Cancer Research and Treatment

Review Article

Intensity-Modulated Radiation Therapy for Uterine Cervical Cancer to Reduce Toxicity and Enhance Efficacy – an Option or a Must?: A Narrative Review: Sea-Won Lee, Aeran Kim, Sung Jong Lee, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2024;56(1):1-17. Published online August 30, 2023; DOI: https://doi.org/10.4143/crt.2023.562

Radiotherapy (RT) is a fundamental modality in treatment of cervical cancer. With advancement of technology, conventional RT used for external beam radiotherapy (EBRT) for over half a century has been rapidly replaced with intensity-modulated radiation therapy (IMRT) especially during the last decade. This newer technique is able to differentiate the intensity of radiation within the same field, thus reduces the inevitable exposure of radiation to normal organs and enables better dose delivery to tumors. Recently, the American Society for Radiation Oncology has released a guideline for RT in cervical cancer. Although a section of the guideline recommends IMRT for the purpose of toxicity reduction, a thorough review of the literature is necessary to understand the current status of IMRT in cervical cancer. This narrative review updates the recent high-level evidences regarding the efficacy and toxicity of IMRT and provides a better understanding of the most innovative techniques currently available for EBRT enabled by IMRT.

Citations

Citations to this article as recorded by

Long term clinical outcomes of cervical cancer patients who were recommended surgery but did not undergo it: A SEER database study
Zhaoming Zhang, Hongfu Zhao, Guanghui Cheng
European Journal of Surgical Oncology.2024; 50(10): 108572. CrossRef
Treatment of secondary uterine malignancy following radiotherapy for cervical cancer: a study based on the SEER database
Xiaojing Tong, Yunyun Xiao, Haozhen Li, Hang Zhang, Jiawen Li
BMC Women's Health.2024;[Epub] CrossRef

4,339 View
309 Download
2 Web of Science
2 Crossref

Original Articles

Breast cancer

Quality Assessment and Trend for Breast Cancer Treatment Practice across South Korea Based on Nationwide Analysis of Korean Health Insurance Data during 2013-2017: Kyu Hye Choi, Soo-Yoon Sung, Sea-Won Lee, Ye Won Jeon, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2023;55(2):570-579. Published online December 5, 2022; DOI: https://doi.org/10.4143/crt.2022.882

Abstract PDF PubReader ePub

Purpose
Quality assessment of breast cancer treatment in South Korea showed the upward standardization of the grade since 2013, but treatment disparities still have existed. This study analyzed the five year trend between 2013 and 2017 in the assessment of breast cancer treatment practice using the Korean health insurance data.
Materials and Methods
All the medical records including surgery, chemotherapy, and radiotherapy for 7,354 patients a year on average were evaluated. Twenty indices were consisted of one structural, 17 process-related, and 2 result-related factors. We calculated the coefficient of variation (CV) annually to determine the variation in adherence rate of evaluation indices according to the type of institution (advanced vs. general hospital vs. clinic).
Results
Based on the initial assessment in 2013, 10 out of 20 indicators showed significant variation among the types of institutions with a CV of less than 0.1%. Six of them had a CV decline of less than 0.1%. The CV was still 0.1% or higher in the four indicators, including the composition of professional staff, the implementation of target therapy, the average length of hospital stay, and the hospitalization cost. Regarding the first-grade of assessment, there was a statistically significant relationship between the institution type (p=0.029) and region (metropolitan vs. province, p<0.001).
Conclusion
There were disparities in the structural and systemic treatment factors depending on the institutional type. The quality improvement of the regional institutions and multidisciplinary experts for breast cancer is necessary.

Citations

Citations to this article as recorded by

Contrasting income-based inequalities in incidence and mortality of breast cancer in South Korea, 2006–2015
Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Kyunghee Jung-Choi
Epidemiology and Health.2024; : e2024074. CrossRef

4,023 View
96 Download
1 Crossref

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.

Citations

Citations to this article as recorded by

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

6,254 View
182 Download
1 Web of Science
1 Crossref

SUVmax Predicts Disease Progression after Stereotactic Ablative Radiotherapy in Stage I Non-small Cell Lung Cancer: Yoo-Kang Kwak, Hee Hyun Park, Kyu Hye Choi, Eun Young Park, Soo Yoon Sung, Sea-Won Lee, Ji Hyun Hong, Hyo Chun Lee, Ie Ryung Yoo, Yeon Sil Kim; Cancer Res Treat. 2020;52(1):85-97. Published online May 17, 2019; DOI: https://doi.org/10.4143/crt.2019.007

