Cancer Research and Treatment

Original Articles

Breast cancer

Locoregional Recurrence in Adenoid Cystic Carcinoma of the Breast: A Retrospective, Multicenter Study (KROG 22-14): Sang Min Lee, Bum-Sup Jang, Won Park, Yong Bae Kim, Jin Ho Song, Jin Hee Kim, Tae Hyun Kim, In Ah Kim, Jong Hoon Lee, Sung-Ja Ahn, Kyubo Kim, Ah Ram Chang, Jeanny Kwon, Hae Jin Park, Kyung Hwan Shin; Cancer Res Treat. 2025;57(1):150-158. Published online July 12, 2024; DOI: https://doi.org/10.4143/crt.2024.201

Abstract PDF PubReader ePub: Purpose
This study aims to evaluate the treatment approaches and locoregional patterns for adenoid cystic carcinoma (ACC) in the breast, which is an uncommon malignant tumor with limited clinical data.
Materials and Methods
A total of 93 patients diagnosed with primary ACC in the breast between 1992 and 2022 were collected from multi-institutions. All patients underwent surgical resection, including breast-conserving surgery (BCS) or total mastectomy (TM). Recurrence patterns and locoregional recurrence-free survival (LRFS) were assessed.
Results
Seventy-five patients (80.7%) underwent BCS, and 71 of them (94.7%) received post-operative radiation therapy (PORT). Eighteen patients (19.3%) underwent TM, with five of them (27.8%) also receiving PORT. With a median follow-up of 50 months, the LRFS rate was 84.2% at 5 years. Local recurrence (LR) was observed in five patients (5.4%) and four cases (80%) of the LR occurred in the tumor bed. Three of LR (3/75, 4.0%) had a history of BCS and PORT, meanwhile, two of LR (2/18, 11.1%) had a history of mastectomy. Regional recurrence occurred in two patients (2.2%), and both cases had a history of PORT with (n=1) and without (n=1) irradiation of the regional lymph nodes. Partial breast irradiation (p=0.35), BCS (p=0.96) and PORT in BCS group (p=0.33) had no significant association with LRFS.
Conclusion
BCS followed by PORT was the predominant treatment approach for ACC of the breast and LR mostly occurred in the tumor bed. The findings of this study suggest that partial breast irradiation might be considered for PORT in primary breast ACC.

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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 Res Treat. 2024;56(2):549-556. Published online December 8, 2023; DOI: https://doi.org/10.4143/crt.2023.1109

Abstract PDF Supplementary Material PubReader ePub

Purpose
We investigated the proportions of patients eligible for accelerated partial breast irradiation (APBI) among those with pT1-2N0 breast cancer, based on the criteria set by the American Society for Radiation Oncology (ASTRO), the Groupe Européen de Curiethérapie and the European Society for Radiotherapy and Oncology (GEC-ESTRO), the American Brachytherapy Society (ABS), and the American Society of Breast Surgeons (ASBS). Additionally, we analyzed the rate of APBI utilization among eligible patients.
Materials and Methods
Patients diagnosed with pT1-2N0 breast cancer in 2019 were accrued in four tertiary medical centers in Korea. All patients had undergone breast conserving surgery followed by radiotherapy, either whole breast irradiation or APBI. To determine which guideline best predicts the use of APBI in Korea, the F1 score and Matthews Correlation Coefficient (MCC) were determined for each guideline.
Results
A total of 1,251 patients were analyzed, of whom 196 (15.7%) underwent APBI. The percentages of eligible patients identified by the ASTRO, GEC-ESTRO, ABS, and ASBS criteria were 13.7%, 21.0%, 50.5%, and 63.5%, respectively. APBI was used to treat 54.4%, 37.2%, 27.1%, and 23.7% of patients eligible by the ASTRO, GEC-ESTRO, ABS, and ASBS criteria, respectively. The ASTRO guideline exhibited the highest F1 score (0.76) and MCC (0.67), thus showing the best prediction of APBI utilization in Korea.
Conclusion
The proportion of Korean breast cancer patients who are candidates for APBI is substantial. The actual rate of APBI utilization among eligible patients may suggest there is a room for risk-stratified optimization in offering radiation therapy.

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Impact of the ASTRO 2024 Guideline on Partial Breast Irradiation Eligibility in Breast Cancer Patients (KROG 24-01)
Seok-Joo Chun, Sangjoon Park, Yong Bae Kim, Sung-Ja Ahn, Kyubo Kim, Kyung Hwan Shin
Practical Radiation Oncology.2024;[Epub] CrossRef

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Impact of Postmastectomy Radiation Therapy on Breast Cancer Patients According to Pathologic Nodal Status after Modern Neoadjuvant Chemotherapy: Dowook Kim, Jin Ho Kim, In Ah Kim, Ji Hyun Chang, Kyung Hwan Shin; Cancer Res Treat. 2023;55(2):592-602. Published online October 11, 2022; DOI: https://doi.org/10.4143/crt.2022.998

Abstract PDF Supplementary Material PubReader ePub

Purpose
The utility of postmastectomy radiation therapy (PMRT) for breast cancer patients after neoadjuvant chemotherapy (NAC) is highly controversial. This study evaluated the impact of PMRT according to pathologic nodal status after modern NAC.
Materials and Methods
We retrospectively reviewed 682 patients with clinical stage II-III breast cancer who underwent NAC and mastectomy from 2013 to 2017. In total, 596 patients (87.4%) received PMRT, and 86 (12.6%) did not. We investigated the relationships among locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), overall survival (OS), and various prognostic factors. Subgroup analyses were also performed to identify patients who may benefit from PMRT.
Results
The median follow-up duration was 67 months. In ypN+ patients (n=368, 51.2%), PMRT showed significant benefits in terms of LRRFS, DFS, and OS (all p < 0.001). In multivariate analyses, histologic grade (HG) III (p=0.002), lymphovascular invasion (LVI) (p=0.045), and ypN2-3 (p=0.02) were significant risk factors for poor LRRFS. In ypN1 patients with more than two prognostic factors among luminal/human epidermal growth factor receptor-2–negative subtype, HG I-II, and absence of LVI, PMRT had no significant effect on LRRFS (p=0.18). In ypN0 patients (n=351, 48.8%), PMRT was not significantly associated with LRRFS, DFS, or OS. However, PMRT showed better LRRFS in triple-negative breast cancer (TNBC) patients (p=0.03).
Conclusion
PMRT had a major impact on treatment outcomes in patients with residual lymph nodes following NAC and mastectomy. Among ypN0 patients, PMRT may be beneficial only for those with TNBC.

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Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey
Xue-mei Chen, Chen-di Xu, Li-ping Zeng, Xiao-tong Huang, Ao-qiang Chen, Lu Liu, Liu-wen Lin, Le-cheng Jia, Hua Li, Xiao-bo Jiang
Technology in Cancer Research & Treatment.2024;[Epub] CrossRef
Does Post-Mastectomy Radiotherapy Confer Survival Benefits on Patients With 1-3 Clinically Positive Lymph Nodes Rendered Pathologically Negative After Neoadjuvant Systemic Chemotherapy: Consensus from A Pooled Analysis?
Munaser Alamoodi
European Journal of Breast Health.2024; 20(2): 81. CrossRef
Oncological outcomes of stage I–II breast cancer treatment after subcutaneous/skin-sparing mastectomies with reconstruction
E. A. Rasskazova, A. D. Zikiryakhodzhaev
MD-Onco.2024; 4(3): 37. CrossRef
Effectiveness of mat pilates on fatigue in women with breast cancer submitted to adjuvant radiotherapy: randomized controlled clinical trial
Daniele Medeiros Torres, Kelly de Menezes Fireman, Erica Alves Nogueira Fabro, Luiz Claudio Santos Thuler, Rosalina Jorge Koifman, Anke Bergmann, Sabrina da Silva Santos
Supportive Care in Cancer.2023;[Epub] CrossRef
The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review
Giulia Ferrarazzo, Alberto Nieri, Emma Firpo, Andrea Rattaro, Alessandro Mignone, Flavio Guasone, Augusto Manzara, Giuseppe Perniciaro, Stefano Spinaci
Current Oncology.2023; 30(10): 8703. CrossRef

