• Title/Summary/Keyword: 와도 분포

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A Study on the Expression of CD44s and CD44v6 in Non-Small Cell Lung Carcinomas (비소세포성 폐암종의 CD44s 및 CD44v6의 발현에 대한 연구 -CD44의 발현에 대한 연구-)

  • Chang, Woon-Ha;Oh, Tae-Yun;Kim, Jung-Tae
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.1-11
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    • 2006
  • Background: CD44 is a glycoprotein on the cell surface which is involved in the cell-to-cell and cell-to-matrix interaction. The standard form, CD44s and multiple isoforms are determined by alternative splicing of 10 exons. Recent studies have suggested that CD44 may help invasion and metastasis of various epithelial tumors as well as activation of Iymphocytes and monocytes. The expression pattern of CD44 can be different according to tumor types. The author studied the expression pattern of CD44s and one of its variants, CD44v6 in non-small cell lung carcinomas (NSCLC) to find their implications on clinicopathologic aspects, including the survival of the patients. Material and Method: A total of 89 primary NSCLSs (48 squamous cell carcinomas, 33 adenocarcinomas, and 8 undifferentiated large cell carcinomas) were retrieved during the years between 1985 to 1994. The immunohisto chemistry was done by using monoclonal antibodies and the CD44 expression for angiogenesis was evaluated by counting the number of tumor microvessels. Result: Seventy-one (79.8$\%$) and 64 (71 .9$\%$) among 89 NSCLSs revealed the expression of CD44s and CD44v6, respectively. The expression of CD44s was well correlated with that of CD44v6 (r=0.710, p < 0.0001). The expression of CD44s and CD44v6 was associated with the histopathologic type of the NSCLCs, and squamous cell carcinoma was the type that showed the highest expression of CD44s and CD44v6 (p < 0.0001). Microvessel count was the highest in adenocarcinomas (113.6$\pm$69.7 on 200-fold magnification and 54.8$\pm$41.1 on 400-fold magnification) and correlated with the tumor size of TNM system (r=0.217, p=0.043) and CD44s expression (r=0.218, p=0.040). In adenocarcinoma, the patients with higher CD44s expression survived shorter than those with lower CD44s expression (p=0.0194) but there was no statistical significance on multivariate analysis(p=0.3298). Conclusion: The expression of both CD44s and CD44v6 may be associated with the squamous differentiation in non-small cell lung carcinomas. The relationship of CD44s expression with micro-vessel density of the tumor suggests an involvement of CD44s in tumor angiogenesis, which in turn would help tumor growth.

Induction Chemotherapy and Radiotherapy in Locally Advanced Non-Small Cell Lung Cancer (NSCLC) (국소 진행된 비소세포성 폐암에서 유도 화학요법 및 방사선치료)

  • Yun, Sang-Mo;Kim, Jae-Cheol;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.195-202
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    • 1999
  • Purpose : We peformed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). Materials and Methods : A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1$.8\~2.0$ Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy ($56\~66$ Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclo-phosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in $2\~5$ cycles (median 2). Results : Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were $41.5\%,{\;}13.7\%,{\;}and{\;}7\%$, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, $32.9\%,{\;}10.\5%,{\;}6\%$ for radiotherapy alone group, and 14 months, $57.8\%,{\;}20\%,{\;}7.6\%$ for induction chemotherapy group, respectively (f=0.0005). Complete response (CR) to overall treatments was $25\%$ (21/84) in radiotherapy alone and $40.5\%$ (17/42) in induction chemotherapy group (p=0.09). The Prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and respense to overall treatment(p=0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure Pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). Conclusion : Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radiotherapy alone, At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.

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Mineralogy and Biogeochemistry of Intertidal Flat Sediment, Muan, Chonnam, Korea (전남 무안 갯벌 퇴적물에 관한 광물학적 및 생지화학적 연구)