Abstract PDF PubReader ePub

Purpose
Fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) is gaining evidence as a predictive factor in non-small cell lung cancer (NSCLC). Stereotactic ablative radiotherapy (SABR) is the standard treatment in early-stage NSCLC when a patient is unsuitable for surgery. We performed a study to assess the prognostic clinical significance of PET-CT after SABR in early-stage NSCLC.
Materials and Methods
Seventy-six patients with stage I NSCLC treated with SABR were investigated. Total radiation dose ranged from 36 to 63 Gy in three to eight fractions depending on tumor location and size. Respiratory motion control was implemented at simulation and during treatment. PET-CT prior to SABR was performed in 66 patients (86.8%).
Results
Median follow-up time was 32 months (range, 5 to 142 months). Local control rate at 1, 2, and 5 years were 95.9%, 92.8%, and 86.7%, respectively. Overall survival (OS) at 1, 2, and 5 years were 91.0%, 71.3%, and 52.1% respectively. Cause-specific survival at 1, 2, and 5 years were 98.6%, 93.1%, and 84.3% respectively. Tumor size and pre-SABR maximal standardized uptake value (SUVmax) demonstrated statistical significance in the Kaplan-Meier survival analyses with log-rank test. In multivariate analyses pre-SABR SUVmax remained statistically significant in correlation to OS (p=0.024; hazard ratio [HR], 3.2; 95% confidence interval [CI], 1.2 to 8.8) and with marginal significance in regards to regional progression-free survival (p=0.059; HR, 32.5; 95% CI, 2.6 to 402.5).
Conclusion
Pre-SABR SUVmax demonstrated a predictive power in statistical analyses. Tumors with SUVmax above 6 at diagnosis were associated with inferior outcomes.

Citations

Citations to this article as recorded by

Enhanced NSCLC subtyping and staging through attention-augmented multi-task deep learning: A novel diagnostic tool
Runhuang Yang, Weiming Li, Siqi Yu, Zhiyuan Wu, Haiping Zhang, Xiangtong Liu, Lixin Tao, Xia Li, Jian Huang, Xiuhua Guo
International Journal of Medical Informatics.2025; 193: 105694. CrossRef
Invasive Nodal Staging via Endobronchial Ultrasound and Outcome in Patients Treated with Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer – Results from a Single Institution Study
Benjamin George, Atallah Baydoun, Samar Bhat, Lauryn Bailey, Theodore Arsenault, Yilun Sun, Yuxia Zhang, Yiran Zheng, Prashant Vempati, Tarun Podder, Tithi Biswas
Clinical Lung Cancer.2024; 25(4): e181. CrossRef
Prognostic value of consolidation-to-tumor ratio on computed tomography in NSCLC: a meta-analysis
Yongming Wu, Wenpeng Song, Denian Wang, Junke Chang, Yan Wang, Jie Tian, Sicheng Zhou, Yingxian Dong, Jing Zhou, Jue Li, Ziyi Zhao, Guowei Che
World Journal of Surgical Oncology.2023;[Epub] CrossRef
Tumor to liver maximum standardized uptake value ratio of FDG-PET/CT parameters predicts tumor treatment response and survival of stage III non-small cell lung cancer
Pengfei Zhang, Wei Chen, Kewei Zhao, Xiaowen Qiu, Tao Li, Xingzhuang Zhu, Peng Sun, Chunsheng Wang, Yipeng Song
BMC Medical Imaging.2023;[Epub] CrossRef
Evaluation of response to stereotactic body radiation therapy for nonsmall cell lung cancer: PET response criteria in solid tumors versus response evaluation criteria in solid tumors
Jixia Han, Qi Song, Feng Guo, Rui Du, Henghu Fang, Jingbo Kang, Zejun Lu
Nuclear Medicine Communications.2022;[Epub] CrossRef
Assessing tumor angiogenesis using dynamic contrast-enhanced integrated magnetic resonance-positron emission tomography in patients with non-small-cell lung cancer
Yu-Sen Huang, Jenny Ling-Yu Chen, Hsin-Ming Chen, Li-Hao Yeh, Jin-Yuan Shih, Ruoh-Fang Yen, Yeun-Chung Chang
BMC Cancer.2021;[Epub] CrossRef
Potential role of functional imaging in predicting outcome for patients treated with carbon ion therapy: a review
Giulia Riva, Sara Imparato, Giovanni Savietto, Mattia Pecorilla, Alberto Iannalfi, Amelia Barcellini, Sara Ronchi, Maria Rosaria Fiore, Chiara Paganelli, Giulia Buizza, Mario Ciocca, Guido Baroni, Lorenzo Preda, Ester Orlandi
The British Journal of Radiology.2021;[Epub] CrossRef
Prognostic value of metabolic signature on 18F-FDG uptake in breast cancer patients after radiotherapy
Jin Meng, Emmanuel Deshayes, Li Zhang, Wei Shi, Xiaomeng Zhang, Xingxing Chen, Xin Mei, Jinli Ma, Yizhou Jiang, Jiong Wu, Zhimin Shao, Xiaoli Yu, Zhaozhi Yang, Xiaomao Guo
Molecular Therapy - Oncolytics.2021; 23: 412. CrossRef
Parámetros cuantitativos de la PET/TC con 18F-FDG como factores pronósticos en el cáncer de pulmón localizado e inoperable
J.R. Infante, J. Cabrera, J.I. Rayo, C. Cruz, J. Serrano, M. Moreno, A. Martínez, P. Jiménez, A. Cobo
Revista Española de Medicina Nuclear e Imagen Molecular.2020; 39(6): 353. CrossRef
18F-FDG PET/CT quantitative parameters as prognostic factors in localized and inoperable lung cancer
J.R. Infante, J. Cabrera, J.I. Rayo, C. Cruz, J. Serrano, M Moreno, A. Martínez, P. Jiménez, A. Cobo
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition).2020; 39(6): 353. CrossRef

