Cancer Research and Treatment

Original Articles

General

Development and Feasibility Evaluation of Smart Cancer Care 2.0 Based on Patient-Reported Outcomes for Post-Discharge Management of Patients with Cancer: Jin Ah Kwon, Songsoo Yang, Su-Jin Koh, Young Ju Noh, Dong Yoon Kang, Sol Bin Yang, Eun Ji Kwon, Jeong-Wook Seo, Jin sung Kim, Minsu Ock; Cancer Res Treat. 2024;56(4):1040-1049. Published online April 9, 2024; DOI: https://doi.org/10.4143/crt.2024.003

Abstract PDF Supplementary Material PubReader ePub: Purpose
A “Smart Cancer Care” platform that integrates patient-reported outcomes (PROs) with management has been established in Korea. This study focused on improving health behaviors and connecting patients to welfare services by introducing and assessing the feasibility of “Smart Cancer Care 2.0,” an enhanced version designed for monitoring complications post-cancer treatment.
Materials and Methods
Smart Cancer Care 2.0 was developed by conducting a literature review and consulting with expert panels to identify symptoms or variables requiring monitoring and management guidelines based on the treatment type. Qualitative and quantitative surveys were conducted to assess the feasibility of the app and web system based on the experiences of patients with cancer and healthcare workers.
Results
A total of 81 symptoms or variables (chemotherapy-, surgery-, radiotherapy-, rehabilitation-, and health management-related) were selected for management in Smart Cancer Care 2.0. PROs for these symptoms were basically categorized into three severity grades: preventive management, self-treatment, and consultation with a healthcare worker or visit to a healthcare institution. The overall mean scores in the feasibility evaluation by patients and healthcare workers were 3.83 and 3.90 points, respectively, indicating high usefulness.
Conclusion
Smart Cancer Care 2.0 leverages the existing information and communication technologies–based platform, Smart Cancer Care, and further includes health behaviors and welfare services. Smart Cancer Care 2.0 may play a crucial role in establishing a comprehensive post-discharge management system for patients with cancer as it provides suitable interventions based on patients’ responses and allows the regularly collected PROs to be easily viewed for streamlined care.

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Breast cancer

A Nationwide Study on HER2-Low Breast Cancer in South Korea: Its Incidence of 2022 Real World Data and the Importance of Immunohistochemical Staining Protocols: Min Chong Kim, Eun Yoon Cho, So Yeon Park, Hee Jin Lee, Ji Shin Lee, Jee Yeon Kim, Ho-chang Lee, Jin Ye Yoo, Hee Sung Kim, Bomi Kim, Wan Seop Kim, Nari Shin, Young Hee Maeng, Hun Soo Kim, Sun Young Kwon, Chungyeul Kim, Sun-Young Jun, Gui Young Kwon, Hye Jeong Choi, So Mang Lee, Ji Eun Choi, Ae Ri An, Hyun Joo Choi, EunKyung Kim, Ahrong Kim, Ji-Young Kim, Jeong Yun Shim, Gyungyub Gong, Young Kyung Bae; Cancer Res Treat. 2024;56(4):1096-1104. Published online March 6, 2024; DOI: https://doi.org/10.4143/crt.2024.092

Abstract PDF Supplementary Material PubReader ePub

Purpose
Notable effectiveness of trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer (BC) has focused pathologists’ attention. We studied the incidence and clinicopathologic characteristics of HER2-low BC, and the effects of immunohistochemistry (IHC) associated factors on HER2 IHC results.
Materials and Methods
The Breast Pathology Study Group of the Korean Society of Pathologists conducted a nationwide study using real-world data on HER2 status generated between January 2022 and December 2022. Information on HER2 IHC protocols at each participating institution was also collected.
Results
Total 11,416 patients from 25 institutions included in this study. Of these patients, 40.7% (range, 6.0% to 76.3%) were classified as HER2-zero, 41.7% (range, 10.5% to 69.1%) as HER2-low, and 17.5% (range, 6.7% to 34.0%) as HER2-positive. HER2-low tumors were associated with positive estrogen receptor and progesterone receptor statuses (p < 0.001 and p < 0.001, respectively). Antigen retrieval times (≥ 36 minutes vs. < 36 minutes) and antibody incubation times (≥ 12 minutes vs. < 12 minutes) affected on the frequency of HER2 IHC 1+ BC at institutions using the PATHWAY HER2 (4B5) IHC assay and BenchMark XT or Ultra staining instruments. Furthermore, discordant results between core needle biopsy and subsequent resection specimen HER2 statuses were observed in 24.1% (787/3,259) of the patients.
Conclusion
The overall incidence of HER2-low BC in South Korea concurs with those reported in previously published studies. Significant inter-institutional differences in HER2 IHC protocols were observed, and it may have impact on HER2-low status. Thus, we recommend standardizing HER2 IHC conditions to ensure precise patient selection for targeted therapy.

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Impact of immunohistochemistry staining conditions on the incidence of human epidermal growth factor receptor 2 (HER2)-low breast cancer
Min Chong Kim, Sun Young Kwon, Hye Ra Jung, Young Kyung Bae
Virchows Archiv.2024; 485(6): 1117. CrossRef
Breast Cancer: Extracellular Matrix and Microbiome Interactions
Lourdes Herrera-Quintana, Héctor Vázquez-Lorente, Julio Plaza-Diaz
International Journal of Molecular Sciences.2024; 25(13): 7226. CrossRef

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Genitourinary cancer

Optimal Definition of Biochemical Recurrence in Patients Who Receive Salvage Radiotherapy Following Radical Prostatectomy for Prostate Cancer: Sung Uk Lee, Jae-Sung Kim, Young Seok Kim, Jaeho Cho, Seo Hee Choi, Taek-Keun Nam, Song Mi Jeong, Youngkyong Kim, Youngmin Choi, Dong Eun Lee, Won Park, Kwan Ho Cho; Cancer Res Treat. 2022;54(4):1191-1199. Published online December 7, 2021; DOI: https://doi.org/10.4143/crt.2021.985

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study proposed the optimal definition of biochemical recurrence (BCR) after salvage radiotherapy (SRT) following radical prostatectomy for prostate cancer.
Materials and Methods
Among 1,117 patients who had received SRT, data from 205 hormone-naïve patients who experienced post-SRT prostate-specific antigen (PSA) elevation were included in a multi-institutional database. The primary endpoint was to determine the PSA parameters predictive of distant metastasis (DM). Absolute serum PSA levels and the prostate-specific antigen doubling time (PSA-DT) were adopted as PSA parameters.
Results
When BCR was defined based on serum PSA levels ranging from 0.4 ng/mL to nadir+2.0 ng/mL, the 5-year probability of DM was 27.6%-33.7%. The difference in the 5-year probability of DM became significant when BCR was defined as a serum PSA level of 0.8 ng/ml or higher (1.0-2.0 ng/mL). Application of a serum PSA level of ≥ 0.8 ng/mL yielded a c-index value of 0.589. When BCR was defined based on the PSA-DT, the 5-year probability was 22.7%-39.4%. The difference was significant when BCR was defined as a PSA-DT ≤ 3 months and ≤ 6 months. Application of a PSA-DT ≤ 6 months yielded the highest c-index (0.660). These two parameters complemented each other; for patients meeting both PSA parameters, the probability of DM was 39.5%-44.5%; for those not meeting either parameter, the probability was 0.0%-3.1%.
Conclusion
A serum PSA level > 0.8 ng/mL was a reasonable threshold for the definition of BCR after SRT. In addition, a PSA-DT ≤ 6 months was significantly predictive of subsequent DM, and combined application of both parameters enhanced predictability.

Citations

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Special Article

Physical and Biological Characteristics of Particle Therapy for Oncologists: Hwa Kyung Byun, Min Cheol Han, Kyungmi Yang, Jin Sung Kim, Gyu Sang Yoo, Woong Sub Koom, Yong Bae Kim; Cancer Res Treat. 2021;53(3):611-620. Published online June 16, 2021; DOI: https://doi.org/10.4143/crt.2021.066

Abstract PDF PubReader ePub

Particle therapy is a promising and evolving modality of radiotherapy that can be used to treat tumors that are radioresistant to conventional photon beam radiotherapy. It has unique biological and physical advantages compared with conventional radiotherapy. The characteristic feature of particle therapy is the “Bragg peak,” a steep and localized peak of dose, that enables precise delivery of the radiation dose to the tumor while effectively sparing normal organs. Especially, the charged particles (e.g., proton, helium, carbon) cause a high rate of energy loss along the track, thereby leading to high biological effectiveness, which makes particle therapy attractive. Using this property, the particle beam induces more severe DNA double-strand breaks than the photon beam, which is less influenced by the oxygen level. This review describes the general biological and physical aspects of particle therapy for oncologists, including non-radiation oncologists and beginners in the field.

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Original Articles

Endocrine cancer

Expression of Estrogen and Progesterone Receptors in Papillary Thyroid Carcinoma in Korea: Hwa Young Ahn, Ra-Yeong Song, Hye Shin Ahn, Hee Sung Kim; Cancer Res Treat. 2021;53(4):1204-1212. Published online February 10, 2021; DOI: https://doi.org/10.4143/crt.2020.1201

Abstract PDF PubReader ePub

Purpose
The aim of this study was to examine the rate of expression of estrogen receptor α (ERα) and β1 (ERβ1), progesterone receptor (PR), and rate of overexpression of epidermal growth factor receptor (EGFR) in a relatively large cohort of patients with papillary thyroid carcinoma (PTC). We also aimed to examine whether each receptor influenced clinicopathological characteristics and prognosis of PTC.
Materials and Methods
We made a microarray of paraffin-embedded PTC surgical tissues from 436 patients. We compared the results of the immunohistochemical staining for each hormone receptor with clinicopathological characteristics.
Results
The positive expression rate of hormonal receptors was 40.4% for ERα, 83.7% for ERβ1, and 71.3% for PR in patients with PTC. Overexpression of EGFR was shown in 19.3% of patients with PTC. The age was lower (44.6±12.1 years vs. 47.1±12.5 years, p=0.040) and tumor smaller (0.96±0.69 cm vs. 1.13±0.82 cm, p=0.020) in the ERα positive group, which also showed higher PR positivity (80.7% vs. 65.0%, p < 0.001) and overexpression of EGFR (27.3% vs. 13.8%, p < 0.001). However, neither the positivity of hormone receptors nor overexpression of EGFR affected the recurrence of PTC.
Conclusion
In conclusion, most (94.6%) patients with PTC were found to exhibit positive expression for ERs or PR. We also found that neither the positive expression of hormone receptors nor overexpression of EGFR were associated with the recurrence of PTC.

