Cancer Research and Treatment

Original Articles

Hematologic malignancy

A New Prognostic Index for Extranodal Natural Killer/T-Cell Lymphoma:Incorporation of Serum β-2 Microglobulin to PINK: Sora Kang, Hyungwoo Cho, Shin Kim, Kyoungmin Lee, Eun Hee Kang, Jung Sun Park, Yoon Sei Lee, Chan-Sik Park, Heounjeong Go, Jooryung Huh, Jin Sook Ryu, Sang-Wook Lee, Seok Jin Kim, Won Seog Kim, Sang Eun Yoon, Young Hyeh Ko, Cheolwon Suh; Cancer Res Treat. 2023;55(1):314-324. Published online March 31, 2022; DOI: https://doi.org/10.4143/crt.2022.015

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Purpose
Prognostic Index for Natural Killer Lymphoma (PINK) is the most widely accepted prognostic model for patients withextranodal natural killer/T-cell lymphoma (ENKTL) treated with non-anthracycline–based therapy. We aimed to evaluate the prognostic implications of serum β-2 microglobulin (β2M) in the context of PINK and proposed a new prognostic model.
Materials and Methods
A total of 138 patients who were newly diagnosed with ENKTL and treated with non-anthracycline-based chemotherapy were identified. The cut-off value of high serum β2M was calculated by maximal-chi square methods (4.1 mg/L). A new prognostic model incorporating serum β2M into PINK was proposed and validated in an independent validation cohort (n=88).
Results
The patients’ median age was 53.5 years (range, 19 to 80 years). Patients with high serum β2M levels had significantly worse overall survival (OS) and progression-free survival (PFS). In multivariate analysis, high serum β2M was an independent adverse prognostic factor for OS. A new PINK-B (Prognostic Index for Natural Killer Lymphoma-serum β-2 microglobulin) model stratifiedpatients into three groups with distinct OS and PFS in the training cohort (3-year OS, 84.1% [95% confidence interval, 75.1 to 94.2], 46.8% [36.1 to 60.8] and 17.6% [6.3 to 49.2] for the low-, intermediate, and high-risk groups, respectively; 3-year PFS, 70.6% [59.4 to 83.8], 35.9% [25.9 to 49.8], and 7.35% [1.1 to 46.7] for the low-, intermediate-, and high-risk groups, respectively). The PINK-B model was further validated in an independent cohort.
Conclusion
Serum β2M is an independent prognostic factor for ENKTL patients. The new serum β2M-based prognostic model may be useful for identifying ultra-high-risk patients, and it can easily be adopted into daily clinical practice.

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Elevated serum IL-6 and total IgEAb are associated with poor survival in natural killer/T-cell lymphoma
Yun Hui, Yingjun Gao, Jiawei Li, Qingtao Kong, Yuanyuan Duan, Haibo Liu, Fang Liu, Hong Sang
Annals of Hematology.2024; 103(4): 1285. CrossRef
Prognostic Impact of Serum β2-Microglobulin Levels in Hodgkin Lymphoma Treated with ABVD or Equivalent Regimens: A Comprehensive Analysis of 915 Patients
Theodoros P. Vassilakopoulos, Maria Arapaki, Panagiotis T. Diamantopoulos, Athanasios Liaskas, Fotios Panitsas, Marina P. Siakantaris, Maria Dimou, Styliani I. Kokoris, Sotirios Sachanas, Marina Belia, Chrysovalantou Chatzidimitriou, Elianna A. Konstantin
Cancers.2024; 16(2): 238. CrossRef
Prognostic Value of18F-FDG PET/CT Radiomics in Extranodal Nasal-Type NK/T Cell Lymphoma
Yu Luo, Zhun Huang, Zihan Gao, Bingbing Wang, Yanwei Zhang, Yan Bai, Qingxia Wu, Meiyun Wang
Korean Journal of Radiology.2024; 25(2): 189. CrossRef
A novel prognostic index for extranodal natural killer/T-cell lymphoma in the era of pegaspargase/L-asparaginase
Ziyuan Shen, Xudong Zhang, Yujie Li, Xicheng Chen, Xing Xing, Hao Zhang, Jingjing Ye, Ling Wang, Tao Jia, Taigang Zhu, Yuqing Miao, Chunling Wang, Hui Liu, Liang Wang, Wei Sang
Future Oncology.2024; 20(28): 2071. CrossRef