7,168 View
133 Download
9 Web of Science
10 Crossref

High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity: Ji Hyun Hong, Yeon-Sil Kim, Sea-Won Lee, So Jung Lee, Jin Hyung Kang, Suk Hee Hong, Ju-Young Hong, GeumSeong Cheon; Cancer Res Treat. 2019;51(3):1156-1166. Published online November 29, 2018; DOI: https://doi.org/10.4143/crt.2018.472

Abstract PDF PubReader ePub

Purpose
Thoracic re-irradiation (re-RT) of lung cancer has been challenged by the tolerance doses of normal tissues. We retrospectively analyzed local control, overall survival (OS) and toxicity after thoracic re-RT using highly conformal radiotherapy, such as intensity modulated radiotherapy and stereotactic body radiotherapy.
Materials and Methods
Thirty-one patients who received high-dose thoracic re-RT were analyzed. Doses were recalculated to determine biologically equivalent doses. The median interval to re-RT was 15.1 months (range, 4.4 to 56.3 months), the median initial dose was 79.2 Gy₁₀ (range, 51.75 to 150 Gy₁₀), and the median re-RT dose was 68.8 Gy₁₀ (range, 43.2 to 132 Gy₁₀).
Results
Eighteen (58.1%) and eleven (35.5%) patients showed loco-regional recurrence and distant metastasis, respectively, after 17.4 months of median follow-up. The 1-year and 2-year local control rates were 60.2% and 43.7%, respectively. The median loco-regional recurrence-free-survival (LRFS) was 15.4 months, and the median OS was 20.4 months. The cumulative and re-RT biologically equivalent dose for α/β=10 (BED₁₀) doses were the most significant prognostic factors. Cumulative BED₁₀≥145 Gy₁₀ and re-RT BED₁₀≥68.7 Gy₁₀ were significantly associated with longer OS (p=0.029 and p=0.012, respectively) and LRFS (p=0.003 and p=0.000, respectively). The most frequent acute toxicity was grade 1-2 pulmonary toxicity (41.9%). No acute grade 3 or higher toxicities occurred.
Conclusion
Our results show that high-dose thoracic re-RT of lung cancer can be safely delivered using highly conformal radiotherapy with favorable survival and acceptable toxicity. An optimal strategy to select patients who would benefit from re-RT is crucial in extending the indications and improving the efficacy with a sufficiently high dose.

