이소성 ACTH 생산에 의해 야기된 Cushing 증후군이 동반된 소세포 폐암

곽영임 ( Young Im Kwak ),임영혁 ( Young Hyuck Im ),천영국 ( Young Kug Cheon ),이가희 ( Ka Hee Yi ),남현석 ( Hyeon Seok Nam ),이춘택 ( Choon Taek Lee ),강윤구 ( Yoon Koo Kang ),이진오 ( Jhin Oh Lee ),강태웅 ( Tae Woong Kang ) 대한결핵 및 호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.6

국소적으로 진행된 식도암 환자에서 Cisplatin , Etoposide 및 5 - Fluorouracil ( PEF ) 선행화학요법의 효과 ; A Pilot Study

정상훈(Sang Hoon Jeong),임영혁(Young Hyuck Im),강윤구(Yoon Koo Kang),손태용(Tae Yong Son),곽영임(Young Im Kwak),천영국(Young Kug Cheon),김현각(Hyun Kag Kim),류백렬(Baek Yeol Ryoo),김유철(You Cheoul Kim),이춘택(Choon Taek Lee),김창민( 대한내과학회 1996 대한내과학회지 Vol.51 No.4

N/A The prognosis of esophageal cancer is very poor. Even for those with localized disease who are potentially curable, 5-year survival rates are under 20% in almost all series. We conducted a pilot study to evaluate the safety and possibility of efficacy of neoadjuvant chemotherapy followed by surgery in patients with locally advanced esophageal cancer. Two or three cycles of neoadjuvant combination chemotherapy with cisplatin (20㎎/㎡/day i.v., D1-5), etoposide (100㎎/㎡/day i.v., D1,3,5), and 5-fluorouracil (800㎎/㎡/day continuous i.v., D1-5) were planned to be given before surgery. Total 21 patients entered this trial. Three patients were lost to follow-up after 1 cycle of chemotherapy to make eighteen patients evaluable. Thirteen out of eighteen patients (72%) had objective improvement after neoadjuvant chemotherapy and four (22%) had no change and one (6%) had progression. Among 18 evaluable patients, surgery was performed in 11 patients. Surgery could not be done in 7 patients because of patient's refusal (5), progression of disease (1), and development of lung abscess (1). In 13 patients who were candidates for surgery, curative resection was done in 10 patients to make curative resection rate 10/13 (77%). One of eleven patients having surgical resection had no pathologic evidence of tumor (pathologic complete remission 9%). Postoperative complications of wound dehiscence and anastomotic site fistula developed in 2 patients. Three courses of postoperative adjuvant chemotherapy with PEF regimen were administered to 9 patients. The median survival time for all 18 patients was 60 weeks. Toxicities of PEF neoadjuvant chemotherapy were leukopenia, nausea/vomiting and alopecia, but they were mild and reversible. There was no treatment-related deaths. In conclusion, neoadjuvant chemotherapy with PEF regimen were tolerable, safe and possibly effective in locally advanced esophageal cancer. Based on this study, we will perform phase 2 or 3 study to assess the efficacy of PEF neoadjuvant chemotherapy for locally advanced esophageal cancer.

전이성 또는 재발성 식도암에 대한 Cisplatin , Etoposide 및 5 - Fluorouracil ( PEF ) 복합화학요법의 치료 효과

류백렬(Baek Yeol Ryoo),임영혁(Young Hyuck Im),강윤구(Yoon Koo Kang),정상훈(Sang Hoon Jeong),김현각(Hyun Kag Kim),이창희(Chang Hee Lee),윤종길(Jong Kil Yoon),천영국(Young Kug Cheon),김서운(Seo Woon Kim),김유철(You Cheoul Kim),김창민(C 대한내과학회 1996 대한내과학회지 Vol.51 No.4