Citations

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Struma Ovarii during Pregnancy
Gabriela Dumachița-Șargu, Răzvan Socolov, Teodora Ana Balan, Dumitru Gafițanu, Mona Akad, Raluca Anca Balan
Diagnostics.2024; 14(11): 1172. CrossRef
Serum sex hormones correlate with pathological features of papillary thyroid cancer
Fa-Zhan Xu, Lu-Lu Zheng, Ke-Hao Chen, Ru Wang, Dan-Dan Yi, Chao-Yu Jiang, Zhi-Jian Liu, Xian-Biao SHI, Jian-Feng Sang
Endocrine.2023; 84(1): 148. CrossRef
Diagnostic and Prognostic Impact of Progesterone Receptor Immunohistochemistry: A Study Evaluating More Than 16,000 Tumors
Florian Viehweger, Lisa-Marie Tinger, David Dum, Natalia Gorbokon, Anne Menz, Ria Uhlig, Franziska Büscheck, Andreas M. Luebke, Claudia Hube-Magg, Andrea Hinsch, Doris Höflmayer, Christoph Fraune, Patrick Lebok, Sören Weidemann, Maximilian Lennartz, Frank
Analytical Cellular Pathology.2022; 2022: 1. CrossRef
Case report: Lymph node metastases of breast cancer and thyroid cancer encountered in axilla
Rihan Li, Qingfu Zhang, Dongdong Feng, Feng Jin, Siyuan Han, Xinmiao Yu
Frontiers in Oncology.2022;[Epub] CrossRef

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Gastrointestinal Cancer

Phase II Trial of Postoperative Adjuvant Gemcitabine and Cisplatin Chemotherapy Followed by Chemoradiotherapy with Gemcitabine in Patients with Resected Pancreatic Cancer: Kyung-Hun Lee, Eui Kyu Chie, Seock-Ah Im, Jee Hyun Kim, Jihyun Kwon, Sae-Won Han, Do-Youn Oh, Jin-Young Jang, Jae-Sung Kim, Tae-You Kim, Yung-Jue Bang, Sun Whe Kim, Sung W. Ha; Cancer Res Treat. 2021;53(4):1096-1103. Published online December 30, 2020; DOI: https://doi.org/10.4143/crt.2020.928

Abstract PDF PubReader ePub

Purpose
Despite curative resection, the 5-year survival for patients with resectable pancreatic cancer is less than 20%. Recurrence occurs both locally and at distant sites and effective multimodality adjuvant treatment is needed.
Materials and Methods
Patients with curatively resected stage IB-IIB pancreatic adenocarcinoma were eligible. Treatment consisted of chemotherapy with gemcitabine 1,000 mg/m² on days 1 and 8 and cisplatin 60 mg/m² on day 1 every 3 weeks for two cycles, followed by chemoradiotherapy (50.4 Gy/28 fx) with weekly gemcitabine (300 mg/m²/wk), and then gemcitabine 1,000 mg/m² on days 1 and 8 every 3 weeks for four cycles. The primary endpoint was 1-year disease-free survival rate. The secondary endpoints were disease-free survival, overall survival, and safety.
Results
Seventy-four patients were enrolled. One-year disease-free survival rate was 57.9%. Median disease-free and overall survival were 15.0 months (95% confidence interval [CI], 11.6 to 18.4) and 33.0 months (95% CI, 21.8 to 44.2), respectively. At the median follow-up of 32 months, 57 patients (77.0%) had recurrence including 11 patients whose recurrence was during the adjuvant treatment. Most of the recurrences were systemic (52 patients). Stage at the time of diagnosis (70.0% in IIA, 51.2% in IIB, p=0.006) were significantly related with 1-year disease-free survival rate. Toxicities were generally tolerable, with 53 events of grade 3 or 4 hematologic toxicity and four patients with febrile neutropenia.
Conclusion
Adjuvant gemcitabine and cisplatin chemotherapy followed by chemoradiotherapy with gemcitabine and maintenance gemcitabine showed efficacy and good tolerability in curatively resected pancreatic cancer.

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Xiao-Dong Huang, Yong-Wei Chen, Lv Tian, Li Du, Xiao-Chen Cheng, Yu-Xin Lu, Dong-Dong Lin, Feng-Jun Xiao
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Obaid Ur Rehman, Eeshal Fatima, Zain Ali Nadeem, Arish Azeem, Jatin Motwani, Habiba Imran, Hadia Mehboob, Alishba Khan, Omer Usman
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Chunhong Sui, Yijia Luo, Xiao Xiao, Jiaxue Liu, Xiaotong Shao, Yingxue Xue, Cheng Wang, Wenliang Li
ChemistrySelect.2023;[Epub] CrossRef
Ivermectin and gemcitabine combination treatment induces apoptosis of pancreatic cancer cells via mitochondrial dysfunction
Da Eun Lee, Hyeon Woong Kang, So Yi Kim, Myeong Jin Kim, Jae Woong Jeong, Woosol Chris Hong, Sungsoon Fang, Hyung Sun Kim, Yun Sun Lee, Hyo Jung Kim, Joon Seong Park
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Yeting Lu, Shuping Zhou, Gong Cheng, Yi Ruan, Yuan Tian, Kaiji Lv, Shuo Han, Xinhua Zhou, Xiangya Ding
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Alice Usai, Gregorio Di Franco, Margherita Piccardi, Perla Cateni, Luca Emanuele Pollina, Caterina Vivaldi, Enrico Vasile, Niccola Funel, Matteo Palmeri, Luciana Dente, Alfredo Falcone, Dimitri Giunchi, Alessandro Massolo, Vittoria Raffa, Luca Morelli
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Clinical Outcomes of Postoperative Radiotherapy Following Radical Prostatectomy in Patients with Localized Prostate Cancer: A Multicenter Retrospective Study (KROG 18-01) of a Korean Population: Sung Uk Lee, Kwan Ho Cho, Won Park, Won Kyung Cho, Jae-Sung Kim, Chan Woo Wee, Young Seok Kim, Jin Ho Kim, Taek-Keun Nam, Jaeho Cho, Song Mi Jeong, Youngkyong Kim, Su Jung Shim, Youngmin Choi, Jun-Sang Kim; Cancer Res Treat. 2020;52(1):167-180. Published online June 25, 2019; DOI: https://doi.org/10.4143/crt.2019.126

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to investigate the clinical outcomes of postoperative radiotherapy (PORT) patients who underwent radical prostatectomy for localized prostate cancer.
Materials and Methods
Localized prostate cancer patients who received PORT after radical prostatectomy between 2001 and 2012 were identified retrospectively in a multi-institutional database. In total, 1,117 patients in 19 institutions were included. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ≥ nadir+2 after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA regardless of its value.
Results
Ten-year biochemical failure-free survival, clinical failure-free survival, distant metastasisfree survival, overall survival (OS), and cause-specific survival were 60.5%, 76.2%, 84.4%, 91.1%, and 96.6%, respectively, at a median of 84 months after PORT. Pre-PORT PSA ≤ 0.5 ng/ml and Gleason’s score ≤ 7 predicted favorable clinical outcomes, with 10-year OS rates of 92.5% and 94.1%, respectively. The 10-year OS rate was 82.7% for patients with a PSA > 1.0 ng/mL and 86.0% for patients with a Gleason score of 8-10. The addition of longterm ADT (≥ 12 months) to PORT improved OS, particularly in those with a Gleason score of 8-10 or ≥ T3b.
Conclusion
Clinical outcomes of PORT in a Korean prostate cancer population were very similar to those in Western countries. Lower Gleason score and serum PSA level at the time of PORT were significantly associated with favorable outcomes. Addition of long-term ADT (≥ 12 months) to PORT should be considered, particularly in unfavorable risk patients with Gleason scores of 8-10 or ≥ T3b.

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Optimal Definition of Biochemical Recurrence in Patients Who Receive Salvage Radiotherapy Following Radical Prostatectomy for Prostate Cancer
Sung Uk Lee, Jae-Sung Kim, Young Seok Kim, Jaeho Cho, Seo Hee Choi, Taek-Keun Nam, Song Mi Jeong, Youngkyong Kim, Youngmin Choi, Dong Eun Lee, Won Park, Kwan Ho Cho
Cancer Research and Treatment.2022; 54(4): 1191. CrossRef
A discussion on controversies and ethical dilemmas in prostate cancer screening
Satish Chandra Mishra
Journal of Medical Ethics.2021; 47(3): 152. CrossRef
Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
Sung Uk Lee, Kwan Ho Cho, Jin Ho Kim, Young Seok Kim, Taek-Keun Nam, Jae-Sung Kim, Jaeho Cho, Seo Hee Choi, Su Jung Shim, Jin Hee Kim, Ah Ram Chang
Technology in Cancer Research & Treatment.2021;[Epub] CrossRef

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Comparison of the 7th and the 8th AJCC Staging System for Non-metastatic D2-Resected Lymph Node–Positive Gastric Cancer Treated with Different Adjuvant Protocols: Jeong Il Yu, Do Hoon Lim, Jeeyun Lee, Won Ki Kang, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Seung Tae Kim, Su Jin Lee, Sung Kim, Tae Sung Sohn, Jun Ho Lee, Ji Yeong An, Min Gew Choi, Jae Moon Bae, Heejin Yoo, Kyunga Kim; Cancer Res Treat. 2019;51(3):876-885. Published online October 1, 2018; DOI: https://doi.org/10.4143/crt.2018.401

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to compare prognostic differentiation performances of the 7th and the 8th edition of American Joint Commission on Cancer (AJCC) staging system for gastric cancer (GC) patients.
Materials and Methods
A total of 1,633 GC patients who underwent curative D2 resection followed by adjuvant chemotherapy alone (CA) or concurrent chemo-radiotherapy (CCRT) from 2004 to 2013 were included. Concordance index (c-index) was applied to compare the discriminatory ability.
Results
In the 8th edition, migration of stage was detected in 248 patients (15.2%). Among them, 121 patients were up-staged while 127 patients were down-staged. Overall, there was no statistically significant difference in the discriminatory ability between the 7th and 8th editions. The new edition of staging system, however, showed a trend of better prognostic performance not only in recurrence-free survival (c-index=0.734; 95% confidence interval [CI], 0.706 to 0.762 in the 7th edition vs. c-index=0.740; 95% CI, 0.712 to 0.768 in the 8th edition; p=0.14), but also in overall survival (c-index=0.717; 95% CI, 0.688 to 0.745 in the 7th edition vs. c-index=0.722; 95% CI, 0.694 to 0.751 in the 8th edition; p=0.19), especially in stage III. This finding was repeated in the subgroup analysis regardless of adjuvant CA or CCRT.
Conclusion
Generally, the 8th edition of AJCC staging system had failed to show a superior discriminatory ability for curatively D2 resected GC patients than the 7th edition, although there was a trend of better prognostic performance of the new edition, regardless of adjuvant treatment method.

