Cancer Research and Treatment

Original Articles

Lung and Thoracic cancer

Contribution of Enhanced Locoregional Control to Improved Overall Survival with Consolidative Durvalumab after Concurrent Chemoradiotherapy in Locally Advanced Non–Small Cell Lung Cancer: Insights from Real-World Data: Jeong Yun Jang, Si Yeol Song, Young Seob Shin, Ha Un Kim, Eun Kyung Choi, Sang-We Kim, Jae Cheol Lee, Dae Ho Lee, Chang-Min Choi, Shinkyo Yoon, Su Ssan Kim; Cancer Res Treat. 2024;56(3):785-794. Published online January 16, 2024; DOI: https://doi.org/10.4143/crt.2023.1014

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Purpose
This study aimed to assess the real-world clinical outcomes of consolidative durvalumab in patients with unresectable locally advanced non–small cell lung cancer (LA-NSCLC) and to explore the role of radiotherapy in the era of immunotherapy.
Materials and Methods
This retrospective study assessed 171 patients with unresectable LA-NSCLC who underwent concurrent chemoradiotherapy (CCRT) with or without consolidative durvalumab at Asan Medical Center between May 2018 and May 2021. Primary outcomes included freedom from locoregional failure (FFLRF), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS).
Results
Durvalumab following CCRT demonstrated a prolonged median PFS of 20.9 months (p=0.048) and a 3-year FFLRF rate of 57.3% (p=0.008), compared to 13.7 months and 38.8%, respectively, with CCRT alone. Furthermore, the incidence of in-field recurrence was significantly greater in the CCRT-alone group compared to the durvalumab group (26.8% vs. 12.4%, p=0.027). While median OS was not reached with durvalumab, it was 35.4 months in patients receiving CCRT alone (p=0.010). Patients positive for programmed cell death ligand 1 (PD-L1) expression showed notably better outcomes, including FFLRF, DMFS, PFS, and OS. Adherence to PACIFIC trial eligibility criteria identified 100 patients (58.5%) as ineligible. The use of durvalumab demonstrated better survival regardless of eligibility criteria.
Conclusion
The use of durvalumab consolidation following CCRT significantly enhanced locoregional control and OS in patients with unresectable LA-NSCLC, especially in those with PD-L1–positive tumors, thereby validating the role of durvalumab in standard care.

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Efficacy and adverse events of immune checkpoint inhibitors: evidence from non-small cell lung cancer and gastric cancer in Korea and Japan
Mc Neil Valencia, Zeeshan Abbas, Seung Won Lee
Precision and Future Medicine.2025; 9(1): 15. CrossRef
Therapeutic effect of induction therapy including nab-paclitaxel followed by surgical resection for the patients with locally advanced non-small-cell lung cancer
Hidetaka Uramoto, Nozomu Motono, Shun Iwai
Journal of Cardiothoracic Surgery.2024;[Epub] CrossRef

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Clinical Outcome of Stereotactic Body Radiotherapy in Patients with Early-Stage Lung Cancer with Ground-Glass Opacity Predominant Lesions: A Single Institution Experience: Jeong Yun Jang, Su Ssan Kim, Si Yeol Song, Young Seob Shin, Sei Won Lee, Wonjun Ji, Chang-Min Choi, Eun Kyung Choi; Cancer Res Treat. 2023;55(4):1181-1189. Published online March 21, 2023; DOI: https://doi.org/10.4143/crt.2022.1656