Citations

Citations to this article as recorded by

ACR-ARS Practice Parameter for the Performance of Proton Beam Therapy
Steven J. Frank, Indra J. Das, Charles B. Simone, Brian J. Davis, Curtiland Deville, Zhongxing Liao, Simon S. Lo, Susan L. McGovern, Rahul R. Parikh, Michael Reilly, William Small, Naomi R. Schechter
International Journal of Particle Therapy.2024; 13: 100021. CrossRef
Ultra-Hypofractionated Re-Irradiation with Anti-PD-1 Immunotherapy for Locoregionally Recurrent (after Radical Chemo-Radiotherapy) Non-Small Cell Lung Cancer
Konstantinos Filippatos, Ioannis M. Koukourakis, Stavros Anevlavis, Axiotis Giaktzidis, Michael I. Koukourakis
Cancers.2023; 15(20): 5083. CrossRef
Re-irradiation for intra-thoracic tumours and extra-thoracic breast cancer: dose accumulation, evaluation of efficacy and toxicity based on a literature review
Dorota Gabrys, Roland Kulik, Agnieszka Namysł-Kaletka
The British Journal of Radiology.2022;[Epub] CrossRef
High Dose Thoracic Re-Irradiation and Chemo-Immunotherapy for Centrally Recurrent NSCLC
Brane Grambozov, Markus Stana, Bernhard Kaiser, Josef Karner, Sabine Gerum, Elvis Ruznic, Barbara Zellinger, Raphaela Moosbrugger, Michael Studnicka, Gerd Fastner, Felix Sedlmayer, Franz Zehentmayr
Cancers.2022; 14(3): 573. CrossRef
Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
Kyungmi Yang, Yang-Gun Suh, Hyunju Shin, Hongryull Pyo, Sung Ho Moon, Yong Chan Ahn, Dongryul Oh, Eunah Chung, Kwanghyun Jo, Jae Myoung Noh
Life.2022; 12(2): 292. CrossRef
Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
Radiation Oncology Journal.2021; 39(1): 24. CrossRef
Thoracic re-irradiation with 3D-conformal or more advanced techniques: A systematic review of treatment safety by the Re-irradiation Study Group of the Italian Association of Radiation and Oncology AIRO
Marta Maddalo, Elisa D’Angelo, Francesco Fiorica, Angela Argenone, Melissa Scricciolo, Salvatore Cozzi, Alessia Nardangeli, Francesco Dionisi, Gianluca Costantino, Stefano Vagge, Antonio Pontoriero, Vittorio Donato, Mariangela Massaccesi
Critical Reviews in Oncology/Hematology.2021; 167: 103500. CrossRef
Radiotherapy for head and neck tumours using an oral fixation and parameter acquisition device and TOMO technology: a randomised controlled study
Xiaofang Zhang, Tianlu Wang, Xinyan Xiao, Xia Li, Chen Yu Wang, Bo Huang, Lei He, Yingqiu Song
BMJ Open.2021; 11(11): e052542. CrossRef
The Medical Physics Management of Reirradiation Patients
Kelly C. Paradis, Martha M. Matuszak
Seminars in Radiation Oncology.2020; 30(3): 204. CrossRef
Reirradiation at local relapse of non-small cell lung cancer
D.V. Gogolin, I.A. Gulidov, Y.S. Mardynsky, T.Y. Antonenko, A.Y. Buksha
Onkologiya. Zhurnal imeni P.A.Gertsena.2020; 9(3): 48. CrossRef

8,240 View
255 Download
8 Web of Science
10 Crossref

A Novel Prognostic Nomogram for Predicting Risks of Distant Failure in Patients with Invasive Breast Cancer Following Postoperative Adjuvant Radiotherapy: Yu Jin Lim, Sea-Won Lee, Noorie Choi, Jeanny Kwon, Keun-Yong Eom, Eunyoung Kang, Eun-Kyu Kim, Jee Hyun Kim, Yu Jung Kim, Se Hyun Kim, So Yeon Park, In Ah Kim; Cancer Res Treat. 2018;50(4):1140-1148. Published online December 7, 2017; DOI: https://doi.org/10.4143/crt.2017.508

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to identify predictors for distant metastatic behavior and build a related prognostic nomogram in breast cancer.
Materials and Methods
A total of 1,181 patients with non-metastatic breast cancer between 2003 and 2011 were analyzed. To predict the probability of distant metastasis, a nomogram was constructed based on prognostic factors identified using a Cox proportional hazards model.
Results
The 7-year overall survival and 5-year post-progression survival of locoregional versus distant recurrence groups were 67.6% versus 39.1% (p=0.027) and 54.2% versus 33.5% (p=0.043), respectively. Patients who developed distant metastasis showed early and late mortality risk peaks within 3 and after 5 years of follow-up, respectively, but a broad and low risk increment was observed in other patients with locoregional relapse. In multivariate analysis of distant metastasis-free interval, age (≥ 45 years vs. < 45 years), molecular subtypes (luminal A vs. luminal B, human epidermal growth receptor 2, and triple negative), T category (T1 vs. T2-3 and T4), and N category (N0 vs. N1 and N2-3) were independently associated (p < 0.05 for all). Regarding the significant factors, a well-validated nomogram was established (concordance index, 0.812). The risk score level of patients with initial brain failure was higher than those of non-brain sites (p=0.029).
Conclusion
The nomogram could be useful for predicting the individual probability of distant recurrence in breast cancer. In high-risk patients based on the risk scores, more aggressive systemic therapy and closer surveillance for metastatic failure should be considered.