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Hematologic Malignancy

Prognostic Stratification of Patients with Burkitt Lymphoma Using Serum β2-microglobulin Levels: Hyung-Don Kim, Hyungwoo Cho, Shin Kim, Kyoungmin Lee, Eun Hee Kang, Jung Sun Park, Chan-Sik Park, Jooryung Huh, Jin Sook Ryu, Sang-Wook Lee, Dok-Hyun Yoon, Seok Jin Kim, Young Hyeh Ko, Won Seog Kim, Cheolwon Suh; Cancer Res Treat. 2021;53(3):847-856. Published online December 17, 2020; DOI: https://doi.org/10.4143/crt.2020.1060

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Purpose
We aimed to investigate the prognostic value of serum β2-microglobulin for patients with Burkitt lymphoma (BL) and to propose a risk-stratifying classification system.
Materials and Methods
A prospective registry-based cohort study of BL patients treated with dose-intensive or effective dose-adjusted chemotherapies (n=81) was conducted. Survival outcomes were compared based on previously reported risk groups and/or serum β2-microglobulin levels. A risk-stratifying classification system incorporating serum β2-microglobulin levels was proposed and validated in an independent validation cohort (n=60).
Results
The median age was 47 years, and 57 patients (70.4%) were male. Patients with high serum β2-microglobulin levels (> 2 mg/L) had significantly worse progression-free survival (PFS) and overall survival (OS) (p < 0.01 for both). Serum β2-microglobulin levels further stratified patients in the low-risk and high-risk groups in terms of PFS (p=0.010 and p=0.044, respectively) and OS (p=0.014 and p=0.026, respectively). Multivariate analyses revealed that a high serum β2-microglobulin level (> 2 mg/L) was independently associated with a shorter PFS (hazards ratio [HR], 3.56; p=0.047) and OS (HR, 4.66; p=0.043). The new classification system incorporating the serum β2-microglobulin level allowed the stratification of patients into three distinct risk subgroups with 5-year OS rates of 100%, 89.5%, and 62.5%. In an independent cohort of BL, the system was validated by stratifying patients with different survival outcomes.
Conclusion
Serum β2-microglobulin level is an independent prognostic factor for BL patients. The proposed β2-microglobulin–based classification system could stratify patients with distinct survival outcomes, which may help define appropriate treatment approaches for individual patients.

