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9 "Concurrent chemoradiotherapy"
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Lung and Thoracic cancer
Contribution of Enhanced Locoregional Control to Improved Overall Survival with Consolidative Durvalumab after Concurrent Chemoradiotherapy in Locally Advanced Non–Small Cell Lung Cancer: Insights from Real-World Data
Jeong Yun Jang, Si Yeol Song, Young Seob Shin, Ha Un Kim, Eun Kyung Choi, Sang-We Kim, Jae Cheol Lee, Dae Ho Lee, Chang-Min Choi, Shinkyo Yoon, Su Ssan Kim
Cancer Res Treat. 2024;56(3):785-794.   Published online January 16, 2024
DOI: https://doi.org/10.4143/crt.2023.1014
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to assess the real-world clinical outcomes of consolidative durvalumab in patients with unresectable locally advanced non–small cell lung cancer (LA-NSCLC) and to explore the role of radiotherapy in the era of immunotherapy.
Materials and Methods
This retrospective study assessed 171 patients with unresectable LA-NSCLC who underwent concurrent chemoradiotherapy (CCRT) with or without consolidative durvalumab at Asan Medical Center between May 2018 and May 2021. Primary outcomes included freedom from locoregional failure (FFLRF), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS).
Results
Durvalumab following CCRT demonstrated a prolonged median PFS of 20.9 months (p=0.048) and a 3-year FFLRF rate of 57.3% (p=0.008), compared to 13.7 months and 38.8%, respectively, with CCRT alone. Furthermore, the incidence of in-field recurrence was significantly greater in the CCRT-alone group compared to the durvalumab group (26.8% vs. 12.4%, p=0.027). While median OS was not reached with durvalumab, it was 35.4 months in patients receiving CCRT alone (p=0.010). Patients positive for programmed cell death ligand 1 (PD-L1) expression showed notably better outcomes, including FFLRF, DMFS, PFS, and OS. Adherence to PACIFIC trial eligibility criteria identified 100 patients (58.5%) as ineligible. The use of durvalumab demonstrated better survival regardless of eligibility criteria.
Conclusion
The use of durvalumab consolidation following CCRT significantly enhanced locoregional control and OS in patients with unresectable LA-NSCLC, especially in those with PD-L1–positive tumors, thereby validating the role of durvalumab in standard care.

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  • Therapeutic effect of induction therapy including nab-paclitaxel followed by surgical resection for the patients with locally advanced non-small-cell lung cancer
    Hidetaka Uramoto, Nozomu Motono, Shun Iwai
    Journal of Cardiothoracic Surgery.2024;[Epub]     CrossRef
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  • 2 Web of Science
  • 1 Crossref
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Central nervous system
Clinical and Genomic Characteristics of Adult Diffuse Midline Glioma
Changhee Park, Tae Min Kim, Jeong Mo Bae, Hongseok Yun, Jin Wook Kim, Seung Hong Choi, Soon-Tae Lee, Joo Ho Lee, Sung-Hye Park, Chul-Kee Park
Cancer Res Treat. 2021;53(2):389-398.   Published online November 9, 2020
DOI: https://doi.org/10.4143/crt.2020.694
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The treatment outcomes and genomic profiles of diffuse midline glioma (DMG) in adult patients are rarely characterized. We performed a retrospective study to evaluate the clinicogenomic profiles of adult patients with brain DMG.
Materials and Methods
Patients aged ≥ 18 years diagnosed with brain DMG at Seoul National University Hospital were included. The clinicopathological parameters, treatment outcomes, survival, and genomic profiles using 82-gene targeted next-generation sequencing (NGS) were analyzed. The 6-month progression-free survival (PFS6) after radiotherapy and overall survival (OS) were evaluated.
Results
Thirty-three patients with H3-mutant brain DMG were identified. The median OS from diagnosis was 21.8 months (95% confidence interval [CI], 13.2 to not available [NA]) and involvement of the ponto-medullary area tended to have poor OS (median OS, 20.4 months [95% CI, 9.3 to NA] vs. 43.6 months [95% CI, 18.2 to NA]; p=0.07). Twenty-four patients (72.7%) received radiotherapy with or without temozolomide. The PFS6 rate was 83.3% (n=20). Patients without progression at 6 months showed significantly prolonged OS compared with those with progression at 6 months (median OS, 24.9 months [95% CI, 20.4 to NA] vs. 10.8 months [95% CI, 4.0 to NA]; p=0.02, respectively). Targeted NGS was performed in 13 patients with DMG, among whom nine (69.2%) harbored concurrent TP53 mutation. Two patients (DMG14 and DMG23) with PIK3CAR38S+E545K and KRASG12A mutations received matched therapies. Patient DMG14 received sirolimus with a PFS of 8.4 months.
Conclusion
PFS6 after radiotherapy was associated with prolonged survival in adult patients with DMG. Genome-based matched therapy may be an encouraging approach for progressive adult patients with DMG.