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Chao Cai, Cheng Chen, Xiuli Lin, Huihui Zhang, Mingming Shi, Xiaolei Chen, Weisheng Chen, Didi Chen
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Kailai Yin, Xuanhong Jin, Yang Pan, Mengli Zi, Yingsong Zheng, Yubo Ma, Chuhong Pang, Kang liu, Jinxia Chen, Yizhou Wei, Dujiang Liu, Xiangdong Cheng, Li Yuan
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A Comprehensive Review of Prognostic Factors in Patients with Gastric Adenocarcinoma
Styliani Mantziari, Penelope St Amour, Francesco Abboretti, Hugo Teixeira-Farinha, Sergio Gaspar Figueiredo, Caroline Gronnier, Dimitrios Schizas, Nicolas Demartines, Markus Schäfer
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Normalization weighted combination scores re-evaluate TNM staging of gastric cancer: a retrospective cohort study based on a multicenter database
Junpeng Wu, Hao Wang, Xin Yin, Yufei Wang, Zhanfei Lu, Jiaqi Zhang, Yao Zhang, Yingwei Xue
International Journal of Surgery.2023;[Epub] CrossRef
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Ri-Sheng Zhao, Yi-Nan Liu, Wei-Gang Dai, Si-Le Chen, Jin-Ning Ye, Er-Tao Zhai, Shi-Rong Cai, Jian-Hui Chen
Frontiers in Oncology.2021;[Epub] CrossRef
Current therapeutic options for gastric adenocarcinoma
C.R. Akshatha, Smitha Bhat, R. Sindhu, Dharini Shashank, Sarana Rose Sommano, Wanaporn Tapingkae, Ratchadawan Cheewangkoon, Shashanka K. Prasad
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Outcomes of Radiotherapy for Mesenchymal and Non-Mesenchymal Subtypes of Gastric Cancer
Jeong Il Yu, Hee Chul Park, Jeeyun Lee, Changhoon Choi, Won Ki Kang, Se Hoon Park, Seung Tae Kim, Tae Sung Sohn, Jun Ho Lee, Ji Yeong An, Min Gew Choi, Jae Moon Bae, Kyoung-Mee Kim, Heewon Han, Kyunga Kim, Sung Kim, Do Hoon Lim
Cancers.2020; 12(4): 943. CrossRef

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Effect of Estradiol in an Azoxymethane/Dextran Sulfate Sodium-Treated Mouse Model of Colorectal Cancer: Implication for Sex Difference in Colorectal Cancer Development: Hee Jin Son, Sung Hwa Sohn, Nayoung Kim, Ha-Na Lee, Sun Min Lee, Ryoung Hee Nam, Ji Hyun Park, Chin-Hee Song, Eun Shin, Hee Young Na, Joo Sung Kim, Dong Ho Lee, Young-Joon Surh; Cancer Res Treat. 2019;51(2):632-648. Published online August 1, 2018; DOI: https://doi.org/10.4143/crt.2018.060

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study demonstrates that estradiol downregulates inflammation and inhibits colorectal cancer (CRC) development in azoxymethane/dextran sulfate sodium (AOM/DSS) mouse model.
Materials and Methods
AOM/DSS-treated male and female mice were sacrificed at weeks 2, 10, and 16, to assess estrogen effects on colitis and carcinogenesis. Macroscopic and histologic severity of colitis and Western blot and quantitative real-time polymerase chain reaction were evaluated, to measure inflammatory mediators and cytokines.
Results
Compared with AOM/DSS-treated male mice (M-AOM/DSS group), AOM/DSS-treated male mice with estradiol administration (M-AOM/DSS+estr group) displayed at week 2 significantly decreased severity of colitis. At weeks 10 and 16, AOM/DSS-treated female mice (F-AOM/DSS group) and the M-AOM/DSS+estr group showed significantly lower tumor multiplicity compared with the M-AOM/DSS group. At week 2, F-AOM/DSS group had a lower level of nuclear factor-κB (NF-κB) expression and higher level of nuclear factor erythroid 2-related factor 2 (Nrf2) expression, compared to the M-AOM/DSS group. At week 2, expression levels of NF-κB and its related mediators decreased in the M-AOM/DSS+estr group, while levels of Nrf2 and Nrf2-related anti-oxidant enzymes increased. In addition, estradiol significantly increased Nod-like receptor protein 3 (NLRP3) inflammasome expressions in AOM/DSS-treated male mice. In contrast, at weeks 10 and 16, Nrf2 and its-related anti-oxidant enzymes and NLRP3 inflammasome were highly expressed in M-AOM/DSS group and in F-AOM/DSS group, who developed cancer.
Conclusion
The data suggest that estradiol inhibits the initiation of CRC by regulating Nrf2-related pathways. Moreover, these imply the dual role of Nrf2 and NLRP3 inflammasome, including promotion of tumor progression upon tumor initiation.

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Increased Risk of Osteoporosis in Gastric Cancer Survivors Compared to General Population Control: A Study with Representative Korean Population: Su-Min Jeong, Dong Wook Shin, Ji Eun Lee, Sang-Man Jin, Sung Kim; Cancer Res Treat. 2019;51(2):530-537. Published online June 27, 2018; DOI: https://doi.org/10.4143/crt.2018.164

Abstract PDF Supplementary Material PubReader ePub

Purpose
Although several studies have suggested that osteoporosis is common in survivors of gastric cancer (GC), no study to date has directly assessed the risk for osteoporosis in GC survivors compared to matched controls. Thus, we aimed to investigate the relative risk for osteoporosis in survivors of GC compared to general population.
Materials and Methods
We used the Korea National Health and Nutrition Examination Survey data (2008-2011). Patients with a history of GC (n=94) were defined as case among 8,142 individuals over 50 years old who were evaluated by dual-energy X-ray absorptiometry. Controls (n=470) were matched to cases by age and sex in a 1:5 ratio. Osteopenia (–2.5 < T-score < –1.0) and osteoporosis (T-score ≤ –2.5) were defined.
Results
The prevalence of osteoporosis in GC survivors was 30.2%, which was significantly greater than that of controls (19.7%). In total, GC survivors had a 3.7-fold increased risk for osteoporosis compared to controls (p=0.021). In addition, the risk for osteoporosis of the total proximal femur total (TF) and femur neck (FN) was significantly increased among GC survivors compared to controls (adjusted relative risk, 4.64; 95% confidence interval, 1.16 to 18.6 in TF and adjusted relative risk, 3.58; 95% confidence interval, 1.19 to 10.8 in FN). Furthermore, we found sub-optimal daily calcium intake and mean serum levels of 25-hydroxy-vitamin D in both groups.
Conclusion
GC survivors are at significantly increased risk for osteoporosis, especially in the femur. Clinically, our finding supports the importance of screening bone health and adequate nutrient supplementation in survivors of GC.

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Redefining the Positive Circumferential Resection Margin by Incorporating Preoperative Chemoradiotherapy Treatment Response in Locally Advanced Rectal Cancer: A Multicenter Validation Study: Joo Ho Lee, Eui Kyu Chie, Seung-Yong Jeong, Tae-You Kim, Dae Yong Kim, Tae Hyun Kim, Sun Young Kim, Ji Yeon Baek, Hee Jin Chang, Min Ju Kim, Sung Chan Park, Jae Hwan Oh, Sung Hwan Kim, Jong Hoon Lee, Doo Ho Choi, Hee Chul Park, Sung-Bum Kang, Jae-Sung Kim; Cancer Res Treat. 2018;50(2):506-517. Published online May 24, 2017; DOI: https://doi.org/10.4143/crt.2016.607

Abstract PDF PubReader ePub

Purpose
This study was conducted to validate the prognostic influence of treatment response among patients with positive circumferential resection margin for locally advanced rectal cancer.
Materials and Methods
Clinical data of 197 patientswith positive circumferentialresection margin defined as ≤ 2 mm after preoperative chemoradiotherapy followed by total mesorectal excision between 2004 and 2009were collected forthis multicenter validation study. All patients underwent median 50.4Gy radiationwith concurrentfluoropyrimidine based chemotherapy. Treatmentresponse was dichotomized to good response, including treatmentresponse of grade 2 or 3, and poor response, including grade 0 or 1.
Results
After 52 months median follow-up, 5-year overall survival (OS) for good responders and poor responders was 79.1% and 48.4%, respectively (p < 0.001). In multivariate analysis, circumferential resection margin involvement and treatment response were a prognosticator for OS and locoregional recurrence-free survival. In subgroup analysis, good responders with close margin showed significantly better survival outcomes for survival. Good responders with involved margin and poor responders with close margin shared similar results, whereas poorresponderswith involved margin hadworst survival (5-year OS, 81.2%, 57.0%, 50.0%, and 32.4%, respectively; p < 0.001).
Conclusion
Among patients with positive circumferential resection margin after preoperative chemoradiotherapy, survival of the good responders was significantly better than poor responders. Subgroup analysis revealed that definition of positive circumferential resection margin may be individualized as involvement for good responders, whereas ≤ 2 mm for poor responders.

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Tailored Strategy for Locally Advanced Rectal Carcinoma (GRECCAR 4): Long-term Results From a Multicenter, Randomized, Open-Label, Phase II Trial
Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stephanie Nougaret
Diseases of the Colon & Rectum.2022; 65(8): 986. CrossRef
Colorectal Cancer Surgery Quality in Manitoba: A Population-Based Descriptive Analysis
Iresha Ratnayake, Jason Park, Natalie Biswanger, Allison Feely, Grace Musto, Kathleen Decker
Current Oncology.2021; 28(3): 2239. 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.