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Prognostic Factors for Survival in Adults With Burkitt Lymphoma: A Systematic Review
Aythami de Armas‐Castellano, Diego Infante‐Ventura, Tasmania del Pino‐Sedeño, Yadira González Hernández, Raul Quiros, Beatriz León‐Salas, Vincent Ribrag, María M. Trujillo‐Martín
Cancer Medicine.2025;[Epub] CrossRef
The clinical significance and prognostic value of serum beta-2 microglobulin in adult lymphoma-associated hemophagocytic lymphohistiocytosis: a multicenter analysis of 326 patients
Ze Jin, Yi Miao, Jie Zhang, Jing Zhang, Chunling Wang, Xuzhang Lu, Yuqing Miao, Miao Sun, Yunping Zhang, Yun Zhuang, Haiwen Ni, Jingyan Xu, Wanchuan Zhuang, Min Zhao, Jianfeng Zhu, Min Xu, Guoqiang Lin, Haiying Hua, Xiaoyan Xie, Maozhong Xu, Tao Jia, Liji
Annals of Hematology.2024; 103(7): 2257. CrossRef
Prognostic Value of18F-FDG PET/CT Radiomics in Extranodal Nasal-Type NK/T Cell Lymphoma
Yu Luo, Zhun Huang, Zihan Gao, Bingbing Wang, Yanwei Zhang, Yan Bai, Qingxia Wu, Meiyun Wang
Korean Journal of Radiology.2024; 25(2): 189. CrossRef
The Role of Beta2-Microglobulin in Central Nervous System Disease
Zhen-Yuan Liu, Feng Tang, Jin-Zhou Yang, Xi Chen, Ze-Fen Wang, Zhi-Qiang Li
Cellular and Molecular Neurobiology.2024;[Epub] CrossRef
Serum beta2-microglobulin acts as a biomarker for severity and prognosis in glioma patients: a preliminary clinical study
Zhen-Yuan Liu, Feng Tang, Jing Wang, Jin-Zhou Yang, Xi Chen, Ze-Fen Wang, Zhi-Qiang Li
BMC Cancer.2024;[Epub] CrossRef
Serum beta2-microglobulin and peripheral blood eosinophils for the assessment of severity and prognosis with omicron variant COVID-19 infection
Jie Tan, Hanxi Fang, Xiao Hu, Ming Yue, Junling Yang
Frontiers in Molecular Biosciences.2024;[Epub] CrossRef
A novel inflammation-related prognostic model for predicting the overall survival of primary central nervous system lymphoma: A real-world data analysis
Zhentian Wu, Chenyi Wang, Yao Lyu, Zheshen Lin, Ming Lu, Shixiong Wang, Bingxuan Wang, Na Yang, Yeye Li, Jianhong Wang, Xiaohui Duan, Na Zhang, Jing Gao, Yuan Zhang, Miaowang Hao, Zhe Wang, Guangxun Gao, Rong Liang
Frontiers in Oncology.2023;[Epub] CrossRef
Beta2-microglobulin is a valuable marker and identifies a poor-prognosis subgroup among intermediate-risk patients with diffuse large B cell lymphoma
Ning-Chun Chen, Hung Chang, Hsiao-Wen Kao, Che-Wei Ou, Ming-Chung Kuo, Po-Nan Wang, Tung-Liang Lin, Jin-Hou Wu, Yu-Shin Hung, Yi-Jiun Su, Yuen-Chin Ong, Hsuan-Jen Shih
Clinical and Experimental Medicine.2023; 23(7): 3759. CrossRef
Tuberculosis combined with Burkitt lymphoma in a kidney transplant recipient: A case report and literature review
Jian-Nan Hu, Mu-Qing Yu, Li-Juan Hua, Chen Bao, Qian Liu, Chao Liu, Zi-Ling Li, Xi Wang, Shu-Yun Xu
Medicine.2023; 102(18): e33671. CrossRef
Elevated serum beta-2 microglobulin level predicts short-term poor prognosis of patients with de novo acute omicron variant COVID-19 infection
Shengping Gong, Ruishuang Ma, Ting Zhu, Xiaoqin Ge, Rongrong Xie, Qingsong Tao, Cong Shi
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef
An Externally Validated Nomogram for Predicting the Overall Survival of Patients With Diffuse Large B-Cell Lymphoma Based on Clinical Characteristics and Systemic Inflammatory Markers
Yajiao Liu, Li Sheng, Haiying Hua, Jingfen Zhou, Ying Zhao, Bei Wang
Technology in Cancer Research & Treatment.2023;[Epub] CrossRef
Prognostic significance of serum β2-microglobulin levels in patients with peripheral T-cell lymphoma not otherwise specified
Hyung-Don Kim, Hyungwoo Cho, Byeong Seok Sohn, Chan-Sik Park, Jooryung Huh, Jin Sook Ryu, Sang-Wook Lee, Sang Eun Yoon, Seok Jin Kim, Young Hyeh Ko, Won Seog Kim, Cheolwon Suh
Leukemia & Lymphoma.2022; 63(1): 124. CrossRef

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Comparison of the Clinical Outcomes of Patients with Squamous Cell Carcinoma of the Tonsil Receiving Postoperative Ipsilateral Versus Bilateral Neck Radiotherapy: A Propensity Score Matching Analysis (KROG 11-07): Youngkyong Kim, Kwan Ho Cho, Sung Ho Moon, Chang Geol Lee, Ki Chang Keum, Sang-wook Lee, Yong Chan Ahn, Dongryul Oh, Yeon-Sil Kim, Yong Kyun Won, Hong-Gyun Wu, J. Hun Hah, Young-Taek Oh; Cancer Res Treat. 2017;49(4):1097-1105. Published online February 9, 2017; DOI: https://doi.org/10.4143/crt.2016.425

