Radiation Oncology Journal最新文献

{"title":"Less is more: level IB-sparing radiation therapy in nasopharyngeal cancer.","authors":"Dongryul Oh","doi":"10.3857/roj.2023.00199","DOIUrl":"https://doi.org/10.3857/roj.2023.00199","url":null,"abstract":"pharynx. There are three pathological subtypes of NPC: keratinizing squamous, non-keratinizing, and basal squamous. Overall, NPC accounts for approximately 0.7% of all cancers worldwide [1]. The incidence of NPC varies significantly with geographic location, with the highest incidence in Southeast Asia and North Africa. According to an annual report on cancer statistics in Korea, the incidence of NPC is approximately 0.2% of all cancer cases [2]. In 2019, 416 new cases of NPC were detected in Korea. Radiotherapy (RT), either alone or in combination with chemotherapy, is the standard treatment for localized NPC. RT targets the gross tumor volume (GTV) of the primary tumor, metastatic lymph nodes (LN), and risk areas, considering the tumor spread patterns. Primary tumors of the nasopharynx tend to invade the surrounding soft tissues and bones, and spread along several foramina of the skull base. Cervical LN metastasis is widespread, with 60%–90% of patients present with LN metastasis at diagnosis [3]. The pattern of cervical LN metastasis in NPC is predictable and ordered. Skip metastasis is rare, with a risk of 0.5% to 2.7% [4,5]. Level II and lateral retropharyngeal LNs are the most commonly involved areas, followed by levels III, VA, and IV. As the nasopharynx is a midline structure, the efferents of lymphatics draining the central location often reach lymph nodes on both sides, resulting in bilateral lymph node metastases in the neck. This is particularly common in NPC, affecting up to 50% of patients. Traditionally, radiation targets routinely included the primary tumor, retropharyngeal area, and whole neck bilaterally. The Radiation Therapy Oncology Group 0225 protocol [6] and an institution in Hong Kong [7] routinely include bilateral level I to V LNs. This was based on the pattern of LN metastases, the radiation field of the conventional two-dimensional RT technique, and the use of less accurate imaging. In contrast, with more advanced imaging methods available, such as magnetic resonance imaging (MRI) and positron emission tomography/computed tomography, LN metastases more easily and accurately detected [8]. Intensity-modulated RT (IMRT) is now the standard technique. IMRT delivers a more precise and conformed radiation dose, allowing irradiation of the selected target volume. In the era of precision medicine, the routine use of traditional RT for the treatment of NPC is currently being challenged due to advancements in diagnostic and therapeutic techniques. As target volume delineation has become more sophisticated, evidence-based consensus guidelines for target volumes in NPC have been suggested [9]. In addition, the accumulated tumor control and failure pattern data, after selected target volume irradiation, have led to significant advances in Less is more: level IB-sparing radiation therapy in nasopharyngeal cancer","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"41 1","pages":"1-3"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/06/72/roj-2023-00199.PMC10073842.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9256473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low body mass index is associated with poor treatment outcome following radiotherapy in esophageal squamous cell carcinoma.","authors":"Ji-Young Lee,&nbsp;Yunseon Choi","doi":"10.3857/roj.2022.00640","DOIUrl":"https://doi.org/10.3857/roj.2022.00640","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to determine whether patients with esophageal cancer with a low baseline body mass index (BMI) have a poor prognosis following radiotherapy (RT).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed data from 50 patients with esophageal cancer to determine whether a low starting BMI (before RT) was associated with a poor outcome. All study participants were diagnosed with non-metastatic esophageal squamous cell carcinoma (SCC).</p><p><strong>Results: </strong>The number of patients at each T stage were as follows: 7 (14%) patients at T1, 18 (36%) at T2, 19 (38%) at T3, and 6 (12%) at T4. Based on BMI, 7 (14%) patients were defined as underweight. A low BMI was common in patients with T3/T4 stage esophageal cancer (7/43, p = 0.01). Overall, the 3-year progression-free survival (PFS) and overall survival (OS) rates were 26.3% and 69.2%, respectively. In univariate analysis, clinical factors associated with poor PFS included being underweight (BMI <18.5 kg/m2; p = 0.011) and a positive N status (p = 0.017). Univariate analysis also revealed that being underweight was associated with a decrease in OS (p = 0.003). However, being underweight was not an independent prognostic factor for PFS and OS.