Cancer Research and Treatment

Original Articles

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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New Prostate MRI Scoring Systems (PI-QUAL, PRECISE, PI-RR, and PI-FAB): AJR Expert Panel Narrative Review
Adriano Basso Dias, Silvia D. Chang, Fiona M. Fennessy, Soleen Ghafoor, Sangeet Ghai, Valeria Panebianco, Andrei S. Purysko, Francesco Giganti
American Journal of Roentgenology.2024;[Epub] CrossRef
A Prospective Randomized Multicenter Study on the Impact of [18F]F-Choline PET/CT Versus Conventional Imaging for Staging Intermediate- to High-Risk Prostate Cancer
Laura Evangelista, Fabio Zattoni, Marta Burei, Daniele Bertin, Eugenio Borsatti, Tanja Baresic, Mohsen Farsad, Emanuela Trenti, Mirco Bartolomei, Stefano Panareo, Luca Urso, Giuseppe Trifirò, Elisabetta Brugola, Franca Chierichetti, Davide Donner, Lucia S
Journal of Nuclear Medicine.2024; 65(7): 1013. CrossRef
Comparison of the Effects of DOTA and NOTA Chelators on 64Cu-Cudotadipep and 64Cu-Cunotadipep for Prostate Cancer
Inki Lee, Min Hwan Kim, Kyongkyu Lee, Keumrok Oh, Hyunwoo Lim, Jae Hun Ahn, Yong Jin Lee, Gi Jeong Cheon, Dae Yoon Chi, Sang Moo Lim
Diagnostics.2023; 13(16): 2649. CrossRef

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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

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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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Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05): Sun Hyun Bae, Hee Chul Park, Won Sup Yoon, Sang Min Yoon, In-Hye Jung, Ik Jae Lee, Jun Won Kim, Jinsil Seong, Tae Hyun Kim, Taek-Keun Nam, Youngmin Choi, Sun Young Lee, Hong Seok Jang, Dong Soo Lee, Jin Hee Kim; Cancer Res Treat. 2019;51(4):1589-1599. Published online April 10, 2019; DOI: https://doi.org/10.4143/crt.2018.687

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Purpose
There is limited data on radiotherapy (RT) for hepatocellular carcinoma (HCC) in patients with Child-Pugh classification B (CP-B). This study aimed to evaluate the treatment outcomes of fractionated conformal RT in HCC patients with CP-B.
Materials and Methods
We retrospectively reviewed the data of HCC patients with CP-B treated with RT between 2009 and 2014 at 13 institutions in Korea. HCC was diagnosed by the Korea guideline of 2009, and modern RT techniques were applied. Fraction size was ≤ 5 Gy and the biologically effective dose (BED) ≥ 40 Gy10 (α/β = 10 Gy). A total of 184 patients were included in this study.
Results
Initial CP score was seven in 62.0% of patients, eight in 31.0%, and nine in 7.0%. Portal vein tumor thrombosis was present in 66.3% of patients. The BED ranged from 40.4 to 89.6 Gy10 (median, 56.0 Gy10). After RT completion, 48.4% of patients underwent additional treatment. The median overall survival (OS) was 9.4 months. The local progression-free survival and OS rates at 1 year were 58.9% and 39.8%, respectively. In the multivariate analysis, non-classic radiation-induced liver disease (RILD) (p < 0.001) and additional treatment (p < 0.001) were the most significant prognostic factors of OS. Among 132 evaluable patients without progressive disease, 19.7% experienced non-classic RILD. Normal liver volume was the most predictive dosimetric parameter of non-classic RILD.
Conclusion
Fractionated conformal RT showed favorable OS with a moderate risk non-classic RILD. The individual radiotherapy for CP-B could be cautiously applied weighing the survival benefits and the RILD risks.

