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Comparison of Functional Materials in Organic Cultivated Minor Cereal Crops (유기농 잡곡의 몇몇 기능성 물질 비교)

  • Yoon, Seong-Tak;Kim, Tae-Ho;Nam, Jung-Chang;Kim, Tae-Yun;Kim, Hye-Rim;Jo, Sung-Hoon;Lee, Seung-Woo;Lee, Myung-Cheol;Kim, Min-Jeong;Kim, Seong-Min
    • Korean Journal of Organic Agriculture
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    • v.20 no.4
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    • pp.619-630
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    • 2012
  • Miscellaneous grain crops has been appeared as a well-being food and the demand of them are increasing recently. It is urgent to study especially about the functional materials of foxtail millet, common millet and sorghum. This experiment was conducted to evaluation and comparison several functional materials of fatty acids, anthocyanin content, total phenol content and DPPH assay of rice, and foxtail millet, common millet and sorghum produced organically so that these results would provide as a basic information for developing functional products by using miscellaneous grain crops. Total content of fatty acids was in order of foxtail millet (0.649%) and common millet (0.33%), sorghum (0.172%) and rice (0.111%) respectively. The content of unsaturated fatty acid was also in order of foxtail millet (0.511%) and common millet (0.269%), sorghum (0.122%) and rice (0.069%) respectively. Although there was no detection of anthocyanin content in rice, foxtail millet and common millet, sorghum showed high content of anthocyanin content. Sorghum of Mongdangsusu showed the highest anthocyanin content (137.5mg/g). In the total phenol content of rice, foxtail millet, common millet and sorghum, rice of Chucheongbyeo had high content ($13.70{\mu}g/g$) whereas Daeanbyeo was the lowest content ($10.07{\mu}g/g$). Foxtail millet of Hinchajo, common millet of Byeorukgijang and sorghum of Chalsusu showed the highest total phenol content of $25.8{\mu}g/g$, $69.4{\mu}g/g$ and $682.2{\mu}g/g$ respectively. In the average of total phenol content among rice, foxtail millet, common millet and sorghum, foxtail millet, common millet and sorghum showed $12.25{\mu}g/g$, $16.95{\mu}g/g$, $51.01{\mu}g/g$ and $447.4{\mu}g/g$ of total phenol content respectively. The average of total phenol content of sorghum was $26.3{\mu}g/g$. It is 36.3 and 26.3 times higher compared with rice and foxtail millet respectively. In the antioxidant activity of seeds by DPPH(1,1-diphenyl-2-picrylhydrazyl) assay for rice, foxtail millet, common millet and sorghum, rice of Chucheongbyeo, foxtail millet of Ganghywajo and common millet of Geumeungijang showed the highest antioxidant activity with 3.6%, 4.78% and 13.4% respectively. Antioxidant activity of sorghum ranged from 88.47 to 90.11%. The average of antioxidant activity among four crops, the highest antioxidant activity was obtained from sorghum (89.50%) and the next was common millet (6.13%), foxtail millet (2.43%), and rice (1.60%) in their order of antioxidant activity. The average of antioxidant activity of sorghum showed 55.9, 37.0 and 15times higher compared with rice, common millet and foxtail millet respectively.

Performance Characteristics of 3D GSO PET/CT Scanner (Philips GEMINI PET/DT) (3차원 GSO PET/CT 스캐너(Philips GEMINI PET/CT의 특성 평가)

