International Journal of Clinical Oncology最新文献

{"title":"Benefits of PARP inhibitor rechallenge in patients with platinum-sensitive recurrent ovarian cancer previously treated with a PARP inhibitor: a multicenter retrospective study.","authors":"Ami Jo, Tadahiro Shoji, Ayaka Kitamura, Miku Musashi, Shunsuke Tatsuki, Nanako Jonai, Yohei Chiba, Sho Sato, Eriko Takatori, Yoshitaka Kaido, Takayuki Nagasawa, Masahiro Kagabu, Fumiaki Takahashi, Takeshi Aida, Tsukasa Baba","doi":"10.1007/s10147-026-03056-5","DOIUrl":"10.1007/s10147-026-03056-5","url":null,"abstract":"<p><strong>Background: </strong>Although poly (ADP-ribose) polymerase (PARP) inhibitor (PARPi) rechallenge has been explored for platinum-sensitive recurrent ovarian cancer, data in Japanese patients remain scarce. This retrospective study evaluated the safety and efficacy of PARPi rechallenge in this population.</p><p><strong>Patients and methods: </strong>Twenty-eight Japanese patients with ovarian cancer who experienced platinum-sensitive recurrence during or after PARPi therapy and subsequently responded to platinum-based chemotherapy were included. Olaparib and niraparib were administered as PARPi rechallenge in 19 and 9 patients, respectively. The primary endpoint was progression-free survival (PFS), and secondary endpoints were overall survival (OS) and adverse events (AEs).</p><p><strong>Results: </strong>The median follow-up period was 19 months (range, 3-47). Median PFS and OS in the overall population were 6 months (95% CI, 3-8) and 32 months (95% CI, 28-not reached), respectively. The median PFS for patients who had received two prior regimens was 6 months, compared with 5 months for those who had received three or more regimens, with no significant difference (P = 0.734). Grade ≥3 hematologic toxicities included neutropenia (n = 4), anemia (n = 7), and thrombocytopenia (n = 2). Non-hematologic toxicities included interstitial pneumonia, hypertension, and proteinuria, with one case each. No treatment-related deaths occurred.</p><p><strong>Conclusions: </strong>PARPi rechallenge in Japanese patients with platinum-sensitive recurrent ovarian cancer demonstrated a manageable safety profile but limited efficacy. Larger, prospective studies incorporating molecular stratification are required to better define the clinical role of PARPi rechallenge.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2158-2168"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excitation-light blocking filter for photoimmunotherapy tailored to the ORBEYE 4K 3D exoscope.","authors":"Ryuhei Okada, Hideki Kanebako, Ryosuke Takahashi, Taisei Nagahisa, Shigeru Kondo, Takaaki Sato, Tomoaki Asamori, Kazuchika Ohno, Michiko Machida, Takahiro Asakage","doi":"10.1007/s10147-026-03131-x","DOIUrl":"10.1007/s10147-026-03131-x","url":null,"abstract":"<p><strong>Background: </strong>Photoimmunotherapy, which involves combining targeted antibodies with light-activatable dyes such as IRDye700DX (IR700), is an emerging cancer treatment modality. Cetuximab-based photoimmunotherapy is approved for the treatment of unresectable head and neck cancer and has been covered by the national health insurance in Japan since 2021. Use of conventional ceiling surgical lighting during photoimmunotherapy is problematic due to concerns about potential cytotoxic effects.</p><p><strong>Methods: </strong>To ensure safe surgical application, we developed a custom short-pass filter for the ORBEYE surgical exoscope to block IR700 excitation light. The filter's impact on the color tone was evaluated using human skin and a color checker, while that on the cytotoxicity was assessed in vitro using cetuximab-IR700 and an HSC-3 cell line. The clinical feasibility of using this filter was tested in six patients who underwent short surgical procedures (e.g., tracheostomy, arterial ligation) during photoimmunotherapy.</p><p><strong>Results: </strong>Recalibrating the white balance after filter placement preserved the natural color tones. In vitro, the filter neutralized the significant cytotoxicity observed under the ORBEYE light. Clinically, the filter could be used safely in all cases with no evidence of postoperative skin damage.</p><p><strong>Conclusion: </strong>This filter system enhances the safety and feasibility of surgical procedures during photoimmunotherapy.