Cancer Research and Treatment

Survey of the Patterns of Using Stereotactic Ablative Radiotherapy for Early-Stage Non-small Cell Lung Cancer in Korea: Sanghyuk Song, Ji Hyun Chang, Hak Jae Kim, Yeon Sil Kim, Jin Hee Kim, Yong Chan Ahn, Jae-Sung Kim, Si Yeol Song, Sung Ho Moon, Moon June Cho, Seon Min Youn; Cancer Res Treat. 2017;49(3):688-694. Published online October 31, 2016; DOI: https://doi.org/10.4143/crt.2016.219

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Purpose
Stereotactic ablative radiotherapy (SABR) is an effective emerging technique for early-stage non-small cell lung cancer (NSCLC). We investigated the current practice of SABR for early-stage NSCLC in Korea.
Materials and Methods
We conducted a nationwide survey of SABR for NSCLC by sending e-mails to all board-certified members of the Korean Society for Radiation Oncology. The survey included 23 questions focusing on the technical aspects of SABR and 18 questions seeking the participants’ opinions on specific clinical scenarios in the use of SABR for early-stage NSCLC. Overall, 79 radiation oncologists at 61/85 specialist hospitals in Korea (71.8%) responded to the survey.
Results
SABR was used at 33 institutions (54%) to treat NSCLC. Regarding technical aspects, the most common planning methods were the rotational intensity-modulated technique (59%) and the static intensity-modulated technique (49%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained using 4-dimensional computed tomography. In the clinical scenarios, the most commonly chosen fractionation schedule for peripherally located T1 NSCLC was 60 Gy in four fractions. For centrally located tumors and T2 NSCLC, the oncologists tended to avoid SABR for radiotherapy, and extended the fractionation schedule.
Conclusion
The results of our survey indicated that SABR is increasingly being used to treat NSCLC in Korea. However, there were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions. Standardization of SABR is necessary before implementing nationwide, multicenter, randomized studies.

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Guidelines for safe practice of stereotactic body (ablative) radiation therapy: RANZCR 2023 update
Howard Yu‐hao Liu, Nicholas Hardcastle, Michael Bailey, Shankar Siva, Anna Seeley, Tamara Barry, Jeremy Booth, Louis Lao, Michelle Roach, Stacey Buxton, David Thwaites, Matthew Foote
Journal of Medical Imaging and Radiation Oncology.2024; 68(2): 217. CrossRef
Technical Giants But Biologic Infants: Defining a More Sophisticated Role for Local Therapy in Metastatic Disease
Sophia C. Kamran, David Palma, Matthew S. Katz, Anthony L. Zietman
Seminars in Radiation Oncology.2021; 31(3): 200. CrossRef
MiR-223-3p regulates cell viability, migration, invasion, and apoptosis of non-small cell lung cancer cells by targeting RHOB
Shufang Li, Yuping Feng, Yuxia Huang, Yu Liu, Yanxi Wang, Yan Liang, Hui Zeng, Hong Qu, Ling Wei
Open Life Sciences.2020; 15(1): 389. CrossRef

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Clinical Experience in Conformal Stereotactic Radiotherapy of Irregularly Shaped Intracranial Tumors: Ki Hwan Kim, Moon June Cho, Dong Wuk Kim, Jun Sang Kim, Seon Hwan Kim, Chang Joon Song, Shi Hun Song, Ji Young Jang, Jae Sung Kim; Cancer Res Treat. 2003;35(1):69-74. Published online February 28, 2003; DOI: https://doi.org/10.4143/crt.2003.35.1.69

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PURPOSE
The dosimetric advantages of multiple non-coplanar stationary fields for stereotactic radiotherapy or adiosurgery (SRT/S) are well known. However, this technique is not widely used due to the logistical problems associated with producing and testing customized collimators. We report our experience of SRT/S using multiple non-coplanar stationary fields (conformal SRT/ S). MATERIALS AND METHODS: Between August 1997 and February 2002, we performed frameless SRT/S in 63 patients. We chose conformal SRT/S when the tumor was of a very irregular shape or larger than 4 cm. We obtained three pieces of information: 1) the couch translations required to bring the target point to the isocenter, 2) the distance between the stereotaxic markers in the CT study, and the distance between the markers determined from orthogonal beam films, taken in the anterior- posterior and lateral directions, and 3) the rotational movement of the head position between the CT study and actual treatment position. We evaluated two kinds of data: 1) the precision of the isocenter setup, and 2) the reproducibility of the head position in the a) translational and b) rotational components. RESULTS: Twenty-six of the 63 patients receiving stereotactic treatment received conformal SRT/S. The precision of the isocenter setup for the conformal SRT/S was x=-0.03+/-0.26 mm, y=0.19+/-0.25 mm and z=-0.20+/-0.27 mm. The reproducibilities of the head position with the conformal SRT/S were 0.5 mm and less than 1degrees C, for the translational and rotational components, in any plane. CONCLUSION: We were able to apply conformal stereotactic irradiation, which has a dosimetric advantage, to irregularly shaped intracranial tumors, with precision and reproducibility of head position for the isocenter setup nearly equivalent to that of frame-based SRS or multiple-arc SRT/S.