  • Kim, Jin-Su;Lee, Jae-Sung;Lee, Byeong-Il;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.318-324
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    • 2004
  • Purpose: Philips GEMINI is a newly introduced whole-body GSO PET/CT scanner. In this study, performance of the scanner including spatial resolution, sensitivity, scatter fraction, noise equivalent count ratio (NECR) was measured utilizing NEMA NU2-2001 standard protocol and compared with performance of LSO, BGO crystal scanner. Methods: GEMINI is composed of the Philips ALLEGRO PET and MX8000 D multi-slice CT scanners. The PET scanner has 28 detector segments which have an array of 29 by 22 GSO crystals ($4{\times}6{\times}20$ mm), covering axial FOV of 18 cm. PET data to measure spatial resolution, sensitivity, scatter fraction, and NECR were acquired in 3D mode according to the NEMA NU2 protocols (coincidence window: 8 ns, energy window: $409[\sim}664$ keV). For the measurement of spatial resolution, images were reconstructed with FBP using ramp filter and an iterative reconstruction algorithm, 3D RAMLA. Data for sensitivity measurement were acquired using NEMA sensitivity phantom filled with F-18 solution and surrounded by $1{\sim}5$ aluminum sleeves after we confirmed that dead time loss did not exceed 1%. To measure NECR and scatter fraction, 1110 MBq of F-18 solution was injected into a NEMA scatter phantom with a length of 70 cm and dynamic scan with 20-min frame duration was acquired for 7 half-lives. Oblique sinograms were collapsed into transaxial slices using single slice rebinning method, and true to background (scatter+random) ratio for each slice and frame was estimated. Scatter fraction was determined by averaging the true to background ratio of last 3 frames in which the dead time loss was below 1%. Results: Transverse and axial resolutions at 1cm radius were (1) 5.3 and 6.5 mm (FBP), (2) 5.1 and 5.9 mm (3D RAMLA). Transverse radial, transverse tangential, and axial resolution at 10 cm were (1) 5.7, 5.7, and 7.0 mm (FBP), (2) 5.4, 5.4, and 6.4 mm (3D RAMLA). Attenuation free values of sensitivity were 3,620 counts/sec/MBq at the center of transaxial FOV and 4,324 counts/sec/MBq at 10 cm offset from the center. Scatter fraction was 40.6%, and peak true count rate and NECR were 88.9 kcps @ 12.9 kBq/mL and 34.3 kcps @ 8.84 kBq/mL. These characteristics are better than that of ECAT EXACT PET scanner with BGO crystal. Conclusion: The results of this field test demonstrate high resolution, sensitivity and count rate performance of the 3D PET/CT scanner with GSO crystal. The data provided here will be useful for the comparative study with other 3D PET/CT scanners using BGO or LSO crystals.

Radiation Therapy Alone for Early Stage Non-small Cell Carcinoma of the Lung (초기 비소세포폐암의 방사선 단독치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.323-327
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    • 2002
  • Purpose : To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. Materials and Methods : A retrospective review was peformed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 59 Gy. No patients were lost to follow-up. Results : The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and $21\%$, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and $25\%$, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was $43\%$. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented $78\%$ of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm $(0\%\;vs\;36\%)$. Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 $(25\%\;vs\;26\%,\;p>0.05)$. Conclusion : Radiation therapy 리one is an effective and safe treatment for early stage non-small ceil lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.