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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

Abstract PDF PubReader ePub

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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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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Impact of Regional Nodal Irradiation for Breast Cancer Patients with Supraclavicular and/or Internal Mammary Lymph Node Involvement: A Multicenter, Retrospective Study (KROG 16-14): Kyubo Kim, Yuri Jeong, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Su Ssan Kim, Chang-Ok Suh, Yong Bae Kim, Doo Ho Choi, Won Park, Jihye Cha, Mison Chun, Dong Soo Lee, Sun Young Lee, Jin Hee Kim, Hae Jin Park, Wonguen Jung; Cancer Res Treat. 2019;51(4):1500-1508. Published online March 15, 2019; DOI: https://doi.org/10.4143/crt.2018.575

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to evaluate the treatment outcomes of radiotherapy (RT) for breast cancer with ipsilateral supraclavicular (SCL) and/or internal mammary (IMN) lymph node involvement.
Materials and Methods
A total of 353 patients from 11 institutions were included. One hundred and thirty-six patients had SCL involvement, 148 had IMN involvement, and 69 had both. All patients received neoadjuvant systemic therapy followed by breast-conserving surgery or mastectomy, and postoperative RT to whole breast/chest wall. As for regional lymph node irradiation, SCL RT was given to 344 patients, and IMN RT to 236 patients. The median RT dose was 50.4 Gy.
Results
The median follow-up duration was 61 months (range, 7 to 173 months). In-field progression was present in SCL (n=20) and/or IMN (n=7). The 5-year disease-free survival (DFS) and overall survival rates were 57.8% and 75.1%, respectively. On multivariate analysis, both SCL/IMN involvement, number of axillary lymph node ≥ 4, triple-negative subtype, and mastectomy were significant adverse prognosticators for DFS (p=0.022, p=0.001, p=0.001, and p=0.004, respectively). Regarding the impact of regional nodal irradiation, SCL RT dose ≥ 54 Gy was not associated with DFS (5-year rate, 52.9% vs. 50.9%; p=0.696) in SCL-involved patients, and the receipt of IMN RT was not associated with DFS (5-year rate, 56.1% vs. 78.1%; p=0.099) in IMN-involved patients.
Conclusion
Neoadjuvant chemotherapy followed by surgery and postoperative RT achieved an acceptable in-field regional control rate in patients with SCL and/or IMN involvement. However, a higher RT dose to SCL or IMN RT was not associated with the improved DFS in these patients.

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Clinical outcomes after post-operative radiotherapy for breast cancer patients presenting with ipsilateral supraclavicular metastasis: considerations on the cranial border of irradiation field
Xiaofang Wang, Xiaomeng Zhang, Li Zhang, Jin Meng, Wei Shi, Xingxing Chen, Zhaozhi Yang, Xin Mei, Xiaoli Yu, Zhen Zhang, Zhimin Shao, Xiaomao Guo, Jinli Ma
Breast Cancer.2025; 32(1): 144. CrossRef
Internal mammary regional management after neoadjuvant therapy in breast cancer
Zhao Bi, Chun-Hui Zheng, Tong-Yue Ren, Yong-Sheng Wang
International Journal of Surgery.2024;[Epub] CrossRef
Oncological outcomes in patients with residual triple-negative breast cancer after preoperative chemotherapy
Hyunki Park, Haeyoung Kim, Won Park, Won Kyung Cho, Nalee Kim, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Jonghan Yu, Byung Joo Chae, Sei Kyung Lee, Jai-Min Ryu
Radiation Oncology Journal.2024; 42(3): 210. CrossRef
Outcomes and Trends in Axillary Management of Stage cN3b Breast Cancer Patients
Julia M. Selfridge, Zachary Schrank, Chris B. Agala, David W. Ollila, Kristalyn K. Gallagher, Dana L. Casey, Philip M. Spanheimer
Annals of Surgical Oncology.2024;[Epub] CrossRef
Clinical audit of breast cancer patients treated with helical tomotherapy for irradiation of the internal mammary chain
Garima Shrivastav, Debanjali Datta, Tabassum Wadasadawala, Pallavi Rane, Subhajit Panda, Rima Pathak, Libin Scaria, Revathy Krishnamurthy, Rajiv Sarin
Journal of Radiotherapy in Practice.2023;[Epub] CrossRef
The optimal regional irradiation volume for breast cancer patients: A comprehensive systematic review and network meta-analysis of published studies
Wei-Xiang Qi, Lu Cao, Cheng Xu, Gang Cai, Jiayi Chen
Frontiers in Oncology.2023;[Epub] CrossRef
Contemporary Outcomes After Multimodality Therapy in Patients With Breast Cancer Presenting With Ipsilateral Supraclavicular Node Involvement
Kevin Diao, Lauren M. Andring, Carlos H. Barcenas, Puneet Singh, Huong (Carisa) Le-Petross, Valerie K. Reed, Jay P. Reddy, Elizabeth S. Bloom, Neelofur R. Ahmad, Lauren L. Mayo, George H. Perkins, Melissa P. Mitchell, Kevin T. Nead, Welela Tereffe, Benjam
International Journal of Radiation Oncology*Biology*Physics.2022; 112(1): 66. CrossRef
Locoregional Management and Prognostic Factors in Breast Cancer With Ipsilateral Internal Mammary and Axillary Lymph Node Involvement
Lauren M. Andring, Kevin Diao, Susie Sun, Miral Patel, Gary J. Whitman, Pamela Schlembach, Isadora Arzu, Melissa M. Joyner, Simona F. Shaitelman, Karen Hoffman, Michael C. Stauder, Benjamin D. Smith, Wendy A. Woodward
International Journal of Radiation Oncology*Biology*Physics.2022; 113(3): 552. CrossRef
Yesterday, Today and Tomorrow – Are We Any Closer to Knowing Which Patients Will Benefit from Adjuvant Internal Mammary Nodal Irradiation?
C.A. Johnson, J. Evans
Clinical Oncology.2022; 34(8): 534. CrossRef
Dynamics of circulating tumor DNA during postoperative radiotherapy in patients with residual triple-negative breast cancer following neoadjuvant chemotherapy: a prospective observational study
Haeyoung Kim, Yeon Jeong Kim, Donghyun Park, Woong-Yang Park, Doo Ho Choi, Won Park, Won kyung Cho, Nalee Kim
Breast Cancer Research and Treatment.2021; 189(1): 167. CrossRef
Cervical Lymph Node Involvement above the Supraclavicular Fossa in Breast Cancer: Comparison with Stage IIIC (KROG 18-02)
Jae Sik Kim, Kyubo Kim, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Su Ssan Kim, Yong Bae Kim, Jee Suk Chang, Doo Ho Choi, Won Park, Tae Hyun Kim, Mison Chun, Jihye Cha, Jin Hee Kim, Dong Soo Lee, Sun Young Lee, Hae Jin Park
Journal of Breast Cancer.2020; 23(2): 194. CrossRef
Aggressive Surgical Excision of Supraclavicular Lymph Node Did Not Improve the Outcomes of Breast Cancer With Supraclavicular Lymph Node Involvement (KROG 16-14)
Kyubo Kim, Su Ssan Kim, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Doo Ho Choi, Won Park, Sun Young Lee, Mison Chun, Jin Hee Kim, Yong Bae Kim, Jihye Cha, Hae Jin Park, Dong Soo Lee, Wonguen Jung
Clinical Breast Cancer.2020; 20(1): 51. CrossRef
Combined Therapy Can Improve the Outcomes of Breast Cancer with Isolated Supraclavicular Lymph Node Involvement

Tianyi Ma, Yan Mao, Haibo Wang
Cancer Management and Research.2020; Volume 12: 11857. CrossRef

