Cancer Research and Treatment

Original Articles

Reduced Dose and Selective Neck Irradiation Policy in Treating Oropharynx Cancer: Excellent Oncological Outcomes with very Low Risk of Locoregional Failure: Eunyeong Yang, Seung Gyu Park, Kyungmi Yang, Dongryul Oh, Yong Chan Ahn; Received December 13, 2024 Accepted April 9, 2025 Published online April 10, 2025; DOI: https://doi.org/10.4143/crt.2024.1204 [Accepted]

Abstract PDF: Purpose
To evaluate the risk of locoregional failure after reduced dose selective neck irradiation (RD-SNI) in patients with oropharyngeal cancer (OPC).
Materials and Methods
Between 2008 and 2022, 342 OPC patients underwent definitive radiation therapy (with or without concurrent systemic therapy). The doses of 67.2–68.4 Gy to gross tumor volume (GTV), 56–60 Gy to high risk clinical target volumes (CTV-HR), and 32–36 Gy to low risk clinical target volumes (CTV-LR) were irradiated. The same target delineation and dosing policy were applied to all patients regardless of human papillomavirus (HPV) status. Oncological outcomes including failure patterns were also investigated.
Results
With a median follow-up of 60.3 months (range: 1.4-196.6 months), the 3- and 5-year locoregional control, distant metastasis-free survival (DMFS), disease-free survival, and overall survival rates were 91.6%/90.7%, 83.7%/80.7%, 78.7%/74.8%, and 91.0%/85.8%, respectively. The HPV-positive patients exhibited significantly better outcomes. Treatment failure occurred in 61 patients (17.8%); 37 (10.8%) had distant metastasis, 22 (6.4%) had local failure, and 8 (2.3%) had regional failure. GTV failure was significantly more common in HPV-negative patients (p=0.003). Among the 27 patients with locoregional failure, either GTV and/or CTV-HR failure occurred in 22 (81.5%), with CTV-LR failure in 1 (3.7%), and out-target regional (OTR) failure in 5 (18.5%). Only five failures (1.5%) could be attributed to the current RD-SNI policy: one CTV-LR failure (0.3%) reflecting the RD policy and four OTR failures (1.2%) reflecting the SNI policy.
Conclusion
Excellent oncological outcomes were achieved with the current RD-SNI policy.

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Breast cancer

Assessment of Eligibility and Utilization of Accelerated Partial Breast Irradiation in Korean Breast Cancer Patients (KROG 22-15): Seok-Joo Chun, Ji Hwan Jo, Yong Bae Kim, Sangjoon Park, Sung-Ja Ahn, Su Ssan Kim, Kyubo Kim, Kyung Hwan Shin; Cancer Res Treat. 2024;56(2):549-556. Published online December 8, 2023; DOI: https://doi.org/10.4143/crt.2023.1109

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Purpose
We investigated the proportions of patients eligible for accelerated partial breast irradiation (APBI) among those with pT1-2N0 breast cancer, based on the criteria set by the American Society for Radiation Oncology (ASTRO), the Groupe Européen de Curiethérapie and the European Society for Radiotherapy and Oncology (GEC-ESTRO), the American Brachytherapy Society (ABS), and the American Society of Breast Surgeons (ASBS). Additionally, we analyzed the rate of APBI utilization among eligible patients.
Materials and Methods
Patients diagnosed with pT1-2N0 breast cancer in 2019 were accrued in four tertiary medical centers in Korea. All patients had undergone breast conserving surgery followed by radiotherapy, either whole breast irradiation or APBI. To determine which guideline best predicts the use of APBI in Korea, the F1 score and Matthews Correlation Coefficient (MCC) were determined for each guideline.
Results
A total of 1,251 patients were analyzed, of whom 196 (15.7%) underwent APBI. The percentages of eligible patients identified by the ASTRO, GEC-ESTRO, ABS, and ASBS criteria were 13.7%, 21.0%, 50.5%, and 63.5%, respectively. APBI was used to treat 54.4%, 37.2%, 27.1%, and 23.7% of patients eligible by the ASTRO, GEC-ESTRO, ABS, and ASBS criteria, respectively. The ASTRO guideline exhibited the highest F1 score (0.76) and MCC (0.67), thus showing the best prediction of APBI utilization in Korea.
Conclusion
The proportion of Korean breast cancer patients who are candidates for APBI is substantial. The actual rate of APBI utilization among eligible patients may suggest there is a room for risk-stratified optimization in offering radiation therapy.

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Impact of the ASTRO 2024 Guideline on Partial Breast Irradiation Eligibility in Breast Cancer Patients (KROG 24-01)
Seok-Joo Chun, Sangjoon Park, Yong Bae Kim, Sung-Ja Ahn, Kyubo Kim, Kyung Hwan Shin
Practical Radiation Oncology.2025; 15(3): e230. CrossRef

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Pediatric cancer

Tandem High-Dose Chemotherapy Increases the Risk of Secondary Malignant Neoplasm in Pediatric Solid Tumors: Hana Lim, Minji Im, Eun Seop Seo, Hee Won Cho, Hee Young Ju, Keon Hee Yoo, Sung Yoon Cho, Jong-Won Kim, Do Hoon Lim, Ki Woong Sung, Ji Won Lee; Cancer Res Treat. 2024;56(2):642-651. Published online November 24, 2023; DOI: https://doi.org/10.4143/crt.2023.999

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Purpose
This study aimed to investigate the incidence and risk factors for secondary malignant neoplasms (SMN) in pediatric solid tumors, focusing on the effects of tandem high-dose chemotherapy (HDCT).
Materials and Methods
Patients (aged < 19 years) diagnosed with or treated for pediatric solid tumors between 1994 and 2014 were retrospectively analyzed. The cumulative incidence of SMN was estimated using competing risk methods by considering death as a competing risk.
Results
A total of 1,435 patients (413 with brain tumors and 1,022 with extracranial solid tumors) were enrolled. Seventy-one patients developed 74 SMNs, with a 10-year and 20-year cumulative incidence of 2.680±0.002% and 10.193±0.024%, respectively. The types of SMN included carcinoma in 28 (37.8%), sarcoma in 24 (32.4%), and hematologic malignancy in 15 (20.3%) cases. Osteosarcoma and thyroid carcinoma were the most frequently diagnosed tumors. Multivariate analysis showed that radiotherapy (RT) > 2, 340 cGy, and tandem HDCT were significant risk factors for SMN development. The SMN types varied according to the primary tumor type; carcinoma was the most frequent SMN in brain tumors and neuroblastoma, whereas hematologic malignancy and sarcomas developed more frequently in patients with sarcoma and retinoblastoma, respectively.
Conclusion
The cumulative incidence of SMN in pediatric patients with solid tumors was considerably high, especially in patients who underwent tandem HDCT or in those who received RT > 2,340 cGy. Therefore, the treatment intensity should be optimized based on individual risk assessment and the long-term follow-up of pediatric cancer survivors.

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Rising Prevalence of Low-Frequency PPM1D Gene Mutations after Second HDCT in Multiple Myeloma
Katja Seipel, Nuria Z. Veglio, Henning Nilius, Barbara Jeker, Ulrike Bacher, Thomas Pabst
Current Issues in Molecular Biology.2024; 46(8): 8197. CrossRef

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Review Article

Intensity-Modulated Radiation Therapy for Uterine Cervical Cancer to Reduce Toxicity and Enhance Efficacy – an Option or a Must?: A Narrative Review: Sea-Won Lee, Aeran Kim, Sung Jong Lee, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2024;56(1):1-17. Published online August 30, 2023; DOI: https://doi.org/10.4143/crt.2023.562

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Radiotherapy (RT) is a fundamental modality in treatment of cervical cancer. With advancement of technology, conventional RT used for external beam radiotherapy (EBRT) for over half a century has been rapidly replaced with intensity-modulated radiation therapy (IMRT) especially during the last decade. This newer technique is able to differentiate the intensity of radiation within the same field, thus reduces the inevitable exposure of radiation to normal organs and enables better dose delivery to tumors. Recently, the American Society for Radiation Oncology has released a guideline for RT in cervical cancer. Although a section of the guideline recommends IMRT for the purpose of toxicity reduction, a thorough review of the literature is necessary to understand the current status of IMRT in cervical cancer. This narrative review updates the recent high-level evidences regarding the efficacy and toxicity of IMRT and provides a better understanding of the most innovative techniques currently available for EBRT enabled by IMRT.

Citations

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Can knowledge-based planning models validated on ethnically diverse patients lead to global standardisation of external beam radiation therapy for locally advanced cervix cancer?
Jeevanshu Jain, Monica Serban, Marianne Sanggaard Assenholt, Varsha Hande, Jamema Swamidas, Yvette Seppenwoolde, Joanne Alfieri, Kari Tanderup, Supriya Chopra
Radiotherapy and Oncology.2025; 204: 110694. CrossRef
Prediction of recurrence risk of cervical cancer after radiotherapy using multi-sequence MRI radiomics
Jie Chen, Lou Liu, Yi Fu, Lu Zhang, Shuyue Li, Juying Zhou, Chenying Ma
Radiation Medicine and Protection.2025; 6(3): 169. CrossRef
Analysis of risk factors for acute radiation toxicity in cervical cancer patients in FIGO IIIC1 and IIIC2 stages treated with definitive chemoradiation
Marija Živković Radojević, Jasmina Jovanović Mirković, Slađana Pirić, Christos Aleksopoulos, Neda Milosavljević
The European Physical Journal Special Topics.2025;[Epub] CrossRef
Long term clinical outcomes of cervical cancer patients who were recommended surgery but did not undergo it: A SEER database study
Zhaoming Zhang, Hongfu Zhao, Guanghui Cheng
European Journal of Surgical Oncology.2024; 50(10): 108572. CrossRef
Treatment of secondary uterine malignancy following radiotherapy for cervical cancer: a study based on the SEER database
Xiaojing Tong, Yunyun Xiao, Haozhen Li, Hang Zhang, Jiawen Li
BMC Women's Health.2024;[Epub] CrossRef

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Original Articles

Gastrointestinal cancer

Differential Perspectives by Specialty on Oligometastatic Colorectal Cancer: A Korean Oligometastasis Working Group’s Comparative Survey Study: Won Kyung Cho, Gyu Sang Yoo, Chai Hong Rim, Jae-Uk Jeong, Eui Kyu Chie, Yong Chan Ahn, Hyeon-Min Cho, Jun Won Um, Yang-Gun Suh, Ah Ram Chang, Jong Hoon Lee, On behalf of the Oligometastasis Working Group, Korean Cancer Association; Cancer Res Treat. 2023;55(4):1281-1290. Published online June 7, 2023; DOI: https://doi.org/10.4143/crt.2023.479

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Purpose
Despite numerous studies on the optimal treatments for oligometastatic disease (OMD), there is no established interdisciplinary consensus on its diagnosis or classification. This survey-based study aimed to analyze the differential opinions of colorectal surgeons and radiation oncologists regarding the definition and treatment of OMD from the colorectal primary.
Materials and Methods
A total of 141 participants were included in this study, consisting of 63 radiation oncologists (44.7%) and 78 colorectal surgeons (55.3%). The survey consisted of 19 questions related to OMD, and the responses were analyzed using the chi-square test to determine statistical differences between the specialties.
Results
The radiation oncologists chose “bone” more frequently compared to the colorectal surgeons (19.2% vs. 36.5%, p=0.022), while colorectal surgeons favored “peritoneal seeding” (26.9% vs. 9.5%, p=0.009). Regarding the number of metastatic tumors, 48.3% of colorectal surgeons responded that “irrelevant, if all metastatic lesions are amendable to local therapy”, while only 21.8% of radiation oncologist chose same answer. When asked about molecular diagnosis, most surgeons (74.8%) said it was important, but only 35.8% of radiation oncologists agreed.
Conclusion
This study demonstrates that although radiation oncologists and colorectal surgeons agreed on a majority of aspects such as diagnostic imaging, biomarker, systemic therapy, and optimal timing of OMD, they also had quite different perspectives on several aspects of OMD. Understanding these differences is crucial to achieving multidisciplinary consensus on the definition and optimal management of OMD.