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2243-2248"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paired tumor-normal targeted sequencing supports clonal independence of multiple primary malignancies in patients with gastrointestinal stromal tumors.","authors":"Yukiko Asakawa, Yosuke Hirotsu, Masao Omata","doi":"10.1007/s10147-026-03205-w","DOIUrl":"https://doi.org/10.1007/s10147-026-03205-w","url":null,"abstract":"<p><strong>Background: </strong>The association between gastrointestinal stromal tumors (GIST) and multiple primary malignancies (MPM) is recognized, but its molecular basis has not been investigated.</p><p><strong>Methods: </strong>The institutional registry recorded 26,783 patients diagnosed between October 2006 and December 2020, of whom 69 had GIST. Of these, 33 consented to genetic analysis under a prospective biospecimen-collection program. We compared clinicopathological characteristics between patients with and those without MPM. We performed paired tumor-normal targeted sequencing using an amplicon-based panel on GIST and MPM tissue from 18 patients, with matched peripheral blood as the germline reference.</p><p><strong>Results: </strong>MPM occurred in 19 of 69 GIST patients (27.5%), ranking fourth among eight cancer types, after gastric (31.5%), colorectal (29.8%) and esophageal cancer (28.4%) in our institutional registry. Older age was the only factor significantly associated with MPM (median 77.0 vs. 65.0 years; p = 0.007). Among the 33 patients who consented to genetic analysis, 19 had MPM and 18 were evaluable for paired tumor-normal sequencing. GISTs harbored KIT or PDGFRA mutations, whereas MPMs carried tumor type-specific driver alterations including TP53, APC, KRAS and PIK3CA. No shared somatic variants were detected within the limits of the targeted sequencing panel, supporting clonal independence between GIST and co-occurring malignancies irrespective of temporal classification.</p><p><strong>Conclusion: </strong>MPM frequently occur in patients with GIST and arise independently. Paired tumor-normal sequencing supports clonal independence between GIST and co-occurring malignancies in all evaluable cases, regardless of timing. Age-appropriate cancer screening and careful evaluation for gastrointestinal malignancies may be considered, particularly in older patients with GIST.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between CCM3 expression and angiogenesis in esophageal squamous cell carcinoma and its possible mechanism.","authors":"Muhammad Saud Tabish, Yiwei Li, Na Zhao, Yichen Hong, Jiao Shu, Chenbo Yang, Zexin Sun, Xiaonan Liu, Miaomiao Sun, Kuisheng Chen","doi":"10.1007/s10147-026-03132-w","DOIUrl":"10.1007/s10147-026-03132-w","url":null,"abstract":"<p><strong>Background: </strong>Angiogenesis is essential for esophageal squamous cell carcinoma (ESCC) progression, yet clinically actionable regulators remain limited. We investigated the expression, functional role, and mechanism of CCM3 in ESCC and its relationship with the HIF-1α/VEGFA angiogenic axis.</p><p><strong>Methods: </strong>CCM3, HIF-1α, VEGFA and microvessel density (MVD, CD31) were assessed by immunohistochemistry in 53 paired ESCC and adjacent non-cancerous tissues. CCM3 knockdown was optimized using four siRNAs in KYSE-70 and KYSE270 cells. CCM3 siRNA 1064-A was selected as the most effective and optimal knockdown achieved at 8 nM, 48 h. Tumor-conditioned HUVECs (referred to as tumor-conditioned endothelial cells, TECs) were generated using conditioned media from knockdown cells; TEC proliferation (CCK8), migration (scratch), invasion (Transwell) and tube formation were evaluated in vitro. A subcutaneous xenograft model using KYSE-70 cells was employed in vivo, followed by intratumoral silencing of CCM3 to assess tumour development, proliferation (Ki-67), and microvessel density (CD31).</p><p><strong>Results: </strong>High endogenous CCM3 expression was significantly upregulated in ESCC tissues compared to adjacent non-cancerous tissues and correlated with clinicopathological features like depth of invasion, lymph node metastasis and advanced stage. CCM3 expression positively correlated with HIF-1α and VEGFA. CCM3 knockdown siRNA 1064-A attenuates TEC proliferation, migration, invasion and tube formation in vitro. In vivo, CCM3 knockdown reduced tumor growth, tumor weight, Ki-67, CD31 staining and levels of HIF-1α and VEGFA.</p><p><strong>Conclusions: </strong>High endogenous CCM3 expression associates with aggressive ESCC clinicopathological features and angiogenesis markers. CCM3 knockdown inhibits tumor-conditioned endothelial function, xenograft growth, intratumoral vascularization, and HIF-1α/VEGFA expression, warranting further mechanistic investigation.