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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
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Sophia C. Kamran, David Palma, Matthew S. Katz, Anthony L. Zietman
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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
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Poor Preoperative Glycemic Control Is Associated with Dismal Prognosis after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Korean Multicenter Study: Sung Gu Kang, Eu Chang Hwang, Seung Il Jung, Ho Song Yu, Ho Seok Chung, Taek Won Kang, Dong Deuk Kwon, Jun Eul Hwang, Jun Seok Kim, Joon Hwa Noh, Jae Hyung You, Myung Ki Kim, Tae Hoon Oh, Ill Young Seo, Seung Baik, Chul-Sung Kim, Seok Ho Kang, Jun Cheon; Cancer Res Treat. 2016;48(4):1293-1301. Published online March 23, 2016; DOI: https://doi.org/10.4143/crt.2016.021

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). Materials and Methods A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival.
Results
The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8%) had DM and 67 patients (11.8%) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95% CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95% CI, 1.40 to 3.22; p=0.001). Conclusion Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome.

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Laura Ashley, Saifuddin Kassim, Ian Kellar, Lisa Kidd, Frances Mair, Mike Matthews, Mollie Price, Daniel Swinson, Johanna Taylor, Galina Velikova, Jonathan Wadsley
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Jie Ming, Yue Wang, Ziliang Su, Chunyang Wang
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Glycosylated haemoglobin and prognosis in 10,536 people with cancer and pre-existing diabetes: a meta-analysis with dose-response analysis
Suping Ling, Michael Sweeting, Francesco Zaccardi, David Adlam, Umesh T. Kadam
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The Impact of Diabetes on the Prognosis of Upper Tract Urothelial Carcinoma After Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
Xiaoshuai Gao, Liang Zhou, Jianzhong Ai, Wei Wang, Xingpeng Di, Liao Peng, Banghua Liao, Xi Jin, Hong Li, Kunjie Wang
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The Prognostic Value of Lymphovascular Invasion in Patients With Upper Tract Urinary Carcinoma After Surgery: An Updated Systematic Review and Meta-Analysis
Lijin Zhang, Bin Wu, Zhenlei Zha, Hu Zhao, Jun Yuan, Yejun Feng
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The impact of preoperative glycated hemoglobin levels on outcomes in oral squamous cell carcinoma
Ze Yun Tay, Huang‐Kai Kao, Kuang‐Hsu Lien, Shao‐Yu Hung, Yenlin Huang, Ngan‐Ming Tsang, Kai‐Ping Chang
Oral Diseases.2020; 26(7): 1449. CrossRef

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Isotype-Specific Inhibition of Histone Deacetylases: Identification of Optimal Targets for Radiosensitization: Jin Ho Kim, Sung Ho Moon, Mina No, Jae Jin Kim, Eun Jung Choi, Bong Jun Cho, Jae Sung Kim, Il Han Kim, In Ah Kim; Cancer Res Treat. 2016;48(3):1130-1140. Published online November 17, 2015; DOI: https://doi.org/10.4143/crt.2015.206

Abstract PDF Supplementary Material PubReader ePub

Purpose
Histone deacetylase (HDAC) inhibitors radiosensitize tumor cells. To elucidate mechanisms underlying radiosensitization by HDAC inhibition, understanding of differential contributions of HDAC isotypes is needed. The aim of this study was to investigate involvement of known HDAC isotypes in modulation of cellular radiosensitivity. Materials and Methods Because pharmacologic HDAC inhibitors lack isotype-specificity, RNA interference against 11 HDAC isotypes was used to inhibit HDAC in an isotype-specific manner. Radiation cell survival was evaluated using a clonogenic assay in SQ20B cells transfected with small interfering RNA specifically targeting HDAC isotypes. Immunocytochemistry was performed for detection of γH2AX foci. Protein expression was measured using Western blotting.
Results
Among 11 HDAC isotypes tested, specific inhibition of 7 isotypes (HDAC1, HDAC3, HDAC4, HDAC6, HDAC7, HDAC10, and HDAC11) enhanced radiation lethality in SQ20B cells. Radiosensitization by inhibition of these HDAC isotypes was accompanied by delay of DNA double strand break repair. Radiosensitivity of SQ20B cells was not altered by selective inhibition of the remaining four isotypes (HDAC2, HDAC5, HDAC8, and HDAC9). Inhibition of HDAC isotypes resulted in downregulation of various proteins involved in pro-survival and DNA damage repair pathways. Conclusion Isotype-specificity exists in HDAC inhibition-induced radiosensitization. Different HDAC isotypes are differentially involved in modulation of cellular radiosensitivity.

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Huixiao Hu, Qi Wang, Yuni Zhang, Shuhua Yang, Aihua Shen, Junfang Yan, Denggao Zhao, Burong Hu
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HDAC11: A novel target for improved cancer therapy
Yan Liu, Xuechao Tong, Weina Hu, Da Chen
Biomedicine & Pharmacotherapy.2023; 166: 115418. CrossRef
Histone deacetylase 10, a potential epigenetic target for therapy
Fajuan Cheng, Bin Zheng, Jianwei Wang, Guiting Zhao, Zhongshun Yao, Zhihong Niu, Wei He
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Synergistic Tumoricidal Effects of Alpha-Lipoic Acid and Radiotherapy on Human Breast Cancer Cells via HMGB1
Hoon Sik Choi, Jin Hyun Kim, Si Jung Jang, Jeong Won Yun, Ki Mun Kang, Hojin Jeong, In Bong Ha, Bae Kwon Jeong
Cancer Research and Treatment.2021; 53(3): 685. CrossRef
HDAC11: a rising star in epigenetics
Shan-Shan Liu, Fei Wu, Yue-Mei Jin, Wei- Qin Chang, Tian-Min Xu
Biomedicine & Pharmacotherapy.2020; 131: 110607. CrossRef
Disulfiram, a Re-positioned Aldehyde Dehydrogenase Inhibitor, Enhances Radiosensitivity of Human Glioblastoma Cells In Vitro
Hyeon Kang Koh, Soo Yeon Seo, Jin Ho Kim, Hak Jae Kim, Eui Kyu Chie, Seung-Ki Kim, Il Han Kim
Cancer Research and Treatment.2019; 51(2): 696. CrossRef
Molecular imaging HDACs class IIa expression-activity and pharmacologic inhibition in intracerebral glioma models in rats using PET/CT/(MRI) with [18F]TFAHA
Maxwell T. Laws, Robin E. Bonomi, Swatabdi Kamal, David J. Gelovani, Jeremy Llaniguez, Shreya Potukutchi, Xin Lu, Thomas Mangner, Juri G. Gelovani
Scientific Reports.2019;[Epub] CrossRef
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Sung-Won Shin, Changhoon Choi, Ga-Haeng Lee, Arang Son, Su-Hyeon Kim, Hee Chul Park, Ines Batinic-Haberle, Won Park
Antioxidants & Redox Signaling.2017; 27(14): 1067. CrossRef
MicroRNA-200c increases radiosensitivity of human cancer cells with activated EGFR-associated signaling
Taeryool Koo, Bong Jun Cho, Dan Hyo Kim, Ji Min Park, Eun Jung Choi, Hans H. Kim, David J Lee, In Ah Kim
Oncotarget.2017; 8(39): 65457. CrossRef
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Alokta Chakrabarti, Jelena Melesina, Fiona R Kolbinger, Ina Oehme, Johanna Senger, Olaf Witt, Wolfgang Sippl, Manfred Jung
Future Medicinal Chemistry.2016; 8(13): 1609. CrossRef

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A Korean Nationwide Survey for Breakthrough Cancer Pain in an Inpatient Setting: Sun Kyung Baek, Do Yeun Kim, Seok Yun Kang, Sun Jin Sym, Young Sung Kim, June Young Lee; Cancer Res Treat. 2016;48(2):768-774. Published online September 15, 2015; DOI: https://doi.org/10.4143/crt.2015.087

Abstract PDF PubReader ePub

Purpose
We evaluated the prevalence and characteristics of breakthrough cancer pain (BTcP) in Korean patients admitted with cancer pain.
Materials and Methods
In-hospital patients with cancer pain completed a questionnaire concerning severity of background cancer pain (BCP), prevalence and treatment for BTcP, sleep disorders, and satisfaction with cancer pain treatment. Medical records showing medications for BCP and BTcP were also evaluated.
Results
Total 609 patients with controlled BCP enrolled. Mean age of the patients was 59.5 years old, and 59% were male. Of all patients, 177 (29%) complained of BTcP. No clinical characteristic predicted BTcP. Of the 177 patients with BTcP, 56% did not receive treatment for BTcP. Patients with BTcP showed significant association with a sleep disorder and dissatisfaction with pain control, compared to those without BTcP (p < 0.0001 and p=0.0498, respectively). Oxycodone-immediate release was the most commonly used short-acting analgesic, followed by intravenous morphine.
Conclusion
The prevalence of BTcP was 29% in patients admitted with controlled BCP. Although the patients had well-controlled BCP, BTcP showed association with a lower quality of life in patients with cancer. More medical attention is needed for detection and management of BTcP.