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Purpose
The impact of postoperative ipsilateral neck radiotherapy (INRT) versus bilateral neck radiotherapy (BNRT) on the clinical outcomes of patients with tonsillar squamous cell carcinoma was analyzed retrospectively.
Materials and Methods
Between October 2001 and June 2012, 241 patients with T1-2 and N0-N2b tonsillar carcinoma from 16 institutes underwent postoperative INRT (n=84) or BNRT (n=157) following a tonsillectomy. Seventy patientswere identified from each group by propensity score matching and compared in terms of the overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates calculated using the Kaplan-Meier method with a log-rank test.
Results
The median follow-up was 55 months (range, 3 to 133 months). The survival outcomes in the INRT and BNRT groupswere similar: 5-year OS (92.8% vs. 94.0%, p=0.985), DFS (80.5% vs. 94.2%. p=0.085), LRRFS (88.1% vs. 97.1%, p=0.083), and DMFS (92.7% vs. 97.0%, p=0.370). Subgroup analysis revealed no contralateral neck recurrence in 61 patients with T1-2N0-2a regardless of the treatment groups. For 79 patients with N2b, contralateral neck recurrence was more common in the INRT group than in the BNRT group (7.9% vs. 0.0%), but the difference was not significant (p=0.107). The overall grade ≥ 2 toxicities were lower in the INRT group: acute (45.7% vs. 74.3%, p=0.001) and late (4.3% vs. 31.4%, p < 0.001), respectively.
Conclusion
INRT is an attractive strategy for patients with T1-2N0-2a tonsillar carcinoma compared to BNRT. For patients with N2b, there was a small risk of contralateral neck recurrence when treated with INRT, but its impact on the OS was limited with successful salvage treatment.