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Barriers in Oligometastasis Care in Korea: Radiation Oncologists’ Perspectives
Eui Kyu Chie, Chai Hong Rim, Won Kyung Cho, Yong Chan Ahn
Cancer Research and Treatment.2023; 55(4): 1063. CrossRef

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One-Week versus Two-Week Chemoradiotherapy Followed by Curative Surgery in Rectal Cancer: Long-Term Comparative Pooled Analysis of Two Prospective Multicenter Phase II Trials: Soo-Yoon Sung, Dae Yong Kim, Hong Seok Jang, Tae Hyun Kim, Hee Chul Park, Eui Kyu Chie, Taek-Keun Nam, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2023;55(3):918-926. Published online February 27, 2023; DOI: https://doi.org/10.4143/crt.2022.1646

Abstract PDF PubReader ePub: Purpose
The optimal short-course chemotherapeutic regimen for rectal cancer has not been clearly defined until now. KROG 10-01 and KROG 11-02 prospective trials investigated the efficacy and safety of 1- and 2-week chemoradiotherapy (CRT), respectively.
Materials and Methods
Patients eligible for KROG 10-01 and KROG 11-02 involved those with clinical T3-4N0-2M0 rectal cancers. They received preoperative CRT and total mesorectal excision. Patients in KROG 10-01 received radiation of 25 Gy in 5 fractions during 1 week with 5-fluorouracil/leucovorin. Patients in KROG 11-02 received radiation of 33 Gy in 10 fractions for 2 weeks with oral capecitabine.
Results
A total of 150 patients consisting of 70 patients from KROG 10-01 and 80 patients from KROG 11-02 were collectively analyzed. With a median follow-up time of 89.2 months, the 5-year overall survival rate was 86.5% in 1-week CRT and 85.3% in 2-week CRT (p=0.841). The 5-year recurrence-free survival rate was 83.5% in 1-week CRT and 77.1% in 2-week CRT (p=0.448). One patient (1.4%) in 1-week CRT and 11 patients (13.8%) in 2-week CRT exhibited pathologic complete regression (ypT0N0M0) after radiotherapy (p=0.006). One-week CRT had significantly higher acute hematologic (12.8% vs. 3.8%, p=0.040) and nonhematologic (38.6% vs. 16.3%, p=0.002) toxicity than 2-week CRT.
Conclusion
Both 1- and 2-week schedules of CRT showed favorable survival outcomes after 7 years of follow-up. But, 2-week course achieved more increased tumor response and decreased acute toxicity than 1-week course.

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Lung and Thoracic cancer

Efficacy of Prophylactic Cranial Irradiation According to the Risk of Extracranial Recurrence in Limited-Stage Small Cell Lung Cancer: Tae Hoon Lee, Joo-Hyun Chung, Hong-Gyun Wu, Suzy Kim, Joo Ho Lee, Bhumsuk Keam, Jin-Soo Kim, Ki Hwan Kim, Byoung Hyuck Kim, Hak Jae Kim; Cancer Res Treat. 2023;55(3):875-884. Published online February 24, 2023; DOI: https://doi.org/10.4143/crt.2022.1583

Abstract PDF Supplementary Material PubReader ePub

Purpose
We aimed to evaluate the effectiveness of prophylactic cranial irradiation (PCI) for “early brain metastasis”, which occurs before extracranial recurrence (ECR), and “late brain metastasis”, which occurs after ECR, in limited-stage small cell lung cancer (LS-SCLC).
Materials and Methods
We retrospectively analyzed 271 LS-SCLC patients who underwent definitive chemoradiation. All patients were initially staged with brain magnetic resonance imaging and positron emission tomography. Intracranial recurrence (ICR), ECR, progression-free rate (PFR), and overall survival (OS) were analyzed as clinical endpoints. The competing risk of the first recurrence with ICR (ICRfirst) was evaluated. Significantly associated variables in multivariate analysis of ECR were considered as ECR risk factors. Patients were stratified according to the number of ECR risk factors.
Results
The application of PCI was associated with higher PFR (p=0.008) and OS (p=0.045). However, PCI was not associated with any of the clinical endpoints in multivariate analysis. The competing risk of ICRfirst was significantly decreased with the application of PCI (hazard ratio, 0.476; 95% confidence interval, 0.243 to 0.931; p=0.030). Stage III disease, sequential, and stable disease after thoracic radiation were selected as ECR risk factors. For patients without these risk factors, the application of PCI was significantly associated with increased OS (p=0.048) and a decreased risk of ICRfirst (p=0.026).
Conclusion
PCI may play a role in preventing early brain metastasis rather than late brain metastasis after ECR, suggesting that only patients with a low risk of ECR may currently benefit from PCI.

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Efficacy evaluation of prophylactic cranial irradiation for limited stage small‑cell lung cancer in the magnetic resonance imaging era: A meta‑analysis
Lihua Shao, Yumei Dong, Meiqiao Jiang, Haixia Song, Yuexiao Qi, Liyun Guo, Jinhui Tian, Shihong Wei
Oncology Letters.2025;[Epub] CrossRef

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Special Article

Top Ten Lessons Learned from Trials in Oligometastatic Cancers: Vivian S. Tan, David A. Palma; Cancer Res Treat. 2023;55(1):5-14. Published online December 16, 2022; DOI: https://doi.org/10.4143/crt.2022.1460

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Recent evidence supports the role of aggressive local treatment in the oligometastatic setting. In this review, we discuss the top 10 lessons we have learned from trials in oligometastatic cancers. Major lessons learned pertain to definitions of oligometastatic disease, outcomes, toxicity, costs, and the combination of ablative therapies with systemic therapy, including immunotherapy. Barriers to accrual for trials and upcoming phase III trials are also reviewed. These lessons may help to inform clinical practice and may be the basis for future research in the oligometastatic space.

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Quality of Life After Locoregional Treatment in Women with De Novo Metastatic Breast Cancer: A Systematic Review and Meta-Analysis
Camille Weiss, Philippe Trensz, Martin Schmitt, Massimo Lodi
Cancers.2025; 17(5): 751. CrossRef
Therapie bei oligometastasierten gastrointestinalen Tumoren
Thorsten Oliver Götze, Maximilian Kloft, Emmanouil Fokas, Thomas Schmidt, Hendrik Dapper
Die Onkologie.2025; 31(7): 688. CrossRef
In situ generated CdTe quantum dot-encapsulated hafnium polymer membrane to boost electrochemiluminescence analysis of tumor biomarkers
Haiyin Li, Zhixin Wang, Feng Li, Panpan Gai
Analytical and Bioanalytical Chemistry.2024; 416(21): 4769. CrossRef
Safety and Efficacy of Stereotactic Body Radiation Therapy for Ultra-central Thoracic Tumors: A Single Center Retrospective Review
George J. Li, Hendrick Tan, Humza Nusrat, Joe Chang, Hanbo Chen, Ian Poon, Jeevin Shahi, May Tsao, Yee Ung, Patrick Cheung, Alexander V. Louie
International Journal of Radiation Oncology*Biology*Physics.2024; 120(2): 359. CrossRef
Prevalence of non-Hodgkin lymphoma patients at high-risk of failure after CAR T-cell therapy eligible for bridging radiation therapy
Adnan Danish, Alexandra Della Pia, Lindsay Fogel, Hassan Alkhatatneh, Charles Zhao, Tony Varughese, Karine A. Al Feghali, Lauren Pascual, Brittany Sinclaire, Michael Marafelias, Joshua Zenreich, Yen-Hong Kuo, Tatyana A. Feldman, Yi Zhang, Andre H. Goy, An
Frontiers in Oncology.2024;[Epub] CrossRef
Multidisciplinary Canadian consensus on the multimodal management of high-risk and radioactive iodine-refractory thyroid carcinoma
Shereen Ezzat, Jesse D. Pasternak, Murali Rajaraman, Omar Abdel-Rahman, Andrée Boucher, Nicole G. Chau, Shirley Chen, Sabrina Gill, Martin D. Hyrcza, Nathan Lamond, Marie-Hélène Massicotte, Eric Winquist, Ozgur Mete
Frontiers in Oncology.2024;[Epub] CrossRef
Primary tumor resection in de novo metastatic breast cancer from an oligometastatic perspective: A systematic review and meta-analysis
Chen Wu, Xiang Li, Shiyang Liu, Litong Yao, Tianyi He, Yusong Wang, Haoran Dong, Shuyi Niu, Mozhi Wang, Yingying Xu
iScience.2024; 27(12): 111224. CrossRef
Oligometastasis: More Lessons to Be Learned
Kyung Hwan Kim, Yong Chan Ahn
Cancer Research and Treatment.2023; 55(1): 1. CrossRef
Role of local ablative treatment in oligometastatic non-small cell lung cancer: a meta-analysis
Chai Hong Rim, Won Kyung Cho, Sunmin Park, Won Sup Yoon, Dae Sik Yang
International Journal of Surgery.2023; 109(4): 1006. CrossRef
Re: Toni K. Choueiri, Thomas Powles, Laurence Albiges, et al. Cabozantinib plus Nivolumab and Ipilimumab in Renal-Cell Carcinoma. N Engl J Med 2023;388:1767–78
Clara Cerrato, Benjamin Pradere, Maria Carmen Mir
European Urology.2023; 84(4): e93. CrossRef
Barriers in Oligometastasis Care in Korea: Radiation Oncologists’ Perspectives
Eui Kyu Chie, Chai Hong Rim, Won Kyung Cho, Yong Chan Ahn
Cancer Research and Treatment.2023; 55(4): 1063. CrossRef

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Original Articles

Breast cancer

Impact of Postmastectomy Radiation Therapy on Breast Cancer Patients According to Pathologic Nodal Status after Modern Neoadjuvant Chemotherapy: Dowook Kim, Jin Ho Kim, In Ah Kim, Ji Hyun Chang, Kyung Hwan Shin; Cancer Res Treat. 2023;55(2):592-602. Published online October 11, 2022; DOI: https://doi.org/10.4143/crt.2022.998

Abstract PDF Supplementary Material PubReader ePub

Purpose
The utility of postmastectomy radiation therapy (PMRT) for breast cancer patients after neoadjuvant chemotherapy (NAC) is highly controversial. This study evaluated the impact of PMRT according to pathologic nodal status after modern NAC.
Materials and Methods
We retrospectively reviewed 682 patients with clinical stage II-III breast cancer who underwent NAC and mastectomy from 2013 to 2017. In total, 596 patients (87.4%) received PMRT, and 86 (12.6%) did not. We investigated the relationships among locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), overall survival (OS), and various prognostic factors. Subgroup analyses were also performed to identify patients who may benefit from PMRT.
Results
The median follow-up duration was 67 months. In ypN+ patients (n=368, 51.2%), PMRT showed significant benefits in terms of LRRFS, DFS, and OS (all p < 0.001). In multivariate analyses, histologic grade (HG) III (p=0.002), lymphovascular invasion (LVI) (p=0.045), and ypN2-3 (p=0.02) were significant risk factors for poor LRRFS. In ypN1 patients with more than two prognostic factors among luminal/human epidermal growth factor receptor-2–negative subtype, HG I-II, and absence of LVI, PMRT had no significant effect on LRRFS (p=0.18). In ypN0 patients (n=351, 48.8%), PMRT was not significantly associated with LRRFS, DFS, or OS. However, PMRT showed better LRRFS in triple-negative breast cancer (TNBC) patients (p=0.03).
Conclusion
PMRT had a major impact on treatment outcomes in patients with residual lymph nodes following NAC and mastectomy. Among ypN0 patients, PMRT may be beneficial only for those with TNBC.

Citations

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Impact of postmastectomy radiotherapy on locoregional recurrence and survival in patients with ypN0 breast cancer after neoadjuvant chemotherapy: A comprehensive meta-analysis and systematic review
Fangjie Ding, Junfeng Zhao, Xue Wu, Xiaoman Liu, Yunxing Yang, Ying Li, Lili Qiao, Yingying Zhang
Journal of Cancer Research and Therapeutics.2025; 21(2): 477. CrossRef
Value of postmastectomy radiotherapy on overall survival in stage II–III node-negative patients following neoadjuvant therapy: A surveillance, epidemiology, and end results-based population study
Xiaoyu Wang, Xiaolin Zhao, Pian Cheng, Xiaomeng Zou, Weike Zhang, Jie Liu
Science Progress.2025;[Epub] CrossRef
Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey
Xue-mei Chen, Chen-di Xu, Li-ping Zeng, Xiao-tong Huang, Ao-qiang Chen, Lu Liu, Liu-wen Lin, Le-cheng Jia, Hua Li, Xiao-bo Jiang
Technology in Cancer Research & Treatment.2024;[Epub] CrossRef
Does Post-Mastectomy Radiotherapy Confer Survival Benefits on Patients With 1-3 Clinically Positive Lymph Nodes Rendered Pathologically Negative After Neoadjuvant Systemic Chemotherapy: Consensus from A Pooled Analysis?
Munaser Alamoodi
European Journal of Breast Health.2024; 20(2): 81. CrossRef
Oncological outcomes of stage I–II breast cancer treatment after subcutaneous/skin-sparing mastectomies with reconstruction
E. A. Rasskazova, A. D. Zikiryakhodzhaev
MD-Onco.2024; 4(3): 37. CrossRef
Effectiveness of mat pilates on fatigue in women with breast cancer submitted to adjuvant radiotherapy: randomized controlled clinical trial
Daniele Medeiros Torres, Kelly de Menezes Fireman, Erica Alves Nogueira Fabro, Luiz Claudio Santos Thuler, Rosalina Jorge Koifman, Anke Bergmann, Sabrina da Silva Santos
Supportive Care in Cancer.2023;[Epub] CrossRef
The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review
Giulia Ferrarazzo, Alberto Nieri, Emma Firpo, Andrea Rattaro, Alessandro Mignone, Flavio Guasone, Augusto Manzara, Giuseppe Perniciaro, Stefano Spinaci
Current Oncology.2023; 30(10): 8703. CrossRef

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Pediatric cancer

Chronological Analysis of Acute Hematological Outcomes after Proton and Photon Beam Craniospinal Irradiation in Pediatric Brain Tumors: Gyu Sang Yoo, Jeong Il Yu, Sungkoo Cho, Youngyih Han, Yoonjin Oh, Do Hoon Lim, Hee Rim Nam, Ji-Won Lee, Ki-Woong Sung, Hyung Jin Shin; Cancer Res Treat. 2022;54(3):907-916. Published online October 15, 2021; DOI: https://doi.org/10.4143/crt.2021.332

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to compare the early hematological dynamics and acute toxicities between proton beam craniospinal irradiation (PrCSI) and photon beam craniospinal irradiation (PhCSI) for pediatric brain tumors.
Materials and Methods
We retrospectively reviewed patients with pediatric brain tumors who received craniospinal irradiation (CSI). The average change in hemoglobin levels (ΔHb_avg), absolute lymphocyte counts (ΔALC_avg), and platelet counts (ΔPLT_avg) from baseline values was evaluated and compared between the PrCSI and PhCSI groups at 1 and 2 weeks after the initiation of CSI, 1 week before and at the end of radiotherapy, and 3-4 weeks after the completion of radiotherapy using t test and mixed-model analysis.
Results
The PrCSI and PhCSI groups consisted of 36 and 30 patients, respectively. There were no significant differences in ΔHb_avg between the two groups at any timepoint. However, ΔALC_avg and ΔPLT_avg were significantly lower in the PhCSI group than in PrCSI group at every timepoint, demonstrating that PrCSI resulted in a significantly lower rate of decline and better recovery of absolute lymphocyte and platelet counts. The rate of grade 3 acute anemia was significantly lower in the PrCSI group than in in the PhCSI group.
Conclusion
PrCSI showed a lower rate of decline and better recovery of absolute lymphocyte and platelet counts than PhCSI in the CSI for pediatric brain tumors. Grade 3 acute anemia was significantly less frequent in the PrCSI group than in the PhCSI group. Further large-scale studies are warranted to confirm these results.