Citations

Citations to this article as recorded by

Predicting Patterns of Distant Metastasis in Breast Cancer Patients following Local Regional Therapy Using Machine Learning
Audrey Shiner, Alex Kiss, Khadijeh Saednia, Katarzyna J. Jerzak, Sonal Gandhi, Fang-I Lu, Urban Emmenegger, Lauren Fleshner, Andrew Lagree, Marie Angeli Alera, Mateusz Bielecki, Ethan Law, Brianna Law, Dylan Kam, Jonathan Klein, Christopher J. Pinard, Ale
Genes.2023; 14(9): 1768. CrossRef
Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Breast Invasive Ductal Carcinoma Patients After Surgery: A Large Population-Based Study
Yuqian Feng, Yiting Zhang, Yuying Xiang, Kaibo Guo, Huimin Jin, Shanming Ruan, Zhuoya Guan
Frontiers in Surgery.2022;[Epub] CrossRef
Cost-effectiveness of postmastectomy hypofractionated radiation therapy vs conventional fractionated radiation therapy for high-risk breast cancer
Jing Yang, Shu-Nan Qi, Hui Fang, Yong-Wen Song, Jing Jin, Yue-Ping Liu, Wei-Hu Wang, Yong Yang, Yu Tang, Hua Ren, Bo Chen, Ning-Ning Lu, Yuan Tang, Ning Li, Hao Jing, Shu-Lian Wang, Ye-Xiong Li
The Breast.2021; 58: 72. CrossRef
Prediction of distant metastatic recurrence by tumor-infiltrating lymphocytes in hormone receptor-positive breast cancer
Koji Takada, Shinichiro Kashiwagi, Yuka Asano, Wataru Goto, Rika Kouhashi, Akimichi Yabumoto, Sae Ishihara, Tamami Morisaki, Masatsune Shibutani, Hiroaki Tanaka, Kosei Hirakawa, Masaichi Ohira
BMC Women's Health.2021;[Epub] CrossRef
Nomogram for the personalisation of radiotherapy treatments in breast cancer patients
Inmaculada Beato Tortajada, Carlos Ferrer Albiach, Virginia Morillo Macias
The Breast.2021; 60: 255. CrossRef
Prognostic Factors and Nomograms to Predict Overall and Cancer-Specific Survival for Children with Wilms’ Tumor
Fucai Tang, Hanbin Zhang, Zechao Lu, Jiamin Wang, Chengwu He, Zhaohui He
Disease Markers.2019; 2019: 1. CrossRef
Score for the Survival Probability in Metastasis Breast Cancer: A Nomogram-Based Risk Assessment Model
Zhenchong Xiong, Guangzheng Deng, Xinjian Huang, Xing Li, Xinhua Xie, Jin Wang, Zeyu Shuang, Xi Wang
Cancer Research and Treatment.2018; 50(4): 1260. CrossRef

9,122 View
233 Download
11 Web of Science
7 Crossref

The Impact of Surgical Timing on Pathologic Tumor Response after Short Course and Long Course Preoperative Chemoradiation for Locally Advanced Rectal Adenocarcinoma: Sea-Won Lee, Jong Hoon Lee, In Kyu Lee, Seong Taek Oh, Dae Yong Kim, Tae Hyun Kim, Jae Hwan Oh, Ji Yeon Baek, Hee Jin Chang, Hee Chul Park, Hee Cheol Kim, Eui Kyu Chie, Taek-Keun Nam, Hong Seok Jang; Cancer Res Treat. 2018;50(3):1039-1050. Published online November 21, 2017; DOI: https://doi.org/10.4143/crt.2017.252

Abstract PDF PubReader ePub

Purpose
A pooled analysis of multi-institutional trials was performed to analyze the effect of surgical timing on tumor response by comparing short course concurrent chemoradiotherapy (CCRT) with long course CCRT followed by delayed surgery in locally advanced rectal cancer.
Materials and Methods
Three hundred patients with cT3-4N0-2 rectal adenocarcinoma were included. Long course patients from KROG 14-12 (n=150) were matched 1:1 to 150 short course patients from KROG 10-01 (NCT01129700) and KROG 11-02 (NCT01431599) according to stage, age, and other risk factors. The primary endpoint was to determine the interval between surgery and the last day of neoadjuvant CCRT which yields the best tumor response after the short course and long course CCRT. Downstaging was defined as ypT0-2N0M0 and pathologic complete response (ypCR) was defined as ypT0N0M0, respectively.
Results
Both the long and short course groups achieved lowest downstaging rates at < 6 weeks (long 20% vs. short 8%) and highest downstaging rates at 6-7 weeks (long 44% vs. short 40%). The ypCR rates were lowest at < 6 weeks (both long and short 0%) and highest at 6-7 weeks (long 21% vs. short 11%) in both the short and long course arms. The downstaging and ypCR rates of long course group gradually declined after the peak at 6-7 weeks and those of the short course group trend to constantly increase afterwards.
Conclusion
It is optimal to perform surgery at least 6 weeks after both the short course and long course CCRT to obtain maximal tumor regression in locally advanced rectal adenocarcinoma.