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2191-2212"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-utility analysis of CAR-T therapy compared to standard of care in patients with relapsed/refractory diffuse large B-cell lymphoma in Colombia, 2025.","authors":"Alexandra Porras Ramírez, Alejandro Rico Mendoza, Liliana Encinales, Oscar Madiedo, María Fernanda Campos Maya, Juan Fernando Ramón Cuellar, Jorge Andres Urquijo Méndez","doi":"10.1007/s10147-026-03077-0","DOIUrl":"10.1007/s10147-026-03077-0","url":null,"abstract":"<p><strong>Background: </strong>Chimeric Antigen Receptor T-cell (CAR-T) therapy has changed the treatment landscape for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). Although its clinical effectiveness has been demonstrated, the cost of CAR-T is concerning, given its accessibility and sustainability, especially in countries with intermediate incomes such as Colombia.</p><p><strong>Objective: </strong>Assess the cost-utility of CAR-T therapy relative to conventional salvage chemotherapy from the perspective of the Colombian health system.</p><p><strong>Methods: </strong>A cost-utility analysis was performed using a state-transition (Markov) model with a 10-year horizon and monthly cycles. The costs were estimated from Colombian tariff manuals (ISS, SOAT), adjusted to 2025 values. Effectiveness was measured by quality-adjusted life-years (QALYs) from clinical trial data (ZUMA-1, JULIET) and literature-based utilities. Both costs and outcomes were discounted by 3% annually. Deterministic and probabilistic sensitivity analyses were performed.</p><p><strong>Results: </strong>The QALYs generated by CAR-T therapy were 4.5 versus 2.0 QALYs from standard chemotherapy, an incremental enhancement of 2.5 QALYs. Total costs were COP 1,825,000,000 for CAR-T and COP 14,825,906 for conventional treatment. The ICER obtained was COP 724,069,638/QALY, which is higher than commonly referenced Colombian willingness-to-pay (WTP) thresholds (COP 25-75 million/QALY). The sensitivity analyses validated that the cost of acquiring CAR-T is the primary driver of the ICER.</p><p><strong>Conclusion: </strong>CAR-T therapy gives substantial clinical benefits but is not cost-effective at current prices in Colombia. Affordability requires significant price reductions or alternative reimbursement strategies.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2169-2178"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encorafenib plus binimetinib for BRAF V600-mutated thyroid cancer in Japan: final analysis.","authors":"Iwao Sugitani, Naomi Kiyota, Hiroo Imai, Shunji Takahashi, Akihiro Nishiyama, Shingo Tamura, Yasushi Shimizu, Shigenori Kadowaki, Ken-Ichi Ito, Yoshinori Hirashima, Shinji Ueno, Teruaki Katayama, Makoto Tahara","doi":"10.1007/s10147-026-03129-5","DOIUrl":"10.1007/s10147-026-03129-5","url":null,"abstract":"<p><strong>Background: </strong>The combination of encorafenib plus binimetinib (ENC + BIN) is approved for the treatment of BRAF V600-mutated thyroid cancer in Japan, based on a phase 2 trial. We update the efficacy and safety data for ENC + BIN of this phase 2 trial after prolonged follow-up.</p><p><strong>Methods: </strong>This multicenter, open-label, uncontrolled phase 2 trial evaluated the efficacy and safety of ENC + BIN in patients with unresectable locally advanced or metastatic BRAF V600-mutated thyroid cancer that was not amenable to curative treatment, who were refractory/intolerant to ≥ 1 previous vascular endothelial growth factor receptor-targeted regimens, or were considered ineligible for these. The primary endpoint was the objective response rate (ORR). The secondary endpoints included progression-free survival (PFS) and overall survival (OS).</p><p><strong>Results: </strong>We enrolled 22 patients: 17 with differentiated thyroid carcinoma (DTC) and 5 with anaplastic thyroid carcinoma (ATC). During a prolonged period with a median follow-up of 28.7 months (range: 3.4-40.6), 3 additional patients with DTC achieved partial responses, increasing the ORR to 68.2% (15/22 patients with either DTC or ATC). Medians for PFS and OS were not reached for DTC and 17.7 and 24.3 months, respectively, for ATC. Common adverse events were eye disorder (5/12), infections and infestations (4/12), and skin and subcutaneous tissue disorder (4/12) after > 360 days; no new safety signals were identified during the extended follow-up period.</p><p><strong>Conclusions: </strong>With a > 24-month median follow-up, this analysis indicates that ENC + BIN provides sustained tumor responses in patients with BRAF V600-mutated thyroid cancer. The long-term safety profile is consistent with previous reports.