Citations

Citations to this article as recorded by

Impact of Postoperative Neck Radiotherapy Volumes on Long‐Term Unstimulated Saliva Flow Following Primary Surgery and Ipsilateral Neck Dissection for Oral Cavity Squamous Cell Carcinoma
Claire M. Rooney, Shao Hui Huang, Jie Su, Scott Bratman, John Cho, John de Almeida, Michael Glogauer, David Goldstein, Ezra Hahn, Ali Hosni, Andrew Hope, Jonathan Irish, John Kim, Brian O'Sullivan, Jolie Ringash, Anna Spreafico, Jillian Tsai, John Waldron
Head & Neck.2025; 47(3): 847. CrossRef
A multi‐institutional feasibility lead‐in trial of lymphatic mapping with SPECT–CT for evaluating contralateral disease in lateralized oropharynx cancer using 99m‐technetium sulfur colloid
Leba Michael Sarkis, Christopher MKL Yao, Aaron Hendler, Ravi Mohan, Michael Au, Han Zhang, Antoine Eskander, Kevin Higgins, Danielle MacNeil, Sharon Tzelnick, David Goldstein, Ali Hosni, John R. de Almeida
Head & Neck.2024; 46(12): 3038. CrossRef
Radiation Therapy for HPV-Positive Oropharyngeal Squamous Cell Carcinoma: An ASTRO Clinical Practice Guideline
Danielle N. Margalit, Christopher J. Anker, Michalis Aristophanous, Musaddiq Awan, Gopal K. Bajaj, Lisa Bradfield, Joseph Califano, Jimmy J. Caudell, Christina H. Chapman, Adam S. Garden, Paul M. Harari, Amanda Helms, Alexander Lin, Ellie Maghami, Ranee M
Practical Radiation Oncology.2024; 14(5): 398. CrossRef
Proton pencil beam scanning radiotherapy in the postoperative treatment of p16 positive squamous cell tonsillar cancer – evaluation of toxicity and effectivity
Jiří Kubeš, Sarah Al-Hamami, Silvia Sláviková, Pavel Vítek, Alexandra Haas, Kateřina Dědečková, Barbora Ondrová, Michal Andrlik, Matěj Navrátil, Eliška Rotnáglová, Vladimír Vondráček
European Archives of Oto-Rhino-Laryngology.2024; 281(10): 5447. CrossRef
Unilateral radiotherapy for tonsillar cancer with multiple ipsilateral neck lymph nodes
Tae Hyun Kim, Hong-Gyun Wu, Soon-Hyun Ahn, Woo-Jin Jeong, Wonjae Cha, Keun-Yong Eom
Radiation Oncology Journal.2024; 42(3): 192. CrossRef
Association of Unilateral Radiotherapy With Contralateral Lymph Node Failure Among Patients With Squamous Cell Carcinoma of the Tonsil
Niema B. Razavian, Ralph B. D’Agostino, Cole R. Steber, Corbin A. Helis, Ryan T. Hughes
JAMA Network Open.2023; 6(2): e2255209. CrossRef
Low contralateral neck recurrence risk with ipsilateral neck radiotherapy in N2b tonsillar squamous cell carcinoma
Divya Natesan, Christina K. Cramer, Taofik Oyekunle, Donna Niedzwiecki, David M. Brizel, Yvonne M. Mowery
Oral Oncology.2023; 139: 106362. CrossRef
Characterizing Lymph Node Burden With Elective Unilateral Neck Irradiation in Human Papillomavirus-Positive Tonsil Squamous Cell Carcinoma: Defining the Upper Limits
Jared H Hara, Stanley I Gutiontov, Sophia Uddin, Ari J Rosenberg, Alexander T Pearson, Zhen Gooi, Elizabeth A Blair, Nishant Agrawal, Everett E Vokes, Daniel T Ginat, Daniel J Haraf, Aditya Juloori
Cureus.2022;[Epub] CrossRef
Evaluating contralateral neck failure in patients with lateralized OPSCC treated with transoral robotic surgery and neck management based on pre-operative SPECT-CT lymphatic mapping
Ilyes Berania, Ali Hosni, Carissa M. Thomas, David Goldstein, Andrew Bayley, Ravi Mohan, Aaron Hendler, Richard M. Cooper, John R. de Almeida
Journal of Otolaryngology - Head & Neck Surgery.2022;[Epub] CrossRef
Short‐term and long‐term unstimulated saliva flow following unilateral vs bilateral radiotherapy for oropharyngeal carcinoma
Shao Hui Huang, John R. de Almeida, Erin Watson, Michael Glogauer, Wei Xu, Sareh Keshavarzi, Brian O'Sullivan, Jolie Ringash, Andrew Hope, Andrew Bayley, Scott V. Bratman, John Cho, Meredith Giuliani, John Kim, John Waldron, Anna Spreafico, David P Goldst
Head & Neck.2021; 43(2): 456. CrossRef
Ipsilateral radiation for squamous cell carcinoma of the tonsil: American Radium Society appropriate use criteria executive summary
C. Jillian Tsai, Thomas J. Galloway, Danielle N. Margalit, Richard L. Bakst, Beth M. Beadle, Jonathan J. Beitler, Steven Chang, Allen Chen, Jay Cooper, Shlomo A. Koyfman, John A. Ridge, Jared Robbins, Minh Tam Truong, Sue S. Yom, Farzan Siddiqui
Head & Neck.2021; 43(1): 392. CrossRef
