (range 38~83). 54 patients had stage IIIA disease and 170 patients had stage IIIB disease. Conventional radiotherapy was given and the radiation dose ranged from 50~70 Gy with a median of 60 Gy, and chemotherapy was combined for 116 patients (52%).

Results

The median survival, the 2-year, and 5-year actuarial survival rates of all 224 patients were 15 months, 30%, and 7%, respectively. The median survival of the patients with stage IIIA and IIIB disease were 21 months and 13 months, respectively (p=0.14). The median survival of patients who received chemoradiation was 18 months compared to 14 months for the patients who received RT alone (p=0.02). Among the chemoradiation group of patients, the median survival time of the patients who received 1 to 3 cycles of chemotherapy was 16 months and that for the patients who received more than 3 cycles was 22 months (p=0.07). We evaluated the effects of the timing of chemoradiation in 57 patients who received more than 3 cycles of chemotherapy. The median survival of the patients with the concurrent sequence was 25 months and that for the patients with the sequential chemotherapy was 19 months (p=0.81).

Conclusions

For advanced stage III non-small cell lung cancer patients who completed the curative radiotherapy, the addition of chemotherapy improved the survival compared to the patients who received radiotherapy alone.

Citations

Citations to this article as recorded by  
  • Treatment for Non-Small-Cell Lung Cancer and Circulating Tumor Cells
    Joel Mason, Benjamin Blyth, Michael P MacManus, Olga A Martin
    Lung Cancer Management.2017; 6(4): 129.     CrossRef
  • Clinical Responses and Prognostic Indicators of Concurrent Chemoradiation for Non-small Cell Lung Cancer
    Dong-Soo Lee, Yeon-Sil Kim, Jin-Hyoung Kang, Sang-Nam Lee, Young-Kyoun Kim, Myung-Im Ahn, Dae-Hee Han, Ie-Ryung Yoo, Young-Pil Wang, Jae-Gil Park, Sei-Chul Yoon, Hong-Seok Jang, Byung-Oak Choi
    Cancer Research and Treatment.2011; 43(1): 32.     CrossRef
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Assessment of Tumor Regression by Consecutive Pelvic Magnetic Resonance Imaging and Dose Modification during High-Dose-Rate Brachytherapy for Carcinoma of the Uterine Cervix
Taek-Keun Nam, Byung-Sik Nah, Ho-Sun Choi, Woong-Ki Chung, Sung-Ja Ahn, Seok-Mo Kim, Ju-Young Song, Mi-Seon Yoon
Cancer Res Treat. 2005;37(3):157-164.   Published online June 30, 2005
DOI: https://doi.org/10.4143/crt.2005.37.3.157
AbstractAbstract PDFPubReaderePub
Purpose

To assess tumor regression, as determined by pelvic magnetic resonance imaging (MRI), and evaluate the efficacies and toxicities of the interim brachytherapy (BT) modification method, according to tumor regression during multi-fractionated high-dose-rate (HDR) BT for uterine cervical cancer.

Materials and Methods

Consecutive MRI studies were performed pre-radiotherapy (RT), pre-BT and during interfraction of BT (inter-BT) in 69 patients with cervical cancer. External beam radiotherapy (EBRT) was performed, using a 10 MV X-ray, in daily fraction of 1.8 Gy with 4-fields, 5 d/wk. Radiation was delivered up to 50.4 Gy, with midline shielding at around 30.6 Gy. Of all 69 patients, 50 received modified interim BT after checking the inter-BT MRI. The BT was delivered in two sessions; the first was composed of several 5 Gy fractions to point A, twice weekly, using three channel applicators. According to the three measured orthogonal diameters of the regressed tumor, based on inter-BT MR images, the initial BT plan was modified, with the second session consisting of a few fractions of less than 5 Gy to point A, using a cervical cylinder applicator.

Results

The numbers of patients in FIGO stages Ib, IIa, IIb and IIIb+IVa were 19 (27.5%), 18 (26.1%), 27 (39.2%) and 5 (7.2%), respectively. Our treatment characteristics were comparable to those from the literatures with respect to the biologically effective dose (BED) to point A, rectum and bladder as reference points. In the regression analysis a significant correlation was observed between tumor regression and the cumulative dose to point A on the follow-up MRI. Nearly 80% regression of the initial tumor volume occurred after 30.6 Gy of EBRT, and this increased to 90% after an additional 25 Gy in 5 fractions of BT, which corresponds to 73.6 Gy of cumulative BED10 to point A. The median total fraction number, and those at the first and second sessions of BT were 8 (5~10), 5 (3~7) and 3 (1~5), respectively. The median follow-up time was 53 months (range, 9~66 months). The 4-year disease-free survival rate of all patients was 86.8%. Six (8.7%) patients developed pelvic failures, but major late complications developed in only two (2.9%).

Conclusion

Our study shows that effective tumor control, equivalent survival and low rates of major complications can be achieved by modifying the fraction size during BT according to tumor regression, as determined by consecutive MR images. We recommend checking the follow-up MRI at a cumulative BED10 of around 65 Gy to point A, with the initial BT modified at a final booster BT session.

Citations

Citations to this article as recorded by  
  • Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer
    Florian Arend, Markus Oechsner, Clara B. Weidenbächer, Stephanie E. Combs, Kai J. Borm, Marciana N. Duma
    Tumori Journal.2021; 107(2): 139.     CrossRef
  • Target volume changes through high-dose-rate brachytherapy for cervical cancer when evaluated on high resolution (3.0 Tesla) magnetic resonance imaging
    Wenqing Sun, Sudershan K. Bhatia, Geraldine M. Jacobson, Ryan T. Flynn, Yusung Kim
    Practical Radiation Oncology.2012; 2(4): e101.     CrossRef
  • Metabolic Response of Lymph Nodes Immediately After RT Is Related With Survival Outcome of Patients With Pelvic Node-Positive Cervical Cancer Using Consecutive [18F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography
    Mee Sun Yoon, Sung-Ja Ahn, Byung-Sik Nah, Woong-Ki Chung, Ho-Chun Song, Su Woong Yoo, Ju-Young Song, Jae-Uk Jeong, Taek-Keun Nam
    International Journal of Radiation Oncology*Biology*Physics.2012; 84(4): e491.     CrossRef
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