Citations

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Pediatric CNS Radiation Oncology: Recent Developments and Novel Techniques
Justin Oh, Samir Patel, Mary-Pat Schlosser, Andrew J. Arifin, Carol Oliveira, Anne-Marie Charpentier, Derek S. Tsang
Current Oncology.2025; 32(3): 180. CrossRef
Acute side effects of proton and photon radiotherapy for medulloblastoma: a retrospective national multicenter study
Linn Söderlund Diaz, Måns Agrup, Anna Askild, Anna Embring, Jacob Engellau, Ingrid Fagerström Kristensen, Anna Flejmer, Charlotta Fröjd, Martin P Nilsson, Anna Maja Svärd, Angelica Walfridsson, Malin Blomstrand
Journal of Neuro-Oncology.2025;[Epub] CrossRef
Long-term effects of local radiotherapy on growth and vertebral features in children with high-risk neuroblastoma
Kyungmi Yang, Joong Hyun Ahn, Sook-Young Woo, Sang Hoon Jung, Ki Woong Sung, Ji Won Lee, Do Hoon Lim
BMC Pediatrics.2024;[Epub] CrossRef
Comparison of Craniospinal Irradiation Using Proton Beams According to Irradiation Method and Initial Experience Treating Pediatric Patients
Nobuyoshi Fukumitsu, Hikaru Kubota, Masayuki Mima, Yusuke Demizu, Takeshi Suzuki, Daiichiro Hasegawa, Yoshiyuki Kosaka, Atsufumi Kawamura, Toshinori Soejima
Advances in Radiation Oncology.2023; 8(5): 101251. CrossRef
Proton versus photon radiation therapy: A clinical review
Zhe Chen, Michael M. Dominello, Michael C. Joiner, Jay W. Burmeister
Frontiers in Oncology.2023;[Epub] CrossRef
Shifting Strategies in the Treatment of Pediatric Craniopharyngioma
Segev Gabay, Thomas E. Merchant, Frederick A. Boop, Jonathan Roth, Shlomi Constantini
Current Oncology Reports.2023; 25(12): 1497. CrossRef

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Gastrointestinal cancer

Radiofrequency Ablation versus Stereotactic Body Radiation Therapy in the Treatment of Colorectal Cancer Liver Metastases: Jesang Yu, Dong Hwan Kim, Jungbok Lee, Yong Moon Shin, Jong Hoon Kim, Sang Min Yoon, Jinhong Jung, Jin Cheon Kim, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Tae Won Kim, Yong Sang Hong, Sun Young Kim, Jeong Eun Kim, Jin-hong Park, So Yeon Kim; Cancer Res Treat. 2022;54(3):850-859. Published online October 13, 2021; DOI: https://doi.org/10.4143/crt.2021.674

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to compare the treatment outcomes of radiofrequency ablation (RFA) and stereotactic body radiation therapy (SBRT) for colorectal cancer liver metastases (CRLM) and to determine the favorable treatment modality according to tumor characteristics.
Materials and Methods
We retrospectively analyzed the records of 222 colorectal cancer patients with 330 CRLM who underwent RFA (268 tumors in 178 patients) or SBRT (62 tumors in 44 patients) between 2007 and 2014. Kaplan–Meier method and Cox models were used by adjusting with inverse probability of treatment weighting (IPTW).
Results
The median follow-up duration was 30.5 months. The median tumor size was significantly smaller in the RFA group than in the SBRT group (1.5 cm vs 2.3 cm, p<0.001). In IPTW-adjusted analysis, difference in treatment modality was not associated with significant differences in 1-year and 3-year recurrence-free survival (35% vs 43%, 22% vs 23%; p=0.198), overall survival (96% vs 91%, 58% vs 56%; p=0.508), and freedom from local progression (FFLP; 90% vs 72%, 78% vs 60%; p=0.106). Significant interaction effect between the treatment modality and tumor size was observed for FFLP (p=0.001). In IPTW-adjusted subgroup analysis of patients with tumor size >2 cm, the SBRT group had a higher FFLP compared with the RFA group (HR, 0.153; p<0.001).
Conclusion
SBRT and RFA showed similar local control in the treatment of patients with CRLM. Tumor size was an independent prognostic factor for local control and SBRT may be preferred for larger tumors.

Citations

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General

Radiation Response Prediction Model Based on Integrated Clinical and Genomic Data Analysis: Bum-Sup Jang, Ji-Hyun Chang, Seung Hyuck Jeon, Myung Geun Song, Kyung-Hun Lee, Seock-Ah Im, Jong-Il Kim, Tae-You Kim, Eui Kyu Chie; Cancer Res Treat. 2022;54(2):383-395. Published online August 24, 2021; DOI: https://doi.org/10.4143/crt.2021.759

Abstract PDF Supplementary Material PubReader ePub

Purpose
The value of the genomic profiling by targeted gene-sequencing on radiation therapy response prediction was evaluated through integrated analysis including clinical information. Radiation response prediction model was constructed based on the analyzed findings.
Materials and Methods
Patients who had the tumor sequenced using institutional cancer panel after informed consent and received radiotherapy for the measurable disease served as the target cohort. Patients with irradiated tumor locally controlled for more than 6 months after radiotherapy were defined as the durable local control (DLC) group, otherwise, non-durable local control (NDLC) group. Significant genomic factors and domain knowledge were used to develop the Bayesian Network model to predict radiotherapy response.
Results
Altogether, 88 patients were collected for analysis. Of those, 41 (43.6%) and 47 (54.4%) patients were classified as the NDLC and DLC group, respectively. Somatic mutations of NOTCH2 and BCL were enriched in the NDLC group, whereas, mutations of CHEK2, MSH2, and NOTCH1 were more frequently found in the DLC group. Altered DNA repair pathway was associated with better local failure–free survival (hazard ratio, 0.40; 95% confidence interval, 0.19 to 0.86; p=0.014). Smoking somatic signature was found more frequently in the DLC group. Area under the receiver operating characteristic curve of the Bayesian network model predicting probability of 6-month local control was 0.83.
Conclusion
Durable radiation response was associated with alterations of DNA repair pathway and smoking somatic signature. Bayesian network model could provide helpful insights for high precision radiotherapy. However, these findings should be verified in prospective cohort for further individualization.

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Head and Neck cancer

Radiation-Induced Ocular Surface Disorders and Retinopathy: Ocular Structures and Radiation Dose-Volume Effect: Ozlem Ozkaya Akagunduz, Suzan Guven Yilmaz, Emin Tavlayan, Mine Esen Baris, Filiz Afrashi, Mustafa Esassolak; Cancer Res Treat. 2022;54(2):417-423. Published online June 24, 2021; DOI: https://doi.org/10.4143/crt.2021.575

Abstract PDF PubReader ePub

Purpose
This study aimed to evaluate the radiation-induced adverse effects on ocular structures in head and neck cancer patients and investigate the radiation dose-volume effects on the cornea, lacrimal gland, retina, optic nerve and chiasm.
Materials and Methods
A total of 38 eyes of 19 patients were included in this prospective, cohort study. All patients underwent complete ophthalmological examination in addition to contrast sensitivity, visual field and visual evoked potentials (VEP) tests. Ophthalmological examinations and psychophysical tests were performed in 6th, 12th, 18th, 24th months and in the last visit. The relationship between the ophthalmologic findings, and the radiation doses below and above the cut-off values was evaluated.
Results
Contrast sensitivity decrease and visual field deterioration were observed in 42% of the patients in the last visit (median 26 months) whereas a prolonged latency and decreased amplitude of P100 wave in VEP was observed in 58% and 33% of the eyes, respectively at 24th month. Totally 16 patients (84.2%) developed dry eye disease and eight of them received radiotherapy below tolerance doses and had mild to moderate dry eye findings. Radiation-induced retinopathy was observed in three of the eyes in eight patients who received radiation above tolerance dose.
Conclusion
Head and neck cancers treated with radiotherapy, resulted in various ophthalmic complications. All patients who are treating with radiotherapy should be evaluated by an ophthalmologist in terms of anterior and posterior segment damage, even if the radiation dose is below the tolerance limit.

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Special Article

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

Abstract PDF PubReader ePub

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

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S. Gaito, N.G. Burnet, M.C. Aznar, G. Marvaso, B.A. Jereczek-Fossa, A. Crellin, D. Indelicato, S. Pan, R. Colaco, R. Rieu, E. Smith, G. Whitfield
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Original Articles

Head and Neck cancer

Long-term Survivals, Toxicities and the Role of Chemotherapy in Early-Stage Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiation Therapy: A Retrospective Study with 15-Year Follow-up: Lin Wang, Jingjing Miao, Huageng Huang, Boyu Chen, Xiao Xiao, Manyi Zhu, Yingshan Liang, Weiwei Xiao, Shaomin Huang, Yinglin Peng, Xiaowu Deng, Xing Lv, Weixiong Xia, Yanqun Xiang, Xiang Guo, Fei Han, Chong Zhao; Cancer Res Treat. 2022;54(1):118-129. Published online June 7, 2021; DOI: https://doi.org/10.4143/crt.2021.101

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was aimed to investigate long-term survivals and toxicities of early-stage nasopharyngeal carcinoma (NPC) in endemic area, evaluating the role of chemotherapy in stage II patients.
Materials and Methods
Totally 187 patients with newly diagnosed NPC and restaged American Joint Committee on Cancer/ International Union Against Cancer 8th T1-2N0-1M0 were retrospectively recruited. All received intensity-modulated radiotherapy (IMRT)±chemotherapy (CT) from 2001 to 2010.
Results
With 15.7-year median follow-up, 10-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were 93.3%, 93.5%, 92.9% and 88.2%, respectively. Multivariable analyses showed cervical lymph nodes positive and pre-treatment prognostic nutritional index ≥ 52.0 could independently predict DMFS (p=0.036 and p=0.011), DSS (p=0.014 and p=0.026), and OS (p=0.002 and p < 0.001); Charlson comorbidity index < 3 points could predict DSS (p=0.011); age > 45 years (p=0.002) and pre-treatment lactate dehydrogenase ≥ 240 U/L (p < 0.001) predicted OS. No grade 4 late toxicity happened; grade 3 late toxicities included subcutaneous fibrosis (4.3%), deafness or otitis (4.8%), skin dystrophy (2.1%), and xerostomia (1.1%). No differences on survivals were shown between IMRT+CT vs. IMRT alone in stage II patients, even in T2N1M0 (p > 0.05). Unsurprising, patients in IMRT+CT had more acute gastrointestinal reaction, myelosuppression, mucositis, late ear toxicity, and cranial nerve injury (all p < 0.05) than IMRT alone group.
Conclusion
Superior tumor control and satisfying long-term outcomes could be achieved with IMRT in early-stage NPC with mild late toxicities. As CT would bring more toxicities, it should be carefully performed to stage II patients.