Citations

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Development and validation of a nomogram for radiation-induced hepatic toxicity after intensity modulated radiotherapy for hepatocellular carcinoma: a retrospective study
Qiaoyuan Wu, Yudan Wang, Yuxin Wei, Zhengqiang Yang, Kai Chen, Jianxu Li, Liqing Li, Tingshi Su, Shixiong Liang
Japanese Journal of Clinical Oncology.2024; 54(6): 699. CrossRef
Managing hepatocellular carcinoma across the stages: efficacy and outcomes of stereotactic body radiotherapy
Ahmed Allam Mohamed, Marie-Luise Berres, Philipp Bruners, Sven Arke Lang, Christian Trautwein, Georg Wiltberger, Alexandra Barabasch, Michael Eble
Strahlentherapie und Onkologie.2024; 200(8): 715. CrossRef
Clinical outcomes and safety of external beam radiotherapy with extensive intrahepatic targets for advanced hepatocellular carcinoma: A single institutional clinical experience
Sunmin Park, Chai Hong Rim, Won Sup Yoon
Saudi Journal of Gastroenterology.2024;[Epub] CrossRef
Role of rapid arc-image-guided radiotherapy in hepatocellular carcinoma with portal vein tumor thrombosis: A study from tertiary care center in Punjab, India
Manjinder Singh Sidhu, Ramandeep, Sandhya Sood, Ritu Aggarwal, Kulbir Singh, Divyanshi Sood
Journal of Cancer Research and Therapeutics.2023; 19(3): 639. CrossRef
Non-classic radiation-induced liver disease after intensity-modulated radiotherapy for Child–Pugh grade B patients with locally advanced hepatocellular carcinoma
Jian-Xu Li, Rui-Jun Zhang, Mo-Qin Qiu, Liu-Ying Yan, Mei-Ling He, Mei-Ying Long, Jian-Hong Zhong, Hai-Yan Lu, Hong-Mei Zhou, Bang-De Xiang, Shi-Xiong Liang
Radiation Oncology.2023;[Epub] CrossRef
Long-term characterization of MRI-morphologic alterations after active motion-compensated liver SBRT: a multi-institutional pooled analysis
Constantin Dreher, Gustavo R. Sarria, Georgia Miebach, Christel Weiss, Daniel Buergy, Paulina Wojtal, Anoshirwan A. Tavakoli, David Krug, Hans Oppitz, Frank A. Giordano, Marcus Both, Frank Lohr, Jürgen Dunst, Oliver Blanck, Judit Boda-Heggemann
Acta Oncologica.2023; 62(3): 281. CrossRef
Radiotherapy trend in elderly hepatocellular carcinoma: retrospective analysis of patients diagnosed between 2005 and 2017
Bong Kyung Bae, Jeong Il Yu, Hee Chul Park, Myung Ji Goh, Yong-Han Paik
Radiation Oncology Journal.2023; 41(2): 98. CrossRef
Radiotherapy plus anti-PD1 versus radiotherapy for hepatic toxicity in patients with hepatocellular carcinoma
Rui-Jun Zhang, Hong-Mei Zhou, Hai-Yan Lu, Hong-Ping Yu, Wei-Zhong Tang, Mo-Qin Qiu, Liu-Ying Yan, Mei-Ying Long, Ting-Shi Su, Bang-De Xiang, Mei-Ling He, Xiao-Ting Wang, Shi-Xiong Liang, Jian-Xu Li
Radiation Oncology.2023;[Epub] CrossRef
Low-dose radiotherapy combined with dual PD-L1 and VEGFA blockade elicits antitumor response in hepatocellular carcinoma mediated by activated intratumoral CD8+ exhausted-like T cells
Siqi Li, Kun Li, Kang Wang, Haoyuan Yu, Xiangyang Wang, Mengchen Shi, Zhixing Liang, Zhou Yang, Yongwei Hu, Yang Li, Wei Liu, Hua Li, Shuqun Cheng, Linsen Ye, Yang Yang
Nature Communications.2023;[Epub] CrossRef
Stereotactic ablative radiotherapy for pulmonary oligometastases from primary hepatocellular carcinoma: a multicenter and retrospective analysis (KROG 17-08)
In Young Jo, Hee Chul Park, Eun Seog Kim, Seung-Gu Yeo, Myungsoo Kim, Jinsil Seong, Jun Won Kim, Tae Hyun Kim, Won Sup Yoon, Bae Kwon Jeong, Sung Hwan Kim, Jong Hoon Lee
Japanese Journal of Clinical Oncology.2022; 52(6): 616. CrossRef
Efficacy and feasibility of surgery and external radiotherapy for hepatocellular carcinoma with portal invasion: A meta-analysis
Han Ah Lee, Yeon Seok Seo, In-Soo Shin, Won Sup Yoon, Hye Yoon Lee, Chai Hong Rim
International Journal of Surgery.2022; 104: 106753. CrossRef
Trend Analysis and Prediction of Hepatobiliary Pancreatic Cancer Incidence and Mortality in Korea
Hyeong Min Park, Young-Joo Won, Mee Joo Kang, Sang-Jae Park, Sun-Whe Kim, Kyu-Won Jung, Sung-Sik Han
Journal of Korean Medical Science.2022;[Epub] CrossRef
Radiofrequency ablation and stereotactic body radiotherapy for hepatocellular carcinoma: should they clash or reconcile?
Chai Hong Rim, Hye Yoon Lee, Jung Sun Kim, Hakyoung Kim
International Journal of Radiation Biology.2021; 97(2): 111. CrossRef
Therapeutic Decision Making in Hepatocellular Carcinoma According to Age and Child–Pugh Class: A Nationwide Cohort Analysis in South Korea
Sunmin Park, Chai Hong Rim, Young Kul Jung, Won Sup Yoon, Alessandro Granito
Canadian Journal of Gastroenterology and Hepatology.2021; 2021: 1. CrossRef
Benefits of Local Treatment Including External Radiotherapy for Hepatocellular Carcinoma with Portal Invasion
Han Lee, Sunmin Park, Yeon Seo, Won Yoon, Chai Rim
Biology.2021; 10(4): 326. CrossRef
Phase I Radiation Dose-Escalation Study to Investigate the Dose-Limiting Toxicity of Concurrent Intra-Arterial Chemotherapy for Unresectable Hepatocellular Carcinoma
Yeona Cho, Jun Won Kim, Ja Kyung Kim, Kwan Sik Lee, Jung Il Lee, Hyun Woong Lee, Kwang-Hun Lee, Seung-Moon Joo, Jin Hong Lim, Ik Jae Lee
Cancers.2020; 12(6): 1612. CrossRef
Do Biliary Complications after Proton Beam Therapy for Perihilar Hepatocellular Carcinoma Matter?
Gyu Sang Yoo, Jeong Il Yu, Hee Chul Park, Dongho Hyun, Woo Kyoung Jeong, Ho Yeong Lim, Moon Seok Choi, Sang Yun Ha
Cancers.2020; 12(9): 2395. CrossRef
Combinational Immunotherapy for Hepatocellular Carcinoma: Radiotherapy, Immune Checkpoint Blockade and Beyond
Yun Hua Lee, David Tai, Connie Yip, Su Pin Choo, Valerie Chew
Frontiers in Immunology.2020;[Epub] CrossRef

