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Cancer Communications 2024年第2期44卷 278-281页

作者： Tiantian Guo Yue Zhou Fei Liang Zezhou Wang Vincent Bourbonne Lukas Käsmann Nora Sundahl Abraham Jing-Ching Wu Jianjiao Ni Zhengfei Zhu department of radiation oncology Fudan University Shanghai Cancer CenterShanghaiP.R.China department of oncology Shanghai Medical CollegeFudan UniversityShanghaiP.R.China Shanghai Clinical Research Center for radiation oncology ShanghaiP.R.China Shanghai Key Laboratory of radiation oncology ShanghaiP.R.China department of Biostatistics Zhongshan HospitalFudan UniversityShanghaiP.R.China department of Cancer Prevention Fudan University Shanghai Cancer CenterShanghaiP.R.China radiation oncology department University HospitalBrestFrance department of radiation oncology University HospitalLMU MunichMunichGermany department of radiation oncology AZ GroeningeKortrijkBelgium department of radiation oncology Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA Institute of thoracic oncology Fudan UniversityShanghaiP.R.China

Dear Editor:Brain metastasis(BM)has long been recognized as a prognostic factor associated with poor prognosis for non-small cell lung cancer(NSCLC)in the era of con-ventional chemotherapy and targeted therapy[1].In the era of immunotherapy,controversial findings have been reported regarding the prognostic significance of BM in patients with NSCLC treated with programmed death-1/programmed death-ligand 1(PD-1/PD-L1)inhibitors.

关键词： chemotherapy NSCLC metastasis death

Incidence and treatment of brain metastasis in patients with esophageal carcinoma

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World Journal of Gastroenterology 2015年第19期21卷 5805-5812页

作者： Wei Feng Peng Zhang Xiao Zheng Ming Chen Wei-Min Mao department of radiation oncology Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus) Zhejiang Key Laboratory of Radiation Oncology Zhejiang Cancer Hospital

Brain metastasis from esophageal carcinoma(BMEC) is very rare, but its incidence has increased in the United States, Japan, China and other counties. Reports on BMEC have largely been focused on examining whether adjuvant therapy for esophageal cancer influences the survival duration of BMEC patients and on the imaging characteristics of BMEC determined using new medical equipment. The difference between different pathological types of esophageal cancer, especially adenocarcinoma and squamous cell carcinoma, is one important factor used to assess the influence of BMEC. Adjuvant therapy, including radiotherapy and chemotherapy, for esophageal cancer with different characteristics in different countries may affect BMEC treatment outcomes. The degree of popularization of advanced medical equipment is a major concern related to the prevalence of BMEC. Furthermore,targeted BMEC treatment is under development in developed countries. In this article, we reviewed the debate surrounding BMEC and analyzed BMEC studies from different perspectives.

关键词： Brain metastasis Esophageal carcinoma Magnetic resonance imagin Computed tomography

Stereotactic body radiation therapy in patients with hepatocellular carcinoma: A mini-review

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World Journal of Gastrointestinal oncology 2019年第5期11卷 367-376页

作者： Sabine Gerum Alexandra D Jensen Falk Roeder department of radiation oncology University Hospital LMU Munich department of radiation oncology University Hospital Gie?en and Marburg CCU Molecular radiation oncology German Cancer Research Center department of Radiotherapy and radiation oncology Paracelsus Medical University

Stereotactic body radiation therapy(SBRT) is an emerging treatment for hepatocellular carcinoma. This technique results in excellent local control rates with favorable toxicity profile despite being predominantly used in heavily pretreated patients or those unsuitable for other local therapies. SBRT may be used as a sole treatment or in combination with other local therapies as well as a bridging strategy for patient awaiting liver transplants. This brief review describes current practice of SBRT with respect to radiation technique, patient selection and treatment concepts. It summarizes available evidence from retroand prospective studies evaluating SBRT alone, SBRT in combination with other treatments and SBRT compared to other local treatment approaches.