Healthcare resource utilization following unilateral versus bilateral radiation therapy for oropharyngeal carcinoma
Ali Hosni, Shao Hui Huang, Wei Xu, Jie Su, Erin Watson, Michael Glogauer, Andrew Bayley, Scott V. Bratman, John Cho, Meredith Giuliani, Andrew Hope, John Kim, Brian O'Sullivan, Jolie Ringash, Anna Spreafico, David P. Goldstein, John Waldron, John R. de Al
Radiotherapy and Oncology.2021; 156: 95. CrossRef
Refining Guidelines Regarding Unilateral Treatment in Patients With Well-lateralized Squamous Cell Carcinoma of the Palatine Tonsil and Multiple Positive Nodes or Extranodal Extension
Robert J. Amdur, Paul M. Harari, Peter T. Dziegielewski, William M. Mendenhall
Practical Radiation Oncology.2021; 11(3): e247. CrossRef
Unilateral versus bilateral nodal irradiation: Current evidence in the treatment of squamous cell carcinoma of the head and neck
Sandra Nuyts, Heleen Bollen, Avrahram Eisbruch, June Corry, Primoz Strojan, Antti A. Mäkitie, Johannes A. Langendijk, William M. Mendenhall, Robert Smee, Remco DeBree, Anne W. M. Lee, Alessandra Rinaldo, Alfio Ferlito
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Phuong Nam Tran
Journal of Clinical Medicine- Hue Central Hospital.2021;[Epub] CrossRef
Efficacy of Postoperative Unilateral Neck Irradiation in Patients with Buccal Mucosa Squamous Carcinoma with Extranodal Extension: A Propensity Score Analysis
Chia-Hsin Lin, Chien-Yu Lin, Kang-Hsing Fan, Sheng-Ping Hung, Yung-Chih Chou, Chia-Jen Liu, Wen-Chi Chou, Yen-Chao Chen, Shiang-Fu Huang, Chung-Jan Kang, Kai-Ping Chang, Hung-Ming Wang, Ann-Joy Cheng, Joseph Tung-Chieh Chang
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Contralateral nodal failures in oropharyngeal cancers after TORS and unilateral neck management: A retrospective study
Axel Sahovaler, John J. W. Lee, Wei Xu, Susie Su, Ali Hosni, Andrew Bayley, David P. Goldstein, John R. de Almeida
Journal of Otolaryngology - Head & Neck Surgery.2021;[Epub] CrossRef
Lymphatic mapping with SPECT‐CT for evaluation of contralateral drainage in lateralized oropharyngeal cancers using an awake injection technique
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Head & Neck.2020; 42(3): 385. CrossRef
Pretreatment predictive factors for feasibility of oral intake in adjuvant concurrent chemoradiotherapy for patients with locally advanced squamous cell carcinoma of the head and neck
Hidenori Kimura, Satoshi Hamauchi, Sadayuki Kawai, Yusuke Onozawa, Hirofumi Yasui, Aiko Yamashita, Hirofumi Ogawa, Tsuyoshi Onoe, Tomoyuki Kamijo, Yoshiyuki Iida, Tetsuro Onitsuka, Tomoya Yokota
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Désescalade thérapeutique dans les cancers de l’oropharynx induit par les HPV : mise au point
C. Lahmamssi, J.-B. Guy, N. Benchekroun, Z. Bouchbika, N. Taoufik, H. Jouhadi, S. Sahraoui, A. Benider, M. Ben Mrad, O. Jmour, A. Bousarsar, M.L. Lan, Q. Lei, M. Benna, D. Moslemi, A. Vallard, N. Magné
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The impact of tongue-deviating and tongue-depressing oral stents on long-term radiation-associated symptoms in oropharyngeal cancer survivors
Sonja Stieb, Ismael Perez-Martinez, Abdallah S.R. Mohamed, Stockton Rock, Nimit Bajaj, Tanaya S. Deshpande, Mohamed Zaid, Adam S. Garden, Ryan P. Goepfert, Richard Cardoso, Renata Ferrarotto, Jay P. Reddy, Jack Phan, William H. Morrison, David I. Rosentha
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Is there a patient population with squamous cell carcinoma of the head and neck region who might benefit from de-intensification of postoperative radiotherapy?
Yonca Onbasi, Sebastian Lettmaier, Markus Hecht, Sabine Semrau, Heinrich Iro, Marco Kesting, Rainer Fietkau, Marlen Haderlein
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Optimal Timing for the Administration of Capecitabine with Preoperative Chemoradiation for Locally Advanced Rectal Cancer: Young Ju Noh, Won Sik Choi, Jong Hoon Kim, Jin Cheon Kim, Chang Sik Yu, Hee Cheol Kim, Tae Won Kim, Heung Moon Chang, Min Hee Ryu, Seung Do Ahn, Sang-wook Lee, Seong Soo Shin, Jung Eun Lee, Eun Kyung Choi; Cancer Res Treat. 2006;38(1):30-34. Published online February 28, 2006; DOI: https://doi.org/10.4143/crt.2006.38.1.30