</p><p><strong>Conclusion: </strong>Patients with esophageal SCC with a low starting BMI (BMI <18.5 kg/m2) are more prone to have a negative survival outcome following RT than patients who are considered to be normal weight or overweight. For this reason, it is important that clinicians pay more attention to BMI when treating patients with esophageal SCC.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"41 1","pages":"40-47"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/95/roj-2022-00640.PMC10073840.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9256479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excluding prepontine cistern from whole ventricle radiotherapy target volume in localized germinoma.","authors":"Hyejo Ryu,&nbsp;Joo Ho Lee","doi":"10.3857/roj.2023.00031","DOIUrl":"https://doi.org/10.3857/roj.2023.00031","url":null,"abstract":"<p><strong>Purpose: </strong>The target delineation of whole ventricle radiotherapy (WVRT) in germinoma varies among radiation oncologists, especially regarding the inclusion of the prepontine cistern (PC). We evaluated the outcome of PC-sparing WVRT in localized germinoma.</p><p><strong>Materials and methods: </strong>We identified 87 localized intracranial germinoma patients who received radiotherapy (RT) following chemotherapy between 1999 and 2020. By institutional policy, RT for localized germinoma excluded PC from the target volume. WVRT was delivered to 65 patients (74.7%) and involved field radiotherapy (IFRT) to 22 patients (25.3%). The median dose was 45.0 Gy (range, 23.4 to 55.8 Gy) for the primary tumor and 19.8 Gy (rangem 14.4 to 36.0 Gy) for the whole ventricle. We analyzed the dosimetric differences of the organs at risk between the PC-excluding plans and the PC-including ones.</p><p><strong>Results: </strong>The median follow-up duration was 7.8 years (range, 1.0 to 22.5 years). The 10-year recurrence-free survival and overall survival rates were 86.3% and 90.9%, respectively. The recurrences occurred in eight patients (8.7%), including five patients after IFRT and three after WVRT. Five of them showed recurrences at lateral ventricles and only one patient experienced spinal cord relapse. However, no relapse in the PC occurred. Endoscopic third ventriculostomy was not a significant prognostic factor. The dosimetric comparisons showed significantly lower mean doses to the brainstem and the cochleae when the PC was excluded.</p><p><strong>Conclusion: </strong>WVRT for localized germinoma can safely exclude the PC in the target volume, reducing radiation dose to the brain stem. The target protocol needs to reach a consensus regarding the PC in prospective trials.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"41 1","pages":"48-57"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/5c/roj-2023-00031.PMC10073837.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9256480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A practical review of watch-and-wait approach in rectal cancer.","authors":"Hwa Kyung Byun,&nbsp;Woong Sub Koom","doi":"10.3857/roj.2023.00038","DOIUrl":"https://doi.org/10.3857/roj.2023.00038","url":null,"abstract":"<p><p>Rectal resection surgery after neoadjuvant treatment has been the mainstay treatment of locally advanced rectal cancer. However, functional outcomes and quality of life after radical resection of the rectum remain suboptimal. The excellent oncologic outcomes in patients who achieved pathologic complete response after neoadjuvant treatment questioned the need for radical surgery. The watch-and-wait approach is a noninvasive therapeutic alternative for organ preservation and avoiding operative morbidity. In the watch-and-wait approach, patients with locally advanced rectal cancer who achieve excellent clinical response after neoadjuvant treatment undergo active surveillance rather than rectal cancer surgery. In this practical review, we summarized the main results of studies on the watch-and-wait approach and provided a practical method for implementing the watch-and-wait approach.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"41 1","pages":"4-11"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/d4/roj-2023-00038.PMC10073843.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9256478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liquid biopsy using cfDNA to predict radiation therapy response in solid tumors.","authors":"Won Kyung Cho,&nbsp;Junnam Lee,&nbsp;Sung-Min Youn,&nbsp;Dongryul Oh,&nbsp;Do Hoon Lim,&nbsp;Han Gyul Yoon,&nbsp;Eun-Hae Cho,&nbsp;Jae Myoung Noh","doi":"10.3857/roj.2022.00444","DOIUrl":"https://doi.org/10.3857/roj.2022.00444","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored the potential feasibility of cell-free DNA (cfDNA) in monitoring treatment response through the measurement of chromosomal instabilities using I-scores in the context of radiation therapy (RT) for other solid tumors.