Citations

Citations to this article as recorded by  
  • The role of adjuvant chemotherapy in patients with H3K27 altered diffuse midline gliomas: a multicentric retrospective study
    Vincenzo Di Nunno, Giuseppe Lombardi, Matteo Simonelli, Giuseppe Minniti, Angela Mastronuzzi, Valentina Di Ruscio, Martina Corrà, Marta Padovan, Marta Maccari, Mario Caccese, Giorgia Simonetti, Arianna Berlendis, Mariangela Farinotti, Bianca Pollo, Manila
    Journal of Neuro-Oncology.2024; 167(1): 145.     CrossRef
  • Neuroradiological, genetic and clinical characteristics of histone H3 K27-mutant diffuse midline gliomas in the Kansai Molecular Diagnosis Network for CNS Tumors (Kansai Network): multicenter retrospective cohort
    Nobuhide Hayashi, Junya Fukai, Hirokazu Nakatogawa, Hiroshi Kawaji, Ema Yoshioka, Yoshinori Kodama, Kosuke Nakajo, Takehiro Uda, Kentaro Naito, Noriyuki Kijima, Yoshiko Okita, Naoki Kagawa, Yoshinobu Takahashi, Naoya Hashimoto, Hideyuki Arita, Koji Takano
    Acta Neuropathologica Communications.2024;[Epub]     CrossRef
  • Genetic alteration analysis of non-pediatric diffuse midline glioma, H3 K27-altered
    Hanbin Jang, Seyoung Moon, Hyun Jung Kwon, Sejoon Lee, Gheeyoung Choe, Kyu Sang Lee
    Human Pathology.2024; 154: 105709.     CrossRef
  • How to treat histone 3 altered gliomas: molecular landscape and therapeutic developments
    Vincenzo Di Nunno, Enrico Franceschi, Lidia Gatto, Alicia Tosoni, Stefania Bartolini, Alba Ariela Brandes
    Expert Review of Clinical Pharmacology.2023; 16(1): 17.     CrossRef
  • Genomic profiles of IDH-mutant gliomas: MYCN-amplified IDH-mutant astrocytoma had the worst prognosis
    Kwanghoon Lee, Seong-Ik Kim, Eric Eunshik Kim, Yu-Mi Shim, Jae-Kyung Won, Chul-Kee Park, Seung Hong Choi, Hongseok Yun, Hyunju Lee, Sung-Hye Park
    Scientific Reports.2023;[Epub]     CrossRef
  • Radiotherapy and radio‐sensitization in H3K27M‐mutated diffuse midline gliomas
    Chao Liu, Shuwen Kuang, Lei Wu, Quan Cheng, Xuan Gong, Jun Wu, Longbo Zhang
    CNS Neuroscience & Therapeutics.2023; 29(7): 1721.     CrossRef
  • Volumetric response and pattern of failure of histone altered high grade glioma in adults following management with radiation therapy
    A. Knight, P. Horsley, A. Yuile, J. Yim, M. Suh, V. Venketesha, M. Kastelan, H. Wheeler, M. Back
    Journal of Neuro-Oncology.2023; 163(1): 281.     CrossRef
  • Differences in survival prognosticators between children and adults with H3K27M‐mutant diffuse midline glioma
    Xuan Gong, Shuwen Kuang, Dongfeng Deng, Jun Wu, Longbo Zhang, Chao Liu
    CNS Neuroscience & Therapeutics.2023; 29(12): 3863.     CrossRef
  • Adult spinal cord diffuse midline glioma, H3 K27-altered mimics symptoms of central nervous system infection: a case report
    Xue Chen, Yi Li, Hui Bu, YueLi Zou, JunYing He, Hu Liu
    Frontiers in Neurology.2023;[Epub]     CrossRef
  • Clinicogenetic characteristics and the effect of radiation on the neural stem cell niche in subventricular zone-contacting glioblastoma
    Jee Ye Kahng, Byung-Hee Kang, Soon-Tae Lee, Seung Hong Choi, Tae Min Kim, Chul-Kee Park, Jae-Kyung Won, Sung-Hye Park, Jaeman Son, Joo Ho Lee
    Radiotherapy and Oncology.2023; 186: 109800.     CrossRef
  • H3 K27M-Altered Diffuse Midline Gliomas: A Review