Citations

Citations to this article as recorded by

Association between personality types and low anterior resection syndrome in rectal cancer patients following surgery
Ting‐Yu Chiang, Yu‐Jen Hsu, Yih‐Jong Chern, Chun‐Kai Liao, Wen‐Sy Tsai, Pao‐Shiu Hsieh, Hung‐Chih Hsu, Yu‐Fen Lin, Hsiu‐Lan Lee, Jeng‐Fu You
Cancer Medicine.2024;[Epub] CrossRef
Lateral Lymph Node Size and Tumor Distance From Anal Verge Accurately Predict Positive Lateral Pelvic Lymph Nodes in Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Diseases of the Colon & Rectum.2023; 66(6): 785. CrossRef
Robotic Lateral Pelvic Lymph Node Dissection Could Harvest More Lateral Pelvic Lymph Nodes over Laparoscopic Approach for Mid-to-Low Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ri Na Yoo, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Biomedicines.2023; 11(6): 1556. CrossRef
Does a long interval between neoadjuvant chemoradiotherapy and surgery benefit the clinical outcomes of locally advanced rectal cancer? A systematic review and meta analyses
Miao Yu, Deng-Chao Wang, Sheng Li, Li-Yan Huang, Jian Wei
International Journal of Colorectal Disease.2022; 37(4): 855. CrossRef
Predicting Factors of Complete Pathological Response in Locally Advanced Rectal Cancer
AmirHossein Latif, Mohammad Shirkhoda, Mohammad Reza Rouhollahi, Saeed Nemati, Seyed Hossein Yahyazadeh, Kazem Zendehdel, Ahmad Reza Soroush, Aidin Yaghoobi Notash
Middle East Journal of Digestive Diseases.2022; 14(4): 443. CrossRef
Practical recommendation for treatment of patients with colon cancer during covid-19 pandemic
M. Yu. Fedyanin
Meditsinskiy sovet = Medical Council.2020; (9): 213. CrossRef
Meta-analysis of the effect of extending the interval after long-course chemoradiotherapy before surgery in locally advanced rectal cancer
É J Ryan, D P O'Sullivan, M E Kelly, A Z Syed, P C Neary, P R O'Connell, D O Kavanagh, D C Winter, J M O'Riordan
British Journal of Surgery.2019; 106(10): 1298. CrossRef
Preoperative short-course radiotherapy (5 × 5 Gy) with delayed surgery versus preoperative long-course radiotherapy for locally resectable rectal cancer: a meta-analysis
Wang Qiaoli, Huang Yongping, Xiong Wei, Xu Guoqiang, Ju Yunhe, Liu Qiuyan, Li Cheng, Guo Mengling, Li Jiayi, Xiong Wei, Yang Yi
International Journal of Colorectal Disease.2019; 34(12): 2171. CrossRef
Comparison of long course and short course preoperative radiotherapy in the treatment of locally advanced rectal cancer: a systematic review and meta-analysis
Yongjun Yu, Yuwei Li, Chen Xu, Zhao Zhang, Xipeng Zhang
Revista Española de Enfermedades Digestivas.2018;[Epub] CrossRef

9,396 View
331 Download
8 Web of Science
9 Crossref

Setup Error and Effectiveness of Weekly Image-Guided Radiation Therapy of TomoDirect for Early Breast Cancer: Mi Joo Chung, Guk Jin Lee, Young Jin Suh, Hyo Chun Lee, Sea-Won Lee, Songmi Jeong, Jeong Won Lee, Sung Hwan Kim, Dae Gyu Kang, Jong Hoon Lee; Cancer Res Treat. 2015;47(4):774-780. Published online February 13, 2015; DOI: https://doi.org/10.4143/crt.2014.189

