Introduction: The aim of this study is to evaluate the characteristics of the dosimetry and the skin dose of interstitial brachytherapy by the use of the free‐hand implantation technique toward the treatment of early breast cancer.Materials & Methods: Seventeen patients diagnosed with early breast cancer were selected for the study. The implantation of the catheters for postoperative interstitial brachytherapy was performed using the free‐hand technique. The total tumor dose to the tumor cavity plus 2 cm margin was 3400 cGy, twice daily for 10 fractions in 5 days. The dosage to the target and the organ at risk (OAR) were recorded for analysis. The skin dose of the patient and the phantom were measured with Gafchromic film (EBT3) and the results were compared with the skin dose calculated by the brachytherapy treatment planning system.Results: The median conformal index is 94% (range 89%–99%), and the median homogeneity index is 71%. The median skin dose measured from the skin of the patients was 20.1% lower than the skin dose calculated from the treatment planning system and consistent with the phantom surface measurement experiment. There were no grade 3 or above acute toxicity recorded.Conclusions: Interstitial brachytherapy by the use of the free‐hand implantation technique for early breast cancer is feasible and avoids the need for a second surgical intervention. The calculated skin dose was overestimated by at least 20%. The results of this study may help in building a modification model for the prediction of skin toxicity in any future study.

Purpose: The purpose of the present study is to determine the impact on survival using adjuvant chemotherapy on patients with locally advanced esophageal cancer. Materials and Methods: From 2007 to 2016, we enrolled 127 locally advanced esophageal squamous cell carcinoma patients treated with combined neoadjuvant chemoradiotherapy (nCRT) and surgery. For patients with the pathological residual primary disease (pT+) and/or residual node disease (pN+) after nCRT, adjuvant chemotherapy was also given after consideration of the toxicity of nCRT, patient performance, and/or comorbidity. The regimen of adjuvant chemotherapy was cisplatin 20 mg/m²/day and 5-fluorouracil 800 mg/m²/day on days 1 through 4 and 22 through 25. The primary endpoint was overall survival (OS). Results: From a total of 127 patients, 26 of them (20.5%) received adjuvant chemotherapy. In the multivariate analysis, pN+ diseases were independently associated with poor OS (hazard ratio (HR): 4.117, 95% confidence interval (CI): 1.366–12.404; p = 0.012). For those with pN+ diseases, their 5-year OS was 36.4% in the follow-up arm compared with 45.8% in the adjuvant chemotherapy arm (p = 0.094). Conclusions: Pathologic node-positive disease is associated with poor OS in locally advanced esophagus cancer patients after combined treatments with nCRT and surgery. Adjuvant chemotherapy appeared to have improved OS in pathologic node-positive diseases.

Introduction: This study aimed to evaluate the psychological and behavioral impacts of the coronavirus disease-2019 (COVID-19) pandemic on cancer diagnosis and staging, with particular focus on patient delays and changes in healthcare-seeking behavior before and after the onset of COVID-19. Methodology: Data pertaining to 8 cancer types, including breast cancer, hepatocellular carcinoma, oral cancer, prostate cancer, gastric cancer, esophageal cancer, colon cancer, and lung cancer, sourced from the cancer registry database of Taichung Veterans General Hospital, was analyzed. The focus was on the comparisons of data between the pre-pandemic period (2017–2019) and the pandemic year (2020). Results: Breast cancer (p < 0.001), hepatocellular carcinoma (p = 0.004), prostate cancer (p < 0.001), gastric cancer (p = 0.037), and esophageal cancer (p < 0.001) exhibited a decrease in the rate of early stage patients and an increase in the rate of advanced stage patients after the COVID-19 outbreak. Furthermore, the number of newly diagnosed patients per year decreased for hepatocellular carcinoma, oral cancer, prostate cancer, gastric cancer, esophageal cancer, colon cancer, and lung cancer. Conclusions: The COVID-19 pandemic disrupted cancer care, resulting in delayed diagnoses, stage migration, and a decline in newly diagnosed cases. These findings highlight the need for resilient healthcare systems to ensure continuity of cancer screening and treatment during global health crises.