유방종양에서 술후방사선치료의 결과

Results of Postoperative Radiotherapy for Breast Carcinoma

1989년부터 1989년까지 인제대학교 의과대학 서울백병원에서 25명의 환자가 수술 및 술후 방사선치료를 받았다. 25명의 환자가 고찰이 가능하였고, 이중 II병기에 7명, III병기에 14명, 그리고 IV병기에 2명이 속해있었다. 21명의 환자가 변성근치유방절제술을, 2명의 환자가 단순유방절세술을 실시하였다. 추적관찰기간은 2년에선 8년이었다. 전체군에서의 국소치유율은 $83\%$이었다. 전이된 액와임파절의 수가 국소치유에 영향을 미치고 있었다. 전이된 임파절이 없거나 3개 이하의 임파절을 갖고 있는 환자의 국소치유율은 $100\%$,이고, 4개 이상을 갖고 있는 환자에서는 $72\%$이었다. 전체환자군의 5년 생존율은 $59\%$이고 5년 무병생존율은 $32\%$이었다. 각 병기에 따른 5년 생존율은 II병기에서 $83\%$, III병기에서 $59\%$, IV병기에서 $50\%$이었다. 원격전이는 23명중 10명에서 발생하였고 가장 빈발부위는 골부위였다. 결론적으로 술후방사선치료가 실패율이 높은 유방종양환자의 치료에서 중요한 역할을 하고 있었다.

Between December 1983 and December 1989, twenty-five breast carcinoma patients were treated with surgical resection and postoperative radiotherapy at Inje University Seoul Paik Hospital. Twenty-three of 25 were evaluable and there were 7 patients with stage II ,14 patients with stage III, and 2 patients with stage IV. Twenty-one patients were treated with modified radical mastectomy and the remained 2 patients with simple mastectomy. The follow-up period ranged from 2 to 8 years. The local control rate was $83\%$ for the entire group. The local control rates for each stage were $100\%$(6/6) for stage II, $73\%$(11/15) for stage III, and $100\%$(2/2) for stage IV. The number of metastatic axillary nodes was a good predictor of locoregional cotrol. It was $100\%$ for the patients with 0-3 metastatic nodes and $72\%$ for more than 4 nodes, respectively. The 5-year overall survival rate for the entire group was $59\%$, and the disease-free survival rate was $32\%$, The 5-year survival rates for each stage II, III and IV was $83\%$, $59\%$ and $50\%$, respectively. The distant metastasis occured in 10 out of 23 patients and the most common site was bone. The results indicate that postoperative radiotherapy continues to play an important role in the primary.