Cancer Research and Treatment

Original Articles

General

Radiation Oncologists’ Perspectives on Oligometastatic Disease: A Korean Survey Study: Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Ah Ram Chang, Eui Kyu Chie, Yong Chan Ahn, on behalf of the Oligometastasis Working Group, Korean Cancer Association; Cancer Res Treat. 2024;56(2):414-421. Published online November 22, 2023; DOI: https://doi.org/10.4143/crt.2023.876

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Purpose
Perspectives of radiation oncologists on oligometastatic disease was investigated using multi-layered survey.
Materials and Methods
Online survey on the oligometastatic disease was distributed to the board-certified regular members of the Korean Society for Radiation Oncology. The questionnaire consisted of four domains: five questions on demographics; five on the definition of oligometastatic disease; four on the role of local therapy; and three on the oligometastatic disease classification, respectively.
Results
A total of 135 radiation oncologists participated in the survey. The median length of practice after board certification was 22.5 years (range, 1 to 44 years), and the vast majority (94.1%) answered affirmatively to the clinical experience in oligometastatic disease management. Nearly two-thirds of the respondents considered the number of involved organs as an independent factor in defining oligometastasis. Most frequently perceived upper limit on the numerical definition of oligometastasis was 5 (64.2%), followed by 3 (26.0%), respectively. Peritoneal and brain metastasis were nominated as the sites to be excluded from oligometastastic disease by 56.3% and 12.6% of the participants, respectively. Vast majority (82.1%) agreed on the role of local treatment in the management of oligometastatic disease. Majority (72%) of the participants acknowledged the European Society for Radiotherapy and Oncology (ESTRO)–European Organisation for Research and Treatment of Cancer (EORTC) classification of oligometastatic disease, however, only 43.3% answered that they applied this classification in their clinical practice. Underlying reasons against the clinical use were ‘too complicated’ (66.0%), followed by ‘insufficient supporting evidence’ (30.0%), respectively.
Conclusion
While most radiation oncologists supported the role of local therapy in oligometastatic disease, there were several inconsistencies in defining and categorizing oligometastatic disease. Continued education and training on oligometastatic disease would be also required to build consensus among participating caregivers.

Citations

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Qian Sun, Hanqing Zhao, Xianwen Zhang, Suli Zhang, Zelai He, Gengming Wang, Hao Jiang, Aili Xuan, Xianming Li
Technology in Cancer Research & Treatment.2025;[Epub] CrossRef
‘Perspectives of pulmonologists and thoracic surgeons on Oligometastatic disease: curability, treatment approaches, and disease trajectory’
Damla Azaklı, Inanc Yazici, Aysegul Erinc, Celal Satici
Future Oncology.2025; : 1. CrossRef
Expert consensus on radiotherapy for oligometastatic esophageal cancer (2025 edition)
Zhiguo Zhou, Xiaoyan Lv, Jun Wang, Zhouguang Hui, Qingsong Pang
Radiation Medicine and Protection.2025;[Epub] CrossRef
A new proposal of simplified classification of non-small cell lung cancer oligometastases for easy applicability through systematic literature analysis and meta-analysis validation
Hanseung Kang, Woohyeon Do, Yong Chan Ahn, Eui Kyu Chie, Chai Hong Rim
European Journal of Cancer.2024; 212: 115043. CrossRef

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Role of Local Treatment for Oligometastasis: A Comparability-Based Meta-Analysis: Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Eui Kyu Chie, Yong Chan Ahn, The Oligometastasis Working Group, Korea Cancer Association; Cancer Res Treat. 2022;54(4):953-969. Published online August 16, 2022; DOI: https://doi.org/10.4143/crt.2022.329

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Purpose
We intend to investigate the oncological efficacy and feasibility of local consolidative therapy (LCT) through a meta-analysis method.
Materials and Methods
Four databases including PubMed, MEDLINE, Embase, and Cochrane library were searched. Target studies are controlled trials comparing outcomes of LCT versus a control group. Primary endpoints are overall survival (OS) and progression-free survival (PFS).
Results
A total of 54 studies involving 7,242 patients were included. Pooled analyses showed that the LCT arm could achieve improved OS with pooled odds ratio of 2.896 (95% confidence interval [CI], 2.377 to 3.528; p < 0.001). Regarding PFS, pooled analyses showed pooled odds ratio of 3.045 (95% CI, 2.356 to 3.937; p < 0.001) in favor of the LCT arm. In the subgroup analyses including the studies with reliable comparability (e.g. randomized studies or intentionally matched studies without significant favorable prognosticator in LCT arms), pooled odds ratio was 2.548 (95% CI, 1.808 to 3.591; p < 0.001) favoring the LCT arm regarding OS. Regarding PFS, pooled OR was 2.656 (95% CI, 1.713 to 4.120; p < 0.001) which also favored the LCT arm. Subgroup analyses limited to the randomized controlled trials (RCT) were also performed and pooled odds ratios on OS and PFS were 1.535 (95% CI, 1.082 to 2.177; p=0.016) and 1.668 (95% CI, 1.187 to 2.344; p=0.003). The rates of grade ≥ 3 complications related to LCT was mostly low (< 10%) and not significantly higher compared to the control arm.
Conclusion
Pooled analyses results of all included studies, selected studies with reliable comparability, and RCT’s demonstrated the survival benefit of LCT. These consistent results suggest that LCT was beneficial to the patients with oligometastasis.