  • Park, Byung-No;Lee, Je-Hyun;Oh, Jong-Min;Lee, Seuug-Hee;Han, Ji-Hee;Kim, Yu-Mi;Seo, Hyun-Hee;Roh, Yul
    • Journal of the Mineralogical Society of Korea
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    • v.20 no.1 s.51
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    • pp.47-60
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    • 2007
  • While sedimentological researches on Western coastal tidal flats of Korea have been much pelformed previously, mineralogical and biogeochemical studies are beginning to be studied. The objectives of this study were to investigate mineralogical characteritics of the inter-tidal flat sediments and to explore phase transformation of iron(oxyhydr)oxides and biomineralization by metal-reducing bacteria enriched from the inter-tidal flat sediments from Muan, Jeollanam-do, Korea. Inter-tidal flat sediment samples were collected in Chungkye-myun and Haeje-myun, Muan-gun, Jeollanam-do. Particle size analyses were performed using the pipette method and sedimentation method. The separates including sand, silt and clay fractions were examined by scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis, transmission electron microscopy (TEM), and X-ray diffiaction (XRD). After enriching the metal-.educing bacteria from the into,-tidal flat sediments, the bacteria were used to study phase transformation of the synthesized iron (oxyhydr)oxides and iron biomineralization using lactate or glucose as the electron donors and Fe(III)-containing iron oxides as the electron accepters. Mineralogical studies showed that the sediments of tidal flats in Chung]rye-myun and Haeje-myun consist of quartz, plagioclase, microcline, biotite, kaolinite and illite. Biogeochemical researches showed that the metal-reducing bacteria enriched from the inter-tidal flat sediments reduced reddish brown akaganeite and mineralized nanometer-sized black magnetite. The bacteria also reduced the reddish brown ferrihydrite into black amorphous phases and reduced the yellowish goethite into greenish with formation of nm-sized phases. These results indicate that microbial Fe(III) reduction may play one of important roles in iron and carbon biogeochemistry as well as iron biomineralization in subsurface environments.

Effect of Seed Mixture on Forage Yields and Botanical Composition at an Altitude of 400 m in Jeju island (표고 400m 제주 중산간 지역에서 혼합조합별 초지 생산성 및 식생구성)

  • Chae, Hyun Seok;Kim, Nam Young;Woo, Jae Hoon;Shin, Moon Cheol;Son, Jun Kyu;Seong, Pil Nam;Lee, Wang Shik;Kim, Si Hyun;Hwang, Kyung Jun;Kim, Young Jin;Park, Nam Gun
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.37 no.1
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    • pp.19-27
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    • 2017
  • The objective of this study was to determine the growth characteristics of cool (C1) and warm season grasses (C2) in pastures mixed with C1 and C2 at an altitude of 400 m in Jeju island to establishing pasture suitable for grazing horses and to evaluate the effect of pastures mixed with tall and short type grasses on the intake characteristics of horses. C1 used in this study was Kentucky bluegrass, redtop (short type grass) and tall type grasses were orchardgrass and tall fescue, respectively. Treatments of this study were consisted of four groups and the short type grass used in pastures mixed with C1 and C2 was mainly bermudagrass. Four treatment groups were follow as; Treatment 1 (bermudagrass + Kentucky bluegrass + redtop) 2) Treatment 2 (bermudagrass + tall fescue + orchardgrass) 3) Treatment 3 (Kentucky bluegrass + redtop) 4) Treatment 4 (tall fescue + orchardgrass). Bermudagrass was a little winter killing and inhibition of plant growth at an altitude of 400 m. Plant heights in pastures mixed with C1 and C2 were grown better than that in pastures mixed with C1. Especially, plant height in Treatment 4 was higher than other treatments. Dry matter yield was in the following order: Treatment 4> Treatment 3> Treatment 2> Treatment 1. Dry matter yield in pastures mixed with C1 increased as compared with pastures mixed with C1 and C2. Dry matter yield in Treatment 3 was higher than other treatments. In the first investigation regarding vegetation distribution, bermudagrass ratios among grasses in Treatment 1 and Treatment 2 were 11.7 and 13.3%, respectively. The growth of bermudagrass in winter was low due to the cold damage. However the growth of Kentucky bluegrass, redtop, tall fescue and orchardgrass was good. In the second investigation, bermudagrass ratios among grasses in Treatment 1 and Treatment 2 were 5.0 and 11.7%, respectively. Growth of forage in the second investigation was poor as compared to the first investigation. nutritive values(crude protein content, neutral detergent fiber content, acid detergent fiber content, digestibility) were good in pastures mixed with C1 Especially, nutritive values in pastures mixed with tall was higher than those of pastures mixed short grasses. P content among minerals in Treatment 1 was higher than other groups. However, the content of Ca, Mg and Mn were lower. The contents of Ca, K, Mg, Na, Cu, Zn and Fe in Treatment 2 were higher. However, the contents of K, Mg, Na, Cu, Zn and Fe in Treatment 3 were lower. Therefore, we suggest that cool season grasses with short grasses were sowed to establishing pasture suitable for grazing horses at an altitude of 400 m in Jeju island.