</p><p><strong>Materials and methods: </strong>This study enrolled 23 patients treated with RT for lung, esophageal, and head and neck cancer. Serial cfDNA monitoring was performed before RT, 1 week after RT, and 1 month after RT. Low-depth whole-genome sequencing was done using Nano kit and NextSeq 500 (Illumina Inc.). To measure the extent of genome-wide copy number instability, I-score was calculated.</p><p><strong>Results: </strong>Pretreatment I-score was elevated to more than 5.09 in 17 patients (73.9%). There was a significant positive correlation between the gross tumor volume and the baseline I-score (Spearman rho = 0.419, p = 0.047). The median I-scores at baseline, post-RT 1 week (P1W), and post-RT 1 month (P1M) were 5.27, 5.13, and 4.79, respectively. The I-score at P1M was significantly lower than that at baseline (p = 0.002), while the difference between baseline and P1W was not significant (p = 0.244).</p><p><strong>Conclusion: </strong>We have shown the feasibility of cfDNA I-score to detect minimal residual disease after RT in patients with lung cancer, esophageal cancer, and head and neck cancer. Additional studies are ongoing to optimize the measurement and analysis of I-scores to predict the radiation response in cancer patients.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"41 1","pages":"32-39"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/a0/roj-2022-00444.PMC10073841.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9270983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral blood lymphocyte changes after stereotactic ablative body radiotherapy to lung or liver metastases in patients with oligometastatic cancers.","authors":"Sergey Nikolaevich Novikov,&nbsp;Irina Aleksandrovna Baldueva,&nbsp;Anton Yurievich Zozulya,&nbsp;Natalya Viktorovna Emelyanova,&nbsp;Dmitriy Viktorovich Girdyuk,&nbsp;Andrey Ivanovich Arsenyev,&nbsp;Elena Alexandrovna,&nbsp;Elena Ivanovna Tyuryaeva,&nbsp;E I Filip Evgenevich Antipov,&nbsp;Mikhail Markovich Girshovich,&nbsp;Sergey Vasilevich Kanayev","doi":"10.3857/roj.2022.00521","DOIUrl":"https://doi.org/10.3857/roj.2022.00521","url":null,"abstract":"<p><strong>Purpose: </strong>To perform the analysis of the peripheral blood lymphocyte changes after stereotactic ablative radiotherapy (SABR) in patients with oligometastatic cancers.</p><p><strong>Materials and methods: </strong>The dynamics of the immune status in peripheral blood was prospectively evaluated in 46 patients with lung (17 cases) or liver (29 cases) metastases treated by SABR. Flow cytometry of peripheral blood lymphocyte subpopulations was performed before SABR, 3-4 weeks and 6-8 weeks after the end of SABR: 3 fractions of 15-20 Gy or 4 fractions of 13.5 Gy. The number of treated lesions varied from 1 (32 patients) to 2-3 (14 patients).</p><p><strong>Results: </strong>SABR induced a significant increase of T-lymphocytes (CD3+CD19-) (p = 0.001), T-helper (CD3+CD4+) (p = 0.004), activated cytotoxic T-lymphocytes (CD3+CD8+HLA-DR+) (p = 0.001), activated T-helpers (CD3+CD4+HLA-DR+) (p < 0.001). A significant decrease of T-regulated immune suppressive lymphocytes (CD4+CD25brightCD127low) (p = 0.002) and NKT-cells (CD3+CD16+CD56+) (p = 0.007) was recorded after the SABR. The comparative analysis demonstrated that lower doses of SABR (EQD2Gy(α/β=10) = 93.7-105.7 Gy) induced significant increase of T-lymphocytes, activated cytotoxic T-lymphocytes, and activated CD4+CD25+ T-helpers, while SABR with higher doses (EQD2Gy(α/β=10) = 150 Gy) was not associated with these effects. A more efficient activations of T-lymphocytes (p = 0.010), activated T-helpers (p < 0.001), and cytotoxic T-lymphocytes (p = 0.003) were associated with SABR to a single lesion. A significant increase of T-lymphocytes (p = 0.002), T-helpers (p = 0.003), and activated cytotoxic T-lymphocytes (p = 0.001) was observed after SABR for hepatic metastases in contrast to SABR for lung lesions.</p><p><strong>Conclusion: </strong>Changes in peripheral blood lymphocytes after SABR could be influenced by the location or the number of irradiated metastasis, and the dose of SABR.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"41 1","pages":"23-31"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/06/roj-2022-00521.PMC10073839.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9625954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of salvage conventional re-irradiation following stereotactic radiosurgery for spine metastases.","authors":"Marcus A Florez,&nbsp;Brian De,&nbsp;Bhavana V Chapman,&nbsp;Anussara Prayongrat,&nbsp;Jonathan G Thomas,&nbsp;Thomas H Beckham,&nbsp;Chenyang Wang,&nbsp;Debra N Yeboa,&nbsp;Andrew J Bishop,&nbsp;Tina Briere,&nbsp;Behrang Amini,&nbsp;Jing Li,&nbsp;Claudio E Tatsui,&nbsp;Laurence D Rhines,&nbsp;Amol J Ghia","doi":"10.3857/roj.2022.00353","DOIUrl":"https://doi.org/10.3857/roj.2022.00353","url":null,"abstract":"<p><strong>Purpose: </strong>There has been limited work assessing the use of re-irradiation (re-RT) for local failure following stereotactic spinal radiosurgery (SSRS). We reviewed our institutional experience of conventionally-fractionated external beam radiation (cEBRT) for salvage therapy following SSRS local failure.