Atsuto Katano

Background/Aim: The aim of the present study was to evaluate clinical outcomes of radiotherapy-based treatment in patients with previously untreated cervical esophageal squamous cell carcinoma at a single institution. Patients and Methods: We retrospectively analyzed consecutive patients who received curative-intent radiotherapy for cervical esophageal cancer between July 2012 and October 2025. Eligible patients had histologically confirmed squamous cell carcinoma and no distant metastasis, except for supraclavicular lymph nodes included within the radiation field. All patients received concurrent platinum-based chemotherapy. Overall (OS) and progression-free (PFS) survival were estimated using the Kaplan–Meier method. Results: A total of 33 patients were included. The median age was 64 years (range=45-83 years), and most patients had advanced disease (T4b: 51.5%). The median follow-up was 20.3 months. The median OS and PFS were 58.2 and 12.1 months, respectively. The 1-, 2-, and 3-year OS rates were 86.2%, 60.1%, and 55.8%, respectively, while the corresponding PFS rates were 51.3%, 37.3%, and 37.3%. Patients with stage I-II disease had significantly better OS than those with stage III-IVA/B disease (2-year OS: 100% vs. 51.2%, p=0.0383), although the difference in PFS did not reach statistical significance. Disease progression occurred in 21 patients (63.6%); among them, 15 (71.4%) developed locoregional-only recurrence. Conclusion: Radiotherapy-based treatment for cervical esophageal squamous cell carcinoma achieved favorable OS despite a high proportion of patients with advanced-stage disease. However, disease progression remained frequent, particularly locoregional recurrence, underscoring the need for optimized multimodal treatment strategies.

Background: Stereotactic body radiotherapy has become an established treatment option for localised prostate cancer. However, real‐world evidence from routine clinical practice remains limited, particularly in cohorts that include older patients. We therefore report long‐term outcomes and treatment‐related adverse events after a uniform linear accelerator–based stereotactic body radiotherapy regimen. Methods: We retrospectively reviewed consecutive patients with localised prostate adenocarcinoma treated between May 2016 and June 2020 with definitive stereotactic body radiotherapy of 36.25 Gy in five fractions delivered every other day. Risk stratification followed National Comprehensive Cancer Network criteria. Results: A total of 232 patients were included. The median age was 73 years (range, 52–88), and the median follow‐up was 84.5 months (range, 3.6–113.8). Overall survival at 3, 5, and 7 years was 98.2%, 95.1%, and 93.3%, respectively. Biochemical recurrence‐free survival at 3, 5, and 7 years was 95.9%, 90.2%, and 87.8%, respectively. In patients with higher‐risk disease, biochemical recurrence‐free survival at 5 years was 90.9% in the high‐risk group and 74.2% in the very high‐risk group. No Grade 3 acute gastrointestinal or genitourinary events occurred. Late Grade 3 genitourinary adverse events occurred in 5 patients (2.2%) and late Grade 3 gastrointestinal adverse events in 3 patients (1.3%); no Grade 4 or 5 treatment‐related adverse events were observed. Conclusions: In this single‐institution real‐world cohort, linear accelerator–based stereotactic body radiotherapy was associated with long‐term disease control and a limited incidence of severe late adverse events. These findings support implementation of five‐fraction prostate stereotactic body radiotherapy in routine practice with appropriate patient counselling and long‐term surveillance.