Seasonal Variation in Lipids and Fatty Acid Composition of Neutral and Phospholipids of Hibernant Fishes(I) - Variation of Muscle Lipid Compositions of Loach (Misgurnus mizolepis) - (동면 어류의 지방질과 중성 및 인지질 조성의 시기적 변화(I) - 미꾸라지 근육 지질 조성의 변화-)

  • 홍재식;최선남;박일웅
    • The Korean Journal of Food And Nutrition
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    • v.10 no.1
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    • pp.14-24
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    • 1997
  • The seasonal variation in lipids, and fatty acid composition of neutral lipid(NL) and phospholipid(PL) contained in the muscles of hibernant fish(loach) were investigated. In the investigation, four groups of wild loaches ere used, those caught May, 1993(before spawning period), August, 1993(after spawning period), November, 1993(just before hibernation) and March, 1994(just after hibernation). The NL was the most abundant in muscle lipid, followed by PL and glycolipid(GL), and also the composition and variation patterns were almost similar between female and male throughout all the periods. NL content began to increase gradually after March and came to the maximum in August(under 90%) ; hereafter got to decrease gradually again and came to the minimum in March of the next year(under 60%). While the variation-pattern of GL and PL was in inverse proportion with that of NL and their content came to the maximum in March of the next year. The NL and PL fractions were mainly consisted of triglyceride and phosphatidyl choline respectively, and both of the contents showed the highest value in August, the lowest in March of the next year. The major fatty acids in NL fraction were 16:0, 16:1, 18:1, 18:2 and 18:3($\omega$3). In particular, the ratio of 16:1 was much higher than that in PL, while those of highly unsaturated fatty acids(HUFAs) such as 20:4($\omega$6), 20:5($\omega$3) and 22:6($\omega$3) were much lower. The ratio of 16:0 in NL was almost constant through the year, however those of 16:1, 18:1, 18:2 and 18:3($\omega$3) showed a tendency to increase after March and were about 2~4% higher in May, compared with that in March, while those of HUFAs were about 2~4% lower. In particular, the ratio of 16:1 in NL continuously decreased after May and markedly decreased in March of the next year, but those of 18:1, 18:2 were almost constant until November. In August, saturates and monoenes were higher levels due to the slight increase of 18:0, 14:1 and 17:1 than in the other periods, while those of HUFAs decreased and the unsaturation(TUFA/TSFA) of NL showed the lowest value in August. On the contrary, saturates and monoenes gradually decreased after November and the most of them including 18:0, 16:1, 18:1 and 18:2 rapidly decreased in March of the next year, while 20:1, 20:4(~6), and 20:5(~3), and 22:6(~3) were in inverse proportion. PL consisted mainly of 16:0, 16:1, 18:1, 18:2, 20:4(~6), and 20:5(~3). Saturates and monoenes-composition showed almost no difference in March and May, while polyene acids ratio showed similar changes with that of NL. In August, the ratio of saturates(16:0, 18:0) were high but that of HUFAs were low, and after November 16:0, 18:0, 18:1, 18:2 and 18:3($\omega$3) began to decrease, while most of HUFAs increased in their composition-ratio until the marking increase of their unsaturation and the big changes of 18:2, 18:3($\omega$3), 20:4($\omega$6), 22:6($\omega$3) in March of the next year.

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Characteristics of Spatio-temporal Variation of the Water Quality in the Lower Keum River (금강 하류역에서 수질의 시공간적 변화특성)