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Clinical results of stereotactic body frame based fractionated radiation therapy for primary or metastatic thoracic tumors
Sang Min Yoon, Eun Kyung Choi, Sang-Wook Lee, Byong Yong Yi, Seung Do Ahn, Seong Soo Shin, Heon Joo Park, Su Ssan Kim, Jin-Hong Park, Si Yeol Song, Charn Il Park, Jong Hoon Kim
Acta Oncologica.2006; 45(8): 1108. CrossRef

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The Change of Tumor Interstitial Fluid Pressure Affected by Radiation Therapy in Patients with Uterine Cervix Cancer: Ji Young Jang, Moon June Cho, Jae Sung Kim, Intae Lee, Jun Sang Kim, Ki Hwan Kim; J Korean Cancer Assoc. 2001;33(1):16-20.

Abstract PDF: No abstract available.

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The Treatment Results of Preoperative Concurrent Chemoradiation in Locally Advanced Rectal Cancer: Jun Sang Kim, Jae Sung Kim, Ji Young Jang, Wan Hee Yoon, Kyu Sang Song, Hae Kyeung In, Moon June Cho; J Korean Cancer Assoc. 2000;32(5):933-942.

Abstract PDF: PURPOSE
To assess the tumor response, sphincter preservation, acute toxicity and survival with preoperative concurrent chemoradiation in locally advanced rectal cancer.
MATERIALS AND METHODS
Fifty-four patients were treated with preoperative chemoradiaton for tumor downstaging and sphincter preservation. Radiation was delivered to whole pelvis to 45 Gy followed by a boost 5.4 Gy to primary tumor site. Chemotherapy consists of concurrent 2 cycles of 5-fluorouracil (500 mg/m2/day) and leucovorin (20 mg/m2/day). Surgery was performed approximately 6 weeks after treatment.
RESULTS
Median follow-up period and rate were 48 months and 98%, respectively. The downstaging including primary tumor and lymph node occurred in 64%. Three of 53 patients (6%) had pathologic complete response. The resectability of tumor was 98%. A sphincter preservation was possible in 61%. Three patients developed grade 4 hematologic toxicity. Grade 3 skin erythema and diarrhea were 24% and 18%, respectively. The 5-year survival and local disease-free survival were 62% and 89%, respectively. Local failure and distant metastasis rate were 9% and 35%, respectively.
CONCLUSION
Preoperative chemoradiation affords considerable downstaging with acceptable acute toxicity and postoperative morbidity. Also sphincter preservation is feasible by improved downstaging of tumor. This treatment could be improved local control of tumor, and may have a potential for long-term survival.

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Initial Experience of Fractionated Stereotactic Radiotherapy for Metastatic Brain Tumors: Moon June Cho, Ki Hwan Kim, Ji Young Jang, Jun Sang Kim, Seong Ho Kim, Chang Joon Song, Jae Sung Kim; J Korean Cancer Assoc. 2000;32(2):374-381.

Abstract PDF: PURPOSE
This study aimed to evaluate the preliminary treatment results of fractionated stereotactic radiotherapy (FSRT) for metastatic brain tumors.
MATERIALS AND METHODS
Between August 1997 and December 1998, frameless FSRT was performed in 11 patients with metastatic brain tumor (1S lesions). Primary sites were lung in 7 patients, breast in 2, stomach in 1, and malignant melanoma in 1, All patients received 30-36 Gy/10-20 fx external beam irradiation to whole brain. Eight patients received FSRT for 1 lesion, one for 2 lesions, and two for 4 lesions. Fractionation schedule was 25 Gy/5 fx in 11 lesions, 18 Gy(1 fx in 3, 30 Gy/5 fx in 2, 15 Gy/5 fx in 1. Mean tumor volume was 7.0 cc (0.39~55.23 cc). Multiple-arc FSRT was delivered to 16 lesions and conformal FSRT through irregular ports shaped to tumor profile to 2 lesions.
RESULTS
No patient experienced any acute side reaction from FSRT. Follow-up radiologic evaluation was available in 9 patients. Six of nine patients achieved the complete response, but two showed the partial response and one showed no response on follow-up radiologic studies. Among six patients with complete response, 5 patients survived from 5 to 15 months and showed no evidence of metastatic brain d#isease clinically and/or radiologically at last follow-up. Among two patients who did not have radiologic evaluation, one showed clinically complete response until death and the other died just after FSRT caused by intercurrent disease. One patient with no response radiologically survived 7 months and showed nearly complete disappearance of clinical symptom with stable status radiologically, CONCLUSION: Initial experience in this study suggests that the external beam irradiation to whole brain with 30 Gy/10 fx followed by FSRT with 20~30 Gy/5~6 fx could be the good treatment option to the patients with metastatic brain tumor. This study suggests that the fractionation schedule for FSRT should be determined in consideration of performance status, number of metastasis, tumor volume, location, presence of extracranial disease, and age.

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The Results of Radiation Therapy in Patients with Cancer of the Esophagus: Jun Sang Kim, Moon June Cho, Jae Sung Kim, Hyun Yong Jeong, Young Lee; J Korean Cancer Assoc. 1997;29(5):832-841.

Abstract PDF: No abstract available

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