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Breakthrough pain among cancer patients at oncology units in Northern Ethiopia; a multi-center study
Yohanes Tekie, Yonas Addisu Nigatu, Wudie Mekonnen, Yophtahe Woldegerima Berhe
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Predicting tolerability of high-dose fentanyl buccal tablets in cancer patients
Mi-Young Kwon, Mi-Yeon Lee, Yun Jae Han, Sung Hyun Lee, Eo Jin Kim, Songyi Park, Yun‑Gyoo Lee, Dong-Hoe Koo, Muhammad Hanif
PLOS ONE.2023; 18(1): e0280212. CrossRef
Knowledge and practice of the management of breakthrough cancer pain among general practitioners providing palliative care in Shanghai, China: a cross-sectional survey
Ying Yu, Panpan Zhang, Danxia Chen, Sun Fang Jiang
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Effect of a theory-driven educational intervention on the level of knowledge, attitudes, and assessment practices regarding breakthrough cancer pain (BTCP) management among medical nurses in Hong Kong
Carman Y.L. Kwok, Dorothy N.S. Chan, Winnie K.W. So
European Journal of Oncology Nursing.2021; 52: 101945. CrossRef
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Significance of descriptive symptoms and signs and clinical parameters as predictors of neuropathic cancer pain
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PLOS ONE.2021; 16(8): e0252781. CrossRef
Interference with daily functioning by breakthrough pain in patients with cancer
Jung Hun Kang, Su-Jin Koh, So Yeon Oh, Rock Bum Kim, Seong Hoon Shin, Yun-Gyoo Lee, Bong-Seog Kim, Hun Mo Ryoo, So Young Yoon, Joung Soon Jang, Ho-Suk Oh, Young Jin Choi, Moon Hee Lee, Kyung-Hee Lee
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Richard J. Bodnar
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Initial titration with 200 μg fentanyl buccal tablets: a retrospective safety analysis in Korean cancer patients
Mi-Young Kwon, Ha-Na Cho, Dong-Hoe Koo, Yun-Gyoo Lee, Sukjoong Oh, Seung-Sei Lee
The Korean Journal of Internal Medicine.2018; 33(3): 577. CrossRef

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Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer: Jeanny Kwon, Keun-Yong Eom, In Ah Kim, Jae-Sung Kim, Young-Beom Kim, Jae Hong No, Kidong Kim; Cancer Res Treat. 2016;48(2):632-640. Published online July 14, 2015; DOI: https://doi.org/10.4143/crt.2015.085

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in highrisk cervical cancer treated with radical surgery and adjuvant treatment. Materials and Methods Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months. Results The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFSwas observed in patients with perineural invasion, ≥ 2 LN metastases, LNR ≥ 10%, upper LN metastasis, and ≥ –1.05 LODDs. In multivariate analysis, ≥ –1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ≥ –1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006). Conclusion LODDs ≥ –1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ≥ –1.05, intensified chemotherapy might be required, considering the high rate of DF.

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Perineural invasion in cervical cancer: A multicenter retrospective study
Xiaolin Chen, Hui Duan, Hongwei Zhao, Fangjie He, Lu Yin, Yueping Liu, Lixia Wang, Chunlin Chen
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Angela Santoro, Frediano Inzani, Giuseppe Angelico, Damiano Arciuolo, Emma Bragantini, Antonio Travaglino, Michele Valente, Nicoletta D’Alessandris, Giulia Scaglione, Stefania Sfregola, Alessia Piermattei, Federica Cianfrini, Paola Roberti, Gian Franco Za
Cancers.2023; 15(4): 1137. CrossRef
Development and Validation of Novel Nomograms to Predict the Overall Survival and Cancer-Specific Survival of Cervical Cancer Patients With Lymph Node Metastasis
Jianying Yi, Zhili Liu, Lu Wang, Xingxin Zhang, Lili Pi, Chunlei Zhou, Hong Mu
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Treatment Strategies and Prognostic Factors of 2018 FIGO Stage IIIC Cervical Cancer: A Review
Fengying Qin, Huiting Pang, Tao Yu, Yahong Luo, Yue Dong
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The Log Odds of Positive Lymph Nodes Predict Survival of Advanced-Stage Endometrial Cancer: A Retrospective Analysis of 3230 Patients in the Surveillance, Epidemiology, and End Results Database
Christopher G. Smith, Quan Chen, Bin Huang, Rachel W. Miller, Christopher P. DeSimone, Charles S. Dietrich, Frederick R. Ueland, Holly H. Gallion, Edward J. Pavlik, John R. van Nagell, Lauren A. Baldwin Branch
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Antoni Llueca, Javier Escrig, Antonio Gil-Moreno, Virginia Benito, Alicia Hernández, Berta Díaz-Feijoo
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Lymph Node Ratio Is a Strong Prognostic Factor in Patients with Early-Stage Cervical Cancer Undergoing Minimally Invasive Radical Hysterectomy
Se Ik Kim, Tae Hun Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Taek Sang Lee, Hye Won Jeon, Jae-Weon Kim, Noh Hyun Park, Yong-Sang Song
Yonsei Medical Journal.2021; 62(3): 231. CrossRef
The role of lymph nodes in cervical cancer: incidence and identification of lymph node metastases—a literature review
Ester P. Olthof, Maaike A. van der Aa, Judit A. Adam, Lukas J. A. Stalpers, Hans H. B. Wenzel, Jacobus van der Velden, Constantijne H. Mom
International Journal of Clinical Oncology.2021; 26(9): 1600. CrossRef
Prognostic implications of ENE and LODDS in relation to lymph node-positive colorectal cancer location
Tengfei Li, Yan Yang, Weidong Wu, Zhongmao Fu, Feichi Cheng, Jiahui Qiu, Qi Li, Kundong Zhang, Zai Luo, Zhengjun Qiu, Chen Huang
Translational Oncology.2021; 14(11): 101190. CrossRef
The prognostic value of lymph node ratio in stage IIIC cervical cancer patients triaged to primary treatment by radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy
Koray Aslan, Mehmet Mutlu Meydanli, Murat Oz, Yusuf Aytac Tohma, Ali Haberal, Ali Ayhan
Journal of Gynecologic Oncology.2020;[Epub] CrossRef
Radiomic signature as a predictive factor for lymph node metastasis in early‐stage cervical cancer
Yangyang Kan, Di Dong, Yuchen Zhang, Wenyan Jiang, Nannan Zhao, Lu Han, Mengjie Fang, Yali Zang, Chaoen Hu, Jie Tian, Chunming Li, Yahong Luo
Journal of Magnetic Resonance Imaging.2019; 49(1): 304. CrossRef
The Prognostic Impact of the Number of Metastatic Lymph Nodes and a New Prognostic Scoring System for Recurrence in Early-Stage Cervical Cancer with High Risk Factors: A Multicenter Cohort Study (KROG 15-04)
Jeanny Kwon, Keun-Young Eom, Young Seok Kim, Won Park, Mison Chun, Jihae Lee, Yong Bae Kim, Won Sup Yoon, Jin Hee Kim, Jin Hwa Choi, Sei Kyung Chang, Bae Kwon Jeong, Seok Ho Lee, Jihye Cha
Cancer Research and Treatment.2018; 50(3): 964. CrossRef
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Weiye Deng, Ting Xu, Yifan Wang, Yujin Xu, Pei Yang, Daniel Gomez, Zhongxing Liao
Lung Cancer.2018; 122: 60. CrossRef
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Ji Hyeon Joo, Young Seok Kim, Joo-Hyun Nam
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Jeong Won Lee, Seob Jeon, Seong Taek Mun, Sang Mi Lee
International Journal of Gynecological Cancer.2017; 27(4): 776. CrossRef

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Objective Measurement of Cosmetic Outcomes of Breast Conserving Therapy Using BCCT.core: Tosol Yu, Keun-Yong Eom, Na Young Jang, Kyung Su Kim, Tae Ryool Koo, Jeanny Kwon, Byoung Hyuck Kim, Eunyoung Kang, Sung-Won Kim, Jae-Sung Kim, In Ah Kim; Cancer Res Treat. 2016;48(2):491-498. Published online June 22, 2015; DOI: https://doi.org/10.4143/crt.2015.088

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study is to evaluate objective cosmetic outcomes and factors related to breast-conserving therapy (BCT) using the BCCT.core software.
Materials and Methods
Fifty-one patients who received BCT with informed consent were evaluated using the BCCT.core software. Patients were divided into two groups based on the BCCT score: excellent or good (n=42) vs. fair or poor (n=9). Analysis of clinical factors was performed to determine factors affecting cosmetic outcomes.
Results
The objective cosmetic outcome of BCT measured using the BCCT.core software was excellent in 10% of patients, good in 72%, and fair in 18%. None of the patients were classified as poor outcome. Tumor characteristics, systemic adjuvant therapy (chemotherapy and hormonal therapy), and radiation dose or energy of electron boost did not show correlation with the score measured by the BCCT.core program (p > 0.05). In univariate analysis, maximum dose within the breast (Dmax), width of tangential field, and excised tumor volume were smaller in patients with excellent or good by the BCCT.core compared to those with fair or poor (Dmax, 110.2±1.5% vs. 111.6±1.7%, p=0.019; width of tangential field, 8.0±1.1 cm vs. 8.6±0.7 cm, p=0.034; excised tumor volume, 64.0±35.8 cm3 vs. 95.3±54.4 cm3, p=0.067). In multivariate analysis, only Dmax was a significant factor for breast cosmetic outcome with a risk ratio of 1.697 (95% confidence interval, 1.006 to 2.863; p=0.047).
Conclusion
Objective measurement of cosmetic outcome of BCT using the BCCT.core software was feasible. The cosmetic outcome of BCT may be affected by the maximum dose within the breast.

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The Effect of Chemoradiotherapy with SRC Tyrosine Kinase Inhibitor, PP2 and Temozolomide on Malignant Glioma Cells In Vitro and In Vivo: Keun-Yong Eom, Bong Jun Cho, Eun Jung Choi, Jin-Ho Kim, Eui Kyu Chie, Hong-Gyun Wu, Il Han Kim, Sun Ha Paek, Jae-Sung Kim, In Ah Kim; Cancer Res Treat. 2016;48(2):687-697. Published online June 4, 2015; DOI: https://doi.org/10.4143/crt.2014.320

Abstract PDF PubReader ePub

Purpose
We investigated the effect of chemoradiotherapy with PP2 and temozolomide (TMZ) on malignant glioma cells using clonogenic assays and in vivo brain tumor model.
Materials and Methods
The effect of PP2 on radiosensitivity of U251 and T98G cells was investigated using clonogenic assays. The expression of E-cadherin, matrix metalloproteinases 2 (MMP2), Ephrin type-A receptor 2 (EphA2), and vascular endothelial growth factor (VEGF) was measured by Western blotting and an accumulation of γH2AX foci 6 hours after radiotherapy was measured after PP2 treatment. The effect of PP2 on migration, invasion, and vasculogenic mimicry formation (VMF) of U251 cells was evaluated. In an orthotopical brain tumor model with U251 cells, PP2 was injected intraperitoneally with or without oral TMZ before, during and after whole brain radiotherapy. Bioluminescence images were taken to visualize in vivo tumors and immunohistochemical staining of VEGF, CD31, EphA2, and hypoxia-inducible factor 1a was performed.
Results
PP2 increased radiosensitivity of U251 and T98G cells without decreasing survival of normal human astrocytes. Chemoradiotherapy with PP2 and TMZ resulted in increased accumulation of γH2AX foci. PP2 induced overexpression of E-cadherin and suppression of MMP2, VEGF, and EphA2. PP2 also compromised invasion, migration, and VMF of U251 cells. In brain tumors, chemoradiotherapy with PP2 and TMZ decreased tumor volume best, but not statistically significantly compared with chemoradiotherapy with TMZ. The expression of VEGF and CD31 was suppressed in PP2-treated tumors.
Conclusion
PP2 enhances radiosensitivity of malignant glioma cells and suppresses invasion and migration of U251 cells. Chemoradiotherapy with PP2 and TMZ resulted in non-significant tumor volume decrease.