    Karol Wiśniewski, Andrew Ghaly, Kate Drummond, Andreas Fahlstrӧm
    Indian Journal of Neurosurgery.2023; 12(02): 104.     CrossRef
  • Adult diffuse midline gliomas H3 K27-altered: review of a redefined entity
    Carlos Axel López-Pérez, Xochitl Franco-Mojica, Ricardo Villanueva-Gaona, Alexandra Díaz-Alba, Marco Antonio Rodríguez-Florido, Victor Garcia Navarro
    Journal of Neuro-Oncology.2022; 158(3): 369.     CrossRef
  • H3K27M-Altered Diffuse Midline Gliomas Among Adult Patients: A Systematic Review of Clinical Features and Survival Analysis
    Othman Bin-Alamer, Adrian E. Jimenez, Tej D. Azad, Chetan Bettegowda, Debraj Mukherjee
    World Neurosurgery.2022; 165: e251.     CrossRef
  • Molecular profile and clinical features of patients with gliomas using a broad targeted next generation‑sequencing panel
    Ourania Romanidou, Paraskevi Apostolou, Kyriakos Kouvelakis, Kyriakos Tsangaras, Alexia Eliades, Achilleas Achilleos, Charalambos Loizides, Christos Lemesios, Marios Ioannides, Elena Kypri, George Koumbaris, Kyriaki Papadopoulou, Athanasios Papathanasiou,
    Oncology Letters.2022;[Epub]     CrossRef
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  • 15 Web of Science
  • 14 Crossref
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Definitive Bimodality Concurrent Chemoradiotherapy in Patients with Inoperable N2-positive Stage IIIA Non-small Cell Lung Cancer
Jae Myoung Noh, Yong Chan Ahn, Hyebin Lee, Hongryull Pyo, BoKyong Kim, Dongryul Oh, Hyojung Park, Eonju Lee, Keunchil Park, Jin Seok Ahn, Myung-Ju Ahn, Jong-Mu Sun
Cancer Res Treat. 2015;47(4):645-652.   Published online February 12, 2015
DOI: https://doi.org/10.4143/crt.2014.144
AbstractAbstract PDFPubReaderePub
Purpose
This study was conducted to evaluate the treatment outcomes following definitive bimodality concurrent chemoradiotherapy (CCRT) in patients with inoperable N2-positive stage IIIA (N2- IIIA) non-small cell lung cancer (NSCLC). Materials and Methods From May 1997 to December 2012, 65 out of 633 patients with N2-IIIA NSCLC received bimodality therapy. The treatment modality was selected during/after neoadjuvant CCRT in 21 patients or primarily at diagnosis in 44 through a multidisciplinary consensus meeting. The median age was 65 years (range, 36 to 76 years). Sixty patients (92.3%) had clinically evident N2 disease, while 22 (33.8%) had multi-station N2 involvement. The median radiation therapy dose was 66 Gy in 33 fractions, while the dose was elevated to 72 Gy in 13 patients who had a treatment break due to delayed decision regarding resectability. The most frequent chemotherapy regimen was weekly paclitaxel or docetaxel plus cisplatin or carboplatin (54, 83.1%).
Results
During the median follow-up of 18.8 months (range, 1.6 to 173.1 months), 34 patients (52.3%) experienced disease progression, with distant metastasis being the most common first treatment failure pattern (23, 34.8%). The median and 2-year rates of progression-free survival were 18.8 months and 45.9%, respectively. The median and 2-year rates of overall survival were 28.6 months and 50.1%, respectively. Conclusion Definitive bimodality therapy in patients with N2-IIIA NSCLC demonstrated favorable outcomes, while trimodality therapy could be considered for candidates for less than pneumonectomy.