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Retrospective analysis of 1539 nasopharyngeal carcinoma cases: chemotherapy should not be excluded for non-Asian patients with T1-2N1M0 stage
Xin-Yu Li, Chang-Ying Zhong, Hui-Xian Xu
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Genistein and chlorin E6-loaded versatile nanoformulation for remodeling the hypoxia-related tumor microenvironment and boosting photodynamic therapy in nasopharyngeal carcinoma treatment
Qiang Zhou, Quazi T. H. Shubhra, Peng Lai, Jiayi Shi, Chenhao Fang, Qian Guo, Wanqing Li, Rui Chen, Xinkun Shen, Lina Huang, Xiaojun Cai, Sen Lin
Advanced Composites and Hybrid Materials.2025;[Epub] CrossRef
Vaccine-Based Immunotherapy for Oropharyngeal and Nasopharyngeal Cancers
Daria Maria Filippini, Elisabetta Broseghini, Carlotta Liberale, Giulia Gallerani, Giambattista Siepe, Elisabetta Nobili, Manuela Ferracin, Gabriele Molteni
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Integrative analysis of taurine metabolism-related genes prognostic signature with immunotherapy and identification of ABCB1 and GORASP1 as key genes in nasopharyngeal carcinoma
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Examining patient-reported late toxicity and its association with quality of life and unmet need for symptom management among nasopharyngeal cancer survivors: a cross-sectional survey
Victor C. W. Tam, Jerry C. F. Ching, Sindy S. T. Yip, Virginia H. Y. Kwong, Catherine P. L. Chan, Kenneth C. W. Wong, Shara W. Y. Lee
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Qilin Gong, Huaying Li, Hui Liu, Youyuan Shi
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Long noncoding RNA LINC00173 induces radioresistance in nasopharyngeal carcinoma via inhibiting CHK2/P53 pathway
Jingjing Miao, Boyu Chen, Yunyun Xiao, Runda Huang, Xiao Xiao, Shunzhen Lu, Lu Zhang, Xuguang Wang, Ying Ouyang, Xiangfu Chen, Qiuyan Chen, Yanqun Xiang, Xiang Guo, Xiaowu Deng, Lin Wang, Haiqiang Mai, Chong Zhao
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Therapeutic hyperthermia regulates complement C3 activation and suppresses tumor development through HSPA5/NFκB/CD55 pathway in nasopharyngeal carcinoma
Chengcong Chen, Anbang Ren, Qi Yi, Jiazuo Cai, Muhammad Khan, Yunen Lin, Zhong Huang, Jie Lin, Jian Zhang, Wei Liu, Anan Xu, Yunhong Tian, YaWei Yuan, Ronghui Zheng
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Immunotherapy for nasopharyngeal carcinoma: Current status and prospects (Review)
Huageng Huang, Yuyi Yao, Xinyi Deng, Zongyao Huang, Yungchang Chen, Zhao Wang, Huangming Hong, He Huang, Tongyu Lin
International Journal of Oncology.2023;[Epub] CrossRef
Quality of life and swallowing outcomes after early proactive swallowing rehabilitation by either transcutaneous neuromuscular electrical stimulation or exercise‐based swallowing training in patients with nasopharyngeal carcinoma after radiotherapy
Peter K. M. Ku, Alexander C. Vlantis, Rita W. M. Wong, Thomas S. C. Hui, Thomas Law, Louisa K. Y. Ng, Eddy W. Y. Wong, W. T. Chang, David R. Johnson, Florence S. T. Mok, K. H. Wong, Victor Abdullah, Andrew van Hasselt, Kathy Y. S. Lee, Michael C. F. Tong
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Prognostic nutritional index and serum lactate dehydrogenase predict the prognosis of nasopharyngeal carcinoma patients who received intensity-modulated radiation therapy
Chunxia Zhang, Zhouwei Zhan, Yunxiang Fang, Yuanyuan Ruan, Mingan Lin, Zhisen Dai, Yanping Zhang, Shanshan Yang, Shuxiang Xiao, Bijuan Chen
Journal of Cancer Research and Clinical Oncology.2023; 149(20): 17795. CrossRef
A Systematic Review and Meta-Analysis of Studies Comparing Concurrent Chemoradiotherapy With Radiotherapy Alone in the Treatment of Stage II Nasopharyngeal Carcinoma
Yao-Can Xu, Kai-Hua Chen, Zhong-Guo Liang, Xiao-Dong Zhu
Frontiers in Oncology.2022;[Epub] CrossRef
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Jinping Liu, Zesheng Zeng, Dingting Wang, Gang Qin
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External Validation of a Nomogram to Predict Survival and Benefit of Concurrent Chemoradiation for Stage II Nasopharyngeal Carcinoma
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Gynecologic cancer

Effect of Waiting Time from Pathological Diagnosis to Definitive Concurrent Chemoradiation for Cervical Cancer on Overall Survival: Kyoung Won Noh, Bomi Kim, Chel Hun Choi, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae, Won Kyung Cho, Won Park, Yoo-Young Lee; Cancer Res Treat. 2022;54(1):245-252. Published online April 15, 2021; DOI: https://doi.org/10.4143/crt.2021.023

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to evaluate the effect of waiting time, from diagnosis to initiation of definitive concurrent chemoradiation (CCRT), on overall survival in cervical cancer patients.
Materials and Methods
Patients with cervical cancer who were treated with definitive CCRT between 2000 and 2017 were retrospectively reviewed. Time from initial pathological diagnosis to definitive CCRT was analyzed both as a continuous variable (per day) and as a categorical variable in two groups (group 1 ≤ median, group 2 > median). Patients with a waiting time of more than 60 days were excluded.
Results
The median waiting time was 14 days (0-60). There were differences between group 1 and group 2 in age and chemotherapy regimens. However, no significant difference was found in the International Federation of Gynecology and Obstetrics stage, cell type, or the number of cycles of chemotherapy received during CCRT. A longer waiting time was associated with poorer overall survival on the Kaplan-Meier curve (group 1 vs. group 2, p=0.042). On multivariate analysis, intervals as either a continuous variable (hazard ratio [HR], 1.023; 95% confidence interval [CI], 1.006 to 1.040; p=0.007) or a categorical variable (HR, 1.513; 95% CI, 1.073 to 2.134; p=0.018), FIGO stage, cell type, and the number of cycles of chemotherapy received during CCRT were significant independent prognostic factors for overall survival.
Conclusion
A shorter waiting time from pathological diagnosis to definitive CCRT showed benefit on overall survival. Our findings suggest that an effort to minimize waiting times should be recommended in cervical cancer patients who are candidates for CCRT.

Citations

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Effect of waiting time for radiotherapy after last induction chemotherapy on prognosis of locally advanced nasopharyngeal carcinoma
Kui‐Xuan Zhu, Ting Ding, Yi‐Min E, Hong‐Wei Yang, Rui‐Ping Wu, Run‐Jia Liu, Ling‐Li Zhou, Wen‐Jie Fu, Mei‐Ping Jiang, Xiao‐Li Wang
Head & Neck.2024; 46(5): 1189. CrossRef
An Innovative Thermal Imaging Prototype for Precise Breast Cancer Detection: Integrating Compression Techniques and Classification Methods
Khaled S. Ahmed, Fayroz F. Sherif, Mohamed S. Abdallah, Young-Im Cho, Shereen M. ElMetwally
Bioengineering.2024; 11(8): 764. CrossRef
Prognostic impact of waiting time between diagnosis and treatment in patients with cervical cancer: A nationwide population-based study
Amy P. Hack, Ronald P. Zweemer, Trudy N. Jonges, Femke van der Leij, Cornelis G. Gerestein, Max Peters, Ina M. Jürgenliemk-Schulz, Peter S.N. van Rossum
Gynecologic Oncology.2022; 165(2): 339. CrossRef
The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching
Chi-Son Chang, Ji Song Min, Ki Hyeon Song, Chel Hun Choi, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie Kim, Yoo-Young Lee
Cancers.2022; 14(16): 3863. CrossRef
Survival outcomes following treatment delays among patients with early-stage female cancers: a nationwide study
Yu Min, Zheran Liu, Rendong Huang, Ruidan Li, Jing Jin, Zhigong Wei, Ling He, Yiyan Pei, Ning Li, Yongllin Su, Xiaolin Hu, Xingchen Peng
Journal of Translational Medicine.2022;[Epub] CrossRef

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5 Crossref

Head and Neck cancer

Re-irradiation with Moderate Hypo-fractionation Using Intensity Modulated Photon or Proton Radiation Therapy in Locally Recurrent Squamous Cell Carcinoma of Nasopharynx: Heerim Nam, Yong Chan Ahn, Kyungmi Yang, Dongryul Oh, Jae Myoung Noh; Cancer Res Treat. 2022;54(1):96-108. Published online March 26, 2021; DOI: https://doi.org/10.4143/crt.2020.1349

Abstract PDF PubReader ePub

Purpose
This study aimed to analyze the treatment outcomes of locally recurrent nasopharyngeal cancer (NPC) patients following moderate hypo-fractionation re-irradiation (re-RT).
Materials and Methods
Sixty locally recurrent NPC patients underwent hypo-fractionation re-RT. Forty-eight point three percentage had rT3-4, and 30.0% did keratinizing squamous cell carcinoma. Intensity-modulated radiation therapy (IMRT), with or without intensity-modulated proton therapy (IMPT), was used in 66.7% of patients.
Results
With the median follow-up of 22 months (range, 2 to 254 months), 31 patients (51.7%) died, 38 (63.3%) developed further treatment failure, and 30 (50.0%) developed ≥ grade 3 toxicity (including seven grade 5) at time of analysis. The 2- and 5-year rates of overall survival, local failure-free survival, and ≥ grade 3 toxicity-free survival were 57.9% and 45.8%, 64.1% and 52.5%, and 54.8% and 44.9%, respectively. In multivariate analyses, worse factors for overall survival (OS) were iT3-4 (p=0.010) and age at re-RT ≥ 53 years (p=0.003), those for local failure-free survival (LFFS) were rT3-4 (p=0.022) and rN0-1 (p=0.035), and those for toxicity-free survival (TFS) were iT3-4 (p=0.020) and re-IMRT/IMPT (p=0.030), respectively. Cumulative dose or fraction size ≥ 3 Gy at re-RT, however, showed no significance for OS, LFFS and TFS.
Conclusion
Current re-RT with modern RT techniques by moderate hypo-fractionation scheme seemed feasible in treating locally recurrent NPC patients.

Citations

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Case Report: Unresectable recurrent nasopharyngeal cancer treated with immuno oncology
Fabiano Flauto, Rosa Maria Di Crescenzo, Vincenzo Damiano
Frontiers in Oncology.2025;[Epub] CrossRef
Envisioning an Italian Head and Neck Proton Therapy Model-Based Selection: Challenge and Opportunity
Giulia Fontana, Matteo Pepa, Anna Maria Camarda, Mimoza Strikchani, Michela Meregaglia, Alessandro Vai, Alfredo Mirandola, Barbara Vischioni, Andrea Pella, Guido Baroni, Barbara Alicja Jereczek-Fossa, Marta Scorsetti, Marco Cianchetti, Elisa D’Angelo, Pie
International Journal of Particle Therapy.2025; 16: 100745. CrossRef
Radiation oncology for the rhinologist
Helena Levyn, Fan Yang, Nancy Y. Lee
Current Opinion in Otolaryngology & Head & Neck Surgery.2024; 32(1): 5. CrossRef
Identifying the prognostic value of MRI-based tumor response and predicting the risk of radio-resistance in re-radiotherapy for locally recurrent nasopharyngeal carcinoma
Zi-Jian Lu, Ting Liu, Jie-Yi Lin, Sheng-Ting Pei, Ling Guo, Sai-Lan Liu, Hai-Qiang Mai
Radiotherapy and Oncology.2023; 183: 109635. CrossRef
Low-dose radiotherapy effects the progression of anti-tumor response
Lei Gao, Anqi Zhang
Translational Oncology.2023; 35: 101710. CrossRef
The Role of Hypofractionation in Proton Therapy
Alexandre Santos, Scott Penfold, Peter Gorayski, Hien Le
Cancers.2022; 14(9): 2271. CrossRef
Toxicity Profiles and Survival Outcomes Among Patients With Nonmetastatic Nasopharyngeal Carcinoma Treated With Intensity-Modulated Proton Therapy vs Intensity-Modulated Radiation Therapy
Xingzhe Li, Sarin Kitpanit, Anna Lee, Dennis Mah, Kevin Sine, Eric J. Sherman, Lara A. Dunn, Loren S. Michel, James Fetten, Kaveh Zakeri, Yao Yu, Linda Chen, Jung Julie Kang, Daphna Y. Gelblum, Sean M. McBride, Chiaojung J. Tsai, Nadeem Riaz, Nancy Y. Lee
JAMA Network Open.2021; 4(6): e2113205. CrossRef

7,201 View
202 Download
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Oncological and Functional Outcomes of Larynx-preserving Surgery for Hypopharyngeal Cancer: A Comparison with Definitive Radiation-based Treatment: Donghyeok Kim, Nalee Kim, Sungmin Koh, Man Ki Chung, Young-Ik Son, Dongryul Oh, Han-Sin Jeong, Yong Chan Ahn; Cancer Res Treat. 2022;54(1):84-95. Published online March 26, 2021; DOI: https://doi.org/10.4143/crt.2020.1197

Abstract PDF Supplementary Material PubReader ePub

Purpose
Larynx-preserving surgery (LPS) have recently gained popularity and achieved comparable oncologic outcomes to conventional radical surgery for localized hypopharyngeal cancer (HPC). In the current study, the role of LPS has been assessed thoroughly in comparison with upfront radiation therapy (RT).
Materials and Methods
We retrospectively reviewed 185 candidates for LPS with cT1-2 disease; 59 patients underwent upfront LPS while 126 patients received upfront RT, respectively. Oncological and functional outcomes were investigated and compared.
Results
Following LPS, safe margin (≥ 5 mm) was achieved in 37.3% of patients. Overall, better clinical outcomes at 5 years were achieved following upfront LPS than those following upfront RT: overall survival (OS) (72.7% vs. 59.0%, p=0.045), disease-free survival (DFS) (59.8% vs. 45.0%, p=0.039), and functional laryngeal preservation (100% vs. 89.7%, p=0.010). Although similar outcomes were observed in patients with cT1 disease, better 5-year DFS was achieved following upfront LPS in patients with cT2 disease (57.0% vs. 36.4%, p=0.023) by virtue of better local control. Despite frequent cN2-3 disease in upfront LPS group, comparable outcomes were observed between upfront RT and LPS group. However, multivariable analyses revealed that performance status and double primary cancer diagnosed within 6 months of HPC diagnosis affected OS significantly, while treatment modality per se did not.
Conclusion
Although upfront LPS could provide better local control than upfront RT in patients with cT2 disease, overall outcomes were comparable following either modality. Treatment selection of larynx-preserving approach for HPC should be individualized based on tumor and patient factors.

