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Original Article
Gastrointestinal cancer
Stereotactic Ablative Radiotherapy versus Surgery in Patients with Pulmonary Metastases from Colorectal Cancer
Byung min Lee, Ha Eun Kim, Young Ho Yang, Seung Yoon Yang, Han Sang Kim, Seo Hee Choi, Woong Sub Koom, Byung Jo Park, Jee Suk Chang
Cancer Res Treat. 2025;57(4):1135-1143.   Published online February 6, 2025
DOI: https://doi.org/10.4143/crt.2024.1040
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We compared the local control rate and toxicity of stereotactic ablative radiotherapy (SABR) versus wedge resection for colorectal pulmonary metastases.
Materials and Methods
We retrospectively reviewed medical charts and imaging of patients treated with SABR or wedge resection between 2010 and 2017 at a single institution.
Results
A total of 404 patients were treated with local therapy for 528 pulmonary metastatic lesions. While surgery was frequently used upfront for smaller, solitary metastases without other site involvement, SABR was often used for larger, multiple lesions and disease burdens beyond the lungs. The 3-year local control rate was 88.6% following surgery, which was not significantly different from that with SABR at 86.7% (p=0.174). No major postoperative complications or mortality were observed in the surgery group, and 2.8% of patients in the SABR group experienced grade 3-4 radiation pneumonitis.
Conclusion
SABR was used in patients with a higher risk of progression compared to those undergoing surgery, yet it has similar local control rates to wedge resection.

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  • Percutaneous Cryoablation Under Local Anesthesia for Pulmonary Metastases From Colorectal Cancer: Long‐Term Outcomes From a Single‐Institution Retrospective Cohort
    Shun Yorimori, Kaoru Kaseda, Yusuke Aoki, Kosuke Sugino, Takahiro Suzuki, Yu Okubo, Shigeki Suzuki, Kyohei Masai, Masashi Tamura, Masanori Inoue, Hideki Yashiro, Seishi Nakatsuka, Yoshikane Yamauchi, Yotaro Izumi, Masafumi Kawamura, Masahiro Jinzaki, Keis
    Cancer Reports.2026;[Epub]     CrossRef
  • Emerging Applications of Stereotactic Ablative Radiotherapy in Oligometastatic Colorectal Cancer
    Hasan Al-Sattar, Esele Okondo, Amir Mashia Jaafari, Inesh Sood, Jakob Hassan Dinif, Su Yin Lim, Charlotte Hafkamp, Irene Chong, Joao R. Galante, Sola Adeleke
    International Journal of Molecular Sciences.2025; 26(21): 10302.     CrossRef
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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
AbstractAbstract PDFPubReaderePub
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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    The Cancer Journal.2026;[Epub]     CrossRef
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    Molecular Pharmaceutics.2026; 23(5): 2829.     CrossRef
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    Translational Oncology.2026; 70: 102841.     CrossRef
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    Radiological Physics and Technology.2025; 18(1): 300.     CrossRef
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Original Articles
Clinical Outcomes of Immune Checkpoint Blocker Therapy for Malignant Melanoma in Korean Patients: Potential Clinical Implications for a Combination Strategy Involving Radiotherapy
Jeongshim Lee, Jee Suk Chang, Mi Ryung Roh, Minkyu Jung, Choong-Kun Lee, Byung Ho Oh, Kee Yang Chung, Woong Sub Koom, Sang Joon Shin
Cancer Res Treat. 2020;52(3):730-738.   Published online February 13, 2020
DOI: https://doi.org/10.4143/crt.2019.598
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We investigated the clinical efficacy of immune checkpoint blocker (ICB) therapy for metastatic or advanced melanoma in Korean patients. As well, we assessed whether the effects of ICBs can be enhanced by combination therapy with palliative radiotherapy (RT).
Materials and Methods
We retrospectively reviewed the records of 127 patients with metastatic melanoma who received ICB with or without palliative RT between 2014 and 2018. The melanoma subtypes were classified as follows: chronic sun-damaged (CSD), acral, mucosal, and uveal. The primary endpoint was the objective response rate (ORR).
Results
The overall ORR was 15%, with 11 complete and eight partial responses. ORRs for CSD, acral/mucosal, and uveal melanomas were 50%, 16.5%, and 0%, respectively (p=0.009). In addition to the subtype, stage at treatment, total tumor burden at treatment, and ICB type were significantly associated with ORR (all p < 0.05). Palliative RT was administered in 44% of patients during the treatment, and it did not affect ORR. Clinical responders to ICB therapy exhibited significantly higher 1-year progression-free and overall survival rates than nonresponders.
Conclusion
ORR for ICB monotherapy in Korean patients with melanoma is relatively modest compared with that in Western patients because the non-CSD subtypes are predominant in the Korean population. Our findings regarding combination therapy with ICB provided a rationale for the initiation of our phase II study (NCT04017897).