Abstract PDF PubReader ePub

Purpose
This study investigated setup error and effectiveness of weekly image-guided radiotherapy (IGRT) of TomoDirect for early breast cancer. Materials and Methods One hundred and fifty-one breasts of 147 consecutive patients who underwent breast conserving surgery followed by whole breast irradiation using TomoDirect in 2012 and 2013 were evaluated. All patients received weekly IGRT. The weekly setup errors from simulation to each treatment in reference to chest wall and surgical clips were measured. Random, systemic, and 3-dimensional setup errors were assessed. Extensive setup error was defined as 5 mm above the margin in any directions.
Results
All mean errors were within 3 mm of all directions. The mean angle of gantry shifts was 0.6°. The mean value of absolute 3-dimensional setup error was 4.67 mm. In multivariate analysis, breast size (odds ratio, 2.82; 95% confidence interval, 1.00 to 7.90) was a significant factor for extensive error. The largest significant deviation of setup error was observed in the first week of radiotherapy (p < 0.001) and the deviations gradually decreased with time. The deviation of setup error was 5.68 mm in the first week and within 5 mm after the second week. Conclusion In this study, there was a significant association between breast size and significant setup error in breast cancer patients who received TomoDirect. The largest deviation occurred in the first week of treatment. Therefore, patients with large breasts should be closely observed on every fraction and fastidious attention is required in the first fraction of IGRT.