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Purpose
The detection rate of early-stage lung cancer with ground-glass opacity (GGO) has increased, and stereotactic body radiotherapy (SBRT) has been suggested as an alternative to surgery in inoperable patients. However, reports on treatment results are limited. Therefore, we performed a retrospective study to investigate the clinical outcome after SBRT in patients with early-stage lung cancer with GGO-predominant tumor lesions at a single institution.
Materials and Methods
This study included 89 patients with 99 lesions who were treated with SBRT for lung cancer with GGO-predominant lesions that had a consolidation-to-tumor ratio of ≤0.5 at Asan Medical Center between July 2016 and July 2021. A median total dose of 56.0 Gy (range, 48.0–60.0) was delivered using 10.0–15.0 Gy per fraction.
Results
The overall follow-up period for the study was median 33.0 months (range, 9.9 to 65.9 months). There was 100% local control with no recurrences in any of the 99 treated lesions. Three patients had regional recurrences outside of the radiation field, and three had distant metastasis. The 1-year, 3-year, and 5-year overall survival rates were 100.0%, 91.6%, and 82.8%, respectively. Univariate analysis revealed that advanced age and a low level of diffusing capacity of the lungs for carbon monoxide were significantly associated with overall survival. There were no patients with grade ≥3 toxicity.
Conclusion
SBRT is a safe and effective treatment for patients with GGO-predominant lung cancer lesions and is likely to be considered as an alternative to surgery.

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Prognostic analysis of helical tomotherapy stereotactic body radiotherapy in multiple primary or second primary lung cancers
Jintao Ma, Xiaohong Xu, Wenhan Huang, Yong Hu, Gang Chen, Jian He
BMC Cancer.2025;[Epub] CrossRef
Place de la radiothérapie en conditions stéréotaxiques dans les cancers bronchiques non à petites cellules localisés
Catherine Durdux, Aurélia Alati
Bulletin du Cancer.2025; 112(3): 3S31. CrossRef
Recent Advancements in Minimally Invasive Surgery for Early Stage Non-Small Cell Lung Cancer: A Narrative Review
Jibran Ahmad Khan, Ibrahem Albalkhi, Sarah Garatli, Marcello Migliore
Journal of Clinical Medicine.2024; 13(11): 3354. CrossRef
The clinical effect of thoracoscopic segmentectomy in the treatment of lung malignancies less than 2CM in diameter
Yafeng Zhang, Renzhong Shi, Xiaoming Xia, Kaiyao Zhang
Journal of Cardiothoracic Surgery.2024;[Epub] CrossRef
Impact of ground-glass component on prognosis in early-stage lung cancer treated with stereotactic body radiotherapy via Helical Tomotherapy
Jintao Ma, Shaonan Fan, Wenhan Huang, Xiaohong Xu, Yong Hu, Jian He
Radiation Oncology.2024;[Epub] CrossRef

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Sarcoma

Clinicopathologic Characteristics and Clinical Outcome of Localized Liposarcoma: A Single-Center Experience over 25 Years and Evaluation of PD-L1 Expression: Heejung Chae, Jeong Eun Kim, Wanlim Kim, Jong-Seok Lee, Si Yeol Song, Min Hee Lee, Hye Won Chung, Kyung-Ja Cho, Joon Seon Song, Jin-Hee Ahn; Cancer Res Treat. 2022;54(2):579-589. Published online July 6, 2021; DOI: https://doi.org/10.4143/crt.2021.496

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Purpose
For liposarcoma (LPS), clinical course and proper treatment strategies have not been well-established. Recently, immune-checkpoint inhibitors have shown potential efficacy in LPS. We aimed to describe the clinical course of LPS and evaluate the clinical impact of programmed death-ligand 1 (PD-L1).
Materials and Methods
We reviewed all consecutive patients (n=332) who underwent curative-intent surgery for localized LPS at Asan Medical Center between 1989 and 2017. PD-L1 testing was performed in well-differentiated and dedifferentiated LPS.
Results
The median age was 56 years with males comprising 60.8%. Abdomen-pelvis (47.6%) and well-differentiated (37.7%) were the most frequent primary site and histologic subtype, respectively. During a median follow-up of 81.2 months, recurrence was observed in 135 (40.7%), and 86.7% (117/135) were loco-regional. Well-differentiated subtype (hazard ratio [HR], 0.38), abdomen-pelvis origin (HR, 2.43), tumor size larger than 5 cm (HR, 1.83), positive resection margin (HR, 2.58), and postoperative radiotherapy (HR, 0.36) were significantly related with recurrence-free survival as well as visceral involvement (HR, 1.84) and multifocality (HR, 3.79) in abdomen-pelvis LPS. PD-L1 was positive in 31.5% (23/73) and 51.3% (39/76) of well-differentiated and dedifferentiated LPS, respectively, but had no impact on survival outcomes.
Conclusion
Clinical course of LPS was heterogeneous according to histology and anatomic location. Clear resection margin was important to lower recurrence and postoperative radiotherapy might have additional benefit. A decent portion of well-differentiated and dedifferentiated LPS were positive for PD-L1, but its prognostic role was unclear. Further research is needed to determine clinical implications of PD-L1, especially for advanced-stage LPS with unmet needs for effective systemic treatment.