Postoperative Adjuvant Chemotherapy and Chemoradiation for Rectal Cancer (직장암의 근치적 절제술 후 보조 화학요법과 보조 화학방사선 병용요법)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Ik Jae;Kim Ik Yong;Sim Kwang Yong;Kim Dae Sung;Lee Jong Young
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.334-342
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    • 2002
  • Purpose : The aim of this study was to determine if postoperative adjuvant chemotherapy (CT) alone and concurrent chemoradiation (CCRT), following radical surgery, improved the disease free survival (DFS) and overall survival (OS) in rectal cancer AJCC stage II and III patients. Materials and Methods : A total of 144 patients with AJCC stage II and III rectal cancer who had had radical surgery between 1989 and 1999 were included in the study. Of these patients, 72 had been treated with postoperative CT, and the other 72 with postoperative CCRT. The chemotherapy regimen consisted of oral UFT on a daily basis for $1\~12$ months (median 12 months) or 5-FU ($500\;mg/m^2$ for 5 days) intravenous (IV) chemotherapy with 4 week intervals for $1\~18$ cycles (median 6 cycles). Radiation of 4,500 cGy was delivered to the surgical bed and regional pelvic lymph nodes area, followed by $540\~1,440\;cGy$ (median 540 cGy) boost to the surgical bed. The follow-up period ranged from 20 to 150 months, with a median of 44 months. Results : The 5-year OS was $60.9\%\;and\;68.9\%$ (p=0.0915), and the 5-year DFS was $56.1\%\;and\;63.8\%$ (p=0.3510) for postoperative CT and postoperative CCRT, respectively. In the stage nm patients, the 5-year OS was $71.1\%\;and\;92.2\%$, and the 5-year DFS was $57.3\%\;and\;85.4\%$ for postoperative CT and CCRT, respectively. The OS was significantly improved (p=0.0379) but the DFS was not with postoperative CCRT compared to the postoperative CT (p=0.1482). In the stage III patients, the 5-year OS was $52.0\%\;and\;55.0\%$, and the 5-year DFS was $47.8\%\;and\;49.8\%$ for postoperative CT and postoperative CCRT. There were no statistically significant differences between postoperative CT and CCRT (p=0.4280 and p=0.7891) in OS and DFS. The locoregional relapses were $16.7\%\;and\;12.5\%$ for postoperative CT and CCRT, respectively. The distant relapses were $25.0\%\;and\;26.4\%$ for postoperative CT and CCRT, respectively. Conclusion : These results showed that postoperative CCRT compared with CT alone improved OS in stage II patients. Although there was no statistical significance, the addition of postoperative RT to CT reduced locoregional relapses compared to CT alone.

The Analyses of Treatment Results and Prognostic Factors in Supradiaphragmatic CS I-II Hodgkin's Disease (횡경막상부에 국한된 임상적 병기 1-2기 호지킨병에서 치료 결과와 예후 인자의 분석)

  • Park Won;Suh Chang Ok;Chung Eun Ji;Cho Jae Ho;Chung Hyun Cheol;Kim Joo Hang;Roh Jae Kyung;Hahn Jee Sook;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.147-157
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    • 1998
  • Purpose : The aim of this retrospective study is to assess the necessity of s1aging laparotomy in the management of supradiaphragmatic CS I-II Hodgkin's disease. Prognostic factors and the usefulness of prognostic factor groups were also analyzed. Materials and Methods : From 1985 to 1995, fifty one Patients who were diagnosed as supradiaphragmatic CS I-II Hodgkin's disease at Yonsei Cancer Center in Seoul, Korea were enrolled in this study Age range was 4 to 67 with median age of 30. The number of patients with each CS IA, II A, and IIB were 16, 25, and 10, respectively. Radiotherapy(RT) was delivered using 4 or 6 MV photon beam to a total dose of 19.5 to 55.6Gy (median dose : 45Gy) with a 1.5 to 1.BGy per fraction. Chemotherapy(CT) was given in 2-12 cycles(median : 6 cycles). Thirty one Patients were treated with RT alone, 4 patients with CT alone and 16 patients with combined chemoradiotherapy. RT volumes varied from involved fields(3), subtotal nodal fields(18) or mantle fields(26). Results : Five-year disease-free survival rate(DFS) was $78.0\%$ and overall survival rate(05) was $87.6\%$. Fifty Patients achieved a complete remission after initial treatment and 8 patients were relapsed. Salvage therapy was given to 7 patients, 1 with RT alone, 4 with CT alone, 2 with RT+CT. Only two patients were successfully salvaged. Feminine gender and large media-stinal adenopathy were significant adverse prognostic factors in the univariate analysis for DFS. The significant adverse prognostic factors of OS were B symptom and clinical stage. When patients were analyzed according to European Organization for Research and Treatment of Cancer(EORTC) prognostic factor groups, the DFS in Patients with very favorable, favorable and unfavorable group was 100, 100 and $55.8\%$(p<0.05), and the 05 in each patients' group was 100, 100 and $75.1\%$(p<0.05), respectively. In very favorable and favorable groups, the DFS and 05 were all $100\%$ by RT alone, but in unfavorable group, RT with CT had a lesser relapse rate than RT alone. The subtotal nodal irradiation had better OFS than mantle RT in patients treated with RT. Conclusion : In present study, the DFS and OS in patients who did not undergo s1aging laparotomy were similar with the results in the literatures of which patients were surgically staged. Therefore, we may suggest that staging laparotomy would not influence the outcome of treatments. In univariate analysis, gender, large mediastinal adenopathy. B symptoms and clinical stage were significant prognostic factors for the survival rate. We confirm the usefulness of EORTC prognostic factor groups which may be a good.