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Purpose

Capecitabine is an oral fluoropyrimidine carbamate and it is known as an effective radiosensitizer. Capecitabine and its metabolite reach their peak concentration in the plasma at 1~2 hours after a single oral administration of capecitabine and the levels fall rapidly thereafter. To verify the radiosensitizing effect of capecitabine that is based on such pharmacokinetic characteristics, we performed a retrospective analysis on the optimal timing of capecitabine administration with performing preoperative chemoradiation for locally advanced rectal cancer.

Materials and Methods

Among 171 patients who were treated with preoperative radiotherapy and concurrent capecitabine administration for rectal cancer, 56 patients were administered capecitabine at 1~2 hours before radiotherapy (group A), and at other time in the other 115 patients (group B). Total mesorectal excision was done at 4 to 6 weeks after the completion of chemoradiation. The radiosensitizing effect of capecitabine was evaluated on the basis of the pathological response.

Results

Complete pathological regression of the primary tumor was observed in 12 patients (21.4%) for group A and in 11 patients (9.6%) for group B (p=0.031). Residual disease less than 0.5 cm (a good response) was observed in 19 patients (33.9%) for group A and in 23 patients (20.0%) for group B (p=0.038). On multivariate analysis, the capecitabine ingestion time showed marginal significance.

Conclusion

When performing preoperative chemoradiation for locally advanced rectal cancer, the radiosensitizing effect of capecitabine was enhanced when it was administered 1 hour before radiotherapy.

Citations

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Systematic review of treatment intensification using novel agents for chemoradiotherapy in rectal cancer
R Clifford, N Govindarajah, J L Parsons, S Gollins, N P West, D Vimalachandran
British Journal of Surgery.2018; 105(12): 1553. CrossRef

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A Preliminary Results of a Randomized Trial Comparing Monthly 5-flourouracil and Cisplatin to Weekly Cisplatin Alone Combined with Concurrent Radiotherapy for Locally Advanced Cervical Cancer: Young Seok Kim, Seong Soo Shin, Eun Kyung Choi, Jong Hoon Kim, Seung Do Ahn, Sang-wook Lee, Heon-Jin Park, Young-Tak Kim, Jung-Eun Mok, Joo-Hyun Nam; Cancer Res Treat. 2005;37(1):37-43. Published online February 28, 2005; DOI: https://doi.org/10.4143/crt.2005.37.1.37

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Purpose

To determine the superior chemotherapeutic regimen between monthly 5-FU plus cisplatin (FP) and weekly cisplatin alone in concurrent chemoradiotherapy for locally advanced cervical cancer, the compliance of treatment, response, survival and toxicities were analyzed between the two arms.

Materials and Methods

Between March 1998 and December 2001, 61 patients with locally advanced cervical cancer (stage IIB through IVA) and negative para-aortic lymph nodes were randomly assigned to either 'monthly FP' (arm I, n=34) or 'weekly cisplatin' (arm II, n=27) with concurrent radiotherapy. The patients of arm I received FP (5-FU 1,000 mg/m²/day + cisplatin 20 mg/m²/day, for 5 days, for 3 cycles at 4 week intervals) and those of arm II received cisplatin (30 mg/m²/day, for 6 cycles at 1 week intervals) with concurrent radiotherapy. The radiotherapy consisted of 41.4~50.4 Gy external beam irradiation in 23~28 fractions to the whole pelvis, with high dose rate brachytherapy delivering a dose of 30~35 Gy in 6~7 fractions to point A. During the brachytherapy, a parametrial boost was delivered. The median follow-up period for survivors was 44 months.

Results

The compliance of treatment in monthly FP weekly cisplatin arms were 62 and 81%, respectively. The complete response rates at 3 months were 96 and 88% in arms I and II, respectively. The 4-year overall survival and disease free survival rates were 64 and 54% in the arm I and 77 and 66% in the arm II, respectively. The incidence of hematologic toxicity more than grade 2 was 29% in the arm I and 15% in the arm II. Only one patient in arm I experienced grade 3 gastrointestinal toxicity. No severe genitourinary toxicity was observed.

Conclusion

No significant difference was observed in the compliance, responses, survival rates and acute toxicities between the two treatment arms. More patients and further follow up will be required.

Citations

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American Brachytherapy Task Group Report: A pooled analysis of clinical outcomes for high-dose-rate brachytherapy for cervical cancer
Jyoti Mayadev, Akila Viswanathan, Yu Liu, Chin-Shang Li, Kevin Albuquerque, Antonio L. Damato, Sushil Beriwal, Beth Erickson
Brachytherapy.2017; 16(1): 22. CrossRef
Concurrent Weekly Cisplatin Versus Triweekly Cisplatin with Radiotherapy in the Treatment of Cervical Cancer: A Meta-analysis Result
Yan Hu, Zhi-Qiang Cai, Xiao-Yan Su
Asian Pacific Journal of Cancer Prevention.2012; 13(9): 4301. CrossRef
Laparoscopy-Assisted Intracavitary Radiotherapy Tandem Placement for Patients With Cervical Cancer
Myong Cheol Lim, Dae Chul Jung, Joo-Young Kim, Sang-Yoon Park
International Journal of Gynecological Cancer.2009; 19(6): 1125. CrossRef
Adoptive Transfer of Human Papillomavirus E7-specific CTL Enhances Tumor Chemoresponse Through the Perforin/Granzyme-mediated Pathway
Jeong-Im Sin, Jung-Min Kim, Sung Hwa Bae, In Hee Lee, Jong Sup Park, Hun Mo Ryoo
Molecular Therapy.2009; 17(5): 906. CrossRef