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The patterns of systemic metastasis in major salivary gland cancer and therapeutic implications
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Radiation Oncologists’ Perspectives on Oligometastatic Disease: A Korean Survey Study
Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Ah Ram Chang, Eui Kyu Chie, Yong Chan Ahn
Cancer Research and Treatment.2024; 56(2): 414. CrossRef
Radiation Oncologists’ Perspectives on Oligometastatic Prostate Cancer: A Survey from Korean Oligometastasis Working Group
Gyu Sang Yoo, Sunmin Park, Chai Hong Rim, Won Kyung Cho, Ah Ram Chang, Young Seok Kim, Yong Chan Ahn, Eui Kyu Chie
Current Oncology.2024; 31(6): 3239. CrossRef
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Hye In Lee, Eun Kyung Choi, Su Ssan Kim, Young Seob Shin, Junhee Park, Chang-Min Choi, Shinkyo Yoon, Hyeong Ryul Kim, Young Hyun Cho, Si Yeol Song
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Cancers.2024; 16(15): 2655. CrossRef
A new proposal of simplified classification of non-small cell lung cancer oligometastases for easy applicability through systematic literature analysis and meta-analysis validation
Hanseung Kang, Woohyeon Do, Yong Chan Ahn, Eui Kyu Chie, Chai Hong Rim
European Journal of Cancer.2024; 212: 115043. CrossRef
Oligometastasis: More Lessons to Be Learned
Kyung Hwan Kim, Yong Chan Ahn
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Top Ten Lessons Learned from Trials in Oligometastatic Cancers
Vivian S. Tan, David A. Palma
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Genomic Characteristics and the Potential Clinical Implications in Oligometastatic Non–Small Cell Lung Cancer
Rongxin Liao, Kehong Chen, Jinjin Li, Hengqiu He, Guangming Yi, Mingfeng Huang, Rongrong Chen, Lu Shen, Xiaoyue Zhang, Zaicheng Xu, Zhenzhou Yang, Yuan Peng
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Metastasis-Directed Local Therapy of Hepatic Oligometastasis from Colorectal Cancer and Future Perspective in Radiation Therapy
Gyu Sang Yoo, Chai Hong Rim, Won Kyung Cho, Jae-Uk Jeong, Eui Kyu Chie, Hyeon-Min Cho, Jun Won Um, Yong Chan Ahn, Jong Hoon Lee
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Eui Kyu Chie, Chai Hong Rim, Won Kyung Cho, Yong Chan Ahn
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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

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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.

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Biochemical recurrence after radical prostatectomy and postoperative radiotherapy: current evidence and controversial issues
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Special Article

Guidelines for Cancer Care during the COVID-19 Pandemic in South Korea: Jii Bum Lee, Minkyu Jung, June Hyuk Kim, Bo Hyun Kim, Yeol Kim, Young Seok Kim, Byung Chang Kim, Jin Kim, Sung Ho Moon, Keon-Uk Park, Meerim Park, Hyeon Jin Park, Sung Hoon Sim, Hong Man Yoon, Soo Jung Lee, Eunyoung Lee, June Young Chun, Youn Kyung Chung, So-Youn Jung, Jinsoo Chung, Eun Sook Lee, Hyun Cheol Chung, Tak Yun, Sun Young Rha; Cancer Res Treat. 2021;53(2):323-329. Published online March 15, 2021; DOI: https://doi.org/10.4143/crt.2020.1256

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At the end of 2019, the cause of pneumonia outbreaks in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In February 2020, the World Health Organization named the disease cause by SARS-CoV-2 as coronavirus disease 2019 (COVID-19). In response to the pandemic, the Korean Cancer Association formed the COVID-19 task force to develop practice guidelines. This special article introduces the clinical practice guidelines for cancer patients which will help oncologists best manage cancer patients during the COVID-19 pandemic.