</p><p><strong>Materials and methods: </strong>We performed a retrospective review of 54 patients that underwent salvage conventional re-RT at previously SSRS-treated sites. Local control following re-RT was defined as the absence of progression at the treated site as determined by magnetic resonance imaging.</p><p><strong>Results: </strong>Competing risk analysis for local failure was performed using a Fine-Gray model. The median follow-up time was 25 months and median overall survival (OS) was 16 months (95% confidence interval [CI], 10.8-24.9 months) following cEBRT re-RT. Multivariable Cox proportional-hazards analysis revealed Karnofsky performance score prior to re-RT (hazard ratio [HR] = 0.95; 95% CI, 0.93-0.98; p = 0.003) and time to local failure (HR = 0.97; 95% CI, 0.94-1.00; p = 0.04) were associated with longer OS, while male sex (HR = 3.92; 95% CI, 1.64-9.33; p = 0.002) was associated with shorter OS. Local control at 12 months was 81% (95% CI, 69.3-94.0). Competing risk multivariable regression revealed radioresistant tumors (subhazard ratio [subHR] = 0.36; 95% CI, 0.15-0.90; p = 0.028) and epidural disease (subHR = 0.31; 95% CI, 0.12-0.78; p =0.013) were associated with increased risk of local failure. At 12 months, 91% of patients maintained ambulatory function.</p><p><strong>Conclusion: </strong>Our data suggest that cEBRT following SSRS local failure can be used safely and effectively. Further investigation is needed into optimal patient selection for cEBRT in the retreatment setting.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"41 1","pages":"12-22"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/58/roj-2022-00353.PMC10073838.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9256477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myxoid liposarcoma: a well-defined clinical target variant in radiotherapy for soft tissue sarcoma.","authors":"Jeong Il Yu","doi":"10.3857/roj.2022.00598","DOIUrl":"https://doi.org/10.3857/roj.2022.00598","url":null,"abstract":"tissues that show even more diverse characteristics than those originating from epithelial tissues [1]. Despite the diverse histological types of STS, these are generally managed and researched as uniform diseases due to their rarity, except for several unique histologic subtypes [2,3]. Nevertheless, the distinct characteristics, variety of treatment responses, and differences in oncologic outcomes between the subtypes of STS, strongly suggest the need for patientand/or subtype-specific customized treatment approaches [1]. The efficacy of radiotherapy (RT) in resectable STS on reducing local recurrence has been quite clearly confirmed in meta-analysis [4]. Additionally, preoperative RT was significantly more advantageous than postoperative RT in terms of local control rate either in retroperitoneal sarcomas or sarcomas of other sites. This beneficial effect on the local control of preoperative RT in STS is highlighted even more in view of its’ lower radiation dose, small target volume, and reducing long-term toxicities, including fibrosis, edema, and joint stiffness. Furthermore, preoperative RT may prevent tumor seeding during surgical management, and thicken and eliminate or minimize viable tumor cells in the pseudocapsule, which can be used as a reference for resection to achieve wider surgical margins [5]. Despite the proven advantages of preoperative RT in STS, the objective response rate is quite limited, at approximately 25% (range, 0% to 50%) in actual clinical practice, except for myxoid liposarcoma (MLS) [6]. Considering that definite surgical resection is planned and unnecessary resection of the surrounding normal organs should be minimized, it is clear that the change in tumor volume itself is also one of the crucial outcomes that cannot be ignored in the management of STS [7]. The importance of tumor volume response could be particularly emphasized for locally advanced unresectable sarcomas [8]. MLS is one of the five types of liposarcomas according to the 2020 World Health Organization classification [1]. MLS is clearly distinguished from the other subtypes of liposarcoma by the presence of the pathognomonic fusion gene FUS-DDIT3 (also known as TLS-CHOP) or less often, as much as 10%, ESWR1-DDIT3 [9], although the variability of the fusion gene transcript is not associated with clinical outcome [10]. MLS also shows unique clinical features, like occur more younger age, and mostly in the thigh rather than the retroperitoneum, and metastasize to sites other than the lungs, including soft tissue or bone [11]. The most notable difference is that, unlike other subtypes of sarcoma, including other types of liposarcomas, which are generally considered resistant to radiotherapy, MLS is much more