The peri-operative management of non-small cell lung cancer (NSCLC) in earlier stage disease has seen significant advances in recent years with the incorporation of immune checkpoint inhibitors and targeted therapy. However, many unanswered questions and challenges remain, including the application of clinical trial data to routine clinical practice. Recognising the unique demographic profile of Asian patients with NSCLC and heterogeneous healthcare systems, the Asian Thoracic Oncology Research Group (ATORG) convened a consensus meeting in Singapore on 26 April 2024 to discuss relevant issues spanning diagnostic testing to post-neoadjuvant treatment considerations and future directions. An interdisciplinary group of 19 experts comprising medical oncologists, thoracic surgeons, radiation oncologists, pulmonologists and pathologists from Singapore, Hong Kong, Mainland China, Korea, Japan, Taiwan, India, Malaysia, Thailand, Vietnam and Australia met to discuss emerging data, identify existing gaps in clinical care and develop a multidisciplinary, multinational expert consensus statement on the peri-operative management of NSCLC tailored to the Asia-Pacific region.

Objectives: Prostate cancer features have been linked to mutations in the BRCA1 and BRCA2 genes. Assessing the status of BRCA1 and BRCA2 gene carriers in patients contributes to accurate diagnosis, disease prognosis as well as appropriate targeted treatment methods. This study evaluated the prevalence of these mutations in Vietnamese prostate cancer patients and assessed their correlation with clinical features. Methods: A cross-sectional study was performed at Bach Mai Hospital between 2021 and 2022. We enrolled 60 prostate cancer patients. Next-generation gene sequencing was used to identify BRCA1 and BRCA2 mutations in formalin-fixed paraffin-embedded samples. Patients with somatic gene mutations underwent further germline mutation analysis. We also reported a case series following the British Medical Journal guidelines, detailing the clinical course of such patients. Results: Patients with BRCA2 pathogenic variants revealed no BRCA1 mutations, although different mutations were identified. Two patients showed germline mutations. Patients with BRCA mutations were younger (average age: 66.2 years) than those with non-mutations (72.1 years) at diagnosis. High Gleason scores, lymph node metastases, and distant metastases were more prevalent in the mutation group. One patient with germline BRCA mutation had aggressive prostate cancer and early resistance to non-PARPi (Poly ADP-ribose polymerase inhibitors) treatments. Conclusions: We provide preliminary data on BRCA mutations in Vietnamese patients with prostate cancer, suggesting that BRCA2 mutations correlate with aggressive disease characteristics. Our findings further elucidate the clinical implications of these mutations.

Aim: To evaluate the role of rotating gamma system (RGS) radiosurgery for low-grade brainstem gliomas. Patients and Methods: Thirty-seven patients undergoing RGS radiosurgery at the Bach Mai Hospital Hanoi for low-grade brainstem glioma were included in this prospective interventional study. The median RGS dose was 12 Gy (range=8-16 Gy). Endpoints included response to RGS radiosurgery given as change in glioma size (maximum diameter), survival and adverse events. Follow-up was performed for 36 months. Three dose-groups (14 Gy) were compared for survival. Results: Mean glioma size decreased from 1.87 cm before RGS irradiation to 1.15 cm at 36 months. Mean survival was 39.5 months. Mean survival after 14 Gy were 22.7, 66.7 and 49 months, respectively (p<0.05). Adverse events, mainly reduced appetite, sleep disturbances, headache and edema, were not associated with RGS dose and were easily managed. Conclusion: RGS radiosurgery led to promising results with acceptable toxicity in patients with low-grade brainstem gliomas.

Background: Microsurgical total removal of vestibular schwannoma (VS) is the definitive treatment but has a high incidence of postoperative neurological deficits. Rotating Gamma Knife (RGK) is a preferred option for a small tumor. This study aims to evaluate long-term neurological outcomes of RGK for VS. Methods: This prospective longitudinal study was conducted at the Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam. Eighty-nine consecutive patients were enrolled from October 2011 to October 2015 and followed up to June 2017. RGK was indicated for VS measuring <2.2 cm, while RGK for tumors measuring 2.2–3 cm was considered in patients with severe comorbidities, high-risk surgery, and who denied surgery. Concurrently, VS consisted of newly diagnosed, postoperative residual, and recurrent tumors. Patients with neurofibromatosis type 2 were excluded from the study. Primary outcomes were radiological tumor control rate, vestibulocochlear functions, facial and trigeminal nerve preservation. Stereotactic radiosurgery was performed by the Rotating Gamma System Gamma ART 6000. Results: The tumors were measured 20.7 ± 5.6 mm at pre treatment and 17.6 ± 4.1 mm at 3-year post treatment. The mean radiation dose was 13.5 ± 0.9 Gy. Mean follow-up was 40.6 ± 13.3 months. The radiological tumor control rate was achieved 95.5% at 5-year post treatment. The hearing and vestibular functions were preserved in 70.3% and 68.9%, respectively. The facial and trigeminal nerve preservation rates were 94.4% and 73.3%, respectively. Conclusion: RGK is an effective and safe treatment for VS measuring ≤3 cm with no significant complications during long-term follow-up.