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Patterns of Care for Radiotherapy in the Neoadjuvant and Adjuvant Treatment of Gastric Cancer: A Twelve-Year Nationwide Cohort Study in Korea
Jee Suk Chang, Young Choi, Jaeyong Shin, Kyung Hwan Kim, Ki Chang Keum, Hyo Song Kim, Woong Sub Koom, Eun-Cheol Park
Cancer Res Treat. 2018;50(1):118-128.   Published online March 8, 2017
DOI: https://doi.org/10.4143/crt.2016.575
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Although Korea has the highest incidence of gastric cancer worldwide and D2-lymphadenectomies are routinely performed, radiotherapy (RT) practice patterns have not been well studied. Therefore, we examined RT usage trends for neoadjuvant/adjuvant patients and identified factors associated with RT. We also examined survival benefits and net medical cost advantages of adding RT.
Materials and Methods
Patients diagnosed with gastric cancer who underwent gastrectomy from 2002-2013 were identified using National Health Insurance Service-National Sample Cohort.
Results
Annually, 30.9 cases per 100,000 population in crude rate underwent gastrectomy in 230 hospitals and 49.8% received neoadjuvant/adjuvant therapy in 182 hospitals. For neoadjuvant/adjuvant patients, postoperative chemo-RT was administered in 4% of cases in 26 hospitals. No significant trends regarding treatment type were observed over time. Having undergone RT was inversely associated with being ≥ 60 years old and having a low income. Having undergone RT was positively related to having a Charlson comorbidity index ≥ 4, hospital location and hospital volume (≥ 2,000 beds). Significant portions of patients treated with RT in this nation (52%) were concentrated in one large-volume hospital. Use of RT linked to increased cost of primary treatment, yet not to reduced overall medical expense. RT did not influence both on overall and disease-specific survivals after adjusting for potential confounders (p > 0.05).
Conclusion
RT was uncommonly utilized as adjuvant or neoadjuvant treatment by physicians in Korea. Despite intrinsic drawback in this data, we did not find either survival benefit or net medical cost advantage by adding RT in adjuvant treatment.

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  • Observational Study Comparing Efficacy and Safety between Neoadjuvant Concurrent Chemoradiotherapy and Chemotherapy for Patients with Unresectable Locally Advanced or Metastatic Gastric Cancer
    Yung-Sung Yeh, Ming-Yii Huang, Cheng-Jen Ma, Ching-Wen Huang, Hsiang-Lin Tsai, Yen-Cheng Chen, Ching-Chun Li, Fang-Jung Yu, Hsiang-Yao Shih, Jaw-Yuan Wang
    Journal of Oncology.2020; 2020: 1.     CrossRef
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    T. A. Agababyan, N. K. Silanteva, V. Yu. Skoropad, S. A. Ivanov, A. D. Kaprin, Yu. A. Komin, A. Yu. Usacheva, D. D. Kudryavtsev
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    Weipeng Gong, Hongwei Zhao, Shanshan Liu, Jie Guan, Xin Liu, Qingsheng Hou, Zhenyu Zhu, Hongliang Guo
    Oncotarget.2018; 9(2): 1726.     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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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.

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  • 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
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    Jeong Il Yu, Hee Chul Park, Yong Chan Ahn, Xian-Shu Gao, Jun-Jie Wang, Zhao-Chong Zeng, Yoshinori Ito, Tatsuya Ohno, Yasumasa Nishimura
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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
AbstractAbstract PDFPubReaderePub
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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    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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