For nasopharyngeal carcinoma, her randomised factorial study on concurrent and adjuvant chemotherapy in NPC is one of the studies included in metaanalysis of NPC which confirmed the importance of concurrent chemoradiotherapy in improving survival of NPC. She pioneered the use of intensity modulation radiotherapy (IMRT) in treatment of NPC in Hong Kong showing the advantage of IMRT in preserving salivary function, improving quality of life in early NPC and allowing dose escalation and improved local control in locally advanced NPC. Both concurrent chemoradiotherapy and IMRT have now been adopted as standard of care in treatment of NPC. Currently we are investigating the role of functional imaging like PET scan in predicting for early disease response and incorporating biological target volume in IMRT in order to adapt radiotherapy to individual disease response during treatment. In laboratory research, we studied the function of a number of novel tumor suppressor genes and found that hypermethylation is an important mechanism in inactivation of tumor suppressor genes.
The predominent histology of CA esophagus in Hong Kong is squamous cell carcinoma which is different from the adenocarcinoma which is more commonly seen in the West. We studied the genetic basis of carcinogenesis of squamous cell carcinoma of esophagus. We showed that chromosomal inbalance is common in CA esophagus and identify a number of areas which would habor novel oncogenes or tumor suppressor genes. We identify and characterize a novel tumor suppressor gene UPK1A in CA esophagus and found miRNA to be important in carcinogenesis. In clinical case management, we worked closely with the surgeons in multidisciplinary and multimodality treatment. Most cases are treated with pre-operative chemoradiation and then surgery. We aim to identify biomarkers which will predict response to pre-operative chemoradiotherapy.
Prof. Kwong also has a long standing interest in studying radiation complications like hearing loss, temporal lobe necrosis and xerostomia after radiotherapy and the ways to reduce such complications. We study advanced radiotherapy techniques like intensity modulated radiotherapy, adaptive radiotherapy and stereotactic body radiotherapy and promote their use of in clinical practice.
• Effective treatment of metastatic forms of Epstein-Barr virus-associated nasopharyngeal carcinoma with a novel adenovirus-based adoptive immunotherapy. Smith C, Tsang J, Beagley L, Chua D, Lee V, Li V, Moss DJ, Coman W, Chan KH, Nicholls J, Kwong DL, Khanna R. Cancer Res. 2012;72(5):1116-25. (Kwong D and Khanna R are co-corresponding authors)
• A prospective study on volumetric and dosimetric changes during intensity-modulated radiotherapy for nasopharyngeal carcinoma patients. Cheng HC, Wu VW, Ngan RK, Tang KW, Chan CC, Wong KH, Au SK, Kwong DL. Radiother Oncol 2012; 104(3): 317-23. (Cheng HC was PhD student of Prof. Kwong)
• Evaluation of radiation dose and image quality for the Varian cone beam computed tomography system. Cheng HC, Wu VW, Liu ES, Kwong DL. Int J Radiat Oncol Biol Phys 80(1): 291-300, 2011. (Cheng HC was PhD student of Prof. Kwong)
• Characterization of a candidate tumor suppressor gene uroplakin 1A in esophageal squamous cell carcinoma. Kong KL, Kwong DL, Fu L, Chan TH, Chen L, Liu H, Li Y, Zhu YH, Bi J, Qin YR, Law SY, Guan XY. Cancer Res 70(21): 8832-41, 2010. (Kong KL was PhD student of Prof. Kwong)
• Preliminary results of radiation dose escalation for locally advanced nasopharyngeal carcinoma.Kwong DL, Sham JS, Leung LH, Cheng AC, Ng WM, Kwong PW, Lui WM, Yau CC, Wu PM, Wei WI, Au GK. Int. J Radiat. Oncol. Bio. Phys. 64: 374-81, 2006.
• Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients. Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT, Kwong DL, Al-Sarraf M, Chi KH, Hareyama M, Leung SF, Thephamongkhol K, Pignon JP; MAC-NPC Collaborative Group. Int J Radiat Oncol Biol Phys 64: 47-56, 2006.
• Chromosomal aberrations in esophageal squamous cell carcinoma among Chinese: gain of 12p predicts poor prognosis after surgery. Kwong DL, Lam A, Guan XY, Law S, Tai A, Wong J, Sham J. Hum Pathol 35: 309-316, 2004.
• Concurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: a factorial study. Kwong DL, Sham JS, Au GK, Chua DT, Kwong PW, Cheng AC, Wu PM, Law MW, Kwok CC, Yau CC, Wan KY, Chan RT, Choy DD. J Clin Oncol 22 :2643-53, 2004.
• Intensity modulated radiotherapy for early stage nasopharyngeal carcinoma: a prospective study on disease control and preservation of salivary function. Kwong DL, Pow EHN, Sham JST, McMillan AS, Leung LHT, Leung WK, Chua DT, Cheng ACK, Wu PM, Au GKH. Cancer 101(7): 1584-93, 2004.