• 대한골관절종양학회지
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• 제12권1호
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• pp.37-46
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• 2006

목적: 장관골의 골육종 치료로써 한국에서 시행된 항암제 치료 및 수술적 치료 후의 결과와, 중국에서 시행된 비침습적인 초음파 치료(high intensity focused ultrasound, HIFU)간의 다국적 임상 결과를 비교하고자 한다. 대상 및 방법: 한국에서 1993년 이래로 통상적인 항암요법과 사지구제술을 시행한 총 67예(IIA; 4 cases, IIB; 58 cases, III; 5 cases)와, 중국에서 1997년 이래로 초음파 치료를 시행한 총 71예(II; 57 cases, III; 14 cases)를 연구 대상으로 하였다. 한국에서는 총 67예 중, 66예에서 수술 전 선행 화학치료를, 반면 중국에서는 총 71예 중, stage II의 34예에서 9회 이상의 full protocol 화학치료가 시행되었고, stage II의 23예와 stage III의 14예에서 8회 이하의 부분 화학치료를 시행하였다. 한국의 67예는 모두 광범위 절제술을 시행하였고, 56예에서 국소 재건술을 병행하였다. 5예에선 국소 재건 없이 광범위 절제만 시행하였고, 6예에선 절단술만을 시행하였다. 반면 중국의 총 71예는 평균 1.5회(1~4회)의 초음파 치료가 시행되었다. 결과: 한국의 stage II의 5년 생존율은 평균 92.7%(IIA 100%, IIB 85.5%), 반면, 중국의 5년 생존율이 평균 78.7%로써 항암제를 병행한 군은 91.8% 및 항암제 치료를 못 받은 군은 56.6%였다. Stage III의 3년 생존율은 한국 20%(5예중 1예 생존), 중국은 7.1%(14예 중 1예 생존)였으며, 전 예의 평균 생존율은 한국 65.2%, 중국 51.8%였다(Table 2). 한국 환자들의 ISOLS에 의한 최종 기능 평가 결과는 평균 24.3(81%)였고, 중국 환자들은 19.8(73%)였으며, 치료의 합병증은 한국 25.4%(17/67 cases), 중국 31%였다. 결론: 한국에서 시행한 수술적 치료전후 화학요법을 시행한 결과는 초음파 치료를 이용한 비침습적 열괴사 방법보다 양호하였으나, 골종양에 대한 초음파 치료도 적응증을 잘 선택한다면 장관골 골육종의 치유 및 국소 재발율을 감소시킬 수 있을 것으로 생각한다.

• 고려인삼학회:학술대회논문집
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• 고려인삼학회 1980년도 학술대회지
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• pp.87-113
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• 1980