Background: Integrating medical students into school cancer education programs as service-learning is a promising strategy. This study assessed the impact of such programs and evaluated their effectiveness in improving students’ teaching self-efficacy and understanding of cancer. Methods: Medical students participated in observations, lectures, preparation, and teaching sessions under the supervision of an experienced oncologist. Effectiveness was measured by comparing the pre- and post-test scores for the Physician Teaching Self-Efficacy Questionnaire (PTSQ) and the Japanese Cancer Intelligence Quotient (JCIQ). Additionally, cancer literacy (JCIQ-Literacy) among pupils was measured before and after the program to compare outcomes in lecturer type: physicians or medical students. An analysis of covariance (ANCOVA) was conducted to adjust for baseline differences in literacy scores. Results: Medical students ( N = 23) showed significant improvements in teaching self-efficacy (self-regulative: pre-score = 2.58, post-score = 3.07, p < 0.01; dyadic-regulation: pre-score = 2.33, post-score = 2.90, p < 0.01) and cancer-related knowledge and literacy (JCIQ-Knowledge: pre-score = 39.9, post-score = 42.9, p < 0.01; JCIQ-Literacy: pre-score = 28.2, post-score = 37.2, p < 0.01). Pupils ( N = 1,210) also improved their cancer-related literacy, with no significant difference between physician- and student-led programs (33.4 vs. 33.1, p = 0.66; ANCOVA: F (1, 1207) = 1.85, p = 0.17, partial η² < 0.01). Conclusions: Participation in school-based cancer education programs was associated with short-term improvements in medical students’ teaching self-efficacy and cancer-related knowledge. These findings suggest that such programs may offer educational value for students and pupils alike, though further research is needed to assess long-term outcomes and broader implementation.

This study evaluated the clinical outcomes and safety of risk-adapted stereotactic body radiotherapy (SBRT) using non-standard fractionation schedules for lung tumors adjacent to organs at risk (OARs). We retrospectively analyzed 81 consecutive patients (92 lesions, 2008–25) who received SBRT, including repeat irradiation outside prior fields, with non-standard regimens (56 Gy/7 fractions [fr], 50 Gy/10 fr, 60 Gy/10 fr, 48 Gy/6 fr and 35 Gy/5 fr). Endpoints included overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), locoregional progression-free survival, local control (LC) and Grade ≥ 3 adverse events. At a median follow-up of 22.2 months (IQR, 12.1–42.9), the median OS was 26.4 months (95% CI: 17.2–43.0), with 1- and 3-year OS rates of 78.6% and 44.1%, respectively. The median PFS was 14.5 months (95% CI: 9.4–21.1), and the median CSS was 43.7 months (95% CI, 22.7–64.4). Median LC was not reached. No significant survival disparities were identified between primary and metastatic cohorts. Grade ≥ 3 toxicities occurred in 10 patients (12.3%), including two Grade 5 events. The 3-year cumulative incidence of Grade ≥ 3 toxicity in ultracentral tumors was 12.6%, with no significant differences among groups. In conclusion, risk-adapted SBRT with increased fractionation demonstrated encouraging LC while maintaining an acceptable toxicity profile for central and ultracentral lung tumors. However, the risk of severe toxicity remains, requiring careful patient selection and optimized OAR dose constraints.

A BSTRACT: Objectives: Follicular lymphoma is an indolent B-cell non-Hodgkin lymphoma that accounts for approximately 20%–30% of all non-Hodgkin lymphoma cases. Although definitive radiotherapy (RT) has historically been the standard treatment for limited-stage (I–II) follicular lymphoma, there are limited data on long-term outcomes beyond 10 years. Materials and Methods: Adult patients with stage I–II follicular lymphoma treated with curative-intent RT between September 2000 and October 2024 were retrospectively reviewed. The eligibility criteria included histologically confirmed follicular lymphoma (grade 1–3A), no bone marrow involvement, localized stage I–II disease, including extranodal stage IE/IIE gastrointestinal follicular lymphoma, at least 6 months of follow-up, and conventionally fractionated RT delivered at 1.5–2.0 Gy per fraction in more than 10 fractions. Results: Forty patients (median age, 62 years; range, 38–80 years) were included in this study. The median follow-up was 100.5 months (range, 9.2–265.0). The 5-, 10-, and 15-year overall survival (OS) rates were 97.1%, 97.1%, and 83.6%, respectively, and the corresponding progression-free survival (PFS) rates were 71.9%, 52.4%, and 39.3%, respectively. The median PFS was 174.0 months. The 10-year PFS did not differ significantly between patients with stage I (58.1%) and stage II (42.9%) ( P = 0.294). Fourteen patients relapsed, including three transformations to diffuse large B-cell lymphoma; no grade 3 or higher RT-related toxicities occurred. Conclusion: Treatment strategies incorporating definitive RT yielded excellent long-term OS and durable disease control in selected patients with localized stage I–II follicular lymphoma, including extranodal stage IE/IIE gastrointestinal follicular lymphoma, without high-grade toxicity. However, late relapse may occur after treatment, indicating the need for long-term surveillance.