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Original Articles

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.

Citations

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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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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 Res Treat. 2018;50(3):964-974. Published online October 24, 2017; DOI: https://doi.org/10.4143/crt.2017.346

Abstract PDF Supplementary Material PubReader ePub

Purpose
We aimed to assess prognostic value of metastatic pelvic lymph node (mPLN) in early-stage cervical cancer treated with radical surgery followed by postoperative chemoradiotherapy. Also, we sought to define a high-risk group using prognosticators for recurrence.
Materials and Methods
A multicenter retrospective study was conducted using the data from 13 Korean institutions from 2000 to 2010. A total of 249 IB-IIA patients with high-risk factors were included. We evaluated distant metastasis-free survival (DMFS) and disease-free survival (DFS) in relation to clinicopathologic factors including pNstage, number of mPLN, lymph node (LN)ratio (number of positive LN/number of harvested LN), and log odds of mPLNs (log(number of positive LN+0.5/number of negative LN+0.5)).
Results
In univariate analysis, histology (squamous cell carcinoma [SqCC] vs. others), lymphovascular invasion (LVI), number of mPLNs (≤ 3 vs. > 3), LN ratio (≤ 17% vs. > 17%), and log odds of mPLNs (≤ ‒0.58 vs. > ‒0.58) were significant prognosticators for DMFS and DFS. Resection margin involvement only affected DFS. No significant survival difference was observed between pN0 patients and patients with 1-3 mPLNs. Multivariate analysis revealed that mPLN > 3, LVI, and non-SqCC were unfavorable index for both DMFS (p < 0.001, p=0.020, and p=0.031, respectively) and DFS (p < 0.001, p=0.017, and p=0.001, respectively). A scoring system using these three factors predicts risk of recurrence with relatively high concordance index (DMFS, 0.69; DFS, 0.71).
Conclusion
mPLN > 3 in early-stage cervical cancer affects DMFS and DFS. A scoring system using mPLNs > 3, LVI, and non-SqCC could stratify risk groups of recurrence in surgically resected early-stage cervix cancer with high-risk factors.

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Jean‐Benoit Tanis, Angharad B. Simlett‐Moss, Malgorzata Ossowksa, Thomas W. Maddox, James Guillem, Cristobal Lopez‐Jimenez, Gerry Polton, Rachel Burrow, Riccardo Finotello
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Ester P. Olthof, Constantijne H. Mom, Malou L. H. Snijders, Hans H. B. Wenzel, Jacobus van der Velden, Maaike A. van der Aa
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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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Fengying Qin, Huiting Pang, Tao Yu, Yahong Luo, Yue Dong
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Tumoral Morphologic Features From Cervical Biopsies That Are Predictive of a Negligible Risk for Nodal Metastasis and Tumor Recurrence in Usual-type Cervical Adenocarcinomas
Yue Wang, Ruby Jean Chang, Rong-Zhen Luo, Jing Yu, Xiaofei Zhang, Xianghong Yang, M.R. Quddus, Li Li, Wentao Yang, Aijun Liu, Qingping Jiang, Ruijiao Zhao, Huiting Zhu, Feng Zhou, Yiying Wang, Xiujie Sheng, Li-Li Liu, Yan-Lin Wen, Natalie Banet, C.J. Sung
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Seiji Mabuchi, Naoko Komura, Michiko Kodama, Michihide Maeda, Yuri Matsumoto, Shoji Kamiura
Current Oncology.2022; 29(7): 4856. CrossRef
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Mengting Wang, Min Ma, Liju Yang, Chengtong Liang
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Can Zhang, Xinghua Zhu, Yong Li, Jia Shao, Haibo Xu, Lei Chen, Youli Dan, Hua Jin, Aiqin He
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Xiaojuan Lv, Huiting Rao, Tao Feng, Chufan Wu, Hanmei Lou
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Haixia Cui, Yuan Huang, Weibo Wen, Xiangdan Li, Dongyuan Xu, Lan Liu
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Cigdem Kilic, Gunsu Kimyon Comert, Caner Cakir, Dilek Yuksel, Bahadır Codal, Fatih Kilic, Osman Turkmen, Alper Karalok, Ozlem Moraloglu Tekin, Nurettin Boran, Taner Turan
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Max Peters, Astrid A.C. de Leeuw, Christel N. Nomden, Kari Tanderup, Kathrin Kirchheiner, Jacob C. Lindegaard, Christian Kirisits, Christine Haie-Meder, Alina Sturdza, Lars Fokdal, Umesh Mahantshetty, Peter Hoskin, Barbara Segedin, Kjersti Bruheim, Bhavan
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Adjuvant Treatment after Surgery in Stage IIIA Endometrial Adenocarcinoma: Mee Sun Yoon, Seung Jae Huh, Hak Jae Kim, Young Seok Kim, Yong Bae Kim, Joo-Young Kim, Jong-Hoon Lee, Hun Jung Kim, Jihye Cha, Jin Hee Kim, Juree Kim, Won Sup Yoon, Jin Hwa Choi, Mison Chun, Youngmin Choi, Kang Kyoo Lee, Myungsoo Kim, Jae-Uk Jeong, Sei Kyung Chang, Won Park; Cancer Res Treat. 2016;48(3):1074-1083. Published online October 29, 2015; DOI: https://doi.org/10.4143/crt.2015.356

