Several therapeutic options are available for clinical T1N0M0 thoracic esophageal squamous cell carcinoma (stage I ESCC); however, the studies on the treatment results are limited. This study assessed the outcomes of stage I ESCC treated with radiotherapy (RT), determined predictive factors, and evaluated the benefits of endoscopic submucosal dissection (ESD) combined with RT. We retrospectively analyzed the data of 50 patients (41 men, 9 women; median age, 66 years) with stage I ESCC treated with RT. The median total irradiation dose was 50 Gy. Elective nodal irradiation (ENI) was performed in 17 patients and ESD in 29 patients (ESD group). Forty-six patients concurrently received chemotherapy with RT. The median tumor length of ESD and non-ESD groups was 2.3 and 5 cm, respectively. The median follow-up was 33 months. The 3-year overall survival, disease-free survival (DFS), and local control (LC) rates were 77.3%, 61.1%, and 88.1%, respectively. Grade 3 adverse events occurred in 14 patients. T stage and tumor length were significant prognostic factors for 3-year DFS and 3-year LC, respectively. ESD appeared to be an important prognostic factor for LC. ENI and total irradiation dose above 50.4 Gy were not predictive factors. Our findings might help in treatment decisions for stage I ESCC.

Background/Aim: To examine the correlation between dosimetric parameters and acute radiation dermatitis in early breast cancer patients subjected to post-operative radiotherapy. Patients and Methods: The data of 84 patients treated with post-operative radiotherapy were analyzed. The total prescribed dose was 50 Gy in 25 fractions over 5 weeks. Radiation dermatitis was assessed according to Common Terminology Criteria for Adverse Events v4.0. We set organ at risk whole body (from neck to abdomen examined by CT images) also as surrogate skin volume (3 mm thickness). Results: A total of 28 patients showed radiation dermatitis grade equal or higher than 2 at the 50 Gy time point. These 28 patients were compared to 56 matched pair patients with grade 0-1 radiation dermatitis during the same treatment period. The mean of V5-20 and V40 in patient's whole volume and V40-50 in skin volume were significantly higher in patients who presented with acute radiation dermatitis Grades ≥2 than in the other patients who did not. The statistically most significant difference was observed for V40 for skin volume and V5 for patient whole volume. Rate of acute radiation dermatitis grade ≥2 was significantly higher for patients with V5 (whole body) >1,360 cm³ than those with V5 (whole body) 45 cm³ compared with those with V40 (skin volume) <45 cm³ (50% vs. 18%, p=0.0043). Conclusion: Dosimetric parameters were useful to predict radiation dermatitis grade ≥2. V5 (whole body) 1,360 cm³ and V40 (skin volume) 45 cm³ may be dose volume constrain for radiation dermatitis grade ≥2.

Background/Objectives To evaluate the efficacy and safety of unique magnetic resonance imaging (MRI)-guided interstitial brachytherapy (ISBT) for locally advanced cervical cancer that is unsuitable for intracavitary brachytherapy (ICBT) or intracavitary/interstitial brachytherapy (ICISBT). Methods: We analyzed the clinical outcomes, including toxicity, of 68 previously untreated patients with cervical cancer treated between 2014 and 2024. Results: The median high-risk clinical target volume (HR-CTV) was 53.20 cc (range, 16.34–147.03 cc) with ISBT. With a median follow-up time of 37.5 months (7–115 months), the three-year local control, progression-free survival, and overall survival rates were 89.8%, 52.4%, and 70.9%, respectively. Multivariate analyses showed significant associations of histology with local control, overall treatment times, HR-CTV volume with overall survival rate, over all treatment times, and HR-CTV volume and M category with progression-free survival. Toxicity grade 3 occurred in 12 patients (17.6%) and consisted of four genitourinary (5.8%) and seven gastrointestinal (10.2%) toxicities. Conclusions: MRI-guided ISBT is an effective treatment strategy for obtaining a favorable local control rate for selected advanced diseases with an acceptable complication rate. Future research is warranted to elucidate who would be good candidates for MRI-guided ISBT.