Citations

Citations to this article as recorded by

AAPM Task Group Report 306: Quality control and assurance for tomotherapy: An update to Task Group Report 148
Quan Chen, Yi Rong, Jay W. Burmeister, Edward H. Chao, Nathan A. Corradini, David S. Followill, X. Allen Li, An Liu, X. Sharon Qi, Hairong Shi, Jennifer B. Smilowitz
Medical Physics.2023;[Epub] CrossRef
Robustness of VMAT to setup errors in postmastectomy radiotherapy of left-sided breast cancer: Impact of bolus thickness
Yipeng He, Sijia Chen, Xiang Gao, Lirong Fu, Zheng Kang, Jun Liu, Liwan Shi, Yimin Li, Akif Enes Arikan
PLOS ONE.2023; 18(1): e0280456. CrossRef
ESTRO-ACROP guideline for positioning, immobilisation and setup verification for local and loco-regional photon breast cancer irradiation
M.E. Mast, A. Leong, S.S. Korreman, G. Lee, H. Probst, P. Scherer, Y. Tsang
Technical Innovations & Patient Support in Radiation Oncology.2023; 28: 100219. CrossRef
Critical Factors of Dose Distribution in Breast Cancer Tomotherapy With Metallic Port Breast Tissue Expander: Image Correction, Delivery Mode, and Volume Impact
Hsing-Yi Lee, Yu-Hsiu Yen, Yu-Lun Tsai, Pei-Chih Tu, Chi-Ming Pu, Chia-Hong Lin, Louis Tak Lui, Suzun Shaw, Ching-Jung Wu, Hsin-Hua Nien
Technology in Cancer Research & Treatment.2022;[Epub] CrossRef
Factors impacting on patient setup analysis and error management during breast cancer radiotherapy
Ioana-Claudia Costin, Loredana G. Marcu
Critical Reviews in Oncology/Hematology.2022; 178: 103798. CrossRef
Postoperative radiotherapy with intensity-modulated radiation therapy versus 3-dimensional conformal radiotherapy in early breast cancer: A randomized clinical trial of KROG 15-03
Kyu Hye Choi, Sung Ja Ahn, Jae Uk Jeong, Mina Yu, Jin Hee Kim, Bae Kwon Jeong, Joo Hwan Lee, Sung Hwan Kim, Jong Hoon Lee
Radiotherapy and Oncology.2021; 154: 179. CrossRef
Analysis of local setup errors of sub-regions in cone-beam CT-guided post-mastectomy radiation therapy
Jidan Zhou, Shuai Li, Chengwei Ye, Konglong Shen, An Li, Gang Chen, Xiaoyu Li, Sen Bai, Weifeng Wang, Renming Zhong
Journal of Radiation Research.2020; 61(3): 457. CrossRef
A Prospective Study to Investigate the Placement of Setup Skin Markings for Larger Breasted Women Undergoing External Beam Radiotherapy (RT) for Breast Cancer
Chris Osam Doudoo, Neill Roberts, Emmanuel Amankwaa Frempong, Clement Edusa, Kwamena Beecham, Kofi Agyiri, Promise Ahiagbenyo, George Felix Acquah, Dominic Gadeka Eric Abakuri, Michael Mordey, Anna Maria Anim, Bismark Djan
International Journal of Scientific Research in Science and Technology.2019; : 99. CrossRef
Dosimetric Comparison of Setup Errors in Intensity Modulated Radiation Therapy with Deep Inspiration Breath Holding in Breast Cancer Radiation Therapy
Ham Il-Sik, Cho Pyong-Kon, Jung Kang-Kyo
Journal of Radiological Science and Technology.2019; 42(2): 137. CrossRef
Setup Error Assessment and Correction in Planar kV Image- Versus Cone Beam CT Image-Guided Radiation Therapy: A Clinical Study of Early Breast Cancer Treated With External Beam Partial Breast Irradiation
Wei Wang, Ting Yu, Min Xu, Qian Shao, Yingjie Zhang, Jianbin Li
Technology in Cancer Research & Treatment.2019;[Epub] CrossRef
A Potential Anti-Tumor Herb Bred in a Tropical Fruit: Insight into the Chemical Components and Pharmacological Effects of Momordicae Semen
Xiao-Rong Xu, Chuan-Hong Luo, Bo Cao, Run-Chun Xu, Fang Wang, Xi-Chuan Wei, Ting Zhang, Li Han, Ding-Kun Zhang
Molecules.2019; 24(21): 3949. CrossRef
Xihuang pill promotes apoptosis of Treg cells in the tumor microenvironment in 4T1 mouse breast cancer by upregulating MEKK1/SEK1/JNK1/AP-1 pathway
Liang Su, Yiming Jiang, Yu Xu, Xinye Li, Wenbin Gao, Chunwei Xu, Changqian Zeng, Jie Song, Wencai Weng, Wenbo Liang
Biomedicine & Pharmacotherapy.2018; 102: 1111. CrossRef
The Antitumor Effect of Xihuang Pill on Treg Cells Decreased in Tumor Microenvironment of 4T1 Breast Tumor‐Bearing Mice by PI3K/AKT~AP‐1 Signaling Pathway
Xin-ye Li, Liang Su, Yi-ming Jiang, Wen-bin Gao, Chun-wei Xu, Chang-qian Zeng, Jie Song, Yu Xu, Wen-cai Weng, Wen-bo Liang, Jian-Li Gao
Evidence-Based Complementary and Alternative Medicine.2018;[Epub] CrossRef
Setup errors and effectiveness of Optical Laser 3D Surface imaging system (Sentinel) in postoperative radiotherapy of breast cancer
Xiaobo Wei, Mengjiao Liu, Yun Ding, Qilin Li, Changhai Cheng, Xian Zong, Wenming Yin, Jie Chen, Wendong Gu
Scientific Reports.2018;[Epub] CrossRef
Applying human factors engineering methods for hazard identification and mitigation in the radiotherapy process
Mariana Bernardes, Clarissa Trzesniak, Patricia Trbovich, Carlos Henrique Pereira Mello
Safety Science.2018; 109: 270. CrossRef
Compared with intensity‐modulated radiotherapy, image‐guided radiotherapy reduces severity of acute radiation‐induced skin toxicity during radiotherapy in patients with breast cancer
Jang‐Chun Lin, Jo‐Ting Tsai, Yu‐Ching Chou, Ming‐Hsien Li, Wei‐Hsiu Liu
Cancer Medicine.2018; 7(8): 3622. CrossRef
A topology-based method to mitigate the dosimetric uncertainty caused by the positional variation of the boost volume in breast conservative radiotherapy
Peng-Yi Lee, Chih-Yuan Lin, Shang-Wen Chen, Chun-Ru Chien, Chun-Nan Chu, Hsiu-Ting Hsu, Ji-An Liang, Ying-Jun Lin, An-Cheng Shiau
Radiation Oncology.2017;[Epub] CrossRef
Setup deviations for whole-breast radiotherapy with TomoDirect: A comparison of weekly and biweekly image-guided protocols
Jae Hong Jung, Joo-Young Jung, Sun Hyun Bae, Seong Kwon Moon, Kwang Hwan Cho
Journal of the Korean Physical Society.2016; 69(7): 1247. CrossRef
Displacement of Surgical Clips during Postoperative Radiotherapy in Breast Cancer Patients Who Received Breast-Conserving Surgery
SooYoon Sung, Joo Hwan Lee, Jong Hoon Lee, Sung Hwan Kim, Yoo-Kang Kwak, Sea-Won Lee, Ye Won Jeon, Young Jin Suh
Journal of Breast Cancer.2016; 19(4): 417. CrossRef
Review on the Applications and Molecular Mechanisms ofXihuangPill in Tumor Treatment
Qiujun Guo, Jinyin Lin, Rui Liu, Yebo Gao, Shulin He, Xinyao Xu, Baojin Hua, Conghuang Li, Wei Hou, Honggang Zheng, Yanju Bao
Evidence-Based Complementary and Alternative Medicine.2015; 2015: 1. CrossRef

14,749 View
178 Download
20 Web of Science
20 Crossref

First
Prev
Page of 1
Next
Last

Search