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Carotid-Sparing TomoHelical 3-Dimensional Conformal Radiotherapy for Early Glottic Cancer: Chae-Seon Hong, Dongryul Oh, Sang Gyu Ju, Yong Chan Ahn, Jae Myoung Noh, Kwangzoo Chung, Jin Sung Kim, Tae-Suk Suh; Cancer Res Treat. 2016;48(1):63-70. Published online March 6, 2015; DOI: https://doi.org/10.4143/crt.2014.265

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to investigate the dosimetric benefits and treatment efficiency of carotid-sparing TomoHelical 3-dimensional conformal radiotherapy (TH-3DCRT) for early glottic cancer. Materials and Methods Ten early-stage (T1N0M0) glottic squamous cell carcinoma patients were simulated, based on computed tomography scans. Two-field 3DCRT (2F-3DCRT), 3-field intensity-modulated radiation therapy (3F-IMRT), TomoHelical-IMRT (TH-IMRT), and TH-3DCRT plans were generated with a 67.5-Gy total prescription dose to the planning target volume (PTV) for each patient. In order to evaluate the plan quality, dosimetric characteristics were compared in terms of conformity index (CI) and homogeneity index (HI) for PTV, dose to the carotid arteries, and maximum dose to the spinal cord. Treatment planning and delivery times were compared to evaluate treatment efficiency.
Results
The median CI was substantially better for the 3F-IMRT (0.65), TH-IMRT (0.64), and TH-3DCRT (0.63) plans, compared to the 2F-3DCRT plan (0.32). PTV HI was slightly better for TH-3DCRT and TH-IMRT (1.05) compared to 2F-3DCRT (1.06) and 3F-IMRT (1.09). TH-3DCRT, 3F-IMRT, and TH-IMRT showed an excellent carotid sparing capability compared to 2F-3DCRT (p < 0.05). For all plans, the maximum dose to the spinal cord was < 45 Gy. The median treatment planning times for 2F-3DCRT (5.85 minutes) and TH-3DCRT (7.10 minutes) were much lower than those for 3F-IMRT (45.48 minutes) and TH-IMRT (35.30 minutes). The delivery times for 2F-3DCRT (2.06 minutes) and 3F-IMRT (2.48 minutes) were slightly lower than those for TH-IMRT (2.90 minutes) and TH-3DCRT (2.86 minutes). Conclusion TH-3DCRT showed excellent carotid-sparing capability, while offering high efficiency and maintaining good PTV coverage.

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Accelerated three‐dimensional conformal radiotherapy for early‐stage glottic cancer in reducing dose to the internal carotid artery and pharyngeal constrictor muscles
Kento Tomizawa, Atsushi Motegi, Hidekazu Oyoshi, Takeshi Fujisawa, Sadamoto Zenda, Yuzheng Zhou, Masaki Nakamura, Hidenari Hirata, Hidehiro Hojo, Shun‐ichiro Kageyama, Kouta Hirotaki, Kazuto Matsuura, Tetsuo Akimoto
Head & Neck.2024; 46(2): 239. CrossRef
Dosimetric comparison between carotid-sparing IMRT and 3DCRT in early glottic cancer patients treated with definitive radiation therapy
Harkirat Kaur, Niketa Thakur, Ramita Sharma, Meena Sudan, Neeraj Jain, Supreet Kaur, Priyanka Lehal
Journal of Cancer Research and Therapeutics.2024; 20(1): 327. CrossRef
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
Application of error classification model using indices based on dose distribution for characteristics evaluation of multileaf collimator position errors
Heesoon Sheen, Han-Back Shin, Hojae Kim, Changhwan Kim, Jihun Kim, Jin Sung Kim, Chae-Seon Hong
Scientific Reports.2023;[Epub] CrossRef
Comparison of Carotid Artery Dose in Early-Stage Glottic Cancer Treated with 3D-Conformal, Helical-IMRT and VMAT
B Pires, D Rothwell, I Guimarães, J Sousa, R Magalhães, T Serra, L Khouri, P Alves
Forum of Clinical Oncology.2022; 13(3): 23. CrossRef
Preliminary Simulation Study of Carotid Artery and Pharyngeal Constrictor Muscle Sparing-Radiotherapy in Glottic Carcinoma
Yurday Ozdemir, Ibrahim Acibuci, Ugur Selek, Erkan Topkan
Technology in Cancer Research & Treatment.2020;[Epub] CrossRef
Dose-Volume Comparison of IMRT and PSPT Treatment Plans for Early-Stage Glottic Cancer
Takahiro Kato, Nobukazu Fuwa, Masao Murakami
International Journal of Particle Therapy.2020; 7(2): 42. CrossRef
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Razzagh Abedi Firouzjah, Amin Banaei, Bagher Farhood, Mohsen Bakhshandeh
Health Physics.2019; 116(5): 631. CrossRef
Feasibility of hybrid TomoHelical- and TomoDirect-based volumetric gradient matching technique for total body irradiation
Chae-Seon Hong, Min-Joo Kim, Jihun Kim, Kyung Hwan Chang, Kwangwoo Park, Dong Wook Kim, Min Cheol Han, Hong In Yoon, Jin Sung Kim, Ho Lee
Radiation Oncology.2019;[Epub] CrossRef
Standardisation of Target Volume Delineation for Carotid-sparing Intensity-modulated Radiotherapy in Early Glottis Cancer
D.M. Gujral, M. Long, J.W.G. Roe, K.J. Harrington, C.M. Nutting
Clinical Oncology.2017; 29(1): 42. CrossRef
Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study
Hoon Sik Choi, Bae Kwon Jeong, Hojin Jeong, Jin Ho Song, Jin Pyeong Kim, Jung Je Park, Seung Hoon Woo, Ki Mun Kang
Radiation Oncology Journal.2016; 34(1): 26. CrossRef

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The Expression of Carbonic Anhydrase (CA) IX/XII and Lymph Node Metastasis in Early Breast Cancer: Keun-Yong Eom, Min Hye Jang, So Yeon Park, Eun Young Kang, Sung Won Kim, Jee Hyun Kim, Jae-Sung Kim, In Ah Kim; Cancer Res Treat. 2016;48(1):125-132. Published online March 3, 2015; DOI: https://doi.org/10.4143/crt.2014.243

Abstract PDF PubReader ePub

Purpose
The aim of study was to test by immunohistochemical (IHC) staining whether carbonic anhydrase (CA) 9 and 12 have an effect on sentinel lymph node (SLN) metastasis in early breast cancer and to find clinicopathologic factors associated with SLN metastasis.
Materials and Methods
Between June 2003 and June 2011, medical records of 470 patients diagnosedwith breast cancer with pT1-2, pN0-2, and M0 were reviewed. Of these 470, 314 patients who underwent SLN biopsy±axillary dissection were subjects of this study. Using tissue microarray, IHC staining for CA9 and CA12 was performed. Clinicopathologic factors such as patient age, tumour size, lymphatic invasion, hormone receptor status, and the Ki-67 labeling index were analysed together.
Results
The mean age of all patients was 51.7 years. The mean number of harvested SLN was 3.62, and 212 patients (67.5%) had negative SLN. Lymphatic invasion, the Ki-67 labelling index of primary tumours, and CA9 staining of stromal cells, were independent risk factors for SLN metastasis in the multivariate analysis. In 33 patients (10.5%) without the three risk factors, no patient had SLN metastasis. In 80 patients without lymphatic invasion of primary tumours or CA9 staining of stromal cells, only four patients (5%) had positive SLN.
Conclusion
CA9 staining of stromal cells is an independent risk factor for SLN metastasis as well as lymphatic invasion and a low Ki-67 labelling index of primary tumours in patients with early breast cancer. IHC staining of primary tumours for CA12was not associatedwith SLN metastasis.

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Impact of CA9 expression in the diagnosis of lymph-node metastases in non-small cell lung cancer based on [18F]FDG PET/CT
Satoshi Suzuki, Masakazu Yashiro, Nobuhiro Izumi, Takuma Tsukioka, Hidetoshi Inoue, Kantaro Hara, Ryuichi Ito, Takuya Tanimura, Noritoshi Nishiyama, Domenico Albano
PLOS ONE.2024; 19(10): e0312846. CrossRef
Carbonic Anhydrase XII Expression Is Modulated during Epithelial Mesenchymal Transition and Regulated through Protein Kinase C Signaling
Daniele Vergara, Sara Ravaioli, Eugenio Fonzi, Loredaria Adamo, Marina Damato, Sara Bravaccini, Francesca Pirini, Antonio Gaballo, Raffaela Barbano, Barbara Pasculli, Julien Franck, Isabelle Fournier, Michel Salzet, Michele Maffia
International Journal of Molecular Sciences.2020; 21(3): 715. CrossRef
The Interplay of Dysregulated pH and Electrolyte Imbalance in Cancer
Khalid O. Alfarouk, Samrein B. M. Ahmed, Ahmed Ahmed, Robert L. Elliott, Muntaser E. Ibrahim, Heyam S. Ali, Christian C. Wales, Ibrahim Nourwali, Ahmed N. Aljarbou, Adil H. H. Bashir, Sari T. S. Alhoufie, Saad Saeed Alqahtani, Rosa A. Cardone, Stefano Fai
Cancers.2020; 12(4): 898. CrossRef
Identification and validation of a combined hypoxia and immune index for triple‐negative breast cancer
Shaoquan Zheng, Yutian Zou, Jie‐ying Liang, Weikai Xiao, Anli Yang, Tiebao Meng, Shilin Lu, Zhongbing Luo, Xiaoming Xie
Molecular Oncology.2020; 14(11): 2814. CrossRef
The roles of carbonic anhydrases IX and XII in cancer cell adhesion, migration, invasion and metastasis
Simonas Daunys, Vilma Petrikaitė
Biology of the Cell.2020; 112(12): 383. CrossRef
Overexpression of HIF1α and CAXI predicts poor outcome in early-stage triple negative breast cancer
Min-Sun Jin, Hyebin Lee, In Ae Park, Yul Ri Chung, Seock-Ah Im, Kyung-Hun Lee, Hyeong-Gon Moon, Wonshik Han, Kyubo Kim, Tae-Yong Kim, Dong-Young Noh, Han Suk Ryu
Virchows Archiv.2016; 469(2): 183. CrossRef
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Bo Lei, Xian-yu Zhang, Jia-peng Zhou, Guan-nan Mu, Yi-wen Li, You-xue Zhang, Da Pang
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Manjulata Singh, Shilpaa Mukundan, Maria Jaramillo, Steffi Oesterreich, Shilpa Sant
Cancer Research.2016; 76(13): 3732. CrossRef