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The Feasibility of Spinal Stereotactic Radiosurgery for Spinal Metastasis with Epidural Cord Compression: Yi-Jun Kim, Jin Ho Kim, Kyubo Kim, Hak Jae Kim, Eui Kyu Chie, Kyung Hwan Shin, Hong-Gyun Wu, Il Han Kim; Cancer Res Treat. 2019;51(4):1324-1335. Published online January 29, 2019; DOI: https://doi.org/10.4143/crt.2018.653

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to investigate the effectiveness and safety of spinal stereotactic radiosurgery (SRS) in treating spinal metastasis with epidural spinal cord compression (ESCC).
Materials and Methods
During 2013-2016, 149 regions of spinal metastasis in 105 patients treated with singlefraction (12-24 Gy) spinal SRS were reviewed. Cord compression of Bilsky grade 2 (with visible cerebrospinal fluid [CSF]) or 3 (no visible CSF) was defined as ESCC. Local progression (LP) and vertebral compression fracture (VCF) rates after SRS were evaluated using multivariate competing-risk regression analysis.
Results
The 1-year cumulative incidences of LP for Bilsky grades 0 (n=80), 1 (n=39), 2 (n=21), and 3 (n=9) were 3.0%, 8.4%, 0%, and 24.9%, respectively. Bilsky grade 2 ESCC did not significantly increase the LP rate (no LP for grade 2). The 1-year cumulative incidences of VCF for Bilsky grades 0, 1, 2, and 3 were 6.6%, 5.2%, 17.1%, and 12.1%, respectively. ESCC may increase VCF risk (subhazard ratio [SHR] for grade 2, 5.368; p=0.035; SHR for grade 3, 2.215; p=0.460). Complete or partial pain response rates after SRS were 79%, 78%, 53%, and 63% for Bilsky grades 0, 1, 2, and 3, respectively (p=0.008). No neurotoxicity of grade ≥ 3 was observed.
Conclusion
Spinal SRS for spinal metastasis with Bilsky grade 2 ESCC did not increase the LP rate, was not associated with severe neurotoxicity, and showed moderate VCF and pain response rates. Bilsky grade 3 had a high LP rate.

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Efficacy and safety of SBRT for spine metastases: A systematic review and meta-analysis for preparation of an ESTRO practice guideline
R.S. Guninski, F. Cuccia, F. Alongi, N. Andratschke, C. Belka, D. Bellut, M. Dahele, M. Josipovic, T.E. Kroese, P. Mancosu, G. Minniti, M. Niyazi, U Ricardi, P. Munck af Rosenschold, A. Sahgal, Y. Tsang, W.F.A.R. Verbakel, M. Guckenberger
Radiotherapy and Oncology.2024; 190: 109969. CrossRef
Metastatic Spinal Lesion with Minimal Epidural Compression: Surgical Treatment or Stereotactic Radiotherapy?
O. I. Kit, D. E. Zakondyrin, A. A. Grin, E. E. Rostorguev, Y. V. Przhedetskiy, P. G. Sakun, V. I. Voshedskii, B. V. Matevosian, T. S. Shepelya
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Surgical Interventions Following Radiotherapy in Spinal Metastases with Intermediate Instability: A Risk Factor Analysis: The Korean Society of Spinal Tumor Multicenter Study (KSST 2022-02)
Se-Jun Park, Jin Ho Kim, Yong Chan Ahn, Woong Sub Koom, Hwa Kyung Byun, Young-Hoon Kim, Sang-Il Kim, Dong-Ho Kang
Cancers.2024; 16(14): 2554. CrossRef
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The Spine Journal.2023; 23(12): 1858. CrossRef
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Cancers.2023; 15(23): 5518. CrossRef
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Chengcheng Gui, Xuguang Chen, Khadija Sheikh, Liza Mathews, Sheng-Fu L. Lo, Junghoon Lee, Majid A. Khan, Daniel M. Sciubba, Kristin J. Redmond
Journal of Neurosurgery: Spine.2022; 36(2): 294. CrossRef
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Lanlan Guo, Lixin Ke, Ziyi Zeng, Chuanping Yuan, Ziwei Wu, Lei Chen, Lixia Lu
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Stephen Supple, Shahjehan Ahmad, Santhosh Gaddikeri, Miral D. Jhaveri
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Spinal metastases 2021: a review of the current state of the art and future directions
Daniel M. Sciubba, Zach Pennington, Matthew W. Colman, C. Rory Goodwin, Ilya Laufer, Joshua C. Patt, Kristin J. Redmond, Philip Saylor, John H. Shin, Joseph H. Schwab, Andrew J. Schoenfeld
The Spine Journal.2021; 21(9): 1414. CrossRef
An updated algorithm for the treatment of spinal metastasis
Kawngwoo Park, Seong Son, Sang Gu Lee, En Kyung Cho, Hee Kyung Ahn, In Keun Park, Sun Jin Sym, Young Saing Kim
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Comparison of Breast Conserving Surgery Followed by Radiation Therapy with Mastectomy Alone for Pathologic N1 Breast Cancer Patients in the Era of Anthracycline Plus Taxane-Based Chemotherapy: A Multicenter Retrospective Study (KROG 1418): Gyu Sang Yoo, Won Park, Jeong Il Yu, Doo Ho Choi, Yeon-Joo Kim, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung-Sik Lee, Jung Soo Kim, Jihye Cha; Cancer Res Treat. 2019;51(3):1041-1051. Published online November 1, 2018; DOI: https://doi.org/10.4143/crt.2018.424

Abstract PDF PubReader ePub

Purpose
We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy.
Materials and Methods
We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups.
Results
The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly.
Conclusion
There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.

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21-gene recurrence score in predicting the outcome of postoperative radiotherapy in T1-2N1 luminal breast cancer after breast-conserving surgery
Shang-Jin Xie, Run-Jie Wang, San-Gang Wu, Fu-Xing Zhang
The Breast.2024; 74: 103679. CrossRef
Assessing Radiation Effects on Chemo-Treated BT20 and 4T1 Breast Cancer, and Neuroblastoma Cell Lines: A Study of Single and Multiple-Cell Ionization via Infrared Laser Trapping
Mulugeta S. Goangul, Daniel B. Erenso, Ying Gao, Li Chen, Kwame O. Eshun, Gisela Alvarez, Horace T. Crogman
Radiation.2024; 4(1): 85. CrossRef
Overall survival after mastectomy versus breast-conserving surgery with adjuvant radiotherapy for early-stage breast cancer: meta-analysis
Kiran K Rajan, Katherine Fairhurst, Beth Birkbeck, Shonnelly Novintan, Rebecca Wilson, Jelena Savović, Chris Holcombe, Shelley Potter
BJS Open.2024;[Epub] CrossRef
Radiotherapy dosimetry and radiotherapy related complications of immediate implant-based reconstruction after breast cancer surgery
Yu Zhang, Fuxiu Ye, Yun Teng, Jin Zheng, Chunlu Li, Ruilan Ma, Haichen Zhang
Frontiers in Oncology.2023;[Epub] CrossRef
Does Breast-Conserving Surgery with Radiotherapy have a Better Survival than Mastectomy? A Meta-Analysis of More than 1,500,000 Patients
Gabriel De la Cruz Ku, Manish Karamchandani, Diego Chambergo-Michilot, Alexis R. Narvaez-Rojas, Michael Jonczyk, Fortunato S. Príncipe-Meneses, David Posawatz, Salvatore Nardello, Abhishek Chatterjee
Annals of Surgical Oncology.2022; 29(10): 6163. CrossRef
Protocol for the postoperative radiotherapy in N1 breast cancer patients (PORT-N1) trial, a prospective multicenter, randomized, controlled, non-inferiority trial of patients receiving breast-conserving surgery or mastectomy
Tae Hoon Lee, Ji Hyun Chang, Bum-Sup Jang, Jae Sik Kim, Tae Hyun Kim, Won Park, Yong Bae Kim, Su Ssan Kim, Wonshik Han, Han-Byoel Lee, Kyung Hwan Shin
BMC Cancer.2022;[Epub] CrossRef
Risk factors to identify the indication for regional nodal irradiation in T1-2N1M0 breast cancer: A joint analysis of 4,243 real-world cases from two institutions
Guang-Yi Sun, Ge Wen, Yu-Jing Zhang, Yu Tang, Hao Jing, Hui Fang, Jian-Yang Wang, Jiang-Hu Zhang, Xu-Ran Zhao, Si-Ye Chen, Yong-Wen Song, Jing Jin, Yue-Ping Liu, Yuan Tang, Shu-Nan Qi, Ning Li, Bo Chen, Ning-Ning Lu, Ye-Xiong Li, Shu-Lian Wang
Frontiers in Oncology.2022;[Epub] CrossRef
Chemo-treated 4T1 breast cancer cells radiation response measured by single and multiple cell ionization using infrared laser trap
Endris Muhammed, Li Chen, Ying Gao, Daniel Erenso
Scientific Reports.2019;[Epub] CrossRef