  • YANG Han-Soeb;KIM Seong-Soo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.23 no.3
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    • pp.225-237
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    • 1990
  • Various chemical constituents were measured from April to August 1988 at the down-ward 20 stations of Keum River, which is located in the Midwest of Korea, to understand the characteristics of water quality with respect to spatio-temporal variations of each constituent. The 24-hrs continuous measurements with 2-hrs interval were made simultaneously at station 2 near the estuary weir and station 9(Ganggyeong) of 35 km upstream from the weir in April. By the results observed for one day in April at station 2, salinity has a range of $7.88\~22.14\%_{\circ}$ and its temporal variability is identical to the pattern of tidal cycle in the neigh-bouring Kunsan Harbor. However, turbidity shows relatively high values only at an interval of 4~5 hours after the lowest salinity time, though hourly fluctuation of pH is very small. Silicate and dissolved inorganic nitrogen have inversively linear correlationships with salinity, implying the concentration of the two nutrients strongly regulated by estuarine mixing of sea and river waters. In contrast, phosphate sustains roughly a constant level over a wide salinity range and distinctly lower values than those corresponding to nitrate in the oceans. Such distributions of phosphate have been observed in some estuaries, and interpreted as driven by removal of dissolved phosphate into bottom sediments and the bufforing of phosphate by particulate matter. COD values at station 2 are relatively high in day-time(particularly afternoon) and in high-salinity periods. At station 9, saltwater intrusion was never found but water level changed to the extent of 2.5 m for one day. Although each parameter at this station exhibits very slight variations in their abundance for 24 hours compared with station 2, the contents of COD, silicate and ammonia are significantly higher than at station 2. Concentration of suspended matter is relatively high in the brackish water region up to $\~20$ km above the river mouth, probably due to strong tidal stirring of the bottom de-posits. Also, relatively high pH, COD and $O_2$ saturation at the upward stations of $40\~50$ km from the weir are presumably attributable to active photosynthesis of plants in the region. In general, COD and nutrients except phosphate are higher values at the upper stations than in the estuary zone, and show the highest abundances in July nearly at all stations. Finally, in the estuarine region tidal mixing of sea-river waters seems to be an important factor controlling the distributions of turbidity, COD, silicate and nitrate as well as salinity. However, water quality in the upward fresh-water zone is remarkably variable according to months or seasons.

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Biodiversity and Community Composition of Benthic Macroinvertebrates from Upo Wetlands in Korea (우포습지의 저서성 대형무척추동물 다양성과 군집 특성)

  • 배연재;조신일;황득휘;이황구;나국본
    • Korean Journal of Environment and Ecology
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    • v.18 no.1
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    • pp.75-91
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    • 2004
  • Biodiversity and seasonal community composition of benthic macroinvertebrates were studied from Upo wetlands in Gyeongsangnam-do, Korea, comprising Upo (4 sites), Mokpo (2 sites), Sajipo (1 site), Jjokjibeol (1 site), Yeobeol (1 site), and Topyeongcheon (2 sites) areas from October 2002 to August 2003. As a result, it was known that Upo wetlands retained relatively well-preserved littoral zones which may provide good habitats for benthic macroinvertebrates; however, frequent disturbances of littoral zones caused by flood were the major factor affecting on the survival and distribution of benthic macroinvertebrates in the areas. During the study period, a total of 135 species of benthic macroinvertebrates in 10 genera, 59 families, 16 orders, 7 classes, and 3 phyla were collected those of which are the highest degree of diversity of the taxa ever known in Korean wetlands: aquatic insects 103 spp. (Diptera 27 spp., Odonata 24 spp., Coleoptera 19 spp., Hemiptera 16 spp., Ephemeroptera 9 spp., Trichoptera 7 spp., and Collembola 1 sp.), Crustacea 2 spp., Mollusca 19 spp. (Gastropoda 12 spp. and Bivalvia 7 spp.), and Annelids 11 spp. (Oligocaeta 1 sp. and Hirudinea 10 spp.). Sajipo (St.G) and Jjokjibeol (St.H) areas yielded relatively larger numbers of species, 54 spp. and 53 spp., respectively, while more than 40 species occurred at most other sites. Based on quantitative sampling (0.5m${\times}$2m), aquatic insects (88.0%), particularly chironomids in Diptera (61.0%), occupied major proportion of the total individuals of benthic macroinvertebrates, while Mollusca (5.3%), Annelida (3.5%), and Crustacea (3.2%) occupied minor proportions. In standing water areas, diverse groups of benthic macroinvertebrates such as chironomids, demselflies, aquatic bugs, aquatic beetles, crustaceans, and gastropods were dominant in terms of individual number; in the running water areas, on the other hand, chironomids and baetid mayflies were dominant. However, gastropods, i.e. viviparids, were the dominant group of benthic macroinvertebrates in most study areas in terms of biomass. Dominance indices were 0.22-0.51 (mean$\pm$sd 0.42$\pm$0.09) in autumn, 0.31-0.96 (0.02$\pm$0.23) in winter, and 0.30-0.89 (0.57$\pm$0.18) in summer; diversity indices were 3.50-4.26 (3.80$\pm$0.24) in autumn,1.55-4.50 (3.10$\pm$1.01) in winter, and 1.35-3.77 (2.55$\pm$0.09) in summer. Highly movable or true aquatic benthic macroinvertebyates such as aquatic bugs, aquatic beetles, and gastropods recovered earlier after flood. In the study sites of Upo wetlands, Upo and Sajipo areas showed relatively higher values of average diversity index which may indicate a good habitat condition for benthic macroinvertebrates.