Citations

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  • Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
    Kyungmi Yang, Yang-Gun Suh, Hyunju Shin, Hongryull Pyo, Sung Ho Moon, Yong Chan Ahn, Dongryul Oh, Eunah Chung, Kwanghyun Jo, Jae Myoung Noh
    Life.2022; 12(2): 292.     CrossRef
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    Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
    Radiation Oncology Journal.2021; 39(1): 24.     CrossRef
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    Choi Eunsook, Park Sunhee
    Clinical Journal of Nursing Care and Practice.2021; 5(1): 015.     CrossRef
  • Prognostic significance of tumor poliovirus receptor and CTLA4 expression in patients with surgically resected non-small-cell lung cancer
    Hui You, Yi-Zhong Zhang, Huan-Ling Lai, Dan Li, Yu-Quan Liu, Run-Ze Li, Imran Khan, Wendy Wen-Lun Hsiao, Fu-Gang Duan, Xing-Xing Fan, Xiao-Jun Yao, Ya-Bing Cao, Qi-Biao Wu, Elaine Lai-Han Leung, Mei-Fang Wang
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    Lung Cancer.2018; 115: 89.     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
AbstractAbstract PDFPubReaderePub
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.

Citations

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    Chong Han, Jingping Qiu, Lu Bai, Tingting Liu, Jun Chen, He Wang, Jun Dang
    International Journal of Radiation Oncology*Biology*Physics.2024; 119(4): 1179.     CrossRef
  • “Mid-P strategy” versus “internal target volume strategy in locally advanced non small cell lung cancer: Clinical results from the randomized non-comparative phase II study Mid-P
    Line Claude, Camille Schiffler, Vanina Isnardi, Séverine Metzger, Sophie Darnis, Isabelle Martel-Lafay, Thomas Baudier, Simon Rit, David Sarrut, Myriam Ayadi
    Radiotherapy and Oncology.2024; 199: 110435.     CrossRef
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    Tingting Liu, Sihan Li, Silu Ding, Jingping Qiu, Chengbo Ren, Jun Chen, He Wang, Xiaoling Wang, Guang Li, Zheng He, Jun Dang
    eClinicalMedicine.2023; 64: 102246.     CrossRef
  • The effect of radiotherapy and surgery on stage IIIA/B NSCLC patients treated with chemotherapy
    Y. Zeng, G. Wang, H. Zheng, Y. Wang, G. Ma, Z. Pang, J. Du
    International Journal of Radiation Research.2023; 21(3): 475.     CrossRef
  • Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
    Kyungmi Yang, Yang-Gun Suh, Hyunju Shin, Hongryull Pyo, Sung Ho Moon, Yong Chan Ahn, Dongryul Oh, Eunah Chung, Kwanghyun Jo, Jae Myoung Noh
    Life.2022; 12(2): 292.     CrossRef
  • Durvalumab After Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer: Inferior Outcomes and Lack of Health Equity in Hispanic Patients Treated With PACIFIC Protocol (LA1-CLICaP)
    Luis E. Raez, Oscar Arrieta, Diego F. Chamorro, Pamela Denisse Soberanis-Piña, Luis Corrales, Claudio Martín, Mauricio Cuello, Suraj Samtani, Gonzalo Recondo, Luis Mas, Zyanya Lucia Zatarain-Barrón, Alejandro Ruíz-Patiño, Juan Esteban García-Robledo, Cami
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Clinical Impact of Supraclavicular Lymph Node Involvement of Stage IIIC Non-Small Cell Lung Cancer Patients
    Sunmin Park, Won Sup Yoon, Mi Hee Jang, Chai Hong Rim
    Medicina.2021; 57(3): 301.     CrossRef
  • Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
    Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
    Radiation Oncology Journal.2021; 39(1): 24.     CrossRef
  • Comparaison dosimétrique et de la toxicité de la radiothérapie conformationnelle avec modulation d’intensité et de la radiothérapie conformationnelle tridimensionnelle des carcinomes bronchiques non à petites cellules
    F. Guillemin, L. Berger, M. Lapeyre, A. Bellière-Calandry
    Cancer/Radiothérapie.2021; 25(8): 747.     CrossRef
  • Real world data of durvalumab consolidation after chemoradiotherapy in stage III non-small-cell lung cancer
    Hyun Ae Jung, Jae Myoung Noh, Jong-Mu Sun, Se-Hoon Lee, Jin Seok Ahn, Myung-Ju Ahn, Hongryull Pyo, Yong Chan Ahn, Keunchil Park
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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
AbstractAbstract PDFPubReaderePub
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.