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Omitting Adjuvant Radiotherapy for Hormone Receptor‒Positive Early-Stage Breast Cancer in Old Age: A Propensity Score Matched SEER Analysis: Yi-Jun Kim, Kyung Hwan Shin, Kyubo Kim; Cancer Res Treat. 2019;51(1):326-336. Published online May 10, 2018; DOI: https://doi.org/10.4143/crt.2018.163

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to investigate the non-inferiority of omitting radiotherapy (RT) after breast-conserving surgery (BCS) for hormone receptor (HR)‒positive T1N0 breast cancer in elderly women.
Materials and Methods
From 2004 to 2014, HR-positive T1N0 breast cancer patients aged 50 years or older and receiving BCS were retrieved from the Surveillance, Epidemiology, and End Results 18 database. After propensity score matching between the no-RT and RT groups, univariate and multivariate analyses were performed. Identified prognostic factors were used to stratify the risk groups. In each risk group, 10-year cancer-specific survival (CSS) rates were compared between the no-RT and RT groups.
Results
After propensity score matching, the numbers of patients in the no-RT and RT groups were both 18,586. For patients who satisfied both a tumor size of 1-10 mm and a tumor grade of 1-2, omitting RT did not decrease the CSS rate at any age group, ranging from ≥ 50 to ≥ 85 years; for patients aged ≥ 50 years, the 10-year CSS rates in the no-RT and RT groups were 97.2% and 96.8%, respectively (adjusted hazard ratio, 0.862; p=0.312). However, for patients with a tumor size of 11-20 mm or tumor grade of 3-4, RT significantly increased the CSS rate irrespective of age.
Conclusion
RT after BCS for HR-positive T1N0 breast cancer in elderly women might be omitted without causing a decrease in the CSS rate, but only in patients who satisfy both a small tumor size (≤ 10 mm) and low tumor grade (1-2).

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Xiaoshu Zhao, Xunan Wei, Qing Shen, Xuanhong Zhou
International Journal of Pharmacology.2024; 20(5): 892. CrossRef
Radiotherapy is recommended for hormone receptor-negative older breast cancer patients after breast conserving surgery
Yaxiong Liu, Jinsong Li, Honghui Li, Gongyin Zhang, Changwang Li, Changlong Wei, Jinsheng Zeng
Scientific Reports.2024;[Epub] CrossRef
Comparison of breast‐conserving surgery without radiotherapy and mastectomy in the treatment of elderly patients with early breast cancer: A PSM and SEER database study
Baiyang Fu, Xi Chen, Wenlong Liang, Yao Wang, Yuan Yao, Jianguo Zhang
Cancer Medicine.2023; 12(14): 15229. CrossRef
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Critical Reviews in Oncology/Hematology.2022; 177: 103774. CrossRef
Research on the cutoff tumor size of omitting radiotherapy for BCSS after breast conserving surgery in women aged 65 years or oder with low-risk invasive breast carcinoma: Results based on the SEER database
Zejian Yang, Kunlong Li, Pei Qiu, Yifei Ma, Bin Wang, Yu Yan, Du Meng, Chen Feng, Yu Ren, Yijun Li, Pingping Li, Can Zhou
The Breast.2021; 60: 287. CrossRef
Effectiveness of radiotherapy after breast-conserving surgery in older patients with T1-2N0 breast cancer
Anna Z. de Boer, Esther Bastiaannet, Nienke A. de Glas, Perla J. Marang-van de Mheen, Olaf M. Dekkers, Sabine Siesling, Linda de Munck, Kelly M. de Ligt, Johanneke E. A. Portielje, Gerrit Jan Liefers
Breast Cancer Research and Treatment.2019; 178(3): 637. CrossRef

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Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23: Kyubo Kim, Hae Jin Park, Kyung Hwan Shin, Jin Ho Kim, Doo Ho Choi, Won Park, Seung Do Ahn, Su Ssan Kim, Dae Yong Kim, Tae Hyun Kim, Jin Hee Kim, Jiyoung Kim; Cancer Res Treat. 2018;50(4):1316-1323. Published online January 8, 2018; DOI: https://doi.org/10.4143/crt.2017.575

Abstract PDF PubReader ePub

Purpose
The aim of this study is to compare the treatment outcomes of breast conserving surgery (BCS) plus radiotherapy (RT) versus mastectomy for patients with pT1-2N1 triple-negative breast cancer (TNBC).
Materials and Methods
Using two multicenter retrospective studies on breast cancer, a pooled analysis was performed among 320 patients with pT1-2N1 TNBC. All patients who underwent BCS (n=212) receivedwhole breast RTwith orwithoutregional nodal RT,while nonewho underwent mastectomy (n=108)received it. All patients received taxane-based adjuvant chemotherapy. The median follow-up periods were 65 months in the BCS+RT group, and 74 months in the mastectomy group.
Results
The median age of all patients was 48 years (range, 24 to 70 years). Mastectomy group had more patients with multiple tumors (p < 0.001), no lymphovascular invasion (p=0.001), higher number of involved lymph node (p=0.028), and higher nodal ratio ≥ 0.2 (p=0.037). Other characteristics were not significantly different between the two groups. The 5-year locoregionalrecurrence-free, disease-free, and overall survivalrates of BCS+RT group versus mastectomy group were 94.6% versus 87.7%, 89.5% versus 80.4%, and 95.0% versus 87.8%, respectively, and the differences were statistically significant after adjusting for covariates (p=0.010, p=0.006, and p=0.005, respectively).
Conclusion
In pT1-2N1 TNBC, breast conservation therapy achieved better locoregional recurrencefree, disease-free, and overall survival rates compared with mastectomy.

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Breast conserving surgery combined with radiation therapy offers improved survival over mastectomy in early-stage breast cancer
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Andrii Zhygulin, Artem Fedosov
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Rajesh Pradhan, Anuradha Dey, Rajeev Taliyan, Anu Puri, Sanskruti Kharavtekar, Sunil Kumar Dubey
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Breast-Conserving Therapy is Associated with Improved Survival Without an Increased Risk of Locoregional Recurrence Compared with Mastectomy in Both Clinically Node-Positive and Node-Negative Breast Cancer Patients
Elizaveta Vasilyeva, Jeremy Hamm, Alan Nichol, Kathryn V. Isaac, Amy Bazzarelli, Carl Brown, Caroline Lohrisch, Elaine McKevitt
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Wahyuni Wahyuni, Ajeng Diantini, Mohammad Ghozali, Sahidin I
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Waruiru Mburu, Shalini Kulasingam, James S Hodges, Beth A Virnig
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Rebekah Macfie, Cynthia Aks, Kathryn Panwala, Nathalie Johnson, Jennifer Garreau
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Are the Outcomes of Breast Conservation Surgery Inferior to Those of Mastectomy in Patients with Stage II-IIIA Triple-Negative Breast Cancer?
Seungju Lee, Hyun Yul Kim, Youn Joo Jung, Hyun-June Paik, Dong-Il Kim, Chang Shin Jung, Seok-Kyung Kang, Jee Yeon Kim, Seokwon Lee, Youngtae Bae
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Prognostic Impact of Elective Supraclavicular Nodal Irradiation for Patients with N1 Breast Cancer after Lumpectomy and Anthracycline Plus Taxane-Based Chemotherapy (KROG 1418): A Multicenter Case-Controlled Study: Haeyoung Kim, Won Park, Jeong Il Yu, Doo Ho Choi, Seung Jae Huh, Yeon-Joo Kim, Eun Sook Lee, Keun Seok Lee, Han-Sung Kang, In Hae Park, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung-Sik Lee, Jung Soo Kim, Jihye Cha; Cancer Res Treat. 2017;49(4):970-980. Published online January 4, 2017; DOI: https://doi.org/10.4143/crt.2016.382

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy.
Materials and Methods
We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups.
Results
A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI.
Conclusion
We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.

