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Clinical impact of local consolidative therapy in EGFR-mutant metastatic NSCLC: A propensity-matched multicenter analysis

Wed, 01 Jul 2026 00:00:00 GMT

Title: Clinical impact of local consolidative therapy in EGFR-mutant metastatic NSCLC: A propensity-matched multicenter analysis Authors: Lee, Eun Hye; Kim, Mi-Hyun; Kang, Da Hyun; Moon, Jisu; Kwak, Se Hyun; Eom, Jung Seop; Lee, Jeong Eun; Kim, Chi Young; Chang, Yoon Soo; Lee, Sang Hoon; Kim, Eun Young; Lee, Chang Young; Cho, Jaeho; 문지수 Abstract: Objectives To evaluate the impact of consolidative surgery and radiotherapy (RT) on survival outcomes in patients with advanced or metastatic epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) treated with EGFR tyrosine kinase inhibitors (TKIs). Methods This retrospective, multicenter cohort study included 864 patients with EGFR-mutant advanced or metastatic NSCLC receiving first-line EGFR-TKIs. Patients were categorized into EGFR-TKI monotherapy (n = 616), TKI plus surgery (n = 100), and TKI plus RT (n = 148). Propensity score matching (PSM) and overlap weighting were applied to balance baseline characteristics. Overall survival (OS) and progression-free survival (PFS) were analyzed using Cox proportional hazards models and restricted mean survival time (RMST). Results After PSM, 97 matched pairs were generated for TKI versus TKI plus surgery and 148 pairs for TKI versus TKI plus RT. Compared with TKI alone, consolidative surgery significantly improved OS (hazard ratio [HR], 0.36; 95% CI, 0.20-0.65; p < 0.001) and PFS (HR, 0.48; 95% CI, 0.34-0.67; p < 0.001), with RMST gains of 10.7 and 10.6 months.Consolidative RT showed a trend toward longer OS (HR, 0.61; 95% CI, 0.39-0.93; p = 0.023)without significant PFS or consistent RMST benefit. Subgroup analyses showed surgery benefit in younger patients with good performance, lower metastatic burden, and no brain metastasis, whereas RT effects were heterogeneous. Conclusion In this real-world cohort, consolidative surgery combined with EGFR-TKI was associated with a clear survival benefit in advanced EGFR-mutant NSCLC while the effect of consolidative RT was less consistent, highlighting the importance of careful patient selection and multidisciplinary management.

Treatment Outcomes and Prognostic Factors of Metastasis-Directed Radiation Therapy for Oligometastatic Endometrial Cancer

Wed, 01 Jul 2026 00:00:00 GMT

Title: Treatment Outcomes and Prognostic Factors of Metastasis-Directed Radiation Therapy for Oligometastatic Endometrial Cancer Authors: Lee, Won Hee; Kim, Yong Bae; 이원희 Abstract: Purpose: To evaluate outcomes and prognostic factors associated with metastasis-directed radiation therapy (MDRT) for oligometastatic endometrial cancer. Methods and Materials: We retrospectively analyzed 101 patients (203 lesions) with <= 5 metastatic lesions treated with MDRT between 2015 and 2025. Oligometastatic states were classified according to the European Society for Radiotherapy and Oncology -European Organisation for Research and Treatment of Cancer framework. Endpoints were overall survival (OS), progression-free survival (PFS), and local failure-free survival. Prognostic factors were assessed using multivariable Cox regression, and toxicities were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0. Results: At a median follow-up of 36.4 months, 3-year OS, PFS, and 2-year local failure-free survival rates were 76.3%, 24.5%, and 64.7%, respectively. Multivariable analyses revealed that favorable oligometastatic disease classification, endometrioid histology, favorable radiation therapy (RT) response, and maximum dose >= 40 Gy (equivalent dose in 2 Gy fractions, a/b = 10) were independently associated with improved OS. All factors, except for histology, were significant for PFS. In a propensity-matched analysis, repeated MDRT for recurrent oligometastases showed a trend toward improved OS compared with a single course. One grade 3 event occurred with no grade >= 4 toxicity. Conclusions: MDRT yielded favorable outcomes in oligometastatic endometrial cancer. Oligometastatic classification, histology, and RT response were major prognostic factors. MDRT may be a viable option within a multidisciplinary framework for de novo and recurrent oligometastases, but validation in prospective multicenter studies is warranted. (c) 2026 The Author(s). Published by Elsevier Inc. on behalf of American Society for Radiation Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