sensitive to RT. One explanation for the higher RT responsiveness of MLS Myxoid liposarcoma: a well-defined clinical target variant in radiotherapy for soft tissue sarcoma","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"40 4","pages":"213-215"},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/e6/roj-2022-00598.PMC9830037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of neck level IB-sparing radiotherapy in nasopharyngeal cancer: a long-term single institution analysis.","authors":"Dowook Kim,&nbsp;Bhumsuk Keam,&nbsp;Soon-Hyun Ahn,&nbsp;Chang Heon Choi,&nbsp;Hong-Gyun Wu","doi":"10.3857/roj.2022.00346","DOIUrl":"https://doi.org/10.3857/roj.2022.00346","url":null,"abstract":"<p><strong>Purpose: </strong>Nasopharyngeal cancer (NPC) has a higher prevalence of regional nodal metastasis than other head and neck cancers; however, level IB lymph node involvement is rare. We evaluated the safety and feasibility of level IB-sparing radiotherapy (RT) for NPC patients.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 236 patients with NPC who underwent definitive intensity-modulated RT with or without chemotherapy between 2004 and 2018. Of them, 212 received IB-sparing RT, and 24 received non-IB-sparing RT. We conducted a propensity score matching analysis to compare treatment outcomes according to IB-sparing status. In addition, dosimetric analysis of the salivary glands was performed to identify the relationship between xerostomia and the IB-sparing RT.</p><p><strong>Results: </strong>The median follow-up duration was 78 months (range, 7 to 194 months). Local, regional, and distant recurrences were observed in 11.9%, 6.8%, and 16.1% of patients, respectively. Of the 16 patients with regional recurrence, 14 underwent IB-sparing RT. The most common site categorization of regional recurrence was level II (75%), followed by retropharyngeal lymph nodes (43.8%); however, there was no recurrence at level IB. In the matched cohorts, IB-sparing RT was not significantly related to treatment outcomes. However, IB-sparing RT patients received a significantly lower mean ipsilateral and contralateral submandibular glands doses (all, p < 0.001) and had a lower incidence of chronic xerostomia compared with non-IB-sparing RT patients (p = 0.006).</p><p><strong>Conclusion: </strong>Our results demonstrated that IB-sparing RT is sufficiently safe and feasible for treating NPC. To reduce the occurrence of xerostomia, IB-sparing RT should be considered without compromising target coverage.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"40 4","pages":"260-269"},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/94/roj-2022-00346.PMC9830035.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10549657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utilization of radiation therapy in Korea between 2017 and 2019.","authors":"Eunji Kim,&nbsp;Won Il Jang,&nbsp;Kwangmo Yang,&nbsp;Mi-Sook Kim,&nbsp;Hyung Jun Yoo,&nbsp;Eun Kyung Paik,&nbsp;Heejin Kim,&nbsp;Jaesun Yoon","doi":"10.3857/roj.2022.00500","DOIUrl":"https://doi.org/10.3857/roj.2022.00500","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the clinical infrastructure and utilization of radiotherapy (RT) services in Korea between 2017 and 2019.</p><p><strong>Materials and methods: </strong>We extracted the data of patients who underwent RT between 2017 and 2019 from the Health Insurance Review and Assessment Service. We further analyzed this data according to the diagnosis and treatment modalities of patients diagnosed with International Classification of Disease 10 (ICD-10) diagnostic codes C00-C97 and D00-D48. In addition, we collected statistics on RT facilities in Korea using a nationwide survey.</p><p><strong>Results: </strong>The total number of patients who received RT in 2017, 2018, and 2019 were 77,901, 81,849, and 87,460, respectively. The number of patients diagnosed with ICD 10 C- and D-codes in 2019 was 86,339, of whom 39,467 were men and 46,872 women. The rate of utilization of RT among cancer patients was 30.4% in 2017 and 2018 and 30.9% in 2019. In 2019, the most common types of cancers treated with RT were breast, lung, prostate, colorectal, and liver cancers. Regarding the RT infrastructure in Korea, there were 95 radiation oncology centers, 237 megavoltage (MV) teletherapy units, 35 brachytherapy units, and two proton accelerators in 2019. There were 4.5 MV teletherapy machines per million.</p><p><strong>Conclusion: </strong>The number of patients treated with RT has increased consistently from 2017 to 2019. As the number of patients with cancer increases, it is expected that the RT infrastructure will be further expanded in Korea.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"40 4","pages":"251-259"},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/68/roj-2022-00500.PMC9830042.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10549653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}