Citations

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Patient-Reported Outcomes Between Whole-Breast Plus Regional Irradiation and Whole-Breast Irradiation Only in pN1 Breast Cancer After Breast-Conserving Surgery and Taxane-Based Chemotherapy: A Randomized Phase 3 Clinical Trial (KROG 17-01)
Nalee Kim, Won Park, Haeyoung Kim, Won Kyung Cho, Sung Ja Ahn, Mi Young Kim, Shin-Hyung Park, Ik Jae Lee, Inbong Ha, Jin Hee Kim, Tae Hyun Kim, Kyu Chan Lee, Hyung-Sik Lee, Tae Gyu Kim, Kyung Hwan Shin, Jong Hoon Lee, Jinhong Jung, Oyeon Cho, Yong Bae Kim
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Wei-Xiang Qi, Lu Cao, Cheng Xu, Gang Cai, Jiayi Chen
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Protocol for the postoperative radiotherapy in N1 breast cancer patients (PORT-N1) trial, a prospective multicenter, randomized, controlled, non-inferiority trial of patients receiving breast-conserving surgery or mastectomy
Tae Hoon Lee, Ji Hyun Chang, Bum-Sup Jang, Jae Sik Kim, Tae Hyun Kim, Won Park, Yong Bae Kim, Su Ssan Kim, Wonshik Han, Han-Byoel Lee, Kyung Hwan Shin
BMC Cancer.2022;[Epub] CrossRef
What Is High-risk Breast Cancer With Pathologically Negative Lymph Nodes for Regional Recurrence?
Sang-Won Kim, Won Kyung Cho, Doo Ho Choi, Haeyoung Kim, Oyeon Cho, Won Park, Mison Chun
International Journal of Radiation Oncology*Biology*Physics.2021; 111(4): 992. CrossRef
Regional nodal irradiation in pT1-2N1 breast cancer patients treated with breast-conserving surgery and whole breast irradiation
Shin-Hyung Park, Jae-Chul Kim
Radiation Oncology Journal.2020; 38(1): 44. CrossRef
Prediction of nodal staging in breast cancer patients with 1-2 sentinel nodes in the Z0011 era
Fabio Corsi, Luca Sorrentino, Sara Albasini, Daniela Bossi, Carlo Morasso, Laura Villani, Marta Truffi
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Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy
Xuran Zhao, Yu Tang, Shulian Wang, Yong Yang, Hui Fang, Jianyang Wang, Hao Jing, Jianghu Zhang, Guangyi Sun, Siye Chen, Jing Jin, Yongwen Song, Yueping Liu, Bo Chen, Shunan Qi, Ning Li, Yuan Tang, Ningning Lu, Hua Ren, Yexiong Li
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Comparison of Dose Distribution in Regional Lymph Nodes in Whole-Breast Radiotherapy vs. Whole-Breast Plus Regional Lymph Node Irradiation: An In Silico Planning Study in Participating Institutions of the Phase III Randomized Trial (KROG 1701)
Haeyoung Kim, Heejung Kim, Won Park, Jong Yun Baek, Sung Ja Ahn, Mi Young Kim, Shin-Hyung Park, Ik Jae Lee, Inbong Ha, Jin Hee Kim, Tae Hyun Kim, Kyu Chan Lee, Hyung-Sik Lee, Tae Gyu Kim, Jin Ho Kim, Jong Hoon Lee, Jinhong Jung, Oyeon Cho, Jee Suk Chang,
Cancers.2020; 12(11): 3261. CrossRef
Clinical Significance of Lymph-Node Ratio in Determining Supraclavicular Lymph-Node Radiation Therapy in pN1 Breast Cancer Patients Who Received Breast-Conserving Treatment (KROG 14-18): A Multicenter Study
Jaeho Kim, Won Park, Jin Kim, Doo Choi, Yeon-Joo Kim, Eun Lee, Kyung Shin, Jin Kim, Kyubo Kim, Yong Kim, Sung-Ja Ahn, Jong Lee, Mison Chun, Hyung-Sik Lee, Jung Kim, Jihye Cha
Cancers.2019; 11(5): 680. CrossRef
Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23
Kyubo Kim, Hae Jin Park, Kyung Hwan Shin, Jin Ho Kim, Doo Ho Choi, Won Park, Seung Do Ahn, Su Ssan Kim, Dae Yong Kim, Tae Hyun Kim, Jin Hee Kim, Jiyoung Kim
Cancer Research and Treatment.2018; 50(4): 1316. CrossRef

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Postmastectomy Radiotherapy in Patients with pT1-2N1 Breast Cancer Treated with Taxane-Based Chemotherapy: A Retrospective Multicenter Analysis (KROG 1418): Yeon-Joo Kim, Won Park, Boram Ha, Boram Park, Jungnam Joo, Tae Hyun Kim, In Hae Park, Keun Seok Lee, Eun Sook Lee, Kyung Hwan Shin, Haeyoung Kim, Jeong Il Yu, Doo Ho Choi, Seung Jae Huh, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung-Sik Lee, Jung Soo Kim, Jihye Cha; Cancer Res Treat. 2017;49(4):927-936. Published online December 26, 2016; DOI: https://doi.org/10.4143/crt.2016.508

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to evaluate the impact of postmastectomy radiotherapy (PMRT) on loco-regional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) in pT1-2N1 patients treated with taxane-based chemotherapy.
Materials and Methods
We retrospectively reviewed the medical data of pathological N1 patients who were treated with modified radical mastectomy and adjuvant taxane-based chemotherapy in 12 hospitals between January 2006 and December 2010.
Results
We identified 714 consecutive patients. The median follow-up duration was 69 months (range, 1 to 114 months) and the 5-year LRRFS, DFS, and OS rates were 97%, 94%, and 98%, respectively, in patients who received PMRT (PMRT [+]). The corresponding figures were 96%, 90%, and 96%, respectively, in patients who did not receive PMRT (PMRT [–]). PMRT had no significant impact on survival. Upon multivariable analysis, only the histological grade (HG) was statistically significant as a prognostic factor for LRRFS and DFS. In a subgroup analysis of HG 3 patients, PMRT (+) showed better DFS (p=0.081).
Conclusion
PMRT had no significant impact on LRRFS, DFS, or OS in pT1-2N1 patients treated with taxane-based chemotherapy. PMRT showed a marginal benefit for DFS in HG 3 patients. Randomized studies are needed to confirm the benefit of PMRT in high risk patients, such as those with HG 3.