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Guidelines for the Treatment of Laryngeal Cancer from the Korean Society of Head and Neck Surgery
Jeon Yeob Jang, Geun-Jeon Kim, Sang-Yeon Kim, Min-Su Kim, Dong Kun Lee, Minsu Kwon, Dongbin Ahn, Myung Jin Ban, Young Kang, Ho-Ryun Won, Jae Won Chang, Dong Won Lee, Ki Nam Park, Yeon Soo Kim, Ah Ra Jung, Jungirl Seok, Hye Ran Lee, Sung-Chan Shin, Chang M
Clinical and Experimental Otorhinolaryngology.2025; 18(2): 89. CrossRef
In Reply to Liu and Luo
Kangpyo Kim, Yong Chan Ahn
International Journal of Radiation Oncology*Biology*Physics.2024; 118(1): 308. CrossRef
The role and clinical significance of microRNA-29a-3p in the development of hypopharyngeal carcinoma
Tao Liu, Detao Ding, Wei Wang, Yungang Wu, Dengdian Ma, Miaomiao Liu, Ziqiao Tan, Jing Yao, Xiaoyu Li
Brazilian Journal of Otorhinolaryngology.2023; 89(3): 401. CrossRef
Survival and swallowing function outcome impact factors analysis of surgery-oriented comprehensive treatment for hypopharyngeal cancer in a series of 122 patients
Wan-Xin Li, Yan-Bo Dong, Cheng Lu, Patrick J. Bradley, Liang-Fa Liu
Ear, Nose & Throat Journal.2022; 101(8): 532. CrossRef

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Lung Cancer

Prognostic Factor and Clinical Outcome in Stage III Non-Small Cell Lung Cancer: A Study Based on Real-World Clinical Data in the Korean Population: Ho Cheol Kim, Wonjun Ji, Jae Cheol Lee, Hyeong Ryul Kim, Si Yeol Song, Chang-Min Choi, Korean Association for Lung Cancer, Korea Central Cancer Registry; Cancer Res Treat. 2021;53(4):1033-1041. Published online February 16, 2021; DOI: https://doi.org/10.4143/crt.2020.1350

Abstract PDF Supplementary Material PubReader ePub

Purpose
The optimal treatment for patients with stage III non-small cell lung cancer (NSCLC) remains controversial. This study aimed to investigate prognostic factors and clinical outcome in stage III NSCLC using real-world clinical data in the Korean population.
Materials and Methods
Among 8,110 patients with lung cancer selected from 52 hospitals in Korea during 2014-2016, only patients with stage III NSCLC were recruited and analyzed. A standardized protocol was used to collect clinical information and cox proportional hazards models were used to identify risk factors for mortality.
Results
A total of 1,383 patients (46.5% had squamous cell carcinoma and 40.9% had adenocarcinoma) with stage III NSCLC were enrolled, and their median age was 70 years. Regarding clinical stage, 548 patients (39.6%) had stage IIIA, 517 (37.4%) had stage IIIB, and 318 (23.0%) had stage IIIC. Pertaining to the initial treatment method, the surgery group (median survival period: 36 months) showed better survival outcomes than the non-surgical treatment group (median survival period: 18 months, p=0.001) in patients with stage IIIA. Moreover, among patients with stage IIIB and stage IIIC, those who received concurrent chemotherapy and radiation therapy (CCRT, median survival period: 24 months) showed better survival outcomes than those who received chemotherapy (median survival period: 11 months), or radiation therapy (median survival period: 10 months, p<0.001).
Conclusion
While surgery might be feasible as the initial treatment option in patients with stage IIIA NSCLC, CCRT showed a beneficial role in patients with stage IIIB and IIIC NSCLC.

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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
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Yu-Hung Chen, Kun-Han Lue, Sung-Chao Chu, Bee-Song Chang, Chih-Bin Lin
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Cheol-Kyu Park, Nakyung Jeon, Hwa-Kyung Park, Hyung-Joo Oh, Young-Chul Kim, Ha-Lim Jeon, Yong-Hyub Kim, Sung-Ja Ahn, In-Jae Oh
Cancers.2023; 15(5): 1606. CrossRef
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Jeong Uk Lim, Hye Seon Kang, Ah Young Shin, Chang Dong Yeo, Chan Kwon Park, Sang Haak Lee, Seung Joon Kim
Thoracic Cancer.2022; 13(9): 1349. CrossRef
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CNS cancer

Long-Term Outcomes and Sequelae Analysis of Intracranial Germinoma: Need to Reduce the Extended-Field Radiotherapy Volume and Dose to Minimize Late Sequelae: Joo Ho Lee, Keun-Yong Eom, Ji Hoon Phi, Chul-Kee Park, Seung Ki Kim, Byung-Kyu Cho, Tae Min Kim, Dae Seog Heo, Kyung Taek Hong, Jung Yoon Choi, Hyoung Jin Kang, Hee Young Shin, Seung Hong Choi, Soon Tae Lee, Sung Hye Park, Kyu-Chang Wang, Il Han Kim; Cancer Res Treat. 2021;53(4):983-990. Published online January 13, 2021; DOI: https://doi.org/10.4143/crt.2020.1052

Abstract PDF PubReader ePub

Purpose
We aimed to refine the radiotherapy (RT) volume and dose for intracranial germinoma considering recurrences and long-term toxicities.
Materials and Methods
Total 189 patients with intracranial germinoma were treated with RT alone (n=50) and RT with upfront chemotherapy (CRT) (n=139). All cases were confirmed histologically. RT fields comprised the extended-field and involved-field only for primary site. The extended-field, including craniospinal, whole brain (WB), and whole ventricle (WV) for cranial field, is followed by involved-field boost. The median follow-up duration was 115 months.
Results
The relapses developed in 13 patients (6.9%). For the extended-field, cranial RT dose down to 18 Gy exhibited no cranial recurrence in 34 patients. In CRT, 74 patients (56.5%) showed complete response to chemotherapy and no involved-field recurrence with low-dose RT of 30 Gy. WV RT with chemotherapy for the basal ganglia or thalamus germinoma showed no recurrence. Secondary malignancy developed in 10 patients (5.3%) with a latency of 20 years (range, 4 to 26 years) and caused mortalities in six. WB or craniospinal field rather than WV or involved-field significantly increased the rate of hormone deficiencies, and secondary malignancy. RT dose for extended-field correlated significantly with the rate of hormone deficiencies, secondary malignancy, and neurocognitive dysfunction.
Conclusion
De-intensifying extended-field rather than involved-field or total scheme of RT will be critical to decrease the late toxicities. Upfront chemotherapy could be beneficial for the patients with complete response to minimize the RT dose down to 30 Gy. Prospective trials focused on de-intensification of the extended-field RT are warranted.

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Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysis
Zhirui Zhou, Jiabing Liu, Qi Yue, Lingxiao Chen, Xiwei Zhang, Xin Lin, Lin Zheng, Enmin Wang, Yang Wang, Ying Mao
BMC Cancer.2025;[Epub] CrossRef
Distribution and failure patterns of primary central nervous system lymphoma related to the hippocampus: implications for hippocampal avoidance irradiation
Hyejo Ryu, Xue Li, Tae Hoon Lee, Tae Min Kim, Seung Hong Choi, Chul-Kee Park, Soon Tae Lee, Sung-Hye Park, Jae-Kyung Won, Bum-Sup Jang, Il Han Kim, Joo Ho Lee
Journal of Neuro-Oncology.2025; 173(1): 95. CrossRef
NTRK-fused central nervous system tumours: clinicopathological and genetic insights and response to TRK inhibitors
Eric Eunshik Kim, Chul-Kee Park, Seung-Ki Kim, Ji Hoon Phi, Sun Ha Paek, Jung Yoon Choi, Hyoung Jin Kang, Joo Ho Lee, Jae Kyung Won, Hongseok Yun, Sung-Hye Park
Acta Neuropathologica Communications.2024;[Epub] CrossRef
Clinical significance of cerebral microbleeds in patients with germinoma who underwent long-term follow-up
Masayuki Kanamori, Shunji Mugikura, Osamu Iizuka, Naoko Mori, Yoshiteru Shimoda, Ichiyo Shibahara, Rei Umezawa, Keiichi Jingu, Ryuta Saito, Yukihiko Sonoda, Toshihiro Kumabe, Kyoko Suzuki, Hidenori Endo
Journal of Neuro-Oncology.2024; 170(1): 173. CrossRef
Excluding prepontine cistern from whole ventricle radiotherapy target volume in localized germinoma
Hyejo Ryu, Joo Ho Lee
Radiation Oncology Journal.2023; 41(1): 48. CrossRef
Intracranial Germinomas: Diagnosis, Pathogenesis, Clinical Presentation, and Management
Natalia Kremenevski, Michael Buchfelder, Nirjhar Hore
Current Oncology Reports.2023; 25(7): 765. CrossRef
Proton therapy for pediatric diencephalic tumors
Adam J. Grippin, Susan L. McGovern
Frontiers in Oncology.2023;[Epub] CrossRef
Intracranial Germinoma—Association between Delayed Diagnosis, Altered Clinical Manifestations, and Prognosis
Iwona Jabłońska, Marcin Goławski, Elżbieta Nowicka, Katarzyna Drosik-Rutowicz, Anna Trybus, Rafał Tarnawski, Marcin Miszczyk
Cancers.2023; 15(10): 2789. CrossRef
Outcomes of intracranial germinoma—A retrospective multinational Asian study on effect of clinical presentation and differential treatment strategies
Kyung-Nam Koh, Ru Xin Wong, Dong-Eun Lee, Jung Woo Han, Hwa Kyung Byun, Hong In Yoon, Dong-Seok Kim, Chuhl Joo Lyu, Hyoung Jin Kang, Kyung Taek Hong, Joo Ho Lee, Il Han Kim, Ji Hoon Phi, Seung-Ki Kim, Tai-Tong Wong, Hsin-Lun Lee, I-Chun Lai, Yu-Mei Kang,
Neuro-Oncology.2022; 24(8): 1389. CrossRef
Photon versus proton whole ventricular radiotherapy for non‐germinomatous germ cell tumors: A report from the Children's Oncology Group
David Y. Mak, Zain Siddiqui, Zhihui Amy Liu, Hitesh Dama, Shannon M. MacDonald, Shengjie Wu, Erin S. Murphy, Matthew D. Hall, Victor Malkov, Arzu Onar‐Thomas, Sameera Ahmed, Girish Dhall, Derek S. Tsang
Pediatric Blood & Cancer.2022;[Epub] CrossRef
Factors Influencing Craniospinal Relapse of Intracranial Germinoma After Complete Remission
Takao Tsurubuchi, Kei Hara, Shingo Takano, Ai Muroi, Hiroko Fukushima, Masashi Mizumoto, Noriaki Sakamoto, Masahide Matsuda, Hiroyoshi Akutsu, Hideyuki Sakurai, Eiichi Ishikawa
World Neurosurgery.2022; 166: e325. CrossRef
Molecular Pathology and Targeted Therapies for Personalized Management of Central Nervous System Germinoma
Cristina Ilcus, Horatiu Silaghi, Carmen Emanuela Georgescu, Carmen Georgiu, Anca Ileana Ciurea, Simona Delia Nicoara, Cristina Alina Silaghi
Journal of Personalized Medicine.2021; 11(7): 661. CrossRef

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Head/neck cancer

Development of a Tongue Immobilization Device Using a 3D Printer for Intensity Modulated Radiation Therapy of Nasopharyngeal Cancer Patients: Sang Gyu Ju, Yong Chan Ahn, Yeong-bi Kim, Seung Gyu Park, Yoo-mi Choi, Cho Hee Na, Chae-Seon Hong, Dongryul Oh, Dong Yeol Kwon, Cheol Chong Kim, Dong Hyeon Kim; Cancer Res Treat. 2021;53(1):45-54. Published online September 15, 2020; DOI: https://doi.org/10.4143/crt.2020.572

Abstract PDF PubReader ePub

Purpose
This study aimed to reduce radiation doses to the tongue, a patient-specific semi-customized tongue immobilization device (SCTID) was developed using a 3D printer for helical tomotherapy (HT) of nasopharyngeal cancer (NPCa). Dosimetric characteristics and setup stability of the SCTID were compared with those of a standard mouthpiece (SMP).
Materials and Methods
For displacement and robust immobilization of the tongue, the SCTID consists of four parts: upper and lower tooth stoppers, tongue guider, tongue-tip position guide bar, and connectors. With the SCTID and SMP, two sets of planning computed tomography and HT plans were obtained for 10 NPCa patients. Dosimetric and geometric characteristics were compared. Position reproducibility of the tongue with SCTID was evaluated by comparing with planned dose and adaptive accumulated dose of the tongue and base of the tongue based on daily setup mega-voltage computed tomography.
Results
Using the SCTID, the tongue was effectively displaced from the planning target volume compared to the SMP. The median mucosa of the tongue (M-tongue) dose was significantly reduced (20.7 Gy vs. 27.8 Gy). The volumes of the M-tongue receiving a dose of 15 Gy, 30 Gy, and 45 Gy and the volumes of the mucosa of oral cavity and oropharynx (M-OC/OP) receiving a dose of 45 Gy and 60 Gy were significantly lower than using the SMP. No significant differences was observed between the planned dose and the accumulated adaptive dose in any dosimetric characteristics of the tongue and base of tongue.
Conclusion
SCTID can not only reduce the dose to the M-tongue and M-OC/OP dramatically, when compared to SMP, but also provide excellent reproducibility and easy visual verification.