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Prospective Phase II Study of Preoperative Chemoradiation with Capecitabine in Locally Advanced Rectal Cancer: Jin-hong Park, Jong Hoon Kim, Seung Do Ahn, Sang-wook Lee, Seong Soo Shin, Jin Cheon Kim, Chang Sik Yu, Hee Cheol Kim, Yoon-Koo Kang, Tae Won Kim, Heung Moon Chang, Min Hee Ryu, Eun Kyung Choi; Cancer Res Treat. 2004;36(6):354-359. Published online December 31, 2004; DOI: https://doi.org/10.4143/crt.2004.36.6.354

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Purpose

Capecitabine is an attractive oral chemotherapeutic agent that has a radiosensitizing effect and tumor-selectivity. This study was performed to evaluate the efficacy and toxicity of preoperative chemoradiation therapy, when used with oral capecitabine, for locally advanced rectal cancer.

Materials and Methods

A prospective phase II trial of preoperative chemoradiation for locally advanced adenocarcinomas of the lower two-thirds of the rectum was conducted. A radiation dose of 50 Gy over five weeks and a daily dose of 1650 mg/m² capecitabine in two potions was administered during the entire course of radiation therapy. Surgery was performed with standardized total mesorectal excision four to six weeks after completion of the chemoradiation.

Results

Between January 2002 and September 2003, 61 patients were enrolled onto this prospective phase II trial. The pretreatment clinical stages were T3 in 64% (n=39), T4 in 36% (n=22) and N1-2 in 82% (n=50) of these patients. Fifty-six (92%) patients completed the chemoradiation as initially planned and a complete resection performed in 58 (95%). Down-staging was observed in 45 patients (74%) and a pathologic complete response in 6 (10%). Among the 37 patients with tumors located within 5 cm from the anal verge on colonoscopy, 27 (73%) underwent a sphincter-preserving procedure. No grade 3 and 4 proctitis or hematological toxicities were observed.

Conclusion

Preoperative chemoradiation therapy with capecitabine achieved encouraging rates of tumor downstaging and sphincter preservation, with a low toxicity profile. This combined modality can be regarded as a safe and effective treatment for locally advanced rectal cancer.

Citations

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Radioresponse of Hepatocellular Carcinoma-Treatment of Lymph Node Metastasis: Sang Min Yoon, Jong Hoon Kim, Eun Kyung Choi, Seung Do Ahn, Sang-wook Lee, Byong Yong Yi, Young Wha Chung, Young Sang Lee, Dong Jin Seo; Cancer Res Treat. 2004;36(1):79-84. Published online February 29, 2004; DOI: https://doi.org/10.4143/crt.2004.36.1.79

Abstract PDF PubReader ePub

Purpose

To analyze the radioresponse of hepatocellular carcinomas (HCC), using accurate measurements of the tumor size in extrahepatic lymph node metastasis, and to obtain information for the future treatment of primary intrahepatic lesions.

Materials and Methods

Fifty-one extrahepatic lymph node metastases from primary HCCs, which could be treated by external radiotherapy alone, were included in this study. The radiation dose ranged from 30 to 51 Gy with fraction sizes of 2.0~3.0 Gy. Responses were determined by measuring the areas on CT scans 0, 1 and 3 months after the completion of radiotherapy. The median follow-up period of the surviving patients was 10 months.

Results

The overall response rate was 76%, and the important factors were; total dose of radiation, time dose fractionation (TDF) value and the biologically effective dose (BED). A dose of 45 Gy or higher showed an objective response rate of 93%, and if the TDF value was higher than 90, a similar result was observed. In about half (47%) of the patients the maximum response was observed at 3 months or later. The response duration was observable in 14 patients surviving 12 months or longer. Regrowth of irradiated lesions were observed in 4 (66.7%) patients among those who received less than 45 Gy, and in 4 (50%) among those who were treated with 45 Gy or more. There was a statistically significant difference in the survivals between the responders and non-responders (p=0.008). Gastrointestinal bleeding or ulceration was observed in 8 patients, including 3 with NCI common toxicity criteria grade III or higher.

Conclusion

Radiotherapy was an effective palliative modality for extrahepatic metastasis in HCCs. A radiation dose of 45 Gy or higher (or a TDF value ≥90), was required for a major response.

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