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Recurrent Intrathoracic Liposarcoma: A Case Report and a Comprehensive Literature Review of a Rare Clinical Entity
Vasileios Leivaditis , Manfred Dahm , Athanasios Papatriantafyllou, Hans-Georg Keul, Lydia Kohl, Hans-Joachim Schäfers
Cureus.2024;[Epub] CrossRef
Clinicopathological Features of Intrathoracic Liposarcoma—A Systematic Review with an Illustrative Case
Kajetan Kiełbowski, Nikola Ruszel, Seweryn Adam Skrzyniarz, Małgorzata Edyta Wojtyś, Rafał Becht, Konrad Ptaszyński, Darko Gajić, Janusz Wójcik
Journal of Clinical Medicine.2022; 11(24): 7353. CrossRef

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Lung Cancer

Prognostic Factor and Clinical Outcome in Stage III Non-Small Cell Lung Cancer: A Study Based on Real-World Clinical Data in the Korean Population: Ho Cheol Kim, Wonjun Ji, Jae Cheol Lee, Hyeong Ryul Kim, Si Yeol Song, Chang-Min Choi, Korean Association for Lung Cancer, Korea Central Cancer Registry; Cancer Res Treat. 2021;53(4):1033-1041. Published online February 16, 2021; DOI: https://doi.org/10.4143/crt.2020.1350

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Purpose
The optimal treatment for patients with stage III non-small cell lung cancer (NSCLC) remains controversial. This study aimed to investigate prognostic factors and clinical outcome in stage III NSCLC using real-world clinical data in the Korean population.
Materials and Methods
Among 8,110 patients with lung cancer selected from 52 hospitals in Korea during 2014-2016, only patients with stage III NSCLC were recruited and analyzed. A standardized protocol was used to collect clinical information and cox proportional hazards models were used to identify risk factors for mortality.
Results
A total of 1,383 patients (46.5% had squamous cell carcinoma and 40.9% had adenocarcinoma) with stage III NSCLC were enrolled, and their median age was 70 years. Regarding clinical stage, 548 patients (39.6%) had stage IIIA, 517 (37.4%) had stage IIIB, and 318 (23.0%) had stage IIIC. Pertaining to the initial treatment method, the surgery group (median survival period: 36 months) showed better survival outcomes than the non-surgical treatment group (median survival period: 18 months, p=0.001) in patients with stage IIIA. Moreover, among patients with stage IIIB and stage IIIC, those who received concurrent chemotherapy and radiation therapy (CCRT, median survival period: 24 months) showed better survival outcomes than those who received chemotherapy (median survival period: 11 months), or radiation therapy (median survival period: 10 months, p<0.001).
Conclusion
While surgery might be feasible as the initial treatment option in patients with stage IIIA NSCLC, CCRT showed a beneficial role in patients with stage IIIB and IIIC NSCLC.