This experiment was carried out to evaluate the effects of Korean ginseng extract on carcinogenesis induced by various chemical carcinogens. Red ginseng extract was used for this study and was administered orally to the experimental animals. Carcinogens that were injected in subscapsular region of ICR newborn mice within 24 hours after birth were 9,10-dimethyl-1,2-benzan-thracene (DMBA), urethane, N-2-fluorenylacetamide(AAF), aflatoxin $B_1$ and tobacco smoke condensate. N -methyl-N -nitroso-N'-nitroguani-dine(MNNG) was injected subcutaneously at the back of wistar rats. Experimental animals were autopsied in immediately after being sacrificed. All major organs were examined grossly and weighted. After fixation histopathological preparations were made for microscopical study. Following results were obtained. In DMBA group sacrificed at the 26th week after the treatment with DMBA, the incidence of lung adenoma was $77\%$ and the average number of the tumor was 17. However, in DMBA combined with red ginseng group, the incidence was $78\%$ and the average number of lung adenoma was 14.1. This indicates that ginseng extract had no effect on the incidence of lung adenoma but decreased the average number of lung adenoma by $17\%.$ In DMBA group sacrificed at the 48th week after the injection of DMBA, the lung adenoma incidence was $88\%.$ The average diameter of the largest lung adenoma was 3.5 cm, the incidence of diffuse pulmonary infiltration was $18\%$ and the average lung weight of male experimental mice was $528.2{\pm}469.1\;gm.$ On the other hand, in DMBA combined with red ginseng group sacrificed at the 48th week, the incidence of lung adenoma was $96\%.$ The average diameter of the largest adenoma was 2.7 cm, the incidence of diffuse pulmonary infiltration was $7\%$ and the average lung weight of male mice was $418.0{\pm}520\;gm.$ These observations show that ginseng extract did not have any inhibitory effect on the incidence of lung adenoma but decreased the average diameter of the largest lung adenoma by $23\%,$ the incidence of duffuse pulmonary infiltration by $63\%$ and the average lung weight of male experimental mice by $21\%.$ From these results we have found that the prolonged administration with ginseng extract showed no inhibitory effect on the incidence of adenoma but it had the inhibitory effect on the proliferation of lung adenomas induced by DMBA. In urethane group sacrificed at the 28th week after the injection of urethane, the incidence of lung adenoma was $94\%$ and the average number of lung adenoma was 8.6. In urethane combined with red ginseng group, the. incidence of lung adenoma was $73\%$ and the average number of adenoma was 6.0. These results indicate that there were $22\%$ decrease of the lung adenoma incidence and $31\%$ decrease of the average number of adenoma in urethane combined with red ginseng group. And in urethane group sacrificed at the 50th week, the incidence of lung adenoma was $98\%$ and the incidence of diffuse pulmonary infiltration was $14\%$. In urethane combined with ginseng group the incidence of lung adenoma was $85\%$ and the incidence of diffuse pulmonary infiltration was $12\%$. Therefore the ginseng administration resulted in $15\%$ decrease of the lung adenoma incidence and $14\%$ decrease of the diffuse pulmonary infiltration incidence. From these results we knew that the prolonged administration with ginseng extract inhibited the incidence and also the proliferation of the lung adenoma induced by urethane. Lung adenoma and hepatoma were induced in the experimental mice sacrificed at the 68th week but not in the experimental mice sacrificed at the 28th week after the injection of AAF. In AAF group sacrificed at the 68th week after the injection of AAF the incidence of lung adenoma was $18\%$ and the incidence of hepatoma was $27\%$. And in AAF combined with ginseng group the lung adenoma incidence was $12\%$ and the hepatoma incidence was $37\%$. So the ginseng seemed to decrease the lung adenoma incidence by AAF, but we were unable to conclude the significant inhibitory effect of the ginseng extract on the incidence of lung adenoma by AAF because the above incidence of lung adenoma were similar to that of control group which was $11\%$. And these experimental data revealed that ginseng extract didn't have any inhibitory effect on the incidence of hepatoma induced by AAF. In aflatoxin $B_1$ group sacrificed at the 56th week, the incidence of lung adenoma was $24\%$ and hepatoma was $11\%$. However in aflatoxin $B_1$ combined with ginseng group the incidence of lung adenoma was $17\%$ and hepatoma was $3\%$ These results indicate that there were $29\%$ decrease of the lung adenoma incidence and $75\%$ decrease of the hepatoma incidence in aflatoxin $B_1$ combined with ginseng group. In tobacco smoke condensate experimental group sacrificed at 67th week, no tumors were induced except just a few lung adenoma. The lung adenoma incidence both in tobacco smoke condensate group and in tobacco smoke condensate combined with ginseng group was $8\%$. And this incidence rate was similar to that of control group. These results indicate that the injection of 320 ug tobacco smoke condensate per ICR newborn mouse was unable to induce lung adenoma in our experiments. In MNNG group sacrificed at the 27th week the tumor incidence was $38.5\%$ and in MNNG combined with ginseng extract group was $37\%$. In MNNG group for investigation of the life span of tumor bearing rats the tumor incidence was $93\%$ and the average life span of tumor bearing rats was 318 days. And in MNNG combined with ginseng extract group the tumor incidence was $96\%$ and the average life span was 337 days. Tumor induced by MNNG was almost sarcoma. This indicates that there was no inhibitory effect of ginseng extract on the tumor incidence, but the extract prolonged the average life span of tumor bearing rats by approximately 19 days.