Association between Genetic Polymorphisms of Milk Proteins and Milk Compositions in Holstein Cows (Holstein 종(種) 유우(乳牛)의 유단백질(乳蛋白質)의 유전적다형(遺傳的多型)과 유조성분간(乳組成分間)의 연관성)

  • Sang, Byong Chan;Lee, Jo Yoon;Choi, Jong Woo;Sung, Chang Keun
    • Korean Journal of Agricultural Science
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    • v.20 no.1
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    • pp.56-67
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    • 1993
  • To applying of genetic markers of milk proteins as dairy cow registration and selection aids for genetic improvement, genopypes controlling the 4 milk protein loci, ${\alpha}S1$-casein (${\alpha}S1$-CN), ${\beta}$-casein(${\beta}$-CN), ${\kappa}$-casein(${\kappa}$-CN), and ${\beta}$-lactoglobulin(${\beta}$-LG), from a total of 159 Holstein lactating cows reared at National Animal Breeding Station in 1992 were detected by polyacrylamide gel(PAGE) electrophoresis, and associations between genetic polymorphisms of milk proteins and milk compositions were analyzed. The observed distribution of phenotypes for ${\alpha}S1$-CN, ${\beta}$-CN, ${\kappa}$-CN and ${\beta}$-LG were agreement with those expected under the assumption of genetic equilibrium. The observed genotypic frequencies of the ${\alpha}S1$-CN BB, ${\beta}$-CN AA, ${\kappa}$-CN AA and ${\beta}$-LG AB genotypes were founded to be very high as 79.87%, 84.28%, 71.70% and 49.10%, respectively. Gene frequencies were 0.899 and 0.101 for ${\alpha}S1-CN^B$ and ${\alpha}S1-CN^C$, 0.921 and 0.079 for ${\beta}-CN^A$ and ${\beta}-CN^B$, 0.837 and 0.163 for ${\kappa}-CN^A$ and ${\kappa}-CN^B$, 0.378 and 0.622 for ${\beta}-LG^A$ and ${\beta}-CN^B$. According to the results of analysis of variance, the genotypes of the ${\alpha}S1-CN$, ${\beta}-CN$, ${\kappa}-CN$ and ${\beta}-LG$ were significantly difference for fat, protein and total solid percentage in milk compositions. On milk compositions, the ${\kappa}$-CN BB genotype was very high fat and protein percentage more than ${\kappa}$-CN AA and AB genotypes, and ${\beta}$-LG AA genotype was very high fat percentage more than ${\beta}$-LG AB and BB genotype at 5% level of significant difference, respectively. As a consequence, the fat and protein percentage may be improved to select to ${\kappa}$-CN BB and ${\beta}$-LG AA genotypes.

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Removal of Red Tide Organisms -2. Flocculation of Red Tide Organisms by Using Loess- (적조생물의 구제 -2. 황토에 의한 적조생물의 응집제거-)