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Salivary Gland Volume Changes and Dry Mouth Symptom Following Definitive Radiation Therapy in Oropharyngeal Cancer Patients—A Comparison of Two Different Approaches: Intensity-Modulated Radiation Therapy Versus Intensity-Modulated Radiation Therapy/Intens
Seung Gyu Park, Yong Chan Ahn, Dongryul Oh, Kyungmi Yang, Sang Gyu Ju, Jin Man Kim, Dongyeol Kwon, Euncheol Choi, Han Gyul Yoon
Cancers.2025; 17(3): 554. CrossRef
A Novel Immobilization Method for the Treatment of Head and Neck Cancer Using 3D Printing
Christopher Szewczyk, Yixiang Liao, Samer Al-Khudari, Michael J. Jelinek, Ken Tatebe
Practical Radiation Oncology.2024; 14(1): 20. CrossRef
Novel tongue-positioning device to reduce tongue motions during radiation therapy for head and neck cancer: Geometric and dosimetric evaluation
Seongmoon Jung, Bitbyeol Kim, Sung Young Lee, Won Ick Chang, Jaeman Son, Jong Min Park, Chang Heon Choi, Joo Ho Lee, Hong-Gyun Wu, Jung-in Kim, Jin Ho Kim, Minsoo Chun
PLOS ONE.2023; 18(9): e0291712. CrossRef
Dosimetric comparison between VMAT plans using the fast-rotating O-ring linac with dual-layer stacked MLC and helical tomotherapy for nasopharyngeal carcinoma
Sang Gyu Ju, Yong Chan Ahn, Yeong-bi Kim, Jin Man Kim, Dong Yeol Kwon, Byoung Suk Park, Kyungmi Yang
Radiation Oncology.2022;[Epub] CrossRef
Tongue Displacement Device in Decreasing the Radiation Dose to Tongue and Preventing Proton Beam Overshoot in Proton Therapy for Unilateral Head and Neck Cancer
Chae-Seon Hong, Dongryul Oh, Sang Gyu Ju, Yong Chan Ahn, Yeong-bi Kim, Seyjoon Park, Woojin Lee
Frontiers in Physics.2021;[Epub] CrossRef

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Intensity-Modulated Radiotherapy-Based Reirradiation for Head and Neck Cancer: A Multi-institutional Study by Korean Radiation Oncology Group (KROG 1707): Jeongshim Lee, Tae Hyung Kim, Yeon-Sil Kim, Myungsoo Kim, Jae Won Park, Sung Hyun Kim, Hyun Ju Kim, Chang Geol Lee; Cancer Res Treat. 2020;52(4):1031-1040. Published online July 7, 2020; DOI: https://doi.org/10.4143/crt.2020.310

Abstract PDF Supplementary Material PubReader ePub

Purpose
The benefits of reirradiation for head and neck cancer (HNC) have not been determined. This study evaluated the efficacy of reirradiation using intensity-modulated radiotherapy (IMRT) for recurrent or second primary HNC (RSPHNC) and identified subgroups for whom reirradiation for RSPHNC is beneficial.
Materials and Methods
A total of 118 patients from seven Korean institutions with RSPHNC who underwent IMRT-based reirradiation between 2006 and 2015 were evaluated through retrospective review of medical records. We assessed overall survival (OS) and local control (LC) within the radiotherapy (RT) field following IMRT-based reirradiation. Additionally, the OS curve according to the recursive partitioning analysis (RPA) suggested by the Multi-Institution Reirradiation (MIRI) Collaborative was determined.
Results
At a median follow-up period of 18.5 months, OS at 2 years was 43.1%. In multivariate analysis, primary subsite, recurrent tumor size, interval between RT courses, and salvage surgery were associated with OS. With regard to the MIRI RPA model, the class I subgroup had a significantly higher OS than class II or III subgroups. LC at 2 years was 53.5%. Multivariate analyses revealed that both intervals between RT courses and salvage surgery were prognostic factors affecting LC. Grade 3 or more toxicity and grade 5 toxicity rates were 8.5% and 0.8%, respectively.
Conclusion
IMRT-based reirradiation was an effective therapeutic option for patients with RSPHNC, especially those with resectable tumors and a long interval between RT courses. Further, our patients' population validated the MIRI RPA classification by showing the difference of OS according to MIRI RPA class.

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Re-irradiation for head and neck cancer: outcome and toxicity analysis using a prospective single institution database
Chiara Scolari, André Buchali, Achim Franzen, Robert Förster, Paul Windisch, Stephan Bodis, Daniel R. Zwahlen, Christina Schröder
Frontiers in Oncology.2023;[Epub] CrossRef
Double trouble: A cohort study of re-irradiation and laryngectomy – Severity of and risk for pharyngocutaneous fistula
Jeffrey M. Weinberger, Narmeen abd el Qadir, Nir Hirshoren
Oral Oncology.2022; 134: 106069. CrossRef
Current radiotherapy for recurrent head and neck cancer in the modern era: a state-of-the-art review
Yue Li, Yuliang Jiang, Bin Qiu, Haitao Sun, Junjie Wang
Journal of Translational Medicine.2022;[Epub] CrossRef
Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies
Franco Ionna, Paolo Bossi, Agostino Guida, Andrea Alberti, Paolo Muto, Giovanni Salzano, Alessandro Ottaiano, Fabio Maglitto, Davide Leopardo, Marco De Felice, Francesco Longo, Salvatore Tafuto, Giuseppina Della Vittoria Scarpati, Francesco Perri
Cancers.2021; 13(10): 2371. CrossRef
Re-irradiation for recurrent or second primary head and neck cancer
Hye In Lee, Jin Ho Kim, Soon-Hyun Ahn, Eun-Jae Chung, Bhumsuk Keam, Keun-Yong Eom, Woo-Jin Jeong, Ji-Won Kim, Chan Woo Wee, Hong-Gyun Wu
Radiation Oncology Journal.2021; 39(4): 279. CrossRef

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Protective Effects of N-Acetylcysteine against Radiation-Induced Oral Mucositis In Vitro and In Vivo: Haeng Jun Kim, Sung Un Kang, Yun Sang Lee, Jeon Yeob Jang, Hami Kang, Chul-Ho Kim; Cancer Res Treat. 2020;52(4):1019-1030. Published online June 18, 2020; DOI: https://doi.org/10.4143/crt.2020.012

Abstract PDF Supplementary Material PubReader ePub

Purpose
Radiation-induced oral mucositis limits delivery of high-dose radiation to targeted cancers. Therefore, it is necessary to develop a treatment strategy to alleviate radiation-induced oral mucositis during radiation therapy. We previously reported that inhibiting reactive oxygen species (ROS) generation suppresses autophagy. Irradiation induces autophagy, suggesting that antioxidant treatment may be used to inhibit radiation-induced oral mucositis.
Materials and Methods
We determined whether treatment with N-acetyl cysteine (NAC) could attenuate radiation-induced buccal mucosa damage in vitro and in vivo. The protective effects of NAC against oral mucositis were confirmed by transmission electron microscopy and immunocytochemistry. mRNA and protein levels of DNA damage and autophagy-related genes were measured by quantitative real-time polymerase chain reaction and western blot analysis, respectively.
Results
Rats manifesting radiation-induced oral mucositis showed decreased oral intake, loss of body weight, and low survival rate. NAC intake slightly increased oral intake, body weight, and the survival rate without statistical significance. However, histopathologic characteristics were markedly restored in NAC-treated irradiated rats. LC3B staining of rat buccal mucosa revealed that NAC treatment significantly decreased the number of radiation-induced autophagic cells. Further, NAC inhibited radiation-induced ROS generation and autophagy signaling. In vitro, NAC treatment significantly reduced the expression of NRF2, LC3B, p62, and Beclin-1 in keratinocytes compared with that after radiation treatment.
Conclusion
NAC treatment significantly inhibited radiation-induced autophagy in keratinocytes and rat buccal mucosa and may be a potentially safe and effective option for the prevention of radiation-induced buccal mucosa damage.

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N-Acetyl-L-Cysteine Protects Organ Function After Hemorrhagic Shock Combined With Seawater Immersion in Rats by Correcting Coagulopathy and Acidosis
Yiyan Liu, Yu Zhu, Zisen Zhang, Daiqin Bao, Haoyue Deng, Liangming Liu, Tao Li
Frontiers in Physiology.2022;[Epub] CrossRef
Nutraceuticals as Modulators of Autophagy: Relevance in Parkinson’s Disease
Michał Rakowski, Szymon Porębski, Agnieszka Grzelak
International Journal of Molecular Sciences.2022; 23(7): 3625. CrossRef
Oxidative Stress and Chemoradiation-Induced Oral Mucositis: A Scoping Review of In Vitro, In Vivo and Clinical Studies
Huynh Nguyen, Simran Sangha, Michelle Pan, Dong Ha Shin, Hayoung Park, Ali I. Mohammed, Nicola Cirillo
International Journal of Molecular Sciences.2022; 23(9): 4863. CrossRef
A Minireview on Gastrointestinal Microbiota and Radiosusceptibility
Aihong Mao, Chao Sun, Takanori Katsube, Bing Wang
Dose-Response.2020;[Epub] CrossRef

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A Radiosensitivity Gene Signature and PD-L1 Status Predict Clinical Outcome of Patients with Glioblastoma Multiforme in The Cancer Genome Atlas Dataset: Bum-Sup Jang, In Ah Kim; Cancer Res Treat. 2020;52(2):530-542. Published online November 20, 2019; DOI: https://doi.org/10.4143/crt.2019.440

Abstract PDF Supplementary Material PubReader ePub

Purpose
Combination of radiotherapy and immune checkpoint blockade such as programmed death- 1 (PD-1) or programmed death-ligand 1 (PD-L1) blockade is being actively tested in clinical trial. We aimed to identify a subset of patients that could potentially benefit from this strategy using The Cancer Genome Atlas (TCGA) dataset for glioblastoma (GBM).
Materials and Methods
A total of 399 cases were clustered into radiosensitive versus radioresistant (RR) groups based on a radiosensitivity gene signature and were also stratified as PD-L1 high versus PD-L1 low groups by expression of CD274 mRNA. Differential and integrated analyses with expression and methylation data were performed. CIBERSORT was used to enumerate the immune repertoire that resulted from transcriptome profiles.
Results
We identified a subset of GBM, PD-L1-high-RR group which showed worse survival compared to others. In PD-L1-high-RR, differentially expressed genes (DEG) were highly enriched for immune response and mapped into activation of phosphoinositide 3-kinase–AKT and mitogen-activated protein kinase (MAPK) signaling pathways. Integration of DEG and differentially methylated region identified that the kinase MAP3K8-involved in T-cell receptor signaling was upregulated and BAI1, a factor which inhibits angiogenesis, was silenced. CIBERSORT showed that a higher infiltration of the immune repertoire, which included M2 macrophages and regulatory T cells.
Conclusion
Taken together, PD-L1-high-RR group could potentially benefit from radiotherapy combined with PD-1/PD-L1 blockade and angiogenesis inhibition.