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2223-2233"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain response after palliative-intent radiotherapy for pancreatic cancer: a systematic review.","authors":"Kenji Makita, Yuichi Hiroshima, Keiichi Takehana, Tetsuo Saito, Naoki Nakamura, Takeo Takahashi, Yoshiyuki Shioyama","doi":"10.1007/s10147-026-03163-3","DOIUrl":"10.1007/s10147-026-03163-3","url":null,"abstract":"<p><strong>Background: </strong>To date, no review has specifically focused on palliative-intent radiotherapy (RT) for pancreatic cancer (PC)-related pain. This study aimed to evaluate the pain response after palliative-intent RT for PC-related pain.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, Ichushi-Web, and the Cochrane Library for studies published between 1971 and 2024. Studies in which palliative-intent RT was administered for PC-related pain were included. Extracted Data were independently assessed by three reviewers.</p><p><strong>Results: </strong>Of the 629 studies identified through the database search, 11 met the inclusion criteria. The most frequently used palliative-intent RT schedules were 30 Gy in 10 fractions for conventional RT and 25 Gy in a single fraction for stereotactic body radiotherapy (SBRT). In addition, 8 Gy once weekly (24 Gy in 3 fractions) RT has also been reported. Because the methods used for pain assessment varied across the included studies, a meta-analysis was considered inappropriate. Pain associated with PC improved following palliative-intent conventional RT (pain response rate, 69-94%), palliative-intent SBRT (pain response rate, 53-90%), and 8 Gy once weekly RT (pain response rate, 80%). A few grade ≥ 3 gastrointestinal adverse events were reported (< 10%).</p><p><strong>Conclusion: </strong>Palliative-intent RT appears to be a promising approach for alleviating PC-related pain. However, the current evidence is heterogeneous in terms of target selection and dose-fractionations. Further studies, including randomized controlled trials, may help identify optimal treatment strategies.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2150-2157"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative prediction of vessels encapsulating tumor clusters in hepatocellular carcinoma based on CT findings and des-γ-carboxy prothrombin level.","authors":"Tomohiko Taniai, Koichiro Haruki, Megumi Shiraishi, Kenei Furukawa, Mitsuru Yanagaki, Kazutaka Gomisawa, Juha P Väyrynen, Yuto Yamahata, Munetoshi Akaoka, Masashi Tsunematsu, Shinji Onda, Atsushi Nara, Shinji Tanaka, Toru Ikegami","doi":"10.1007/s10147-026-03127-7","DOIUrl":"10.1007/s10147-026-03127-7","url":null,"abstract":"<p><strong>Background: </strong>Vessels encapsulating tumor clusters (VETC) has been associated with poor prognosis in hepatocellular carcinoma (HCC). However, the preoperative prediction of VETC remains insufficient. We established the VETC predictive score based on CT findings and clinical data in patients with HCC.</p><p><strong>Methods: </strong>A total of 209 patients were enrolled, and we investigated clinical features and computed tomography (CT) findings in patients with VETC-positive HCC. The preoperative VETC predictive score was established based on the odds ratios calculated by logistic regression analysis using identified predictive factors, and the accuracy of this score was investigated. The utility of VETC predictive score was validated in the validation cohort.</p><p><strong>Results: </strong>VETC-positive HCC was associated with higher protein induced by des-γ-carboxy prothrombin (DCP) level (p = 0.03), larger tumor size (p < 0.01), intratumor necrosis (p < 0.01), and intratumor vessels (p < 0.01), and the VETC predictive score was established using these variables. The positive rate of VETC was significantly higher in the score-high group compared to the score-low group (60% vs. 27%, p < 0.01). Patients with high scores showed higher DCP level (p < 0.01), moderate/poor differentiation (p < 0.01), larger tumor (p < 0.01), microvascular invasion (p < 0.01), VETC-positivity (p < 0.01), lower densities of CD8⁺ cells in center of tumor and invasive margin (p < 0.01, and p < 0.01, respectively), intratumor necrosis (p < 0.01), and intratumor vessels (p < 0.01). In the validation cohort, the high VETC predictive score was associated with VETC-positivity (54% vs. 20%, p < 0.01).