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Effect of Radiation Therapy Techniques on Outcome in N3-positive IIIB Non-small Cell Lung Cancer Treated with Concurrent Chemoradiotherapy: Jae Myoung Noh, Jin Man Kim, Yong Chan Ahn, Hongryull Pyo, BoKyong Kim, Dongryul Oh, Sang Gyu Ju, Jin Sung Kim, Jung Suk Shin, Chae-Seon Hong, Hyojung Park, Eonju Lee; Cancer Res Treat. 2016;48(1):106-114. Published online February 12, 2015; DOI: https://doi.org/10.4143/crt.2014.131

Abstract PDF PubReader ePub

Purpose
This study was conducted to evaluate clinical outcomes following definitive concurrent chemoradiotherapy (CCRT) for patients with N3-positive stage IIIB (N3-IIIB) non-small cell lung cancer (NSCLC), with a focus on radiation therapy (RT) techniques. Materials and Methods From May 2010 to November 2012, 77 patients with N3-IIIB NSCLC received definitive CCRT (median, 66 Gy). RT techniques were selected individually based on estimated lung toxicity, with 3-dimensional conformal RT (3D-CRT) and intensity-modulated RT (IMRT) delivered to 48 (62.3%) and 29 (37.7%) patients, respectively. Weekly docetaxel/paclitaxel plus cisplatin (67, 87.0%) was the most common concurrent chemotherapy regimen.
Results
The median age and clinical target volume (CTV) were 60 years and 288.0 cm3, respectively. Patients receiving IMRT had greater disease extent in terms of supraclavicular lymph node (SCN) involvement and CTV ≥ 300 cm3. The median follow-up time was 21.7 months. Fortyfive patients (58.4%) experienced disease progression, most frequently distant metastasis (39, 50.6%). In-field locoregional control, progression-free survival (PFS), and overall survival (OS) rates at 2 years were 87.9%, 38.7%, and 75.2%, respectively. Although locoregional control was similar between RT techniques, patients receiving IMRT had worse PFS and OS, and SCN metastases from the lower lobe primary tumor and CTV ≥ 300 cm3were associated with worse OS. The incidence and severity of toxicities did not differ significantly between RT techniques. Conclusion IMRT could lead to similar locoregional control and toxicity, while encompassing a greater disease extent than 3D-CRT. The decision to apply IMRT should be made carefully after considering oncologic outcomes associated with greater disease extent and cost.

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p27 Loss Is Associated with Poor Prognosis in Gastroenteropancreatic Neuroendocrine Tumors: Hee Sung Kim, Hye Seung Lee, Kyung Han Nam, Jiwoon Choi, Woo Ho Kim; Cancer Res Treat. 2014;46(4):383-392. Published online July 17, 2014; DOI: https://doi.org/10.4143/crt.2013.102

Abstract PDF PubReader ePub

Purpose
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) represent a heterogeneous disease group originating from the neuroendocrine cells. Identification of prognostic markers, related to neuroendocrine tissue-selective tumorigenesis, is necessary to find therapeutic targets.
Materials and Methods
A total of 327 patients with GEP-NETs were included in this study; there were 49 gastric, 29 duodenal, 49 pancreatic, 12 hepatobiliary, 33 appendiceal, 5 proximal colon, and 150 distal colon cases. We performed immunostaining with the tissue microarray method for menin, p27, and p18.
Results
We observed negative staining for menin, p27, and p18 in 34%, 21%, and 56% of GEP-NETs, respectively. The loss of p27, but not menin, was positively correlated with the grade of Ki-67. Menin–/p27–, menin–/p27+, menin+/p27–, and menin+/p27+ phenotype groups included 13%, 22%, 8%, and 57% of patients, respectively. A dichotomized comparison showed that menin– or p27– tumors were significantly associated with foregut and midgut localizations, high World Health Organization (WHO) grade, lymph node metastasis, and more advanced stage as compared to menin+/p27+ patients. Kaplan-Meier analysis for the overall survival showed that p27 loss was significantly associated with decreased survival. Multivariate analysis showed that p27 loss is an independent factor for poor overall survival.
Conclusion
Our results revealed that the loss of p27 is associated with poor prognosis and the menin-p27 pathway is important in the tumorigenesis of GEP-NETs.

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Outcome of Local Excision Following Preoperative Chemoradiotherapy for Clinically T2 Distal Rectal Cancer: A Multicenter Retrospective Study (KROG 12-06): Jae Myoung Noh, Won Park, Jae-Sung Kim, Woong Sub Koom, Jin Hee Kim, Doo Ho Choi, Hee Chul Park; Cancer Res Treat. 2014;46(3):243-249. Published online July 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.3.243

Abstract PDF PubReader ePub

Purpose
The aim of this study was to examine the clinical implications of a pathologically complete response after neoadjuvant chemoradiotherapy (CRT) followed by local excision for patients with cT2 rectal cancer who refused radical surgery. Materials and Methods Seventeen patients with cT2 primary rectal cancer within 6 cm from the anal verge who received neoadjuvant CRT and local excision because of patient refusal of radical surgery or poor performance status were included. Two patients had clinical involvement of a regional lymph node. Preoperative radiotherapy was delivered to the whole pelvis at a dose of 44 to 50.4 Gy in 22 to 28 fractions. All patients underwent transanal excision and eight patients (47%) received postoperative chemotherapy. Results Ten patients (59%) achieved ypT0. At a median follow-up period of 75 months (range, 22 to 126 months), four (24%) patients developed recurrence (two locoregional and two distant). The 5-year disease-free survival of all patients was 82%, and was higher in patients with ypT0 (90%) than in patients with ypT1-2 (69%, p=0.1643). Decreased disease-free survival was also observed in patients receiving capecitabine compared with 5-fluorouracil (54% vs. 100%, p=0.0298). Conclusion Local excision could be a feasible alternative to radical surgery in patients with ypT0 after neoadjuvant CRT for cT2 distal rectal cancer without further radical surgery.

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Neoadjuvant chemoradiation followed by transanal local excision for T2 rectal cancer confers equivalent survival benefit as traditional transabdominal resection
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Young Seob Shin, Jin-hong Park, Sang Min Yoon, Jin Cheon Kim, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Tae Won Kim, Yong Sang Hong, Kyu-pyo Kim, Eun Kyung Choi, Seung Do Ahn, Sang-Wook Lee, Jong Hoon Kim
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Bo Young Oh, Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun
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Fraser McLean Smith, Abdul Ahad, Rodrigo Oliva Perez, John Marks, Krzysztof Bujko, Richard J. Heald
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Deborah S. Keller, Reena N. Tahilramani, Juan R. Flores-Gonzalez, Ali Mahmood, Eric M. Haas
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T. Sprenger, H. Rothe, T. Beissbarth, L.-C. Conradi, A. Kauffels, K. Homayounfar, C. L. Behnes, C. Rödel, T. Liersch, M. Ghadimi
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Oncologic Safety of Local Excision Compared With Total Mesorectal Excision for ypT0-T1 Rectal Cancer
Sung Min Jung, Chang Sik Yu, In Ja Park, Tae Won Kim, Jong Hoon Kim, Yong Sik Yoon, Seok-Byung Lim, Jin Cheon Kim
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Sally Hallam, David E. Messenger, Michael G. Thomas
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Preoperative chemoradiotherapy followed by local excision in clinical T2N0 rectal cancer
Young Seob Shin, Yong sik Yoon, Seok-Byung Lim, Chang Sik Yu, Tae Won Kim, Heung Moon Chang, Jin-hong Park, Seung Do Ahn, Sang-Wook Lee, Eun Kyung Choi, Jin Cheon Kim, Jong Hoon Kim
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Sam Atallah, Deborah Keller
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Juefeng Wan, Kaitai Liu, Ji Zhu, Guichao Li, Zhen Zhang
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Clinical Significance of Protein Expression of Cyclooxygenase-2 and Somatostatin Receptors in Gastroenteropancreatic Neuroendocrine Tumors: Hee Sung Kim, Hye Seung Lee, Woo Ho Kim; Cancer Res Treat. 2011;43(3):181-188. Published online September 30, 2011; DOI: https://doi.org/10.4143/crt.2011.43.3.181

Abstract PDF PubReader ePub

PURPOSE
This study was undertaken to evaluate the significance of cyclooxygenase-2 (COX2) overexpression and the expression of somatostatin receptor (SSTR) subtypes in gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
MATERIALS AND METHODS
Two hundred and forty-seven cases of GEP-NET, comprising 86 foregut and 156 hindgut primary NETs, and 5 metastatic NETs in the liver, were studied retrospectively with immunohistochemistry for COX2, chromogranin A, Ki-67, SSTR1, SSTR2, and SSTR5.
RESULTS
COX2 overexpression was observed in 54%(126 of 234), and SSTR1, SSTR2, and SSTR5 positivity in 84%(196 of 233), 72%(168 of 233), and 55%(128 of 232), respectively. COX2 overexpression was found to be positively correlated with Ki-67 labeling index and inversely correlated with the expression of SSTR subtypes. In addition, the expression of SSTR subtypes was tightly correlated in any comparative pairs. A significant inverse correlation was found between COX2 and SSTR2 expression in the foregut, but not hindgut NETs. Kaplan-Meier analyses showed that COX2 overexpression (p=0.003) and high Ki-67 labeling index (p<0.001) were associated with poor overall survival (OS), whereas expression of SSTR2 (p<0.001) was associated with better OS of GEP-NET patients. Multivariate analysis revealed negative SSTR2 expression as an independent prognostic marker in GEP-NET patients (p<0.001).
CONCLUSION
Our results suggest that expression of SSTR subtypes is associated with favorable prognosis, whereas COX2 overexpression is associated with poor prognosis in GEP-NETs. Taken together, COX2 could be a possible therapeutic target in some subsets of GEP-NETs.