Citations

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The value of 18F-FDG PET/CT combined with 3D quantitative technology and clinicopathological features in predicting prognosis of NSCLC
Yuling Su, Siwen Qiu, Jinyu Wang
Frontiers in Oncology.2025;[Epub] CrossRef
Real‐world treatment patterns and clinical outcomes in patients with stage III NSCLC in Korea: The KINDLE study
Jiyun Lee, Hee Kyung Ahn, Sang‐We Kim, Ji‐Youn Han, Sung Sook Lee, Hyung Soon Park, Hyun Woo Lee, Joo‐Hang Kim, Eunhan Cho, Reto Huggenberger, Byoung Chul Cho
Cancer Medicine.2024;[Epub] CrossRef
Contribution of Enhanced Locoregional Control to Improved Overall Survival with Consolidative Durvalumab after Concurrent Chemoradiotherapy in Locally Advanced Non–Small Cell Lung Cancer: Insights from Real-World Data
Jeong Yun Jang, Si Yeol Song, Young Seob Shin, Ha Un Kim, Eun Kyung Choi, Sang-We Kim, Jae Cheol Lee, Dae Ho Lee, Chang-Min Choi, Shinkyo Yoon, Su Ssan Kim
Cancer Research and Treatment.2024; 56(3): 785. CrossRef
Risk factors in depression in oncology patients. Dr. Julio Villacreses Colmont Hospital
Mayra Viviana Zambrano Escobar, Julia Teresa Espinel García
Seminars in Medical Writing and Education.2024; 3: 660. CrossRef
Glucose metabolic heterogeneity correlates with pathological features and improves survival stratification of resectable lung adenocarcinoma
Yu-Hung Chen, Yen-Chang Chen, Kun-Han Lue, Sung-Chao Chu, Bee-Song Chang, Ling-Yi Wang, Ming-Hsun Li, Chih-Bin Lin
Annals of Nuclear Medicine.2023; 37(2): 139. CrossRef
The combined tumor-nodal glycolytic entropy improves survival stratification in nonsmall cell lung cancer with locoregional disease
Yu-Hung Chen, Kun-Han Lue, Sung-Chao Chu, Bee-Song Chang, Chih-Bin Lin
Nuclear Medicine Communications.2023; 44(1): 100. CrossRef
Prognostic value of pretherapeutic FDG PET/CT in non-small cell lung cancer with pulmonary lymphangitic carcinomatosis
Yong-Jin Park, Yunjoo Im, O. Jung Kwon, Joungho Han, Myung-Ju Ahn, Jhingook Kim, Sang-Won Um, Joon Young Choi
Scientific Reports.2023;[Epub] CrossRef
A Propensity-Matched Retrospective Comparative Study with Historical Control to Determine the Real-World Effectiveness of Durvalumab after Concurrent Chemoradiotherapy in Unresectable Stage III Non-Small Cell Lung Cancer
Cheol-Kyu Park, Nakyung Jeon, Hwa-Kyung Park, Hyung-Joo Oh, Young-Chul Kim, Ha-Lim Jeon, Yong-Hyub Kim, Sung-Ja Ahn, In-Jae Oh
Cancers.2023; 15(5): 1606. CrossRef
Association between clinical outcomes and local treatment in stage IV non‐small cell lung cancer patients with single extrathoracic metastasis
Jeong Uk Lim, Hye Seon Kang, Ah Young Shin, Chang Dong Yeo, Chan Kwon Park, Sang Haak Lee, Seung Joon Kim
Thoracic Cancer.2022; 13(9): 1349. CrossRef
Conversion therapy from unresectable stage IIIC non-small-cell lung cancer to radical surgery via anti-PD-1 immunotherapy combined with chemotherapy and anti-angiogenesis: A case report and literature review
Guohua Jia, Shuimei Zhou, Tangpeng Xu, Yabing Huang, Xiangpan Li
Frontiers in Oncology.2022;[Epub] CrossRef
A phase II, multicenter study of lazertinib as consolidation therapy in patients with locally advanced, unresectable, EGFR mutation‐positive non‐small cell lung cancer (stage III) who have not progressed following definitive, platinum‐based, chemoradiatio
Juwhan Choi, Jeong Eun Lee, Chang‐Min Choi, In‐Jae Oh, Kye Young Lee, Tae Won Jang, Seung Hyeun Lee, Eun Young Kim, Dong Won Park, Sun Hyo Park, Sung Yong Lee
Thoracic Cancer.2022; 13(23): 3431. CrossRef
Prognostic Value of Combing Primary Tumor and Nodal Glycolytic–Volumetric Parameters of 18F-FDG PET in Patients with Non-Small Cell Lung Cancer and Regional Lymph Node Metastasis
Yu-Hung Chen, Sung-Chao Chu, Ling-Yi Wang, Tso-Fu Wang, Kun-Han Lue, Chih-Bin Lin, Bee-Song Chang, Dai-Wei Liu, Shu-Hsin Liu, Sheng-Chieh Chan
Diagnostics.2021; 11(6): 1065. CrossRef

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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

Abstract PDF Supplementary Material PubReader ePub

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.