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Clinical Practice Patterns of Radiotherapy in Patients with Hepatocellular Carcinoma: A Korean Radiation Oncology Group Study (KROG 14-07): Hyejung Cha, Hee Chul Park, Jeong Il Yu, Tae Hyun Kim, Taek-Keun Nam, Sang Min Yoon, Won Sup Yoon, Jun Won Kim, Mi Sook Kim, Hong Seok Jang, Youngmin Choi, Jin Hee Kim, Chul Seung Kay, Inkyung Jung, Jinsil Seong; Cancer Res Treat. 2017;49(1):61-69. Published online June 13, 2016; DOI: https://doi.org/10.4143/crt.2016.097

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Purpose
The aim of this study was to examine patterns of radiotherapy (RT) in Korean patients with hepatocellular carcinoma (HCC) according to the evolving guideline for HCC established by the Korean Liver Cancer Study Group-National Cancer Center (KLCSG-NCC).
Materials and Methods
We reviewed 765 patients with HCC who were treated with RT between January 2011 and December 2012 in 12 institutions.
Results
The median follow-up period was 13.3 months (range, 0.2 to 51.7 months). Compared with previous data between 2004 and 2005, the use of RT as a first treatment has increased (9.0% vs. 40.8%). Increased application of intensity-modulated RT resulted in an increase in radiation dose (fractional dose, 1.8 Gy vs. 2.5 Gy; biologically effective dose, 53.1 Gy₁₀ vs. 56.3 Gy₁₀). Median overall survival was 16.2 months, which is longer than that reported in previous data (12 months). In subgroup analysis, treatments were significantly different according to stage (p < 0.001). Stereotactic body RT was used in patients with early HCC, and most patients with advanced stage were treated with three-dimensional conformal RT.
Conclusion
Based on the evolving KLCSG-NCC practice guideline for HCC, clinical practice patterns of RT have changed. Although RT is still used mainly in advanced HCC, the number of patients with good performance status who were treated with RT as a first treatment has increased. This change in practice patterns could result in improvement in overall survival.

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Complications After Exosome Treatment for Aesthetic Skin Rejuvenation
William J. Nahm, Sukruthi Thunga, Jane Yoo
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Frontiers in Oncology.2021;[Epub] CrossRef
Patterns of definitive radiotherapy practice for cervical cancer in South Korea: a survey endorsed by the Korean Radiation Oncology Group (KROG 20-06)
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Sunmin Park, Won Sup Yoon, Chai Hong Rim
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Optimizing radiotherapy with immune checkpoint blockade in hepatocellular carcinoma
Changhoon Choi, Gyu Sang Yoo, Won Kyung Cho, Hee Chul Park
World Journal of Gastroenterology.2019; 25(20): 2416. CrossRef
2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma
KLCA Korean Liver Cancer Association, NCC National Cancer Center
Gut and Liver.2019; 13(3): 227. CrossRef
2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

Korean Journal of Radiology.2019; 20(7): 1042. CrossRef
Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05)
Sun Hyun Bae, Hee Chul Park, Won Sup Yoon, Sang Min Yoon, In-Hye Jung, Ik Jae Lee, Jun Won Kim, Jinsil Seong, Tae Hyun Kim, Taek-Keun Nam, Youngmin Choi, Sun Young Lee, Hong Seok Jang, Dong Soo Lee, Jin Hee Kim
Cancer Research and Treatment.2019; 51(4): 1589. CrossRef
EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
Peter R. Galle, Alejandro Forner, Josep M. Llovet, Vincenzo Mazzaferro, Fabio Piscaglia, Jean-Luc Raoul, Peter Schirmacher, Valérie Vilgrain
Journal of Hepatology.2018; 69(1): 182. CrossRef

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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

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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

14,082 View
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