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Does Post-Mastectomy Radiotherapy Confer Survival Benefits on Patients With 1-3 Clinically Positive Lymph Nodes Rendered Pathologically Negative After Neoadjuvant Systemic Chemotherapy: Consensus from A Pooled Analysis?
Munaser Alamoodi
European Journal of Breast Health.2024; 20(2): 81. CrossRef
Effect of postmastectomy radiotherapy on T1-2N1M0 triple-negative breast cancer
Lin-Yu Xia, Wei-Yun Xu, Yan Zhao, Sudeep Gupta
PLOS ONE.2022; 17(6): e0270528. CrossRef
Suggestion for the omission of post-mastectomy chest wall radiation therapy in patients who underwent skin-sparing/nipple-sparing mastectomy
Nalee Kim, Won Park, Won Kyung Cho, Hae Young Kim, Doo Ho Choi, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Jonghan Yu, Byung Joo Chae, Se Kyung Lee, Jai Min Ryu, Goo-Hyun Mun, Jai-Kyong Pyon, Byung-Joon Jeon
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Post-mastectomy radiation therapy in breast cancer patients with 1–3 positive lymph nodes: No one size fits all
Majd Kayali, Joseph Abi Jaoude, Arafat Tfayli, Nagi El Saghir, Philip Poortmans, Youssef H. Zeidan
Critical Reviews in Oncology/Hematology.2020; 147: 102880. CrossRef
The survival benefit of postmastectomy radiotherapy for breast cancer patients with T1-2N1 disease according to molecular subtype
Jinli Wei, Yizhou Jiang, Zhimin Shao
The Breast.2020; 51: 40. CrossRef
The effect of postmastectomy radiotherapy in node-positive triple-negative breast cancer
Lei Zhang, Ru Tang, Jia-Peng Deng, Wen-Wen Zhang, Huan-Xin Lin, San-Gang Wu, Zhen-Yu He
BMC Cancer.2020;[Epub] CrossRef
Comparison of Breast Conserving Surgery Followed by Radiation Therapy with Mastectomy Alone for Pathologic N1 Breast Cancer Patients in the Era of Anthracycline Plus Taxane-Based Chemotherapy: A Multicenter Retrospective Study (KROG 1418)
Gyu Sang Yoo, Won Park, Jeong Il Yu, Doo Ho Choi, Yeon-Joo Kim, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung-Sik Lee, Jung Soo Kim, Jihye Cha
Cancer Research and Treatment.2019; 51(3): 1041. CrossRef
Effect of postmastectomy radiotherapy on triple-negative breast cancer with T1-2 and 1-3 positive axillary lymph nodes: a population-based study using the SEER 18 database
Jie Zhang, Xiao-Xiao Wang, Jun-Yu Lian, Chuan-Gui Song
Oncotarget.2019; 10(50): 5245. CrossRef
Local and regional recurrence following mastectomy in breast cancer patients with 1–3 positive nodes: implications for postmastectomy radiotherapy volume
Shin-Hyung Park, Jeeyeon Lee, Jeong Eun Lee, Min Kyu Kang, Mi Young Kim, Ho Yong Park, Jin Hyang Jung, Yee Soo Chae, Soo Jung Lee, Jae-Chul Kim
Radiation Oncology Journal.2018; 36(4): 285. CrossRef

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Incorporating Risk Factors to Identify the Indication of Post-mastectomy Radiotherapy in N1 Breast Cancer Treated with Optimal Systemic Therapy: A Multicenter Analysis in Korea (KROG 14-23): Hae Jin Park, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Ja Young Kim, Won Park, Yong Bae Kim, Yeon-joo Kim, Jin Hee Kim, Kyubo Kim, Kyung Ran Park, Hyun Soo Shin, Bae Kwon Jeong, Sun Young Lee, Suzy Kim; Cancer Res Treat. 2017;49(3):739-747. Published online October 19, 2016; DOI: https://doi.org/10.4143/crt.2016.405

Abstract PDF Supplementary Material PubReader ePub

Purpose
In a recent meta-analysis, post-mastectomy radiotherapy (PMRT) reduced any first recurrence (AFR) and improved survival in N1 and N2 patients. We investigated risk factors for AFR in N1 after optimal systemic therapy without PMRT, to define a subgroup of patients who may benefit from PMRT.
Materials and Methods
One thousand three hundred eighty-two pT1-2N1M0 breast cancer patients treated with mastectomy without PMRT between 2005 and 2010 were retrospectively analyzed. Only 0.6% had no systemic therapy.
Results
After a median follow-up of 5.9 years, there were 173 AFR (53 loco-regional recurrence [LRR] without distant metastases [DM], 38 LRR with DM, and 82 DM without LRR). The 5-year LRR and AFR rates were 6.1% and 12.0%, respectively. Multivariate analysis revealed that close resection margin (p=0.001) was the only independent risk factor for LRR. Multivariate analysis for AFR revealed that age < 35 years (p=0.025), T2 stage (p=0.004), high tumor grade (p=0.032), close resection margin (p=0.035), and triple-negative biological subtype (p=0.031) were independent risk factors. Two or three positive lymph nodes (p=0.078) were considered a marginally significant factor. When stratified by these six factors, the 5-year LRR rates were 3.6% with 0-1 (n=606), 7.5% with 2-3 (n=655), and 12.7% with 4-6 (n=93) risk factors. The 5-year AFR rates were 7.1% with 0-1, 15.0% with 2-3, and 24.5% with 4-6 risk factors.
Conclusion
Patients with pT1-2N1M0 breast cancer who underwent mastectomy and optimal systemic therapy showed excellent loco-regional control and disease control. The patients with four or more risk factors may benefit from PMRT, and those with two or three risk factors merit consideration of PMRT.

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Locoregional Recurrence by Tumor Biology in Breast Cancer Patients after Preoperative Chemotherapy and Breast Conservation Treatment: Eunjin Jwa, Kyung Hwan Shin, Ja Young Kim, Young Hee Park, So-Youn Jung, Eun Sook Lee, In Hae Park, Keun Seok Lee, Jungsil Ro, Yeon-Joo Kim, Tae Hyun Kim; Cancer Res Treat. 2016;48(4):1363-1372. Published online February 18, 2016; DOI: https://doi.org/10.4143/crt.2015.456

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). Materials and Methods We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2–/Ki-67 < 15%, n=113), luminal B1 (HR+/HER2–/Ki-67 ≥ 15%, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR–/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T–]) (HR–/HER2+, n=31), and triple negative (TN) (HR–/HER2–, n=61).
Results
After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4%; B1, 93.9%; B2, 90.3%; HER2(T+), 92.9%; HER2(T–), 78.3%; and TN, 79.6%. The 5-year IBTR-free survival rates were luminal A, 97.2%; B1, 93.9%; B2, 92.8%; HER2(T+), 92.9%; HER2(T–), 89.1%; and TN, 84.6%. In multivariate analysis, HER2(T–) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). Conclusion The TN and HER2(T–) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype.

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Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer: Myungsoo Kim, Kyung Hwan Shin, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Seung Hyun Chung, Yeon-Joo Kim, Tae Hyun Kim, Kwan Ho Cho; Cancer Res Treat. 2016;48(4):1330-1337. Published online February 3, 2016; DOI: https://doi.org/10.4143/crt.2015.463

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to identify risk factors for transient lymphedema (TLE) and persistent lymphedema (PLE) following treatment for breast cancer. Materials and Methods A total of 1,073 patients who underwent curative breast surgery were analyzed. TLE was defined as one episode of arm swelling that had resolved spontaneously by the next followup; arm swelling that persisted over two consecutive examinations was considered PLE.
Results
At a median follow-up period of 5.1 years, 370 cases of lymphedema were reported, including 120 TLE (11.2%) and 250 PLE (23.3%). Initial grade 1 swelling was observed in 351 patients, of which 120 were limited to TLE (34%), while the other 231 progressed to PLE (66%). All initial swelling observed in TLE patients was classified as grade 1. In multivariate analysis, chemotherapy with taxane and supraclavicular radiation therapy (SCRT) were associated with development of TLE, whereas SCRT, stage III cancer and chemotherapy with taxane were identified as risk factors for PLE (p < 0.05). The estimated incidence of TLE among initial grade 1 patients was calculated using up to three treatment-related risk factors (number of dissected axillary lymph nodes, SCRT, and taxane chemotherapy). The approximate ratios of TLE and PLE based on the number of risk factors were 7:1 (no factor), 1:1 (one factor), 1:2 (two factors), and 1:3 (three factors). Conclusion One-third of initial swelling events were transient, whereas the other two-thirds of patients experienced PLE. Estimation of TLE and PLE based on known treatment factors could facilitate prediction of this life-long complication.