Citations

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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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Variation in Practice Patterns of Korean Radiation Oncologists for Spine Metastasis between 2009 and 2014: Jeong Il Yu, Hee Chul Park, Yong Chan Ahn, Yoonsun Chung, Woong Sub Koom, Si Yeol Song; Cancer Res Treat. 2016;48(3):1102-1109. Published online December 2, 2015; DOI: https://doi.org/10.4143/crt.2015.207

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Purpose
The Korean Society of Radiation Oncologists (KOSRO) conducted the Patterns of Care Study (PCS) of radiotherapy (RT) for spine metastases in 2009. The current study was conducted to investigate current practice patterns and compare them with the results of the PCS.
Materials and Methods
The survey questionnaire was composed of 10 questions regarding general information and seven questions for each of two clinical scenarios.
Results
Fifty-four members of the KOSRO answered at least one question on the web-based questionnaire. The yearly number of patients treated who underwent palliative spine RT was greater than 200 in 14 (25.9%), 51 to 100 in 13 (24.1%), and 31 to 50 in 11 respondents (20.4%). Scenario 1 described a patient presenting with cord compressive spine metastasis in multiple bones and liver metastasis from non-small cell lung cancer. Thirty gray (Gy) in 10 fractions was chosen by 35 respondents (64.8%). Scenario 2 described a case of a single spine metastasis without progression after targeted therapy. Thirty Gy in 10 fractions was chosen by 19 respondents (35.2%), and a single fraction or less than four fractions of stereotactic ablative radiotherapy (SABR) were selected by 18 respondents (33.3%). When compared with the 2009 PCS, practice patterns of Korean radiation oncologists had not changed significantly over 5 years, except that SABR emerged as a new treatment modality in the selected population.
Conclusion
The 2014 PCS demonstrated that multiple fraction RT is still preferred in a considerable proportion of Korean radiation oncologists.

Citations

Citations to this article as recorded by

Different decision-making in spine metastasis management among radiation oncologists and orthopedic surgeons: a Korean online survey study
Hwa Kyung Byun, Woong Sub Koom, Se-Jun Park, Sang-Il Kim, Jin Ho Kim, Young-Hoon Kim, Bong-Soon Chang, Yong Chan Ahn
Frontiers in Neurology.2024;[Epub] CrossRef
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
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Evaluation of predictive factors of vertebral compression fracture after conventional palliative radiotherapy for spinal metastasis from colorectal cancer
Jeongshim Lee, Woo Joong Rhee, Jee Suk Chang, Sei Kyung Chang, Woong Sub Koom
Journal of Neurosurgery: Spine.2018; 28(3): 333. CrossRef
Spine Metastasis Practice Patterns among Korean, Chinese, and Japanese Radiation Oncologists: A Multinational Online Survey Study
Jeong Il Yu, Hee Chul Park, Yong Chan Ahn, Xian-Shu Gao, Jun-Jie Wang, Zhao-Chong Zeng, Yoshinori Ito, Tatsuya Ohno, Yasumasa Nishimura
Journal of Radiation Research.2017; 58(1): 155. CrossRef
Nephrologists' likelihood of referring patients for kidney transplant based on hypothetical patient scenarios
Ankita Tandon, Ming Wang, Kevin C. Roe, Surju Patel, Nasrollah Ghahramani
Clinical Kidney Journal.2016; 9(4): 611. CrossRef
The Effect of Perioperative Radiation Therapy on Spinal Bone Fusion Following Spine Tumor Surgery
Tae-Kyum Kim, Wonik Cho, Sang Min Youn, Ung-Kyu Chang
Journal of Korean Neurosurgical Society.2016; 59(6): 597. CrossRef

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