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Case Report

A Case of Metachronous Metastasis to the Breast from Non-Small Cell Lung Carcinoma: Min Yong Yoon, Chang Seok Song, Mi Hae Seo, Min Jae Kim, Tae Yun Oh, Un Ha Jang, Hyon Joo Kwag, Hee Sung Kim, Si Young Lim, Seong Yong Lim, Seung Sae Lee; Cancer Res Treat. 2010;42(3):172-175. Published online September 30, 2010; DOI: https://doi.org/10.4143/crt.2010.42.3.172

Abstract PDF PubReader ePub

Breast metastases from an extramammary primary tumor are very rare and the prognosis for such patients is generally poor. We report here on a case of a 42-year-old female with metastasis of non-small cell lung cancer to the breast, and she is now being followed up on an outpatient basis. In 2004, she presented with a solitary pulmonary nodule in the left lung, and this lesion had been noted to have gradually increased in size over time. The final pathological diagnosis was adenocarcinoma, and the diagnosis was made by performing percutaneous needle aspiration and lobectomy of the left upper lobe. Adjuvant chemotherapy and radiotherapy were given. Unfortunately, a nodule in the left breast was noted three years later, and metastatic non-small-cell lung cancer to the breast was diagnosed by excisional biopsy. Making the correct diagnosis to distinguish a primary breast carcinoma from a metastatic one is important, because the therapeutic plan and outcome for these two types of cancer are quite different.

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Original Articles

Leptin and Leptin Receptor Expression in Breast Cancer: Hee Sung Kim; Cancer Res Treat. 2009;41(3):155-163. Published online September 28, 2009; DOI: https://doi.org/10.4143/crt.2009.41.3.155

Abstract PDF PubReader ePub

Purpose

Leptin is a multifunctional hormone that's produced by adipose tissue and leptin is involved in the regulation of food intake and energy balance. The aims of this study were to determine the leptin and leptin receptor (Ob-R) expressions in human breast cancer and their corresponding influence on the prognosis of patients with breast cancer.

Materials and Methods

We examined the correlations between the leptin and Ob-R expressions and the breast cancer-related pathobiologic markers by performing immunohistochemistry in 517 patients with breast cancer. We analyzed the leptin and Ob-R expressions with respect to overall survival and relapse-free survival (RFS).

Results

Positive cytoplasmic immunoreactivity for leptin was noted in 39% of the patients and 79% of the patients showed positive cytoplasmic immunoreactivity for Ob-R. The expression of leptin in breast cancer was correlated with a high Ki-67 labeling index (p=0.019). Based on the univariate survival analysis, the clinicopathologic variables with prognostic value included the histologic grade, the T stage, the N stage, the HER2 status, the Bcl-2, p53 and Ki-67 expressions (p<0.05). The patients with leptin-positive breast cancers and a negative hormone receptor status had a significantly longer overall survival (p=0.021). Multivariate survival analysis showed that a positive expression of leptin was an independent prognostic marker for overall survival (hazard ratio, 0.20; 95% CI, 0.04~0.99; p=0.05).

Conclusion

A leptin expression in breast cancer is significantly associated with the Ki-67 labeling index, and this suggests there is an association of a leptin expression with the proliferation activity. In addition, a leptin expression is an indicator of better survival for breast cancer patients.

Citations

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A Histone Deacetylase Inhibitor, Trichostatin A, Enhances Radiosensitivity by Abrogating G2/M Arrest in Human Carcinoma Cells: In Ah Kim, Jin Ho Kim, Jin Hee Shin, Il Han Kim, Jae Sung Kim, Hong-Gyun Wu, Eui Kyu Chie, Yong Ho Kim, Bo-Kyung Kim, Semie Hong, Seok Won Park, Sung Whan Ha, Charn Il Park; Cancer Res Treat. 2005;37(2):122-128. Published online April 30, 2005; DOI: https://doi.org/10.4143/crt.2005.37.2.122

Abstract PDF PubReader ePub

Purpose

Histone deacetylase inhibitors (HDIs) are emerging as potentially useful components in anticancer therapy. In this study, we tried to confirm the radiosensitizing effect of trichostatin A (TSA) on a panel of human carcinoma cell lines and elucidate its mechanism of interaction.

Materials and Methods

A549, HeLa and Caski cells were exposed to TSA for 18 hr prior to irradiation, and the cell survival then measured using a clonogenic assay. Western blot and flow cytometric analyses, for histone acetylation, and cell cycle and apoptosis, respectively, were also performed.

Results

TSA increased the acetylation of histone H3. The pretreatment of TSA consistently radiosensitized all three cell lines. The SF2 (surviving fraction at 2 Gy) of TSA-treated cells was significantly lower than that of mock treated cells. The SER (sensitizer enhancement ratio) increased in all 3 cell lines, in concentration dependent manners. The TSA treated cells showed abrogation of radiation-induced G2/M arrest, in a concentration dependent manner.

Conclusion

The pretreatment of TSA enhanced the radiosensitivity of a panel of human carcinoma cells, which was attributed, in part, to the abrogation of radiation-induced G2/M arrest.

Citations

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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

Abstract PDF

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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Concurrent Etoposide/Cisplatin Combination Chemotherapy (EP) and Thoracic Radiotherapy after Two Cycles of EP for Limited Stage Small Cell Lung Cancer: Hee Jung Sohn, Sang We Kim, Jin Hee Ahn, Hye Jin Kang, Sarah Park, Heon Nyoung Jung, Cheol Won Suh, Woo Kun Kim, Sang Wook Lee, Eun Kyung Choi, Sang Do Lee, Woo Sung Kim, Dong Sun Kim, Won Dong Kim, Jung Shin Lee; Cancer Res Treat. 2002;34(6):409-415. Published online December 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.6.409

Abstract PDF

Purpose
s: Although the standard management of limited stage small cell lung cancer is concurrent platinum-based chemotherapy with thoracic radiotherapy (TRT), the optimal timing of the TRT remains controversial. We investigated the feasibility of concurrent chemoradiation for the patients with limited stage small cell lung cancer after 2 cycles of combination chemotherapy with Etoposide/Cisplatin (EP).
MATERIALS AND METHODS
EP consisted of Etoposide 100 mg/m2 on day 1 to 3 and Cisplatin 70 mg/m2 on day 1. Six cycles were given to the responders every 4 weeks. Total 55 Gy (1.8 Gy once-daily or 1.2 Gy twice-daily, 5 days per week) of TRT were given to the patients who showed at least a partial response after 2 cycles of EP. The other patients were treated by the physician's decision. The patients with complete remission were recommended to receive prophylactic cranial irradiation.
RESULTS
Fifty patients were enrolled. Thirty-five (70%) of them showed responses (2 complete remissions and 33 partial remissions) after 2 cycles of EP. Thirty-three of the responders were given TRT starting with the 3rd cycle of EP. The nonresponders were treated with salvage chemotherapy and TRT. After completion of treatment for 50 patients, the overall response rate was 86% (29 complete remissions, 14 partial remissions). One patient (2%) showed stable disease, and 6 (12%) showed a progressive disease. The median progression free survival was 326 days and the median survival time was 410 days. One-, 2-, 3-, 4- and 5-year survival rates were 62%, 24%, 14%, 9% and 6%, respectively. As hematologic toxicities during chemoradiation, 35.1% with grade III/IV neutropenia and 18.9% with grade III/IV thrombocytopenia were noted. Grade II/III radiation pneumonitis and radiation esophagitis were noted in 5/1 and 13/1 patients (15.2%/ 3.0% and 39.4%/3.0%), respectively. One patient died of septicemia during chemoradiation.
CONCLUSION
The concurrent EP and TRT after 2 cycles of EP was feasible in limited stage small cell lung cancer. Further study is required for the indentification of optimum timing of TRT during combination chemotherapy.

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Effect of early chemoradiotherapy in patients with limited stage small cell lung cancer
In-Bong Ha, Bae-Kwon Jeong, Hojin Jeong, Hoon-Sik Choi, Gyu-Young Chai, Myoung-Hee Kang, Hoon Gu Kim, Gyeong-Won Lee, Jae-Beom Na, Ki-Mun Kang
Radiation Oncology Journal.2013; 31(4): 185. CrossRef

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Evaluation of E1B-mutant Replicating Adenoviruses for Cancer Gene Therapy: Jae Sung Kim, Joo Hang Kim, Heui Ran Lee, Kyeong Cheon Jung, Chae Ok Yun; Cancer Res Treat. 2001;33(6):500-511. Published online December 31, 2001; DOI: https://doi.org/10.4143/crt.2001.33.6.500

Abstract PDF: PURPOSE
Gene-attenuated replication-competent adenoviruses are emerging as a promising new modality for the treatment of cancer. In an effort to continually improve upon cancer gene therapy, we have modified gene- attenuated replication-competent adenoviruses so as to cause them to replicate efficiently and lyse the infected cancer cells more effectively.
MATERIALS AND METHODS
We modified the E1 region of the adenovirus (Ad) systematically, generating Ad-deltaE1B19, Ad-deltaE1B55, Ad-deltaE1B19/55, and Ad-WT. The cytopathic effects (CPE) and viral replication of these four gene modified adenoviruses were compared, and the morphology and DNA fragmentation of the infected cells was evaluated.
RESULTS
Among the constructed adenoviruses, E1B 19kD-inactivated adenovirus (Ad-deltaE1B19) was the most potent, inducing the largest-sized plaques and markedCPE. Moreover, cells infected with Ad-deltaE1B19 showed complete cell lysis with disintegrated cellular structure whereas cells infected with Ad-WT maintained intact cellular and nuclear membrane with properly structured organelles. TUNEL assay was also used to monitor DNA integrity, and a more profound induction of apoptosis was observed in the Ad-deltaE1B19 infected cells in comparison to wild type adenovirus infected cells.
CONCLUSION
We demonstrate that the inactivation of the E1B19kD gene in a replicating adenovirus leads to increased CPE, rapid viral release, improved cell-to-cell viral spread and increased induction of apoptosis.

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