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Effect of Time Interval between Breast-Conserving Surgery and Radiation Therapy on Outcomes of Node-Positive Breast Cancer Patients Treated with Adjuvant Doxorubicin/Cyclophosphamide Followed by Taxane: Hyeon Kang Koh, Kyung Hwan Shin, Kyubo Kim, Eun Sook Lee, In Hae Park, Keun Seok Lee, Jungsil Ro, So-Youn Jung, Seeyoun Lee, Seok Won Kim, Han-Sung Kang, Eui Kyu Chie, Wonshik Han, Dong-Young Noh, Kyung-Hun Lee, Seock-Ah Im, Sung Whan Ha; Cancer Res Treat. 2016;48(2):483-490. Published online June 5, 2015; DOI: https://doi.org/10.4143/crt.2015.111

Abstract PDF PubReader ePub

Purpose
This study evaluated the effect of surgery-radiotherapy interval (SRI) on outcomes in patients treated with adjuvant radiotherapy (RT) after breast-conserving surgery (BCS) and adjuvant four cycles of doxorubicin/cyclophosphamide (AC) followed by four cycles of taxane. Materials and Methods From 1999 to 2007, 397 eligible patients were diagnosed. The effect of SRI on outcomes was analyzed using a Cox proportional hazards model, and a maximal chi-square method was used to identify optimal cut-off value of SRI for each outcome.
Results
The median SRI was 6.7 months (range, 5.6 to 10.3 months). A SRI of 7 months was the significant cut-off value for distant metastasis-free survival (DMFS) and disease-free survival (DFS) using a maximal chi-square method. For overall survival, a significant cut-off value was not found. The patients with SRI > 7 months had worse 6-year DMFS and DFS than those with SRI ≤ 7 months on univariate analysis (DMFS, 81% vs. 91%, p=0.003; DFS, 78% vs. 89%, p=0.002). On multivariate analysis, SRI > 7 months did not affect DMFS and DFS. Conclusion RT delayed for more than 7 months after BCS and adjuvant four cycles of AC followed by four cycles of taxane did not compromise clinical outcomes.

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Breast Cancer–Related Lymphedema after Neoadjuvant Chemotherapy: Myungsoo Kim, In Hae Park, Keun Seok Lee, Jungsil Ro, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Tae Hyun Kim, Kwan Ho Cho, Kyung Hwan Shin; Cancer Res Treat. 2015;47(3):416-423. Published online November 17, 2014; DOI: https://doi.org/10.4143/crt.2014.079

Abstract PDF PubReader ePub

Purpose
The risk for lymphedema (LE) after neoadjuvant chemotherapy (NCT) in breast cancer patients has not been fully understood thus far. This study is conducted to investigate the incidence and time course of LE after NCT. Materials and Methods A total of 313 patients with clinically node-positive breast cancer who underwent NCT followed by surgery with axillary lymph node (ALN) dissection from 2004 to 2009 were retrospectively analyzed. All patients received breast and supraclavicular radiation therapy (SCRT). The determination of LE was based on both objective and subjective methods, as part of a prospective database. Results At a median follow-up of 5.6 years, 132 patients had developed LE: 88 (28%) were grade 1; 42 (13%) were grade 2; and two (1%) were grade 3. The overall 5-year cumulative incidence of LE was 42%. LE first occurred within 6 months after surgery in 62%; 1 year in 77%; 2 years in 91%; and 3 years in 96%. In a multivariate analysis, age (hazard ratio [HR], 1.66; p < 0.01) and the number of dissected ALNs (HR, 1.68; p < 0.01) were independent risk factors for LE. Patients with both of these risk factors showed a significantly higher 5-year cumulative incidence of LE compared with patients with no or one risk factor (61% and 37%, respectively; p < 0.001). The addition of adjuvant chemotherapy did not significantly correlate with LE. Conclusion LE after NCT, surgery, and SCRT developed early after treatment, and with a high incidence rate. More frequent surveillance of arm swelling may be necessary in patients after NCT, especially during the first few years of follow-up.

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Evaluation of Parotid Gland Function following Intensity Modulated Radiation Therapy for Head and Neck Cancer: Seok Ho Lee, Tae Hyun Kim, Joo Young Kim, Sung Yong Park, Hong Ryull Pyo, Kyung Hwan Shin, Dae Yong Kim, Joo Young Kim, Kwan Ho Cho; Cancer Res Treat. 2006;38(2):84-91. Published online April 30, 2006; DOI: https://doi.org/10.4143/crt.2006.38.2.84

Abstract PDF PubReader ePub

Purpose

This study was undertaken to determine the parotid gland tolerance dose levels following intensity modulated radiation therapy (IMRT) for treating patients who suffered with head and neck cancer.

Materials and Methods

From February 2003 through June 2004, 34 head and neck patients with 6 months of follow-up were evaluated for xerostomia after being treated by IMRT. Their median age was 59 years (range: 29~78). Xerostomia was assessed using a 4-question xerostomia questionnaire score (XQS) and a test for the salivary flow rates (unstimulated and stimulated: USFR and SSFR, respectively). The patients were also given a validated LENT SOMA scale (LSS) questionnaire. Evaluations were performed before IMRT and at 1, 3 and 6 months after IMRT.

Results

All 34 patients showed significant changes in the XQS, LSS and Salivary Flow rates (USFR and SSFR) after IMRT. No significant changes in the XQS or LSS were noted in 12 patients who received a total parotid mean dose of ≤3,100 cGy at 1, 3 and 6 months post-IMRT relative to the baseline values. However, for the 22 patients who received >3,100 cGy, significant increases in the XQS and LSS were observed. The USFR and SSFR from the parotid glands in 7 patients who received ≤2,750 cGy were significantly preserved at up to 6 months after IMRT. However, the USFR and SSFR in 27 patients who were treated with >2,750 cGy were significantly lower than the baseline values at all times after IMRT.

Conclusion

We suggest that the total parotid mean dose should be limited to ≤2,750 cGy to preserve the USFR and SSFR and so improve the subsequent quality of life.

