Publications by authors named "Shangwen Chen"

Objectives: This study aimed to develop an integrated segmentation-free deep learning (DL) framework to predict multiple aspects of radiotherapy outcome in pharyngeal cancer patients by analyzing pretreatment 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT).

Methods: We utilized baseline 18F-FDG-PET/CT scans from patients newly diagnosed with oropharyngeal or hypopharyngeal cancer. The study cohort comprised 162 patients for training and 32 for validation, all of whom completed definitive chemoradiotherapy or radiotherapy for organ-preservation.

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  • A deep learning model was developed to predict distant metastases in patients with locally advanced uterine cervical cancer using baseline [18F]FDG-PET and CT images, enhanced by a novel imaging augmentation technique.
  • The study utilized data from 186 and 25 patients for training and validation, respectively, measuring the model's performance through ROC curve analysis.
  • The model showed promising results with an area under the ROC of 0.818 and 0.830 for the training and validation cohorts, highlighting its ability to predict outcomes effectively, although external validation is still needed.
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Objectives: To predict KRAS mutation in rectal cancer (RC) through computer vision of [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) by using metric learning (ML).

Methods: This study included 160 patients with RC who had undergone preoperative PET/CT. KRAS mutation was identified through polymerase chain reaction analysis.

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Stereotactic ablative radiotherapy (SABR) may improve survival in patients with inoperable pulmonary oligometastases. However, the impact of pulmonary oligometastatic status after systemic therapy on SABR outcomes remains unclear. Hence, we investigated the outcomes of SABR in 45 patients with 77 lung tumors and the prognostic value of pulmonary oligoprogression.

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With the rapid development of web technologies and the popularity of smartphones, users are uploading and sharing a large number of images every day. Therefore, it is a very important issue nowadays to enable users to discover exactly the information they need in the vast amount of data and to make it possible to integrate their large amount of image material efficiently. However, traditional content-based image retrieval techniques are based on images, and there is a "semantic gap" between this and people's understanding of images.

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Primary intestinal T-cell lymphomas (PITLs) comprise enteropathy-associated T-cell lymphoma (EATL), monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), extranodal NK/T-cell lymphoma (ENKTL), anaplastic large cell lymphoma (ALCL), and intestinal T cell lymphoma, NOS (ITCL-NOS). MEITL is composed of monomorphic medium cells expressing CD8 and CD56, with a cytotoxic phenotype. We retrospectively analyzed 77 cases of intestinal T-cell lymphomas, 71 primary and six secondary, at a tertiary center in Taiwan from 2001 to 2021.

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  • The study aimed to evaluate the effectiveness of external-beam radiation therapy (EBRT) combined with image-guided brachytherapy (IGBT) in patients with inoperable endometrial cancer (EC).
  • Out of 50 patients treated, the main reasons for inoperability included anesthesia risks due to medical conditions and obesity, with the treatment showing promising local control rates and manageable side effects.
  • The results indicated a 2-year overall survival rate of 75% and a cancer-specific survival rate of 83%, suggesting that this combined treatment approach can be effective with low incidences of severe complications.
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The five-year overall survival rate of patients without neck lymph node recurrence is over 50% higher than those with lymph node metastasis. This study aims to investigate the prognostic impact of computed tomogram (CT)-based radiomics on the outcome of metastatic neck lymph nodes in patients with head and neck cancer (HNC) receiving definitive radiotherapy or chemoradiotherapy for organ preservation. The pretreatment 18F-FDG PET/CT of 79 HNC patients was retrospectively analyzed with radiomics extractors.

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The incidence of nasopharyngeal carcinoma (NPC) in Southeast Asia and Taiwan is high due to epidemiological factors. Cisplatin-based chemoradiotherapy is an important treatment strategy with excellent outcomes for patients with NPC. However, the outcomes for patients who are refractory to cisplatin-based therapy are poor.

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Classic Hodgkin lymphoma (CHL) is a lymphoid neoplasm deriving from B cells in a rich inflammatory background. There are four histological subtypes with different epidemiological features. Bone marrow involvement by CHL is infrequent, and subtyping CHL from the bone marrow is not suggested as there might be discordant histopathology between the primary tumors and bone marrow specimens.

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  • Neoadjuvant chemoradiotherapy (NCRT) is a key treatment for locally advanced rectal cancer, and a new AI model aims to predict patient responses using 18F-FDG-PET/CT imaging.
  • The study analyzed data from 236 rectal cancer patients, training the model on 202 cases and validating it on 34, with treatment responses graded based on tumor regression.
  • The model showed high predictive performance in both training (sensitivity: 98.3%) and validation (sensitivity: 95.0%) cohorts, indicating that PET/CT images can effectively forecast favorable treatment outcomes, though further external validation is needed.
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Background: The emergence of chemoresistance to 5-fluorouracil (5-FU)-based chemotherapy is the main cause of treatment failure in advanced and metastatic colorectal cancer (CRC) patients. Long noncoding RNAs (lncRNAs) have been reported to be involved in 5-FU resistance. Previously, we first detected that lncRNA cetuximab resistance-associated RNA transcript 16 (CRART16) could contribute to cetuximab resistance by upregulating V-Erb-B2 erythroblastic leukemia viral oncogene homologue 3 (ERBB3) expression by sponging miR-371a-5p in CRC cells.

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Background: Primary cutaneous gamma/delta T-cell lymphoma (PCDG-TCL) is aggressive, frequently presenting as multiple plaques, tumors, and/or subcutaneous nodules.

Methods: In this study, we conducted a retrospective study in a tertiary center in Taiwan to characterize this rare tumor.

Results: We identified six patients.