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Studies on the Browning of Red Ginseng (홍삼(紅蔘)의 갈변(褐變)에 관(關)한 연구(硏究))

  • Kim, Dong-Youn
    • Applied Biological Chemistry
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    • v.16 no.2
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    • pp.60-77
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    • 1973
  • The non-enzymatic browning phenomenons of red ginseng were studied to identify these compounds which function as the factors for browning. The samples were classified into five divisions; Fresh ginseng, blanched ginseng, sun dried red ginseng, dehydrated red ginseng, and browning accelerated red ginseng respectively, and the various compounds in each of them were analyzed quantitatively and investigated the compounds which were thought to function for browning during the drying and the dehydration processes; the results were as follows. 1. The chemical compositions among five divisions did not show any difference except a) total and reducing sugars, b) total acids, c) water soluble extracts; a) and b) were decreased during the drying process, c) was decreased about 6-7% in red ginseng divisions. 2. Sixteen free amino acids; asp., thr., ser., glu., gly., ala., val., cys., met., ileu., leu., tyr., phe., lys., his., and arg, were identified in each division. Among them the arg, was extremly high. All of the essential amino acids were contained, while generally these amino acids were decreased in drying period and their rates were smaller in dehydrated red ginseng than in sun dried red ginseng. 3. Three kinds of sugars; fructose, glucose and sucrose were identified and other four kinds of unidentified sugars were seperated. The content of sucrose was 80% and all kind of sugars were generally less in red ginseng divisions than in the other two divisions. The decreasing rate of sngars was higher in the sun dried red ginseng than in the dehydrated red ginseng. Especially the decreasing rate of the reducing sugars was high as compared with that of sucrose. 4. Almost all the ascorbic acid was decomposed during the blanching whereas there could'nt be shown any change of the ascorbic acid content during the period of drying. 5. Eleven kinds of volatile acids; acetic acid, propionic acid, acrylic acid, iso-butyric acid, n-butyric acid, isovaleric acid, n-valeric acid, isoheptylic acid, n-heptylic acid, and an unknown volatile acid were identified. They showed a little decrease during the period of blanching perhaps on account of their volatility whereas they were increased in drying period. 6. Six kinds of non-volatile acids; citric acid, malic acid, ${\alpha}-ketoglutaric$ acid, succinic acid, pyruvic acid and glutaric acid were identified. The content of them were decreased during the drying procedures in red ginseng but only that of succinic acid was increased. 7. Three kinds of polyphenols; 3-caffeyl quinic acid, 4-caffeyl quinic acid, 5-caffeyl quinic acid and an unknown polyphenol were identified. The content of them showed considerable decrease during the drying procedures, especially in sun drying. 8. The intensity of the browning in each divisior was as follows; browning accelerated red ginseng> sun dried red ginseng> dehydrated red ginseng. 9. In the process of red ginseng preparation, a. certain relationship could be found between the decreasing rates of amino acids, reducing sugars, polyphenols and the intensity of browning. Therefore the browning phenomenon may be concluded that nonenzymatic browning reactions of the amino-carbonyl reaction and autoxidation of polyphenols are the most important processes, furthermore, as their reactions could be controlled it is thought to be possible to accelerate effectively browning within a relatively short period.