关键词： Hepatocellular carcinoma Stereotactic body radiation therapy Local-ablative treatment Combination approaches Mini-review

Stereotactic radiotherapy for prostate cancer:A review and future directions

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World Journal of Clinical oncology 2017年第5期8卷 389-397页

作者： Yusef A Syed Ami K Patel-Yadav Charlotte Rivers Anurag K Singh department of radiation oncology Winship Cancer Institute of Emory University department of radiation oncology University at Buffalo department of radiation oncology Roswell Park Cancer Institute

Prostate cancer affects over 200000 men annually in the United States alone.The role of conventionally fractionated external beam radiation therapy (RT) is well established as a treatment option for eligible prostate cancer patients; however,the use of stereotactic body radiotherapy (SBRT) in this setting is less well defined.Within the past decade,there have been a number of studies investigating the feasibility of SBRT as a potential treatment option for prostate cancer patients.SBRT has been well studied in other disease sites,and the shortened treatment course would allow for greater convenience for patients.There may also be implications for toxicity as well as disease control.In this review we present a number of prospective and retrospective trials of SBRT in the treatment of prostate cancer.We focus on factors such as biochemical progression-free survival,prostate specific antigen (PSA) response,and toxicity in order to compare SBRT to established treatment modalities.We also discuss future steps that the clinical community can take to further explore this new treatment approach.We conclude that initial studies examining the use of SBRT in the treatment of prostate cancer have demonstrated impressive rates of biochemical recurrencefree survival and PSA response,while maintaining a relatively favorable acute toxicity profile,though long-term follow-up is needed.

关键词： Stereotactic body radiotherapy Prostate cancer radiation therapy Hypofractionation Toxicity Stereotactic ablative radiotherapy

Can we triumph over locally advanced cervical cancer with colossal para-aortic lymph nodes? A case report

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World Journal of Clinical Cases 2024年第10期12卷 1851-1856页

作者： Abdulla Alzibdeh Issa Mohamad Lina Wahbeh Ramiz Abuhijlih Fawzi Abuhijla department of radiation oncology King Hussein Cancer CenterAmman 11941Jordan

BACKGROUND Para-aortic lymph nodes(PALNs)are common sites for the regional spread of cervical squamous cell carcinoma(SCC).CASE SUMMARY We report the case of a 36-year-old woman who presented with cervical SCC with multiple bulky PALNs,largest measured 4.5 cm×5 cm×10 cm.The patient was treated with radical intent with definitive chemoradiation using sequential doseescalated adaptive radiotherapy,followed by maintenance chemotherapy.The patient achieved a complete response;she has been doing well since the completion of treatment with no evidence of the disease for 2 years.CONCLUSION Regardless of the size of PALN metastases of cervical carcinoma origin,it is still treatable(with radical intent)via concurrent chemoradiation.Adaptive radiotherapy allows dose escalation with minimal toxicity.

关键词： Cervical cancer Bulky Lymph node Radiotherapy Para-aortic Case report

Strategies to tackle the challenges of external beam radiotherapy for liver tumors

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World Journal of Hepatology 2017年第14期9卷 645-656页

作者： Michael I Lock Jonathan Klein Hans T Chung Joseph M Herman Edward Y Kim William Small Nina A Mayr Simon S Lo department of radiation oncology London Regional Cancer ProgramUniversity of Western Ontario department of radiation oncology Odette Cancer CentreSunnybrook Health Sciences Centre department of radiation oncology the University of Texas department of radiation oncology University of Washington School of Medicine department of radiation oncology Loyola University Medical Center

Primary and metastatic liver cancer is an increasingly common and difficult to control disease entity.radiation offers a non-invasive treatment alternative for these patients who often have few options and a poor prognosis.However,the anatomy and aggressiveness of liver cancer poses significant challenges such as accurate localization at simulation and treatment,management of motion and appropriate selection of dose regimen.This article aims to review the options available and provide information for the practical implementation and/or improvement of liver cancer radiation programs within the context of stereotactic body radiotherapy and image-guided radiotherapy guidelines.Specific patient inclusion and exclusion criteria are presented given the significant toxicity found in certain sub-populations treated with radiation.Indeed,certain sub-populations,such as those with tumor thrombosis or those with larger lesions treated with transarterial chemoembolization,have been shown to have significant improvements in outcome with the addition of radiation and merit special consideration.Implementing a liver radiation programrequires three primary challenges to be addressed:(1) immobilization and motion management;(2) localization;and(3) dose regimen and constraint selection.Strategies to deal with motion include simple internal target volume(ITV) expansions,non-gated ITV reduction strategies,breath hold methods,and surrogate marker methods to enable gating or tracking.Localization of the tumor and organs-at-risk are addressed using contrast infusion techniques to take advantage of different normal liver and cancer vascular anatomy,imaging modalities,and margin management.Finally,a dose response has been demonstrated and dose regimens appear to be converging.A more uniform approach to treatment in terms of technique,dose selection and patient selection will allow us to study liver radiation in larger and,hopefully,multicenter randomized studies.