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Inhibiting ADORA1 enhances glioma apoptosis and increases its sensitivity to anti-PD1 therapy
Hong-jiang Li, Zhi-yun Yu, Hua-ping Gao, Yi-ran Xu, Xue-yuan Li, Wei Jiang, Di Chen, Dong-ming Yan, Chao Yang, Xian-zhi Liu
Frontiers in Oncology.2025;[Epub] CrossRef
Clinical Biomarkers of Tumour Radiosensitivity and Predicting Benefit from Radiotherapy: A Systematic Review
Christopher W. Bleaney, Hebatalla Abdelaal, Mark Reardon, Carmel Anandadas, Peter Hoskin, Ananya Choudhury, Laura Forker
Cancers.2024; 16(10): 1942. CrossRef
A retrospective cohort study of neoadjuvant chemoradiotherapy combined with immune checkpoint inhibitors in locally advanced rectal cancer
Zhuo Chen, Zhuoling Zou, Min Qian, Qin Xu, Guojuan Xue, Juan Yang, Tinglan Luo, Lianjie Hu, Bin Wang
Translational Oncology.2024; 44: 101955. CrossRef
Understanding the immunosuppressive microenvironment of glioma: mechanistic insights and clinical perspectives
Hao Lin, Chaxian Liu, Ankang Hu, Duanwu Zhang, Hui Yang, Ying Mao
Journal of Hematology & Oncology.2024;[Epub] CrossRef
PSF-lncRNA interaction as a target for novel targeted anticancer therapies
Ren Liu, Xiaojing Wang, Min Zhou, Jingfang Zhai, Jie Sun
Biomedicine & Pharmacotherapy.2024; 180: 117491. CrossRef
Bladder Cancer Treatments in the Age of Personalized Medicine: A Comprehensive Review of Potential Radiosensitivity Biomarkers
Charbel Feghaly, Rafka Challita, Hanine Bou Hadir, Tala Mobayed, Tarek Al Bitar, Mohammad Harbi, Hala Ghorayeb, Rana El-Hassan, Larry Bodgi
Biomarker Insights.2024;[Epub] CrossRef
Improving the efficacy of combined radiotherapy and immunotherapy: focusing on the effects of radiosensitivity
Zhiru Gao, Qian Zhao, Yiyue Xu, Linlin Wang
Radiation Oncology.2023;[Epub] CrossRef
In Vivo Evaluation of Near-Infrared Fluorescent Probe for TIM3 Targeting in Mouse Glioma
Michael Zhang, Quan Zhou, Chinghsin Huang, Carmel T. Chan, Wei Wu, Gordon Li, Michael Lim, Sanjiv S. Gambhir, Heike E. Daldrup-Link
Molecular Imaging and Biology.2022; 24(2): 280. CrossRef
Relationship between Macrophage and Radiosensitivity in Human Primary and Recurrent Glioblastoma: In Silico Analysis with Publicly Available Datasets
Bum-Sup Jang, In Ah Kim
Biomedicines.2022; 10(2): 292. CrossRef
Optimal management of recurrent and metastatic upper tract urothelial carcinoma: Implications of intensity modulated radiation therapy
Mi Sun Kim, Woong Sub Koom, Jae Ho Cho, Se-Young Kim, Ik Jae Lee
Radiation Oncology.2022;[Epub] CrossRef
Translational landscape of glioblastoma immunotherapy for physicians: guiding clinical practice with basic scientific evidence
Daniel Kreatsoulas, Chelsea Bolyard, Bill X. Wu, Hakan Cam, Pierre Giglio, Zihai Li
Journal of Hematology & Oncology.2022;[Epub] CrossRef
The Next Frontier in Health Disparities—A Closer Look at Exploring Sex Differences in Glioma Data and Omics Analysis, from Bench to Bedside and Back
Maria Diaz Rosario, Harpreet Kaur, Erdal Tasci, Uma Shankavaram, Mary Sproull, Ying Zhuge, Kevin Camphausen, Andra Krauze
Biomolecules.2022; 12(9): 1203. CrossRef
Immunosuppression in Gliomas via PD-1/PD-L1 Axis and Adenosine Pathway
Thamiris Becker Scheffel, Nathália Grave, Pedro Vargas, Fernando Mendonça Diz, Liliana Rockenbach, Fernanda Bueno Morrone
Frontiers in Oncology.2021;[Epub] CrossRef
The Combination of Radiotherapy With Immunotherapy and Potential Predictive Biomarkers for Treatment of Non-Small Cell Lung Cancer Patients
Lu Meng, Jianfang Xu, Ying Ye, Yingying Wang, Shilan Luo, Xiaomei Gong
Frontiers in Immunology.2021;[Epub] CrossRef
Explore association of genes in PDL1/PD1 pathway to radiotherapy survival benefit based on interaction model strategy
Junjie Shen, Jingfang Liu, Huijun Li, Lu Bai, Zixuan Du, Ruirui Geng, Jianping Cao, Peng Sun, Zaixiang Tang
Radiation Oncology.2021;[Epub] CrossRef
Combination of Radiosensitivity Gene Signature and PD-L1 Status Predicts Clinical Outcome of Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma: A Study Based on The Cancer Genome Atlas Dataset
Dongjun Dai, Yinglu Guo, Yongjie Shui, Jinfan Li, Biao Jiang, Qichun Wei
Frontiers in Molecular Biosciences.2021;[Epub] CrossRef
Prognostic Values of Radiosensitivity Genes and CD19 Status in Gastric Cancer: A Retrospective Study Using TCGA Database

Li-Bo Liang, Xin-Yan Huang, He He, Ji-Yan Liu
Pharmacogenomics and Personalized Medicine.2020; Volume 13: 365. CrossRef
Gene signature based on B cell predicts clinical outcome of radiotherapy and immunotherapy for patients with lung adenocarcinoma
Linzhi Han, Hongjie Shi, Yuan Luo, Wenjie Sun, Shuying Li, Nannan Zhang, Xueping Jiang, Yan Gong, Conghua Xie
Cancer Medicine.2020; 9(24): 9581. CrossRef

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Carcinoembryonic Antigen Improves the Performance of Magnetic Resonance Imaging in the Prediction of Pathologic Response after Neoadjuvant Chemoradiation for Patients with Rectal Cancer: Gyu Sang Yoo, Hee Chul Park, Jeong Il Yu, Doo Ho Choi, Won Kyung Cho, Young Suk Park, Joon Oh Park, Ho Yeong Lim, Won Ki Kang, Woo Yong Lee, Hee Cheol Kim, Seong Hyeon Yun, Yong Beom Cho, Yoon Ah Park, Kyoung Doo Song, Seok-Hyung Kim, Sang Yun Ha; Cancer Res Treat. 2020;52(2):446-454. Published online September 25, 2019; DOI: https://doi.org/10.4143/crt.2019.261

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to investigate the role of carcinoembryonic antigen (CEA) levels in improving the performance of magnetic resonance imaging (MRI) for the prediction of pathologic response after the neoadjuvant chemoradiation (NCRT) for patients with rectal cancer.
Materials and Methods
We retrospectively reviewed the medical records of 524 rectal cancer patients who underwent NCRT and total mesorectal excision between January 2009 and December 2014. The performances of MRI with or without CEA parameters (initial CEA and CEA dynamics) for prediction of pathologic tumor response grade (pTRG) were compared by receiver-operating characteristic analysis with DeLong’s method. Cox regression was used to identify the independent factors associated to pTRG and disease-free survival (DFS) after NCRT.
Results
The median follow-up was 64.0 months (range, 3.0 to 113.0 months). On multivariate analysis, poor tumor regression grade on MRI (mrTRG; p < 0.001), initial CEA (p < 0.001) and the mesorectal fascia involvement on MRI before NCRT (mrMFI; p=0.054) showed association with poor pTRG. The mrTRG plus CEA parameters showed significantly improved performances in the prediction of pTRG than mrTRG alone. All of mrTRG, mrMFI, and initial CEA were also identified as independent factors associated with DFS. The initial CEA further discriminated DFS in the subgroups with good mrTRG or that without mrMFI.
Conclusion
The CEA parameters significantly improved the performance of MRI in the prediction of pTRG after NCRT for patients with rectal cancer. The DFS was further discriminated by initial CEA level in the groups with favorable MRI parameters.

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Clinical outcomes of neoadjuvant chemoradiotherapy followed by total mesorectal excision in locally advanced rectal cancer with mesorectal fascia involvement
Jeong Ha Lee, Nalee Kim, Jeong Il Yu, Gyu Sang Yoo, Hee Chul Park, Woo-Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jung Kyong Shin, Joon Oh Park, Seung Tae Kim, Young Suk Park, Jeeyun Lee, Won Ki Kang
Radiation Oncology Journal.2024; 42(2): 130. CrossRef
Predicting the response to neoadjuvant chemoradiation for rectal cancer using nomograms based on MRI tumour regression grade
S. Qin, Y. Chen, K. Liu, Y. Li, Y. Zhou, W. Zhao, P. Xin, Q. Wang, S. Lu, H. Wang, N. Lang
Cancer/Radiothérapie.2024; 28(4): 341. CrossRef
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Jianguo Yang, Qican Deng, Zhenzhou Chen, Yajun Chen, Zhongxue Fu
Frontiers in Oncology.2023;[Epub] CrossRef
Pretreatment blood biomarkers combined with magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Xinyu Shi, Min Zhao, Bo Shi, Guoliang Chen, Huihui Yao, Junjie Chen, Daiwei Wan, Wen Gu, Songbing He
Frontiers in Oncology.2022;[Epub] CrossRef
Clinical implication and management of rectal cancer with clinically suspicious lateral pelvic lymph node metastasis: A radiation oncologist’s perspective
Gyu Sang Yoo, Hee Chul Park, Jeong Il Yu
Frontiers in Oncology.2022;[Epub] CrossRef
High-Resolution T2-Weighted MRI to Evaluate Rectal Cancer: Why Variations Matter
Kirsten L Gormly
Korean Journal of Radiology.2021; 22(9): 1475. CrossRef
MRI Assessment of Complete Response to Preoperative Chemoradiation Therapy for Rectal Cancer: 2020 Guide for Practice from the Korean Society of Abdominal Radiology
Seong Ho Park, Seung Hyun Cho, Sang Hyun Choi, Jong Keon Jang, Min Ju Kim, Seung Ho Kim, Joon Seok Lim, Sung Kyoung Moon, Ji Hoon Park, Nieun Seo
Korean Journal of Radiology.2020; 21(7): 812. CrossRef

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High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity: Ji Hyun Hong, Yeon-Sil Kim, Sea-Won Lee, So Jung Lee, Jin Hyung Kang, Suk Hee Hong, Ju-Young Hong, GeumSeong Cheon; Cancer Res Treat. 2019;51(3):1156-1166. Published online November 29, 2018; DOI: https://doi.org/10.4143/crt.2018.472

Abstract PDF PubReader ePub

Purpose
Thoracic re-irradiation (re-RT) of lung cancer has been challenged by the tolerance doses of normal tissues. We retrospectively analyzed local control, overall survival (OS) and toxicity after thoracic re-RT using highly conformal radiotherapy, such as intensity modulated radiotherapy and stereotactic body radiotherapy.
Materials and Methods
Thirty-one patients who received high-dose thoracic re-RT were analyzed. Doses were recalculated to determine biologically equivalent doses. The median interval to re-RT was 15.1 months (range, 4.4 to 56.3 months), the median initial dose was 79.2 Gy₁₀ (range, 51.75 to 150 Gy₁₀), and the median re-RT dose was 68.8 Gy₁₀ (range, 43.2 to 132 Gy₁₀).
Results
Eighteen (58.1%) and eleven (35.5%) patients showed loco-regional recurrence and distant metastasis, respectively, after 17.4 months of median follow-up. The 1-year and 2-year local control rates were 60.2% and 43.7%, respectively. The median loco-regional recurrence-free-survival (LRFS) was 15.4 months, and the median OS was 20.4 months. The cumulative and re-RT biologically equivalent dose for α/β=10 (BED₁₀) doses were the most significant prognostic factors. Cumulative BED₁₀≥145 Gy₁₀ and re-RT BED₁₀≥68.7 Gy₁₀ were significantly associated with longer OS (p=0.029 and p=0.012, respectively) and LRFS (p=0.003 and p=0.000, respectively). The most frequent acute toxicity was grade 1-2 pulmonary toxicity (41.9%). No acute grade 3 or higher toxicities occurred.
Conclusion
Our results show that high-dose thoracic re-RT of lung cancer can be safely delivered using highly conformal radiotherapy with favorable survival and acceptable toxicity. An optimal strategy to select patients who would benefit from re-RT is crucial in extending the indications and improving the efficacy with a sufficiently high dose.

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Comparison of Breast Conserving Surgery Followed by Radiation Therapy with Mastectomy Alone for Pathologic N1 Breast Cancer Patients in the Era of Anthracycline Plus Taxane-Based Chemotherapy: A Multicenter Retrospective Study (KROG 1418): Gyu Sang Yoo, Won Park, Jeong Il Yu, Doo Ho Choi, Yeon-Joo Kim, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung-Sik Lee, Jung Soo Kim, Jihye Cha; Cancer Res Treat. 2019;51(3):1041-1051. Published online November 1, 2018; DOI: https://doi.org/10.4143/crt.2018.424

Abstract PDF PubReader ePub

Purpose
We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy.
Materials and Methods
We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups.
Results
The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly.
Conclusion
There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.

