• Radiation Oncology Journal
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• v.26 no.4
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• pp.204-212
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• 2008

Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.

• Korean Journal of Veterinary Research
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• v.35 no.3
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• pp.543-552
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• 1995

This study was undertaken to investigate the eftects of Cd administered ad libitum for 6 weeks on the cellular immune responses of Balb/c mice. The results were summarized as follows; 1. The mice fed 25, 50 and 100ppm Cd drank as much as control, but the mice fed 200ppm Cd drank significantly less water after Cd exposure than did control. Increasing rates of body weight of Cd-fed mice for 6 weeks were as this, control group 27.0%, Cd administered groups(25, 50, 100 and 200ppm) 28.54%, 28.31%, 20.49% and 18.04%, respectively. 2. Absolute spleen to body weight(mg/g) of control, 25, 50, 100 and 200ppm Cd administered groups were $4.34{\pm}0.23$, $4.20{\pm}0.54$, $4.80{\pm}0.87$, $4.25{\pm}0.32$ and $4.40{\pm}0.32$, respectively. Splenic cellularity(${\times}10^7$) of control was $24.29{\pm}5.98$ but increased to $27.72{\pm}5.48$, $32.96{\pm}8.44$, $28.32{\pm}8.76$ and $29.64{\pm}4.08$ in 25, 50, 100 and 200ppm Cd-fed groups, respectively. 3. Total $CD_4{^+}$ cells(${\times}10^7$) of control, 25, 50, 100 and 200ppm Cd-fed groups were $9.15{\pm}2.24$, $10.40{\pm}2.04$, $12.04{\pm}3.08$, $10.20{\pm}3.16$ and $10.80{\pm}1.48$, respectively and total $CD_8{^+}$ cells(${\times}10^7$) of these groups were $2.32{\pm}0.56$, $2.54{\pm}0.27$, $3.12{\pm}0.80$, $2.25{\pm}0.70$ and $2.24{\pm}0.28$, in order. On the other hand, $CD_4{^+}/CD_8{^+}$ ratios in total cells were increased significantly except for 50ppm Cd-fed group($3.88{\pm}0.01$). And that of control was $3.97{\pm}0.02$, but those of 25, 100 and 200ppm were $4.35{\pm}0.01$, $4.54{\pm}0.03$ and $4.81{\pm}0.03$. 4. Phagocytosis rates of peritoneal macrophages were increased significantly in 25 and 50ppm Cd groups($36.34{\pm}9.45$ and $37.15{\pm}9.22$, respectively), but 100 and 200ppm groups showed similar rates($18.20{\pm}3.04$ and $19.48{\pm}3.22$ respectively) to that of control($21.43{\pm}3.62$). 5. In mitogen-induced splenocyte proliferation, various concentraions of $CdCl_2(10^{-4}-10^{-7}M)$ were added to mitogen-stimulated culture in vitro. Splenocyte proliferation induced by LPS was decreased dose dependently, but proliferation by Con-A was increased slightly in concentrations of $10^{-7}-10^{-6}M$. 6. Significant cytotoxicity of splenocytes with $CdCl_2$ were shown at $10^{-4}M$ treated group, especially at 24 hrs. From these results, it could be concluded that Cd might modulate the immune responses by modifying a distribution of T cell subpopulations.