关键词： Hepatocellular 癌肝转移 4DCT 指导图象的放射疗法 Stereotactic 身体放射治疗

Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multiinstitutional analysis (KROG 19-04)

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Cancer Biology & Medicine 2022年第6期19卷 931-944页

作者： Sung Uk Lee Jinsil Seong Tae Hyun Kim Jung Ho Im Woo Chul Kim Kyubo Kim Hae Jin Park Tae Gyu Kim Youngkyong Kim Bae Kwon Jeong Jin Hee Kim Byoung Hyuck Kim Taek-Keun Nam Center for Proton Therapy and Center for Liver and Pancreatobiliary Cancer National Cancer CenterGoyang 10408Korea department of radiation oncology Yonsei Cancer CenterYonsei University College of MedicineSeoul 03722Korea department of radiation oncology CHA Bundang Medical CenterCHA University School of MedicineSeongnam 13497Korea department of radiation oncology Inha University HospitalInha University School of MedicineIncheon 22332Korea department of radiation oncology Ewha Womans University Mokdong HospitalEwha Womans University College of MedicineSeoul 07985Korea department of radiation oncology Hanyang University Medical CenterHanyang University College of MedicineSeoul 04763Korea department of radiation oncology Samsung Changwon HospitalSungkyunkwan University School of MedicineChangwon 51353Korea department of radiation oncology Kyung Hee University HospitalKyung Hee University College of MedicineSeoul 02447Korea department of radiation oncology Gyeongsang National University HospitalGyeongsang National University College of MedicineJinju 52727Korea department of radiation oncology Dongsan Medical CenterKeimyung University School of MedicineDaegu 41931Korea department of radiation oncology Seoul Metropolitan Government Seoul National University Boramae Medical CenterSeoul 07061Korea department of radiation oncology Chonnam National University Hwasun HospitalChonnam National University College of MedicineHwasun 58128Korea

Objective:The effectiveness of adjuvant treatments for resected gallbladder carcinoma(GBC)has remained unclear due to lack of randomized controlled trials;thus,the aim of present study was to evaluate the role of adjuvant treatments,including chemoradiotherapy(CRT)and/or chemotherapy(CTx),in patients with resected GBC.Methods:A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database.Of 733 patients,372(50.8%)did not receive adjuvant treatment,whereas 215(29.3%)and 146(19.9%)received adjuvant CTx and CRT,respectively.The locoregional recurrence-free survival(LRFS),recurrence-free survival(RFS),and overall survival(OS)of the adjuvant treatment groups were compared according to tumor stage(stage II vs.stage III–IV).Results:In stage II disease(n=381),the 5-year LRFS,RFS,and OS were not significantly different among the no-adjuvant therapy,CTx,and CRT groups,and positive resection margin,presence of perineural invasion,and Nx classification were consistently associated with worse LRFS,RFS,and OS in the multivariate analysis(P<0.05).For stage III–IV(n=352),the CRT group had significantly higher 5-year LRFS,RFS,and OS than the no-adjuvant therapy and CTx groups(67.8%,45.2%,and 56.9%;37.9%,28.8%,and 35.4%;and 45.0%,30.0%,and 45.7%,respectively)(P<0.05).Conclusions:CRT has value as adjuvant treatment for resected GBC with stage III–IV disease.Further study is needed for stage II disease with high-risk features.

关键词： Gallbladder cancer adjuvant treatment chemoradiotherapy locoregional recurrence-free survival overall survival

Chemotherapy in non-small cell lung cancer: opportunities for advancement

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Chinese Journal of Cancer 2016年第9期35卷 438-440页

作者： Mani Akhtari Eric H.Bernicker Bin S.Teh department of radiation oncology Houston Methodist Hospital Cancer Center and Research Institute Weil Cornell Medical College department of radiation oncology The University of Texas Medical Branch at Galveston Cancer Center Thoracic Medical Oncology Houston Methodist Hospital

Locally advanced non-small cell lung cancer(NSCLC) continues to be a challenging disease to treat. With high rates of both local and distant failures, there is signiicant interest in inding more biologically active chemotherapy regimens that can contribute to reduce both failures. The phase III PROCLAIM trial, recently published in the Journal of Clinical oncology entitled "PROCLAIM: randomized phase III trial of pemetrexed–cisplatin or etoposide–cisplatin plus thoracic radiation therapy followed by consolidation chemotherapy in locally advanced nonsquamous non-small-cell lung cancer", compared two diferent chemotherapy regimens given concurrently with radiotherapy in patients with stage III non-squamous lung cancer: pemetrexed plus cisplatin versus cisplatin plus etoposide. Both groups received consolidation chemotherapy. After enrolling 598 of planned 600 patients, the study was stopped early due to futility as no diference was seen in the primary end-point of overall survival. Since PROCLAIM was designed as a superiority trial, these results suggest that pemetrexed regimens do not ofer a clinical advantage over standard cisplatin plus etoposide. There are some subpopulations who might still beneit from pemetrexed, especially if clinicians are concerned about myelosuppression-related adverse events. Future trials are needed to investigate novel biologic agents and irradiation techniques that can result in more durable local and distant disease control in locally advanced NSCLC.