Citations

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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
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    Yan Hu, Zhi-Qiang Cai, Xiao-Yan Su
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    Molecular Therapy.2009; 17(5): 906.     CrossRef
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Concurrent FP (5-fluorouracil, cisplatin) Chemoradiotherapy for Patients with Esophageal Cancer
Min Ok Kim, Eui Sil Hong, Ji Young Chai, Joung Muk Leem, Il Young You, Won Dong Kim, Woo Yoon Park, Seung Taik Kim, Ki Hyeong Lee
Cancer Res Treat. 2003;35(4):330-334.   Published online August 31, 2003
DOI: https://doi.org/10.4143/crt.2003.35.4.330
AbstractAbstract PDF
PURPOSE
The outcomes of a surgical approach for patients with an esophageal carcinoma remain unsatisfactory despite its high complication rates. We conducted a phase II trial, using combined FP (5-fluorouracil and cisplatin) chemotherapy and concurrent radiotherapy, as a definitive therapy for patients with esophageal cancer.
MATERIALS AND METHODS
Patients with histologically proven esophageal cancer were enrolled onto this study. The treatment consisted of four courses of chemotherapy and six and a half weeks of radiotherapy. The patients received chemotherapy in weeks 1, 5, 12 and 16 (5-fluorouracil 1, 000 mg/m2 on days 1 to 4 and cisplatin 75 mg/m2 on day 1). Radiotherapy was administered at a dose of 59.4 Gy, in five 1.8 Gy fractions a week.
RESULTS
A total of 22 eligible patients entered the study. Of the 19 evaluable patients, a complete response occurred in 7 (37%), and a partial response in 8 (42%). After a median follow-up of 35 months, the overall survival rate was 32% at three years and the median survival was 11 months. Fourteen (64%) received planned dose of radio-therapy and 13 (59%) received more than three courses of chemotherapy. However, there was no difference in three-year survival rates between the patients that received less than three courses of chemotherapy and those that received three or more courses (31% vs. 32%). The major treatment related toxicity was mucositis, which developed in every patient, with grades III or IV in thirteen (59%) patients. During the treatment, the patients lost, on average, 3.8% of their body weight. The mean hospital stay was 23 days, with a total duration of treatment of 74 days.
CONCLUSIONS
Concurrent FP chemoradiotherapy was effective as a definitive therapy for patients with esophageal cancer. The major toxicity was mucositis. Although the treatment was relatively feasible, a randomized trial of reduced courses of chemotherapy is warranted.

Citations

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  • Anti-cancer Effects of a Novel Quinoline Derivative 83b1 on Human Esophageal Squamous Cell Carcinoma through Down-Regulation of COX-2 mRNA and PGE2
    Ivan Ho Yuen Pun, Dessy Chan, Sau Hing Chan, Po Yee Chung, Yuan Yuan Zhou, Simon Law, Alfred King Yin Lam, Chung Hin Chui, Albert Sun Chi Chan, Kim Hung Lam, Johnny Cheuk On Tang
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    Sang-Hee Cho, Ik-Joo Chung, Sang-Yun Song, Deok-Hwan Yang, Jeong-Rae Byun, Yeo-Kyeoung Kim, Je-Jung Lee, Kook-Joo Na, Hyeoung-Joon Kim
    Journal of Korean Medical Science.2005; 20(4): 618.     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
AbstractAbstract 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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5-Fluorouracil and Cisplatin (FP) with Concurrent Radiotherapy for Locally Advanced Head and Neck Cancer
Hyoung Sam Kim, Ki Seok Kim, Sang Seok Bea, Seok Jin Oh, Ki Hyeong Lee, Won Dong Kim, Woo Yoon Park, Seung Taik Kim
Cancer Res Treat. 2002;34(4):296-301.   Published online August 31, 2002
DOI: https://doi.org/10.4143/crt.2002.34.4.296
AbstractAbstract PDF
The combination of chemotherapy and radiotherapy is emerging as the new standard modality for the treatment of locally advanced head and neck cancer, due to the inherent functional and cosmetic sequelae associated with its surgical management. Combination chemotherapy with 5-fluorouracil and cisplatin (FP) is one of the most active regimens for the head and neck cancer. Furthermore, both agents are known to act as radiosensitizer. This study was conducted to determine the efficacy, feasibility, and the toxicities of concurrent FP chemotherapy with radiotherapy.
MATERIALS AND METHODS
Patients with histologically proven locally advanced head and neck cancer (T3-4 or node positive) were enrolled in the study. Patients received 5-fluorouracil, 1,000 mg/m2/day, continuously for 4 days, and cisplatin, 75 mg/m2, on day 1. This regimen was given every four weeks. The radiotherapy (45 Gy) was started on day 1 of the first cycle, and administered in 25 fractions. Following a three-week interval, the radiotherapy was resumed on day 1 of the third cycle of chemotherapy, and administered in 15 fractions (27 Gy).
RESULTS
Of the 31 eligible patients included, 28 were able to be evaluated for the tumor response. The response rate for the 28 patients was 93% (16 complete responses, 10 partial responses). Disease free survival for the 16 complete responders was 37 months (median, 1 ~41 months), with a median follow-up time of 31 months. The 1-, 2-, and 3-year survival rates were 82%, 69%, and 63%, respectively. Regarding the feasibility of this treatments, only nineteen patients (61%) received the complete courses of scheduled treatments. The median duration of admission for all patients was 39 days. Grade 3 or 4 stomatitis were observed in 25 patients (83%) and appeared as the dose limiting toxicity of this regimen CONCLUSION: Although FP chemotherapy with concurrent radiotherapy is toxic, it is an effective and relatively feasible treatment for locally advanced head and neck cancer. The majority of patients experienced severe stomatitis, which appeared as the dose limiting toxicity of this regimen.