</p><p><strong>Conclusion: </strong>The VETC predictive score based on CT and DCP is useful, and preoperative diagnosis of VETC may contribute to optimized treatment management for HCC.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2249-2259"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderately hypofractionated intensity-modulated radiation therapy for intermediate- or high-risk prostate cancer: five-year results from a single-institution study in Japan.","authors":"Wataru Anno, Shuri Aoki, Hiroaki Kunogi, Yasuhiro Ogura, Tatsuya Kamima, Takuyo Kozuka, Noboru Numao, Takeshi Ebara, Junji Yonese, Yasuo Yoshioka","doi":"10.1007/s10147-026-03125-9","DOIUrl":"10.1007/s10147-026-03125-9","url":null,"abstract":"<p><strong>Background: </strong>Moderately hypofractionated radiotherapy has become a preferred option for localized prostate cancer based on multiple randomized trials demonstrating non‑inferiority to conventional fractionation. However, its adoption in Japan has been slower, partly due to limited domestic evidence. This study evaluated long‑term outcomes, toxicity, and dose-volume predictors of late gastrointestinal (GI) toxicity in patients treated with a uniform moderately hypofractionated regimen.</p><p><strong>Methods: </strong>We retrospectively analyzed 486 consecutive patients treated with intensity‑modulated radiation therapy (IMRT) delivering 70 Gy in 28 fractions between 2010 and 2023. Biochemical relapse‑free survival (bRFS) was assessed using the Phoenix definition. Toxicities were graded using CTCAE v5.0. Dose-volume histogram (DVH) parameters were extracted for all patients, and associations with grade ≥ 2 late GI toxicity were examined using receiver‑operating characteristic (ROC) curves.</p><p><strong>Results: </strong>With a median follow‑up of 62 months, 5‑year bRFS rates were 100% for favorable intermediate‑risk, 98% for unfavorable intermediate‑risk, 97% for high‑risk, and 75% for very high‑risk disease. Acute grade ≥ 2 genitourinary (GU) and GI toxicities occurred in 29% and 3.1% of patients, while late grade ≥ 2 GU and GI toxicities occurred in 13% and 2.8%. Hydrogel spacers (used in 27% of patients) improved rectal DVH parameters and numerically reduced late GI toxicity. Rectal V40Gy, V50Gy, and V60Gy were strongly associated with late GI toxicity, and ROC analyses confirmed their predictive value.</p><p><strong>Conclusions: </strong>Moderately hypofractionated IMRT using 70 Gy in 28 fractions provides excellent biochemical control with low toxicity in real‑world practice. These findings support the use of moderate hypofractionation in Japan.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2260-2270"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of salvage hepatectomy for local recurrence of hepatocellular carcinoma after radiofrequency ablation or selective transarterial chemoembolization.","authors":"Yukako Takehara, Yu Saito, Yuji Morine, Shinichiro Yamada, Hiroki Teraoku, Yuhei Waki, Tetsuya Ikemoto, Mitsuo Shimada","doi":"10.1007/s10147-026-03141-9","DOIUrl":"10.1007/s10147-026-03141-9","url":null,"abstract":"<p><strong>Background: </strong>Local recurrence of hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) or selective transarterial chemoembolization (sTACE) is relatively common. This study aimed to examine salvage hepatectomy as a treatment of such recurrences.</p><p><strong>Methods: </strong>We retrospectively analyzed 382 patients who underwent up-front hepatectomy for treatment of HCC and 44 patients who underwent salvage hepatectomy for treatment of local recurrence after RFA or sTACE. Propensity score matching analysis was performed to account for group differences.</p><p><strong>Results: </strong>Mean time between the initial treatment and salvage hepatectomy was 3.5 ± 3.0 years. At the time of salvage hepatectomy, macroscopic vessel invasion was present in 15 patients (34.1%) and mean tumor size was significantly larger (3.0 ± 1.7 cm vs. 2.4 ± 1.1 cm; p = 0.097). Propensity score matching resulted in 33 matched pairs. After matching, 5-year overall survival did not significantly differ between the salvage and up-front hepatectomy groups. Multivariate analysis in the salvage hepatectomy group showed that serum α-fetoprotein concentration > 100 ng/mL was the only independent predictor of overall and disease-free survival.</p><p><strong>Conclusions: </strong>Salvage hepatectomy appears to be feasible for selected patients with local recurrence of HCC after RFA or sTACE.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2374-2381"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}