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Adjuvant concurrent chemoradiotherapy (CCRT) is the standard care for patients with resected advanced gastric cancer, but its survival benefits remain undetermined in patients undergoing D2 lymph node dissection (D2 dissection). We evaluated safety and efficacy of adjuvant CCRT with 5-fluorouracil (5-FU) versus chemotherapy alone in 110 gastric cancer patients with D2 dissection treated in Taiwan between January 2009 and January 2013. All the 71 patients receiving adjuvant CCRT were treated with daily infusional 5-FU and radiotherapy.

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Diet-induced obesity (DIO) is considered the main risk factor for cardiovascular diseases. Increases in the plasma levels of tumor necrosis factor alpha (TNF-α) is associated with DIO. Etanercept, a TNF-α inhibitor, has been shown to alleviate cardiac hypertrophy.

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  • The study aimed to assess the effectiveness of stereotactic body radiotherapy (SBRT) in gynecological cancer patients who had pelvic recurrences or an intact uterus when brachytherapy wasn't suitable.
  • A total of 25 patients were reviewed, with doses administered yielding a notable 72% initial response rate, though the overall survival rates varied between groups.
  • Early side effects were manageable, with further long-term follow-up needed to fully understand the treatment’s impact on control and survival.
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Purpose: The objective of this study was to determine whether pretreatment neutrophil-to-lymphocyte ratio (NLR) could predict survival outcomes and liver toxicity in hepatocellular carcinoma (HCC) patients treated with stereotactic ablative radiation therapy (SABR).

Methods And Materials: In this retrospective study we collected pretreatment NLR of HCC patients treated with SABR between December 2007 and August 2018 and determined its association with overall survival (OS), progression-free survival, and radiation-related liver toxicity defined as an increase in the Child-Turcotte-Pugh score by ≥2 within 3 months after SABR in the absence of disease progression.

Results: A total of 153 patients with a median follow-up of 13.

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Background: Thyroid transcription factor-1 (TTF-1) is a useful marker for identifying thyroid and lung cancers in diagnostic pathology, particularly for the investigation of unknown primary cancers. However, some other tumors such as colorectal cancer might aberrantly express TTF-1, particularly with the less specific clone SPT24. Occasional diffuse large B-cell lymphoma (DLBCL) cases have been reported to be TTF-1-positive, yet there is no information on TTF-1 expression in peripheral T-cell lymphoma (PTCL).

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  • The NALA trial compares the effectiveness of neratinib plus capecitabine (N+C) with lapatinib plus capecitabine (L+C) in patients with HER2-positive metastatic breast cancer who have previously undergone treatment.
  • Results showed that N+C led to a significant improvement in progression-free survival (PFS) and reduced the need for interventions related to central nervous system (CNS) disease compared to L+C.
  • While both treatments had adverse effects such as diarrhea and nausea, the safety profiles and quality of life measures were similar between the two groups.
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  • The study examined how certain genomic biomarkers can predict treatment outcomes for patients with adenocarcinoma of the uterine cervix undergoing chemoradiotherapy (CRT).
  • It analyzed data from 21 patients using tissue samples and next-generation sequencing to identify key genetic alterations affecting survival rates.
  • Key findings indicated that MCL1 gene amplification and lower TNF-α levels were linked to worse disease-free survival, with specific prognostic implications suggested for better patient management.
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Background: Neoadjuvant chemoradiotherapy (NCRT) followed by surgery is the standard treatment for patients with locally advanced rectal cancer. This study developed a random forest (RF) model to predict pathological complete response (pCR) based on radiomics derived from baseline F-fluorodeoxyglucose ([F]FDG)-positron emission tomography (PET)/computed tomography (CT).

Methods: This study included 169 patients with newly diagnosed rectal cancer.

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Background: Stereotactic ablative radiotherapy (SABR) can deliver tumoricidal doses and achieve long-term control in early hepatocellular carcinoma (HCC). However, limited studies have investigated the safety and effectiveness of SABR in patients with advanced diseases that is unsuitable for transarterial chemoembolization (TACE).

Methods: In this observational study, we reviewed the medical records of patients with Barcelona Clinic Liver Cancer (BCLC) stage C disease treated with linear accelerator-based SABR between 2008 and 2016.

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  • The study aimed to assess the impact of specific immunohistochemical biomarkers on the treatment outcomes of patients with adenocarcinoma of the uterine cervix undergoing chemoradiotherapy (CRT).
  • A total of 42 patients were analyzed, with their cancer stages classified according to the International Federation of Gynecology and Obstetrics, and several biomarkers were examined through tissue microarrays from biopsy samples.
  • The findings revealed that overexpression of MCL1 and higher H-scores of c-MYC were significant factors linked to poorer survival and local cancer recurrence, highlighting their potential role in predicting treatment outcomes for these patients.
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  • This study compares image-guided brachytherapy (IGBT) and conventional two-dimensional brachytherapy (2DBT) for treating advanced cervical squamous cell carcinoma in 253 patients.
  • Both treatment groups were matched for tumor stage, age, and size, with 136 patients receiving 2DBT and 117 receiving IGBT.
  • While overall survival rates were similar, IGBT showed significantly lower rates of severe gastrointestinal (8.5% vs. 21.3%) and genitourinary (1.7% vs. 11.8%) complications, highlighting its advantages in reducing late toxicities.
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  • Researchers developed a deep learning model to analyze F-FDG PET/CT images for predicting local and distant failures in patients with cervical cancer.
  • The study involved 142 patients, resulting in the creation of 1562 slice sets from imaging data to enhance accuracy in predicting treatment outcomes.
  • The model showed promising results with high sensitivity and specificity: 71% sensitivity and 93% specificity for local recurrence, and 77% sensitivity and 90% specificity for distant metastasis.
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