关键词：非小细胞肺癌化疗放射治疗临床医生疾病控制 III 生物活性生物制剂

Leptomeningeal metastases originated from esophagogastric junction/gastric cancer:A brief report of two cases

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World Journal of Gastrointestinal oncology 2018年第1期10卷 56-61页

作者： Panteleimon Kountourakis Demetris Papamichael Haris Haralambous Michael Michael Georgios Nakos Sylvia Lazaridou Eleni Fotiou Vassilios Vassiliou Demetrios Andreopoulos department of Medical oncology BOC Oncology Centre department of Radiology BOC Oncology Centre department of Cytology General Hospital of Nicosia department of Pathology General Hospital of Nicosia department of radiation oncology BOC Oncology Centre

Leptomeningeal carcinomatosis is a very rare manifestation in patients diagnosed with esophagogastric junction and gastric cancer. Its prognosis is ominous and therapy outcomes are disappointing. Herein, we present two patients; one initially diagnosed with gastric cancer and leptomeningeal carcinomatosis but no other evidence of metastatic disease and the other one initially diagnosed with esophagogastric junction cancer, who recurred solitary with leptomeningeal seedings several years after the initial diagnosis and treatment. Furthermore, a thorough and short review of the literature is carried out.

关键词： Esophagogastric junction cancer Gastric cancer Leptomeningeal carcinomatosis Prognosis Investigation Therapy

Role of Recursive Partitioning Analysis and Graded Prognostic Assessment on Identifying Non-Small Cell Lung Cancer Patients with Brain Metastases Who May Benefit from Postradiation Systemic Therapy

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Chinese Medical Journal 2018年第10期131卷 1206-1213页

作者： Shuai Liu Peng Chen Yan-Wei Liu Xue-Nan GU Xiao-Guang Qiu Bo Li department of radiation oncology BeijLng Tiantan Hospital Capital Medical University Beijing 100050 China department of thoracic oncology Tianjin Medical University Cancer Institute and Hospital Tianjin 300060 China

Background：The role ofpostradiation systemic therapy in non-small cell lung cancer （NSCLC） patients with brain metastasis （BM） was controversial.Thus,we explored the role of radiation Therapy oncology Group recursive partitioning analysis （RTOG-RPA） and graded prognostic assessment （GPA） in identifying population who may benefit from postradiation systemic therapy.Methods：The clinical data of NSCLC patients with documented BM from August 2007 to April 2015 of two hospitals were studied retrospectively.Cox regression was used for multivariate analysis.Survival of patients with or without postradiation systemic therapy was compared in subgroups stratified according to RTOG-RPA or GPA.Results：Of 216 included patients,67.1% received stereotactic radiosurgery （SRS）,24.1% received whole-brain radiation therapy （WBRT）,and 8.8% received both.After radiotherapy,systemic therapy was administered in 58.3% of patients.Multivariate analysis found that postradiation systemic therapy （yes vs.no）（hazard ratio [HR] =0.36 l,95% confidence interval [CI] =0.202-0.648,P =0.001）,radiation technique （SRS vs.WBRT）（HR =0.462,95% CI =0.238-0.849,P =0.022）,extracranial metastasis （yes vs.no）（HR =3.970,95% CI =1.757-8.970,P =0.001）,and Kamofsky performance status （〈70 vs.≥70）（HR =5.338,95% CI =2.829-10.072,P 〈 0.001） were independent factors for survival.Further analysis found that subsequent tyrosine kinase inhibitor （TKI） therapy could significantly reduce the risk of mortality of patients in RTOG-RPA Class IⅡ （HR =0.411,95% CI =0.183-）.923,P =0.031） or with a GPA score of 1.5-2.5 （HR =0.420,95% CI =0.182-0.968,P =0.042）.However,none of the subgroups stratified according to RTOG-RPA or GPA benefited from the additional conventional chemotherapy.Conclusion：RTOG-RPA and GPA may be useful to identify beneficial populations in NSCLC patients with BM ifTKIs were chosen as postradiation systemic therapy.

关键词： Chemotherapy Non-Small Cell Lung Cancer Recursive Partitioning Analysis Stereotactic Radiosurgery Tyrosine Kinase Inhibitors Whole-Brain radiation Therapy