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Evaluation of External Quality of Polished Barley (시판 소포장 보리쌀의 품위 평가)

  • Bae, Sook-Hyun;Kim, Hong-Sig;Jong, Seung-Keun
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.54 no.1
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    • pp.124-133
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    • 2009
  • Demand for the high quality barley with fibroid material and functional substances has been increasing in recent although the amount of barley consumption decreased drastically during the last two decades. But the limited information on quality of barley makes consumers hard when they purchase barley for their own consumption. Therefore, 51 brand barley, .i.e., 28 naked barley and 23 waxy barley from supermarkets and 10 polished barley from local markets were collected, and their external quality were analyzed to provide basic information on brand barley. Among 51 brand barley, 56% were 1kg package and 25% were 800 g package and there was no significant difference ($1{\pm}3.62\;g$) between printed and actual weighs. The weight of 1,000 grains of naked barley and waxy barley ranged $18.6{\sim}26.7\;g$ and $14.6{\sim}24.7\;g$, respectively. Thousand grain weight of 38% of naked barley ranged $20{\sim}22\;g$, while that of 43% of waxy barley ranged $18{\sim}20\;g$. The ratio of normal grains was 88% and 94% for naked barley and waxy barley, respectively, when separated with 1.7 mm sieve. Although 82% of brand barley products were free from foreign substances, in 18% of brand barley products, sands, pieces of cloth and wood, other kinds of grain and insect larvae were found, Average test weight of brand barleys was $843g{\cdot}L^{-1}$ with range of $805{\sim}917g{\cdot}L^{-1}$. Water content was less than 14% in 7.8% of barley products, while it was $14{\sim}15%$ in 62.7% of them. Average whiteness of brand barley was 31.06, while waxy barley had higher whiteness with 27.28 than naked barley with 34.16. Heated water uptake rate of milled naked barley and milled waxy barley were 215.4% and 231.7%, respectively, while expansion rate of milled naked barley and milled waxy barley were 379.7% and 401.6%, respectively. Barley from local markets were as good as brand barley products in 1,000 grain weight, ratio of normal grains, inclusion of foreign substances, test weight, water content, whiteness, water uptake rate, and expansion rate, but they showed higher ratio of foreign substances included.

The Protective Effects of Ethanol Extract of Wild Simulated Ginseng on Carbon Tetrachloride Induced Acute Hepatic Injury in Mouse (사염화탄소 유발 급성 간독성 생쥐모델에서 산양삼 에탄올 추출물의 간 보호 효과)