CdSe/CdZnS core/shell nanocrystal scintillators: Light yield, decay time, and solvent effects

Mon, 01 Jun 2026 00:00:00 GMT

Title: CdSe/CdZnS core/shell nanocrystal scintillators: Light yield, decay time, and solvent effects Authors: Boo, Jihwan; Kim, Byong Jae; Kim, Nam Young; Han, Ill-hyuk; Lim, Soobin; Lim, Jaehoon; Kim, Geehyun Abstract: Semiconductor nanocrystals (NCs) have emerged as promising candidates for next-generation scintillators owing to their tunable band gaps and high photoluminescence quantum yields (PLQYs). However, most NC-based scintillators rely on polymer or solvent matrices, in which inefficient energy transfer and self-absorption significantly limit their light yield. In this study, we developed solvent- and polymer-free CdSe/CdZnS NC films (50-200 mu m thick) and quantitatively evaluated their gamma-ray response and its light yield through single-photoelectron (SPE)-based measurements. The NC films preserved their intrinsic optical characteristics after fabrication and exhibited distinct photopeaks at 59.5 keV (Am-241) and 81.0 keV (Ba-133), achieving a light yield of approximately 3200 +/- 100 photons/MeV with a fast decay time of similar to 20 ns-comparable to reported NC/polymer nanocomposite scintillators. We further investigated solvent effects using NC-doped liquid scintillators, revealing the importance of solvent selection for observing measurable scintillation signals.

Impact of trastuzumab deruxtecan (T-DXd) and brain stereotactic radiosurgery on intracranial control and radionecrosis risk in HER2-positive or -low breast cancer brain metastases

Mon, 01 Jun 2026 00:00:00 GMT

Title: Impact of trastuzumab deruxtecan (T-DXd) and brain stereotactic radiosurgery on intracranial control and radionecrosis risk in HER2-positive or -low breast cancer brain metastases Authors: Chun, Seok-Joo; Kim, Kyubo; Chang, Won Ick; Kim, Yong Bae; Ha Paek, Sun; Lee, Kyung-Hun; Song, Jin-Ho; Hong, Ji Hyun; Lee, Jieun; Il Jang, Won; Kim, Tae Hyun; Shin, Kyung Hwan Abstract: Background While trastuzumab deruxtecan (T-DXd) demonstrates intracranial efficacy, the potential for radionecrosis (RN) when combined with stereotactic radiosurgery (SRS) remains a concern, given the established risk with other antibody-drug conjugates like T-DM1. This study evaluated the safety and efficacy of T-DXd and SRS in patients with HER2-positive or -low breast cancer brain metastases (BCBM). Methods We conducted a multi-center retrospective analysis of 113 patients (461 SRS treatments) treated with SRS and anti-HER2 agents. Patients were stratified into T-DXd(+) (n = 29 patients, 61 treatments) and T-DXd(-) (n = 84 patients, 400 treatments) groups. Endpoints included RN, radionecrosis-free survival (RNFS), and intracranial control outcomes (any intracranial progression, local failure, and distant intracranial metastasis). Results No cases of RN were observed in the T-DXd(+) group, compared with 11 cases in the T-DXd(-) group (p = 0.028). On multivariate analysis, T-DXd(+) status remained significantly associated with improved RNFS (HR 0.31, p = 0.009). In the treatment-level analysis, the 1-year cumulative incidence of RN was 0% for T-DXd(+) versus 4.3% for T-DXd(-) (p = 0.009). Additionally, T-DXd(+) was associated with significantly better 1-year outcomes for any intracranial progression (40% vs. 76%, p < 0.001), local failure (6.6% vs. 29%, p = 0.002), and distant intracranial metastasis (40% vs. 66%, p = 0.009). All efficacy endpoints remained significant on multivariate analysis. Conclusion Combining T-DXd with SRS demonstrated a favorable safety profile without increasing the risk of radionecrosis. Furthermore, this combination was associated with superior intracranial control, encompassing both local and distant outcomes, supporting the potential of T-DXd combined with SRS as an effective and well-tolerated approach for HER2-positive or -low BCBM.