Background/Aim: We conducted a prospective exploratory study to investigate the relationship between radiation pneumonitis (RP) and transforming growth factor-β1 (TGF-β1) in exhaled breath condensate (EBC). Patients and Methods: The inclusion criteria were: patients who 1) received thoracic radiotherapy (RT) for lung cancer, 2) were aged ≥20 years, and 3) provided written informed consent. EBC was collected before and 1 month after RT. TGF-β1 levels in EBC were measured using an enzyme-linked immunosorbent assay. We evaluated RP using the Common Terminology Criteria for Adverse Events v4 and analyzed the relationship between grade (G) 2 RP and TGF-β1 levels in EBC. Results: Ten patients were enrolled [median age, 75 years (range=60-81 years)], and none of them had interstitial lung disease. Conventional fractionation, accelerated hyperfractionation, hypofractionation, and stereotactic ablative fractionation were used in four, one, two, and three patients, respectively. G1 and G2 RP were observed in five patients each; no G3-G5 RP occurred. The median TGF-β1 levels in EBC before and 1 month after RT were 79.1 pg/ml (0.1-563.7 pg/ml) and 286.9 pg/ml (33.7-661.3 pg/ml), respectively. Of the seven patients with increased TGF-β1 levels in EBC 1 month after RT than before RT, five (71%) experienced G2 RP, whereas the remaining three patients with decreased TGF-β1 levels had G1 RP (p=0.083,. Conclusion: Increased TGF-β1 levels in EBC 1 month after RT might be promising for the detection of G2 RP.Patients. This prospective study (clinical trial registration number: UMIN000040894) was approved by the Institutional Ethics Committee (approval number: H30-094). The inclusion criteria were as follows: patients who 1) received thoracic RT for lung cancer, 2) 1485

Purpose To retrospectively review locally advanced cervical cancer (CC) cases treated with three-dimensional image-guided brachytherapy (3D-IGBT) and two-dimensional (2D)-IGBT. Materials and Methods Patients with Stage IB–IVa CC who underwent intracavitary irradiation between 2007 and 2021 were divided into the 3D-IGBT and 2D-IGBT groups. Local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), overall survival (OS), and gastrointestinal toxicity (G3 or more) were investigated at 2/3 years post-treatment. Results Seventy-one patients in the 2D-IGBT group from 2007 to 2016 and 61 patients in the 3D-IGBT group from 2016–2021 were included in the study. The median follow-up period was 72.7 (4.6–183.9) months in the 2D-IGBT group and 30.0 (4.2–70.5) months in the 3D-IGBT group. The median age was 65.0 (40–93) years in the 2D-IGBT group and 60.0 (28–87) years in the 3D-IGBT group, but there was no difference in FIGO stage, histology, or tumor size between the groups. In treatment, the median A point dose was 56.1 (40.0–74.0) Gy in the 2D-IGBT group and 64.0 (52.0–76.8) Gy in the 3D-IGBT group (P < 0.0001), and the proportion of patients who underwent chemotherapy more than five times was 54.3% in the 2D-IGBT group and 80.8% in the 3D-IGBT group (P = 0.0004). The 2/3-year LC, DMFS, PFS, and OS rates were 87.3%/85.5%, 77.4%/65.0%, 69.9%/59.9%, and 87.9%/77.9% in the 2D-IGBT group, and 94.2%/94.2%, 81.8%/81.8%, 80.5%/80.5%, and 91.6%/83.0% in the 3D-IGBT group, respectively. A significant difference was observed in PFS (P = 0.02). There was no difference in gastrointestinal toxicity, but there were four intestinal perforations in the patients from the 3D-IGBT group, three of whom had a history of bevacizumab treatment. Conclusion The 2/3-year LC of the 3D-IGBT group was excellent and PFS also tended to improve. Care should be taken with concomitant use of bevacizumab after radiotherapy.

Background/Aim: We retrospectively compared stereotactic body radiotherapy (SBRT) with conventionally fractionated radiotherapy (CFRT) for a solitary lung tumor after resection of a non-small cell lung cancer (NSCLC), due to a lack of data concerning whether SBRT or CFRT is more effective in this setting. Patients and Methods: SBRT using 48 Gy in 4 fractions was administered to 15 patients with a peripheral tumor (SBRT group). CFRT using 66-70 Gy in 33-35 fractions was administered to 11 patients with a central tumor (CFRT group). Results: The median follow-up time was 32 months (range: 9-79 months). The 3-year overall survival rates in SBRT and CFRT groups were 81% and 40%, respectively (p=0.008). The 3-year local control rates in SBRT and CFRT groups were 83% and 35%, respectively (p=0.035). Regarding toxicities, no significant differences were found between the two groups. Conclusion: Compared to CFRT, SBRT may be more effective in solitary-lung-tumor patients after the complete resection of an NSCLC as with inoperable-stage I-NSCLC patients.

Background/Aim: We retrospectively investigated the relationship between pathological complete response (pCR) and tumor volume (TV) reduction during neoadjuvant chemoradiation therapy (NACRT) in non-small cell lung cancer (NSCLC). Patients and Methods: We evaluated patients who received NACRT (50 Gy/25 fractions with platinum-doublet) plus surgery for NSCLC. TVs before and during NACRT (TV before and TV during , respectively) were measured based on the sums of the volumes of primary tumors and clinically positive lymph nodes. Relative change in TV was computed as % (TV during -TV before )/TV before . Results: In total, 31 patients were analyzed. The median of the relative change in TV was -49% and ranged from -83 to -10%. Postoperatively, pCR was achieved in 11 patients (35%). In multivariate analysis, the relative change in TV was found to be an independent predictor of pCR (p=0.003). Conclusion: TV reduction during NACRT appears to be associated with pCR in NSCLC.

The purpose of the present retrospective study was to evaluate the feasibility of hippocampal dose-volume parameters associated with memory decline for intensity-modulated radiotherapy (IMRT). In total, 18 patients who underwent IMRT for supratentorial tumors were analyzed. Prescribed doses of IMRT in 30 fractions were 60 Gy to planning target volume (PTV) 1 of the local area and 48-51 Gy to PTV2 of the extended local area. Based on previous literature, the present study investigated dose-volume parameters of the bilateral hippocampi: D 40% of 13.1 Gy, D 50% of 29.6 Gy, and V 55Gy of 5.0%. It was evaluated which of the parameters was most achievable, and unfavorable factors that interfere with reaching these parameters were identified. As a result, D 40% of 13.1 Gy, D 50% of 29.6 Gy and V 55Gy of 5.0% were achieved in 17, 67 and 33% of patients, respectively. For D 50% of 29.6 Gy, PTV2 ≥500 cc (P=0.004) and tumor in temporal/corpus callosum/basal ganglia (P= 0.009) were significant unfavorable factors. In conclusion, D 50% of 29.6 Gy was most achievable. In daily clinical practice, it should be primarily attempted to achieve D 50% of 29.6 Gy of the bilateral hippocampi.