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Investigation of the clinical benefits of regular breath-holding training utilizing surface guided radiation therapy technology for patients with left breast cancer
Hongming Li, Zheng Miao, Jie Shen, Jianing Xiao, Zhiwei Yang, Wei Tian, Xiansong Sun, Zhen Zhou, Jing Shen, Jie Qiu
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21-gene recurrence score in predicting the outcome of postoperative radiotherapy in T1-2N1 luminal breast cancer after breast-conserving surgery
Shang-Jin Xie, Run-Jie Wang, San-Gang Wu, Fu-Xing Zhang
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Assessing Radiation Effects on Chemo-Treated BT20 and 4T1 Breast Cancer, and Neuroblastoma Cell Lines: A Study of Single and Multiple-Cell Ionization via Infrared Laser Trapping
Mulugeta S. Goangul, Daniel B. Erenso, Ying Gao, Li Chen, Kwame O. Eshun, Gisela Alvarez, Horace T. Crogman
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Overall survival after mastectomy versus breast-conserving surgery with adjuvant radiotherapy for early-stage breast cancer: meta-analysis
Kiran K Rajan, Katherine Fairhurst, Beth Birkbeck, Shonnelly Novintan, Rebecca Wilson, Jelena Savović, Chris Holcombe, Shelley Potter
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Radiotherapy dosimetry and radiotherapy related complications of immediate implant-based reconstruction after breast cancer surgery
Yu Zhang, Fuxiu Ye, Yun Teng, Jin Zheng, Chunlu Li, Ruilan Ma, Haichen Zhang
Frontiers in Oncology.2023;[Epub] CrossRef
Does Breast-Conserving Surgery with Radiotherapy have a Better Survival than Mastectomy? A Meta-Analysis of More than 1,500,000 Patients
Gabriel De la Cruz Ku, Manish Karamchandani, Diego Chambergo-Michilot, Alexis R. Narvaez-Rojas, Michael Jonczyk, Fortunato S. Príncipe-Meneses, David Posawatz, Salvatore Nardello, Abhishek Chatterjee
Annals of Surgical Oncology.2022; 29(10): 6163. CrossRef
Protocol for the postoperative radiotherapy in N1 breast cancer patients (PORT-N1) trial, a prospective multicenter, randomized, controlled, non-inferiority trial of patients receiving breast-conserving surgery or mastectomy
Tae Hoon Lee, Ji Hyun Chang, Bum-Sup Jang, Jae Sik Kim, Tae Hyun Kim, Won Park, Yong Bae Kim, Su Ssan Kim, Wonshik Han, Han-Byoel Lee, Kyung Hwan Shin
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Risk factors to identify the indication for regional nodal irradiation in T1-2N1M0 breast cancer: A joint analysis of 4,243 real-world cases from two institutions
Guang-Yi Sun, Ge Wen, Yu-Jing Zhang, Yu Tang, Hao Jing, Hui Fang, Jian-Yang Wang, Jiang-Hu Zhang, Xu-Ran Zhao, Si-Ye Chen, Yong-Wen Song, Jing Jin, Yue-Ping Liu, Yuan Tang, Shu-Nan Qi, Ning Li, Bo Chen, Ning-Ning Lu, Ye-Xiong Li, Shu-Lian Wang
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Endris Muhammed, Li Chen, Ying Gao, Daniel Erenso
Scientific Reports.2019;[Epub] CrossRef

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Risk Assessment of Secondary Primary Malignancies in Nasopharyngeal Carcinoma: A Big-Data Intelligence Platform-Based Analysis of 6,377 Long-term Survivors from an Endemic Area Treated with Intensity-Modulated Radiation Therapy during 2003-2013: Lu-Lu Zhang, Guo-Hong Li, Yi-Yang Li, Zhen-Yu Qi, Ai-Hua Lin, Ying Sun; Cancer Res Treat. 2019;51(3):982-991. Published online October 11, 2018; DOI: https://doi.org/10.4143/crt.2018.298

Abstract PDF PubReader ePub

Purpose
The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized.
Methods
and Materials Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT±chemotherapy between January 2003 and June 2013 were retrospectively analyzed. Cumulative incidence of SPMs was calculated using the Kaplan-Meier method. Cox proportional hazards model was used to identify potential risk factors for SPMs and assess whether SPMs affect overall survival.
Results
Of the 6,377 patients, 189 (3.0%) suffered SPMs (median follow-up, 62 months). One-, 2-, 3-, 4-, and 5-cumulative risks of SPMs were 0.4%, 0.9%, 1.6%, 2.2%, and 2.6%, respectively. Latency from start of IMRT to SPMs diagnosis was 37 months (range, 6 to 102 months). In patients with SPMs, 14.3% suffered SPMs within 1 year post-IMRT: 1-3 years, 38.1%; 3-5 years, 33.9%; and >5 years, 13.7%. Lung cancer was the most common SPM (50/6,377, 0.78%). Multivariate analysis demonstrated sex (male, 64% increase), age (≥50 years, 68% increase), and smoking history (41% increase) were significant risk factors for SPMs, and SPMs were associated with poorer overall survival.
Conclusion
This large cohort study confirms SPMs a dreadful complication for long-term survivors of NPC treated with IMRT. SPMs negatively impact overall survival in NPC. Close follow-up is recommended for older male survivors with a smoking history.

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Long-term results of locoregionally advanced nasopharyngeal carcinoma treated with cisplatin and 5-fluorouracil induction chemotherapy with or without docetaxel in young and middle aged adults
Yuming Zheng, Fen Xue, Dan Ou, Xiaoshuang Niu, Chaosu Hu, Xiayun He
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Age-specific characteristics of head and neck second primary malignancies in patients treated for nasopharyngeal carcinoma: a retrospective study
Q. Jiang, T. Xu, M. Zeng, Y. He, Y. Cai, Z. Huang
International Journal of Oral and Maxillofacial Surgery.2024; 53(1): 11. CrossRef
The prevalence of gastroesophageal reflux disease and laryngopharyngeal reflux in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma
Peter K. M. Ku, Alexander C. Vlantis, Thomas S. C. Hui, Zenon W. C. Yeung, Ryan H. W. Cho, Marc H. K. Wong, Alex K. F. Lee, David C. M. Yeung, Simon Y. P. Chan, Becky Y. T. Chan, Wai‐tsz Chang, Florence Mok, Kam‐hung Wong, Jeffrey K. T. Wong, Victor Abdul
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Maxillary sinus anterior wall recurrence after intensity-modulated radiotherapy for nasopharyngeal carcinoma
Y Fang, L Wang, X Chen, C Cao
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Detection and staging of recurrent or metastatic nasopharyngeal carcinoma in the era of FDG PET/MR
Yongfeng Piao, Caineng Cao, Yuanfan Xu, Shuang Huang, Feng Jiang, Ting Jin, Qifeng Jin, Yonghong Hua, Qiaoying Hu, Xiaozhong Chen
European Archives of Oto-Rhino-Laryngology.2022; 279(1): 353. CrossRef
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Fen Xue, Xiaoshuang Niu, Chaosu Hu, Xiayun He
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Qian Wang, Hui Xie, Yannan Li, Nicholas Theodoropoulos, Yaning Zhang, Changchuan Jiang, Chi Wen, Laura S. Rozek, Paolo Boffetta
International Journal of Cancer.2022; 151(8): 1291. CrossRef
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Inmaculada Salcedo‐Bellido, Pilar Requena, Rocío Mateos, Carmen Ortega‐Rico, Rocío Olmedo‐Requena, Macarena Lozano‐Lorca, Juan Pedro Arrebola, Rocío Barrios‐Rodríguez
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Nasopharyngeal carcinoma: an evolving paradigm
Kenneth C. W. Wong, Edwin P. Hui, Kwok-Wai Lo, Wai Kei Jacky Lam, David Johnson, Lili Li, Qian Tao, Kwan Chee Allen Chan, Ka-Fai To, Ann D. King, Brigette B. Y. Ma, Anthony T. C. Chan
Nature Reviews Clinical Oncology.2021; 18(11): 679. CrossRef
The Chinese Society of Clinical Oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma
Ling‐Long Tang, Yu‐Pei Chen, Chuan‐Ben Chen, Ming‐Yuan Chen, Nian‐Yong Chen, Xiao‐Zhong Chen, Xiao‐Jing Du, Wen‐Feng Fang, Mei Feng, Jin Gao, Fei Han, Xia He, Chao‐Su Hu, De‐sheng Hu, Guang‐Yuan Hu, Hao Jiang, Wei Jiang, Feng Jin, Jin‐Yi Lang, Jin‐Gao Li,
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Chao Liu, Lieqiang Liao, Guoying Wu, Honghong Yan, Xiaoqi Chen, Chao Wang, Xiajing Zheng, Ziyi Zeng, Zheng Zhao, Di Wu, Xuekui Liu
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James C.H. Chow, Anthony H.P. Tam, Ka-Man Cheung, Victor H.F. Lee, Chi-Leung Chiang, Macy Tong, Edwin C.Y. Wong, Alice K.W. Cheung, Sunny P.C. Chan, Jessica W.Y. Lai, Roger K.C. Ngan, Wai-Tong Ng, Anne W.M. Lee, Kwok-Hung Au
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Salvage Concurrent Chemo-radiation Therapy for Loco-regional Recurrence Following Curative Surgery of Non-small Cell Lung Cancer: Kyung Hwa Lee, Yong Chan Ahn, Hongryull Pyo, Jae Myoung Noh, Seung Gyu Park, Tae Gyu Kim, Eonju Lee, Heerim Nam, Hyebin Lee, Jong-Mu Sun, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park; Cancer Res Treat. 2019;51(2):769-776. Published online September 11, 2018; DOI: https://doi.org/10.4143/crt.2018.366

Abstract PDF PubReader ePub

Purpose
This study is to report clinical outcomes of salvage concurrent chemo-radiation therapy (CCRT) in treating patients with loco-regional recurrence (LRR) following initial complete resection of non-small cell lung cancer.
Materials and Methods
Between February 2004 and December 2016, 127 patients underwent salvage CCRT for LRR. The median radiation therapy (RT) dose was 66 Gy and clinical target volume was to cover recurrent lesion with margin without elective inclusion of regional lymphatics. Majority of patients (94.5%) received weekly platinum-based doublet chemotherapy during RT course.
Results
The median follow-up time from the start of CCRT was 25 months. The median survival duration was 49 months, and overall survival (OS) rates at 2 and 5 years were 72.9% and 43.9%. The 2- and 5-year rates of in-field failure-free survival, distant metastasis free survival, and progression free survival were 82.4% and 73.8%, 50.4% and 39.9%, and 34.6% and 22.3%, respectively. Grade ≥ 3 radiation-related esophagitis and pneumonitis occurred in 14 (11.0%) and six patients (4.7%), respectively. On both univariate and multivariate analysis, higher biologically equivalent dose (BED10) (≥ 79.2 Gy10 vs. < 79.2 Gy10; hazard ratio [HR], 0.431), smaller CTV (≤ 80 cm3 vs. > 80 cm3; HR, 0.403), and longer disease-free interval (> 1 year vs. ≤ 1 year; HR, 0.489) were significantly favorable factors for OS.
Conclusion
The current study has demonstrated that high dose salvage CCRT focused to the involved lesion only was highly effective and safe. In particular, higher BED₁₀, smaller CTV, and longer disease-free interval were favorable factors for improved survival.

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Feasibility of Selective Neck Irradiation with Lower Elective Radiation Dose in Treating Nasopharynx Cancer Patients: Won Kyung Cho, Dongryul Oh, Eonju Lee, Tae Gyu Kim, Hyebin Lee, Heerim Nam, Jae Myoung Noh, Yong Chan Ahn; Cancer Res Treat. 2019;51(2):603-610. Published online July 18, 2018; DOI: https://doi.org/10.4143/crt.2018.240

Abstract PDF PubReader ePub

Purpose
This study aimed to report the clinical outcomes following selective neck irradiation (SNI) with lower elective radiation therapy (RT) dose in treating nasopharyngeal cancer (NPC) patients.
Materials and Methods
A total of 347 NPC patients received definitive RT according to our SNI policy and were retrospectively analyzed. The clinical target volumes (CTVs) were subdivided into CTV at high risk (CTV-HR) and CTV at low risk (CTV-LR). The typical doses to gross tumor volume (GTV), CTV-HR, and CTV-LR were 68.4-70.0 Gy, 54.0-60.0 Gy, and 36.0 Gy.
Results
With the median follow-up of 68.1 months (range, 2.3 to 197.1 months), the 5-year rates of loco-regional control and progression-free survival in all the patients were 85.0% and 70.8%, respectively. Thirty patients developed regional failure and the regional control rates at 3 and 5 years were 92.6% and 91.4%, respectively. The sites of regional failure in relation to the target volume were exclusively inside GTV/CTV-HR in 20, inside and outside GTV/CTVHR in three, and exclusively outside GTV/CTV-HR in seven, which were 5.7%, 0.9%, and 2.0% of total patients, respectively.
Conclusion
The clinical outcomes by the current SNI policy were feasible and comparable to those following classic elective nodal irradiation policy.

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