Citations

Citations to this article as recorded by

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Journal of Lasers in Medical Sciences.2024; 15: e4. CrossRef
Salivary microbiome changes distinguish response to chemoradiotherapy in patients with oral cancer
Marcell Costa de Medeiros, Stephanie The, Emily Bellile, Nickole Russo, Ligia Schmitd, Erika Danella, Priyanka Singh, Rajat Banerjee, Christine Bassis, George R. Murphy, Maureen A. Sartor, Isabelle Lombaert, Thomas M. Schmidt, Avi Eisbruch, Carol Anne Mur
Microbiome.2023;[Epub] CrossRef
Translation and cross-cultural adaption of the Chinese version of the Vanderbilt Head and Neck Symptom Survey version 2.0: a tool for oral symptom assessment in head and neck cancer patients
Min Jin, Li Sun, Rui Meng, Wenjing Wang, Rui Sun, Jing Huang, You Qin, Bian Wu, Qian Ding, Gang Peng, Tao Zhang, Kunyu Yang
Health and Quality of Life Outcomes.2021;[Epub] CrossRef
Study of dosimetry and clinical factors for assessment of xerostomia in head and neck squamous cell carcinoma treated by intensity-modulated radiotherapy: A prospective study
Vrinda Singla, Vipul Nautiyal, Meenu Gupta, Viney Kumar, Shivani Mehra, Mushtaq Ahmad
Journal of Carcinogenesis.2021; 20(1): 14. CrossRef
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Supportive Care in Cancer.2020; 28(6): 2701. CrossRef
Xerostomia, salivary characteristics and gland volumes following intensity‐modulated radiotherapy for nasopharyngeal carcinoma: a two‐year follow up
CPC Sim, YL Soong, EPP Pang, C Lim, GD Walker, DJ Manton, EC Reynolds, JTS Wee
Australian Dental Journal.2018; 63(2): 217. CrossRef
Radiotherapy changes salivary properties and impacts quality of life of children with Hodgkin disease
L. Marangoni-Lopes, L.P. Rodrigues, R.H. Mendonça, M. Nobre-dos Santos
Archives of Oral Biology.2016; 72: 99. CrossRef
Is linac-based volumetric modulated arc therapy better than helical tomotherapy in the radiotherapy of nasopharyngeal carcinoma?
Vincent W. C. Wu, Bing-kin Choi, Ho-nam Chan, Ruby Lam, Yu-king Wong, Alan W. L. Mui, George Chiu
Journal of Radiation Oncology.2015; 4(1): 29. CrossRef
Preventing and Therapeutic Effect of Propolis in Radiotherapy Induced Mucositis of Head and Neck Cancers: A Triple-Blind, Randomized, Placebo-Controlled Trial
Abbas Javadzadeh Bolouri, Atessa Pakfetrat, Arghavan Tonkaboni, Seyed Amir Aledavood, Mohsen Fathi Najafi, Zahra Delavarian, Mohammad Taghi Shakeri, Azade Mohtashami
Iranian Journal of Cancer Prevention.2015;[Epub] CrossRef
Evaluation of an automated knowledge based treatment planning system for head and neck
Jerome Krayenbuehl, Ian Norton, Gabriela Studer, Matthias Guckenberger
Radiation Oncology.2015;[Epub] CrossRef
Translation and validation of the Chinese version of the quality of life radiation therapy instrument and the head & neck module (QOL-RTI/H&N)
Xin-lin Chen, Zhen-wen Qiu, Mo-fa Gu, Yong Su, Li-zhi Liu, Yan Liu, Chuan-wei Mo, Qian Xu, Juan Sun, Dong-hai Li
Health and Quality of Life Outcomes.2014;[Epub] CrossRef
Correlation of Parotid Gland Function in Head and Neck Cancer Patients treated with Intensity-modulated Radiotherapy
Sonal Vahanwala, Sukhjinder Kaur Khosa, Sandeep S Pagare
International Journal of Head and Neck Surgery.2012; 3(1): 1. CrossRef
Effects of Intensity-modulated Radiotherapy on Human Oral Microflora
Zi-Yang SHAO, Zi-Sheng TANG, Chao YAN, Yun-Tao JIANG, Rui MA, Zheng LIU, Zheng-Wei HUANG
Journal of Radiation Research.2011; 52(6): 834. CrossRef

15,250 View
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13 Crossref

Intracranial beta-hCG Secreting Germinoma: Clinical Significance and Radiotherapy Results: Kyung Hwan Shin, Il Han Kim, Wee Saing Kang, Sung Whan Ha, Charn Il Park; J Korean Cancer Assoc. 1999;31(2):396-402.

Abstract PDF: No abstract available.

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Concomitant Boost Radiotherapy for Stage 3 Non - Small Cell Lung Cancer: Kyung Hwan Shin, Charn Il Park, Young Soo Shim, Yung Jue Bang, Sung Koo Han; J Korean Cancer Assoc. 1998;30(6):1110-1118.

Abstract PDF: PURPOSE
This study was undertaken to evaluate the treatment outcome and side effects of accelerated radiotherapy (RT) using concomitant boost for stage III non-small cell lung cancer (NSCLC).
METHODS
Between April 1991 and December 1994, 102 patients with stage III NSCLC who had the favorable prognostic factors by CALGB criteria, were treated with concomitant boost radiotherapy. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment was administered concomitantly during the last 2 weeks with a dose of 13 Gy in 10 fractions. The interfraction interval was at least 6 hours. The total tumor dose was 66-70 Gy, given over 6 weeks.
RESULTS
With 30 months median follow-up period for survivors, median survival was 15 months with 2 and 3-year overall survival rates of 34% and 19%, respectively. Thirty patients (29%) who had achieved complete remission after RT showed significantly better 2-year survival rates than those without complete remission (58% vs 22%, p 0.001). Local failure and distant metastases as the first or only failure occurred in 40 (44%) and 13 (14%), respectively, and ultimate local and distant failure rates were 45% and 29%, respectively. Although Grade IV esophageal complication of T-E fistula was observed in one patient, most patients with pulmonary complication showed mild, transient radiation pneumonitis.
CONCLUSION
This result suggests that the treatrnent of stage III NSCLC with concomitant boost RT may improve survival rates without enhanced radiation induced toxicity compared with conventional RT. Further investigation of dose escalation by conformal radiotherapy of combining chemotherapy and accelerated RT is warranted.

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Prognostic Factors for Local Control and Survival in T1-T2 Glottic Cancer: Charn Il Park, Kyung Hwan Shin, Suk Won Park, Seong Soo Shin, Kwang Hyun Kim; J Korean Cancer Assoc. 1997;29(6):984-991.

Abstract PDF: PURPOSE
To evaluate the efficacy of radiotherapy as the first treatment of T1-T2 golttic cancers, we analyzed survival rates, local control rates, and voice preservation rates retrospectively. Furthermore, prognostic factors potentially influencing local control and incidence of second primary tumors were analyzed.
MATERIALS AND METHODS
One hundred patients with T1-T2 glottic cancer were irradiated between February 1989 and July 1991. Median follow-up time was 80 months. 1) Factors analyzed for each patient included age, stage, anterior commissure involvement, fraction size, field size, total dose and treatment time. 2) Survival analysis methods were employed to assess the effects of these factors in local control and survival rates. All patients received Co-60 irradiation, one daily fraction of 1.75~2.0 Gy to doses of 60~72 Gy.
RESULTS
The overall survival rate, disease free survival rate and cause specific survival rates for all patients at 5 year were 80.7%, 78.6% and 87.3%, respectively. The 5-year overall survival rates for patients with T1, 2 were 82.8% and 76.9%, respectively. Overall treatment time of 50 days or less was uniquely found to have superior impact on local control rate to that of more than 50 days in univariate prognostic factor analysis (p=0.0494), and showed statistical trend in multivariate analysis (p=0.0577). Fourteen patients who had showed relapse after radiotherapy underwent salvage operation, among whom nine patients were cured. The 5-year local control rate for all patients after radiotherapy was 79% and ultimate local control rate was 87%. Voice preservation rate after radiotherapy and salvage operation was 87.6%. The second primary cancer developed in 9 patients (9%).
CONCLUSION
Radiotherapy which showed high survival rates and voice preservation rate proved to be the optimal initial treatment for patients with T1-T2 glottic cancer. Prolongation of overall treatment should be avoided as the overall treatment was found to have a significant impact on the local control of tumor. The close follow-up and prevention should be needed to decrease the death rate by second primary tumor.

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Concomitant Boost Radiotherapy in Clinical Study 3 Non - Small Cell Lung Cancer: Chan Il Park, Kyung Hwan Shin; J Korean Cancer Assoc. 1994;26(5):778-786.

Abstract PDF: A single treatement arm, phase I/II trial was performed to determine the tumor response to concomitant boost radiotherapy and to assess the toxic effects of this techneque in patients with stage III NSCLC. Between 1991-1992, 52 patients with stage III NSCLC were treated according to the concomi- tant boost technique. The large fields including primary mass and mediastinum received a dose of 54Gy in 30 daiiy fractions. The boost dose(13 Gy) was administered concomitantly with the last ten fractions of the large fields treatment, with a 6 haur intervaL The maximal allowed dose to the spinal cord was 45 Gy. At a median follow-up of 13 months, complete remission was achieved in 15 patients(28.8%) and a partial remission in 28 aptients(53.8%). The overall survival rate at 2 year was 19.9%. The median survival time was 13 months. The survival rates were 28% and 16% for the complete responders and partial/non responders. Grade 1 and 2 esophagitis occurred in 86.5% and 13.5% of the patients, respectively. The clinical or radiologic condition of 38 patients (73.1%) was compatible with radiation pneumonitis but no patients showed severe symptoms. Late complications have been limited to radiologically detected lung fibrosis in 12(23.1%) patients. The results so far appeared to be better than the outcome of conventional radiotherapy. Its real value will be determined in a prospective randomized study.

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