Anterior inferior cerebellar artery aneurysm formation after stereotactic radiosurgery for vestibular schwannoma is rare, occurring exclusively in patients with meatal loop–tumor contact at pretreatment brain MRI, suggesting an anatomic association.

A BSTRACT: Objectives: To assess the real-world outcomes of postoperative radiotherapy (PORT) for oral cavity squamous cell carcinoma and to examine whether delay in starting PORT affects the survival. Methods: We retrospectively reviewed 47 consecutive patients who underwent curative surgery followed by PORT. Radiotherapy was delivered using standard planning procedures, with 66 Gy in 33 fractions for high-risk patients and 60 Gy in 30 fractions for low-risk patients. Time from surgery to PORT initiation was evaluated both continuously and as ≤6 weeks versus >6 weeks. Overall survival (OS) and progression-free survival (PFS) were measured from the start of radiotherapy and analyzed using the Kaplan–Meier methods and multivariable Cox regression. Results: The median interval from surgery to PORT was 6.1 weeks (range, 2.7–9.1). With a median follow-up of 19.4 months, the 2-year OS and PFS rates were 62.3% and 39.1%, respectively. Two-year OS was 77.8% in the ≤6-week group versus 49.0% in the >6-week group ( P = 0.045). Two-year PFS was 52.2% versus 26.1%, respectively ( P = 0.062). In multivariable analysis, PORT initiation >6 weeks after surgery was independently associated with worse PFS (hazard ratio 2.865, 95% confidence interval: 1.065–7.709; P = 0.037). Conclusion: In this real-world cohort, delayed initiation of PORT beyond 6 weeks after surgery was associated with inferior outcomes, including significantly worse PFS. Optimizing postoperative treatment timelines may improve the outcomes in oral cavity squamous cell carcinoma.

A BSTRACT: Head-and-neck cancer is a major global health challenge, and radiotherapy plays an essential role in its management. However, radiation-induced impairment of bone healing and the risk of osteoradionecrosis raise concerns regarding dental implant placement after treatment. This review summarizes current evidence on implant survival in patients who have undergone radiotherapy for head-and-neck cancer. Available studies indicate that implant survival is reduced in irradiated bone compared with non-irradiated bone, with a clear dose-dependent effect. Higher radiation dose, grafted bone, unfavorable implant location, and shorter intervals between radiotherapy and implantation are associated with increased failure risk. Careful patient selection, individualized treatment planning, and multidisciplinary collaboration are therefore required to ensure safe and effective implant rehabilitation in irradiated patients.

Stereotactic radiosurgery (SRS) is a treatment option for intracranial dural arteriovenous fistulas (DAVFs); however, its effectiveness in Borden type III remains unclear. This study aimed to clarify clinical characteristics, indications, and outcomes of SRS for Borden type III DAVFs. Patients who underwent SRS between 1990 and 2024 were retrospectively analyzed, including primary SRS and adjuvant SRS after endovascular treatment (EVT) or surgery. Borden type was determined from pre-SRS angiography. Primary outcome was complete fistula obliteration, and secondary outcomes were post-SRS hemorrhage, improvement of DAVF-related symptoms, and radiation-induced complications. Seventeen patients were included, with a median age of 65 years (interquartile range [IQR] 52–75 years) and follow-up of 30 months (IQR 15–75 months). Among five hemorrhagic-onset patients, four underwent EVT and/or surgery before SRS. Primary SRS was performed in six patients (35.3%) for low-flow shunts, and adjuvant SRS in eleven (64.7%) for remnant/recurrent shunts after previous treatment. The median prescription dose was 18 Gy (IQR 18–20 Gy). Complete fistula obliteration was achieved in 13 patients (76.5%), with cumulative 2- and 5-year rates of 60.3% and 76.2%, and no difference between primary and adjuvant SRS (log-rank test, p = 0.340). DAVF-related symptoms improved in five of six patients (83.3%). No post-SRS hemorrhage or radiation-induced complications occurred. In conclusion, SRS could be a safe and effective treatment option for selected Borden type III DAVFs utilized as primary treatment for low-flow shunts or as adjuvant treatment for remnant/recurrent shunts, when other treatment modalities are not indicated.