  • Lee, Soo-Min;Park, Sun-Young;Jang, Gi-Seuk;Ly, Sun-Yung
    • Journal of Nutrition and Health
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    • v.41 no.8
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    • pp.701-710
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    • 2008
  • The wild simulated ginseng (WSG) has been effectively used in folk medicine as a remedy against hepatic disease, hypertension and arthritic disease. However, there is still lack of scientific proof about its antioxidant capability. The present study has been conducted to evaluate the protective role of the WSG ethanol extract in the CCl4-induced oxidative stress and resultant hepatic disfunction in ICR mice. The electron donating abilities and IC50 of WSG etnanol extract were 76.86 ${\pm}$ 1.06% and 33.3 ${\mu}g$/mL (that of ascobic acid was 16.5 ${\mu}g$/mL), respectively. Total antioxidant status of WSG extract was 2.13 ${\pm}$ 0.06 mmoL/mg, while the values of ascorbic acid and BHT were 3.63 ${\pm}$ 0.06 and 3.12 ${\pm}$ 0.02, respectively. ICR mice (aged 3weeks) were fed for 4 weeks on AIN-93M diet and had free access to food and water. The animals were divided into three groups: normal group (intraperitoneally (i.p) injected with PBS at 100 ${\mu}L$/mouse), group C; CCl4-induced and without any treatment. (i.p injected only PBS, 100 ${\mu}L$ /mice), group G; CCl4-induced and treated with WSG (i.p injected with 5 mg WSG extract per mouse, suspended in 100 ${\mu}L$ phosphate buffer). After the i.p. injection of WSG or PBS (5 times for 7weeks), all mice were administered CCl4 in olive oil at the last day of the experiment, except for normal group. The normal group was administered only olive oil. Determination of plasma triglyceride, total cholersterol, fasting glucose and GPT activity was performed using automatic blood analyzer. To evaluate the protective effect against the oxidative stress, DNA fragmentation and TBARS were determined in blood leucocytes and RBC and hepatocyte, respectively. Body and organs weights and food intake did not show significant differences among the groups. Blood total cholesterol of group G was similar to that of normal group, which was the lowest in group C. The fasting blood glucose level was the highest in normal group (205.20 ${\pm}$ 135.24), which were decreased in group C (134.2 ${\pm}$ 79.31) and group G (126.48 ${\pm}$ 77.05). TBARS values in a red blood cell and hepatic tisuue homogenate were lower in group G comparing to the group C. DNA% in tail, tail length (TL) and tail moment (TM) of blood leucoocytes showed the highest values in group C (20.11 ${\pm}$ 2.47, 17.36 ${\pm}$ 2.58, 94.11 ${\pm}$ 12.29) and they were significantly diminished in group G (9.63 ${\pm}$ 1.19, 7.04 ${\pm}$ 1.50, 38.64 ${\pm}$ 7.60). In conclusion, wild simulated ginseng might be a protective agent against the oxidative stress.

Phase II Study of Gemcitabine and Vinorelbine as a Combination Chemotherapy for the Second-Line Treatment of Nonsmall Cell Lung Carcinoma (비소세포 폐암 환자의 2차 치료로서 Gemcitabine과 Vinorelbine의 병합 요법의 효과)

  • Lee, EunJoo;Ha, EunSil;Park, SangHoon;Hur, GyuYoung;Jung, KiHwan;Jeong, HyeCheol;Lee, SungYong;Kim, JeHyeong;Lee, SangYeub;Sin, Chol;Shim, JaeJeong;In, KwangHo;Kang, KyungHo;Yoo, SeHwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.510-516
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    • 2005
  • Backgroud : Lung cancer is the leading cause of cancer deaths in Korea and the number of lung cancer deaths is increasing. The higher response rates, decreased toxicity and improved performance status of the first-line treatments have resulted in an increased number of patients becoming candidates for second-line therapy. Several new antineoplastic agents, including gemcitabine, docetaxel and paclitaxel, have recently demonstrated second-line activity. This phase II study evaluated the efficacy and toxicity of gemcitabine and vinorelbine as combination chemotherapy for Korean patients with NSCLC as a second-line treatment. Methods : Sixty response-evaluable patients were enrolled from December 2000 to July 2003. We conducted a phase II study of a combination gemcitabine and vinorelbine chemotherapy for patients with histologically confirmed NSCLC that was stage IIIB and IV disease at the time of diagnosis, and the disease had progressed onward or the patients had relapsed after first-line platinum-based chemotherapy. They were treated with intravenous gemcitabine $1000mg/m^2$ and intravenous vinorelbine $25mg/m^2$ on days 1 and 8. This chemotherapy regimen was repeated every 3 weeks. Results : A total of 215 cycles of treatment were given and the mean number of cycles was 3.6 cycles. All the patients were evaluable for the toxicity profile. The response rate was 10% according to the WHO criteria. The median progression free survival was 3.8 months and the median survival time was 10.1 months. The 1-year survival rate was 32.9%. Grade III and IV neutropenia were seen in 20 (33.3%) and 7 (11.7%) patients, respectively. Conclusion : The combination of gemcitabine and vinorelbine is active and well tolerated as a second-line therapy for patients with advanced nonsmall cell lung carcinoma.

Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.