Abstract PDF PubReader ePub

Purpose
We evaluated the role of adjuvant therapy in stage IIIA endometrioid adenocarcinoma patients who underwent surgery followed by radiotherapy (RT) alone or chemoradiotherapy (CTRT) according to risk group. Materials and Methods A multicenter retrospective study was conducted including patients with surgical stage IIIA endometrial cancertreated by radical surgery and adjuvant RT or CTRT. Disease-free survival (DFS) and overall survival (OS) were analyzed.
Results
Ninety-three patients with stage IIIA disease were identified. Nineteen patients (20.4%) experienced recurrence, mostly distant metastasis (17.2%). Combined CTRT did not affect DFS (74.1% vs. 82.4%, p=0.130) or OS (96.3% vs. 91.9%, p=0.262) in stage IIIA disease compared with RT alone. Patients with age ≥ 60 years, grade G2/3, and lymphovascular space involvement had a significantly worse DFS and those variables were defined as risk factors. The high-risk group showed a significant reduction in 5-year DFS (≥ 2 risk factors) (49.0% vs. 88.0%, p < 0.001) compared with the low-risk group (< 2). Multivariate analysis confirmed that more than one risk factor was the only predictor of worse DFS (hazard ratio, 5.45; 95% confidence interval, 2.12 to 13.98; p < 0.001). Of patients with no risk factors, a subset treated with RT alone showed an excellent 5-year DFS and OS (93.8% and 100%, respectively). Conclusion We identified a low-risk subset of stage IIIA endometrioid adenocarcinoma patients who might be reasonable candidates for adjuvant RT alone. Further randomized studies are needed to determine which subset might benefit from combined CTRT.

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Practice patterns and survival in FIGO 2009 stage 3B endometrial cancer
Jessica Jou, Lindsey Charo, Marianne Hom-Tedla, Katherine Coakley, Pratibha Binder, Cheryl Saenz, Ramez N. Eskander, Michael McHale, Steven Plaxe
Gynecologic Oncology.2021; 163(2): 299. CrossRef
Treatment strategies for endometrial cancer: current practice and perspective
Yeh C. Lee, Stephanie Lheureux, Amit M. Oza
Current Opinion in Obstetrics & Gynecology.2017; 29(1): 47. CrossRef

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

Abstract PDF PubReader ePub

Purpose

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

Materials and Methods

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

Results

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

Conclusion

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

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

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Ependymoma: a Retrospective Analysis of 25 Cases: Young Seok Kim, Seung Do Ahn, Eun Kyung Choi, Jong Hoon Kim, Sang Wook Lee, Young Ju Noh, Chang Jin Kim, Jeong Hoon Kim, Byung Duk Kwun; Cancer Res Treat. 2002;34(6):450-456. Published online December 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.6.450

