• Radiation Oncology Journal
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• v.19 no.4
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• pp.327-334
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• 2001

Purpose : To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. Materials and methods : From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coiler stage $B2\~C3$. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was peformed in the range of $39.6\~55.8\;Gy$ (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by $5.4\~10\;Gy$. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was peformed by Cox proportional hazards model. Results : 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were $53\%\;and\;49\%$, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were $63\%\;vs\;45\%$, respectively (p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups (p<0.05 by $\chi^2-test$) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were $68\%\;vs\;55\%$ (p=0.09), $100\%\;vs\;100\%$, $40\%\;vs\;33\%$ (p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were $65\%\;vs\;49\%$ (p=0.14), $100\%\;vs\;100\%$, $33\%\;vs\;31\%$ (p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was $72.5\%$. 5YPCRs of surgery alone and adjuvant radiotherapy group were $71\%\;vs\;74\%$, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were $79\%\;vs\;75\%$ (p=0.88), $100\%\;vs\;100\%$, $44\%\;vs\;68\%$ (p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. Conclusion : Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, with radiotherapy should be considered.

• Journal of Nutrition and Health
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• v.9 no.1
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• pp.84-91
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• 1976

Chemical determination were made to analyze the concentration of nutrients including proximate composition, vitamins, minerals, amino acids and fatty acids in three kinds of locally produced infantile formula milk(DFM) and one fermented milk(FM). An attempt was also made to compare the analytical values of nutrients against guaranteed values. The results obtained are summarized as follows; 1. The analyzed value of protein and fat content in DFM-A.B.C was slightly lower than that of guaranteed values and a reverse trend was observed in the case of total carbohydrate. There were no differences in proximate composition among the three kinds of DFM. It was found that the FM contained less protein and fat than the fresh milk, but it seemed that a considerable amount of sugar was added to FM. 2. The analyzed values of vitamin $A(2{\sim}3\;times)$ and $E(4{\sim}6\;times)$ contents in DFMS were higher than those of the guaranteed values except niacin. There were a little differences in vitamin contents among DFMS analyzed. 3. In the case of minerals, the analyzed values were similar to the guaranteed values except the calcium concentration that analyzed value was much higher than guaranted value. When the DFMS were diluted to 15% by adding water to compare with the human and fresh cow milk, it was found that the diluted DFMS resembled the human milk rather than cow milk in the content of energy, carbohydrates, protein and ash. The higher contents of iron and most vitamins in the diluted DFMS than the human milk or cow milk would indicate that they were fortificated with these nutrients. When these diluted DFMS were compared with the Korean R.D.A. for infant, it was clear that they could supply sufficient amount of the nutrients required by R.D.A. except the niacin which failed to reach the recommended level. The fact that iron content of DFM-C was not sufficient while vitamin A supply was excessive by 6 fold would indicate that further studies for the improvement may be necessary. 4. There was a little difference among DFMS in amino acid composition. The similarity of the essential amino acids composition between DFMS and cow milk indicated that there was no modification of the essential amino acids. However, present data showed that the amino acid compositon of FM was similar to that of the cow milk. 5. There was no difference among DFMS in the degree of saturation of fatty acids. The similar or higher levels of essential fatty acids contents of DFMS as compared with human milk revealed that essential fatty acids were added to DFMS during the course of process. From the experimental results described above, it may be concluded that the nutritive effects of three kinds of locally produced DFMS were much alike. It was also found that macro and micro nutrient composition except amino acid composition of locally produced dried formula milk was very much similar to that of the human milk. Moreover, fortification of iron and vitamins resulted in improving their nutritive values as the single form of infantile food, but it seemed that more consideration should be given on the fortification of some nutrients.