  • KIM Sung-Jae
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.33 no.5
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    • pp.455-462
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    • 2000
  • The objective of this study was to examine the physicochemical characteristics of coagulation reaction between loess and red tide organisms (RTO) and its feasibility, in developing a technology for the removal of RTO bloom in coastal sea. The physicochemical characteristics of loess were examined for a particle size distribution, surface characteristics by scanning electron microscope, zeta potential, and alkalinity and pH variations in sea water. Two kinds of RTO that were used in this study, Cylindrothen closterium and Skeietonema costatum, were sampled in Masan bay and were cultured in laboratory. Coagulation experiments were conducted using various concentrations of loess, RTO, and a jar tester. The supernatant and RTO culture solution were analyzed for pH, alkalinity, RTO cell number. A negative zeta potential of loess increased with increasing pH at $10^(-3)M$ NaCl solution and had -71.3 mV at pH 9.36. Loess had a positive zeta potential of +1,8 mV at pH 1.98, which resulted in a characteristic of material having an amphoteric surface charge. In NaCl and $CaCl_2$, solutions, loess had a decreasing negative zeta potential with increasing $Na^+\;and\;Ca^(+2)$ ion concentration and then didn't result in a charge reversal due to not occurring specific adsorption for $Na^+$ ion while resulted in a charge reversal due to occurring specific adsorption for $Ca^(+2)$ ion. In sea water, loess and RTO showed the similar zeta potential values of -112,1 and -9.2 mV, respectively and sea sand powder showed the highest zeta potential value of -25.7 mV in the clays. EDLs (electrical double-layers) of loess and RTO were extremely compressed due to high concentration of salts included in sea water, As a result, there didn't almost exist EDL repulsive force between loess and RTO approaching each other and then LVDW (London-yan der Waals) attractive force was always larger than EDL repulsive force to easily form a floe. Removal rates of RTO exponentially increased with increasing a loess concentration. The removal rates steeply increased until $800 mg/l$ of loess, and reached $100{\%}$ at 6,400 mg/l of loess. Removal rates of RTO exponentially increased with increasing a G-value. This indicated that mixing (i.e., collision among particles) was very important for a coagulation reaction. Loess showed the highest RTO removal rates in the clays.

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Postmastectomy Radiotherapy and Chemotherapy in Patients with Breast Cancer (유방절제술을 시행한 유방암 환자에서 방사선과 항암제 치료성적)

  • Ahn Sung-Ja;Chung Woong-Ki;Nam Taek-Keun;Nah Byung-Sik;Song Ju-Young;park Seung-Jin
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.17-24
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    • 2004
  • Purpose: To evaluate the treatment outcomes after postmastectomy radiotherapy (PMRT) and chemotherapy in patients with breast cancer. Materials and Methods: The PMRT were retrospectively analyzed in 83 patients with stage II-III female breast cancer treated between 1989 and 1995. The median age was 46 years (range, 23-77): Seventy-seven patients had modified radical mastectomies, 5 radical mastectomies and 1 simple mastectomy. Three patients ($4\%$) had pathologically negative axillae, and the remaining 80 ($96\%$) had positive axillae. Eleven, 23, 44 and 5 patients had pathological stages IIA, IIB, IIIA, and IIIB, retrospectively. Eighty ($96\%$) patients were treated with hockey-stick fields. The median dose of PMRT was 50.4 ey, in 1.8 Gy fractions. Adjuvant systemic chemotherapy was given to 74 patients ($89\%$). CMF-based or doxorubicin-containing regimens were given to 54 patients ($55\%$). The median follow-up time was 82 months (range, 8-171) after the mastectomy. Results: The 5 and 10-year overall survival rates for all patients were 65 and $49\%$, respectively. The univariate and multivariate analyses of the factors affecting the overall survival revealed the stage to be the most significant prognostic factor (p=0.002), followed by the combination of chemotherapy. Thirteen patients $16\%$ developed a LRF, at an interval of 4-84 months after radiotherapy, with a median of 20 months. The only significant prognostic factor affecting LRF was the combination of chemotherapy, in both the univariate and multivariate analyses. With respect to the sequence of chemoradiation, the sequence had no saatistical significance (p=0.90). According to the time interval from mastectomy to the onset of radiotherapy, the LRFR of the patients group treated by RT within or after 6 month postmastectomy 6 months were 14 vs. $27\%$ respectively (p=0.24). One third of the pa41en1s (26/83) developed distant metastasis, in 2-92 months, after radiotherapy, with a median of 21 months. The most commonly involved site was bone in 13 cases. The pathological staging was the only significant prognostic factor in both the univariate and multivariate analyses that affected distant failure. Radiological finding of radiation pneumonitis on a simple chest x-ray was shown in $20\%$ (17/83), with a time interval ranging from 2 to 7 months post-radiotherapy, with a median of 3 months. The stable lung fibrosis settled in 11 patients ($65\%$). Conclusion: It was concluded through this analysis that the combination of PMRT with in chemotherapy resulted in better overall survival and local control than PMRT alone in patients needing PMRT.