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  • Chemotherapy of Head and Neck Cancer
    Chang Ki Yeo
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2014; 57(5): 291.     CrossRef
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Induction Chemotherapy Followed by Concurrent Chemoradiotherapy in Locoregional Esophageal Cancer
Gyeong Won Lee, Jung Hun Kang, Hun Gu Kim, In Gyu Hwang, Ki Shik Shim, Seok Hyun Kim, Won Sep Lee, Woon Tae Jung, Ok Jae Lee, Jung Hyeun Cho, Joung Soon Jang, Kyu Yong Chae, Jong Seok Lee
Cancer Res Treat. 2001;33(6):489-494.   Published online December 31, 2001
DOI: https://doi.org/10.4143/crt.2001.33.6.489
AbstractAbstract PDF
PURPOSE
The object of this study is to evaluate the efficacy and toxicity of induction chemotherapy followed by concomitant chemoradiotherapy in locoregional esophageal cancer.
MATERIALS AND METHODS
Between December 1992 and December 1999, 43 patients with locoregional esophageal cancer were enrolled in this phase II trial. Patients were treated with 2-cycles of induction chemotherapy followed by concomitant chemoradiotherapy. F-P chemotherapy consists of 1,000 mg/m2/Day of 5-FU as continuous infusion on day 1~5 and 80 mg/m2 of cisplatin as an intravenous bolus on day 1 and was repeated every 3~4 weeks. All patients received 60 Gy of external beam radiation concomitantly with F-P chemotherapy; intraluminal brachytherapy was added in 12 patients. A total of 4 cycles of chemotherapy were delivered. No further treatment was planned in patients who achieved complete remission after completion of the treatment.
RESULTS
Among the 43 patients entered, 35 patients completed the protocol. Of the 35 evaluable patients, 12 patients (34%) achieved complete response and 13 patients (37%) achieved partial response. In 26 of 33 patients, dysphagia was improved. At a median follow-up of 22 months, the 2-year and 5-year survival rates were 39% and 19%, respectively. The median survival duration of the complete responder group was 69 months (4~100 months) and the 2-year survival rate of the complete responder group was 82%. Toxicities were tolerable, comprised of mucositis and cytopenia.
CONCLUSION
Induction chemotherapy followed by concurrent chemoradiotherapy in locoregional esophageal cancer is well tolerated and effective.

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  • A Clinical Scoring Model to Predict the Effect of Induction Chemotherapy With Definitive Concurrent Chemoradiotherapy on Esophageal Squamous Cell Carcinoma Prognosis
    Yang Li, Qingwu Du, Xiaoying Wei, Zhoubo Guo, Tongda Lei, Yanqi Li, Dong Han, Xiaoyue Wu, Kunning Zhang, Tian Zhang, Xi Chen, Jie Dong, Baozhong Zhang, Hui Wei, Wencheng Zhang, Qingsong Pang, Ping Wang
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Salvage Esophagectomy for Locoregional Failure After Chemoradiotherapy in Patients With Advanced Esophageal Cancer
    Changhoon Yoo, Ji Hyun Park, Dok Hyun Yoon, Seung-Il Park, Hyeong Ryul Kim, Jong Hoon Kim, Hwoon-Yong Jung, Gin Hyug Lee, Kee Don Choi, Ho June Song, Ho-Young Song, Ji Hoon Shin, Kyung-Ja Cho, Yong Hee Kim, Sung-Bae Kim
    The Annals of Thoracic Surgery.2012; 94(6): 1862.     CrossRef
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