Abstract PDF

PURPOSE
We evaluated the patterns of failure, survival rate, prognostic factors and treatment related complication in postoperative radiation treatment of patients with ependymoma.
MATERIALS AND METHODS
We retrospectively analyzed 25 patients with histologically confirmed ependymoma treated between Jun. 1990 and Jun. 2001 with postoperative radiotherapy at Asan Medical Center. The study group comprised of 16 men and 9 women, with a median age of 23 years; including 6 supratentorial, 15 infratentorial and 4 spinal cord lesions. The extents of resection were ranked as either: gross total, near total, subtotal, partial resection or biopsy, with these types of surgical resection being performed in 13, 3, 6, 1 and 2 patients, respectively. Twelve of the patients had low grade ependymoma, and the other 13 a high grade tumor. The postoperative irradiation was administered using 4 MV or 6 MV photons, up to median dose of 55.0 Gy (range, 45.0~59.4 Gy), with the radiation field encompassing the preoperative tumor volume plus a 2 cm margin. Only 8 of the patients received either pre- or postoperative chemotherapy. The median follow-up period of survivors was 43 months.
RESULTS
Ten of the 25 patients (40%) developed a recurrence, and 5 died. Of the 10 recurred patients, 6 showed an in-field recurrence, and one developed both an in-field and an out of field recurrence. The remaining 3 patients showed an out of field recurrence, including one case with a leptomeningeal recurrence. The 5-year overall survival, and progression-free, survival rates were 74.0 and 56.1%, respectively. The histological grades were statistically significant prognostic factors of the overall and progression-free survival rates. There were no significant treatment related complications, with the exception of one case of panhypopituitarism, which occurred 30 months after completion of the radiotherapy.
CONCLUSION
The main pattern of recurrence was due to local failure. In order to improve the local control, and to reduce complications, advanced radiation treatment techniques, such as 3 dimensional radiotherapy, may be needed.

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Clinical outcomes of radiotherapy for spinal cord ependymoma with adverse prognostic features: a single-center study
Hwa Kyung Byun, Seong Yi, Hong In Yoon, Se Hoon Kim, Jaeho Cho, Chang-Ok Suh
Journal of Neuro-Oncology.2018; 140(3): 649. CrossRef

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Concurrent Chemoradiotherapy in Locally Advanced Carcinoma of the Uterine Cervix Preliminary Results of Phases III Prospective Randomized Trial: Young Seok Kim, Eun Kyung Choi, Jong Hoon Kim, Seung Do Ahn, Sang Wook Lee, Jong Hyeok Kim, Yong Man Kim, Young Tak Kim, Jung Eun Mok, Joo Hyun Nam; Cancer Res Treat. 2002;34(3):191-197. Published online June 30, 2002; DOI: https://doi.org/10.4143/crt.2002.34.3.191

Abstract PDF: PURPOSE
A prospective, randomized phase III, clinical trial was performed to assess treatment related acute toxicity, early response and survival difference, between a monthly 5-FU cisplatin, and a weekly cisplatin group alone, for concurrent chemoradiotherapy in the locally advanced uterine cervical carcinoma patients. MATERIALS AND METGODS: Between March 1998 and March 2000, 35 patients, with locally advanced (FIGO stage IIB to IVA) cervical carcinoma, were studied, but 5 patients were excluded inform the analysis due to their refusal of treatment. The patients were randomly assigned to 'monthly 5-FU cisplatin' (arm I), or 'weekly cisplatin' (arm II), groups. The patients of arm I received 5-FU cisplatin (5-FU 1,000 mg/m2/day cisplatin 20 mg/m2/day, IV continuous infusion, for 5 days, 3 cycles with 4-week intervals) with radiation therapy. Those of arm II received only cisplatin (cisplatin 30 mg/m2/day, IV bolus, 6 cycles with 1-week intervals) with radiation therapy. The radiation therapy consisted of external beam irradiation of 41.4~50.4 Gy/23~28 fractions, and high dose rate intracavitary treatments, delivering a dose of 30~35 Gy to point A in 6~7 fractions. During intracavitary radiation, a parametrial boost was delivered for a point B dose of 60 Gy in the non-thickened side, and 65 Gy in the thickened side. Treatment related acute toxicities were assessed using Radiation Therapy Oncology Group (RTOG) acute morbidity scoring criteria. The response to treatment, and survival, were analyzed. The median follow-up period was 19 months.
RESULTS
The FIGO stage distributions of arm I (n=16) and arm II (n=14) were as follows; IIB 10, IIIA 1, IIIB 4, IVA 1 in arm I, 12, 0, 1 and 1 in arm II respectively. The compliance of both arms were 80.0% and 93.3%, respectively (p=0.37). During radiation therapy, the incidences of leukopenia, greater than RTOG grade 2, were 25.0%, 14.3%, respectively. There were no patients with gastrointestinal or genitourinary toxicity greater than RTOG grade 2. The complete response rates at 3 months, following radiation therapy, were 87.5% and 92.9% respectively. Two-year disease free survival rates were 81.3%, 85.7%, respectively, for each arms.
CONCLUSION
There was no significant difference in response to treatment, or patterns of failure, between the monthly FP and weekly cisplatin arms. Although there were no statistically significant differences, the patients of the weekly cisplatin arm had better compliance. More patients, and a longer follow up, are needed for improved evaluation of the regimen.

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