N/A Esophageal cancer is widely disseminated in more than 80% of patients at the time of diagnosis and the prognosis of advanced esophageal cancer is dismal with a median survival of 5 to 8 months. Therefore, systemic chemotherapy has assumed an important role in the treatment of these patients. Among various combination chemotherapy regimens, the combination of cisplatin and 5-fluorouracil has been one of the most effective for esophageal cancer because of their synergism. Etoposide, although reported ineffective as a single agent, has been shown to be synergistic with cisplatin in vitro and in vivo. So, we conducted a phase 2 trial to evaluate the effect of a combination of cisplatin, etoposide and 5- FU (PEF) in patients with metastatic or recurrent esophageal cancer. Thirty-four patients with measurable lesion(s) received cisplatin (20㎎/㎡ i.v. Day 1~5), etoposide (100㎎/㎡ i.v. Day 1, 3 & 5) and 5-FU (800㎎/㎡ continuous i.v. for 12 hours, Day 1~5). Of 30 evaluable patients, 1(3.3%) had a complete response and 11(37%) had partial responses. The median duration of response was 29 weeks. The overall median survival was 34 weeks and the survival time in the responders was longer significantly than that of the non-responders. There was no significant prognostic factor influencing the response rate. Among total 135 cycles of chemotherapy, leukopenia was observed in 36% and thrombocytopenia in 4%. There was no treatment-related death. Main non-hematologic toxicities were neurotoxicity (17%), nephrotoxicity (3%), and stomatitis (10%) and diarrhea (10%). All the toxicities were mild and well tolerated. Conclusion: A combination chemotherapy of cisplatin, etoposide and 5-FU (PEF) was effective and well tolerated in patients with metastatic or recurrent esophageal cancer.

Klinefelter 증후군에 병발된 원발성 종격동 생식세포종

김용조 ( Yong Jo Kim ),권교선 ( Gyo Seon Kwun ),이영우 ( Young Wo Lee ),김경태 ( Kyung Tae Kim ),박연희 ( Yeon Hee Park ),류백렬 ( Baek Yeol Ryoo ),김태유 ( Tae You Kim ),임영혁 ( Young Hyuck Im ),이춘택 ( Choon Taek Lee ),강윤구 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.6

수술이 불가능한 제 III기 비소세포폐암에서 Cisplatin 및 Etoposide(EP)의 화학요법과 방사선요법의 병행요법(2상 임상연구)

허남현,이춘택,김재학,장재진,남승모,박연희,류백렬,김태유,임영혁,강윤구,김미숙,류성렬,이진오,강태웅,Hur, Nam-Hyun,Lee, Choon-Taek,Kim, Jae-Hag,Jang, Jae-Jin,Nam, Seung-Mo,Park, Yeon-Hee,Ryoo, Baek-Yeol,Kim, Tae-You,Im, Young-Hyuck,Kang, Yoon-Ko 대한결핵및호흡기학회 1997 Tuberculosis and Respiratory Diseases Vol.44 No.4

서 론 : 비소세포폐암은 전체 폐암의 약 75%를 차지하고 있으며 조기 발견에 이은 외과적 절제가 유일한 완치방법으로 알려져 있다. 그러나 병기 III기에서는 정립된 치료방법이 없고 여러 종류 및 조합의 치료방법이 시도되고 있다. 이에 연구자들은 수술이 불가능한 병기 IIIA 및 악성흉수를 제외한 병기 IIIB의 과거 치료력이 없는 비소세포폐암 환자에서 cisplatin, etoposide 이용한 복합화학요법을 동시에 시행하여 그의 효과 및 순응성을 조사하였다. 대상 및 방법 : 1995년 10월부터 1996년 12월까지 원자력병원에 입원하여 조직학적으로 비소세포폐암으로 진단된 병기 III기의 환자중 수술이 불가능한 IIIA 및 IIIB의 환자를 대상으로 하였다. 복합화학요법은 cisplatin 30mg/$m^2$/D, etoposide 80mg/$m^2$/D를 방사선요법과 동시에 시작하여 3일간 투여후 4주 간격으로 총 3회 투여하였고, 방사선요법은 5940cGy까지 진행후 치료효과를 평가하였다. 결 과 : 총 대상환자 32명 중 조기종료한 3명을 제외한 29명에서 평가가 가능하였으며, 완전관해는 없었고 부분관해 22명(75.9%), 불변 5명(17.2%), 치료중 진행하였던 경우가 2명(6.9%)으로 전체관해율은 75.9%, 중앙 생존기간 12.1개월, 1년 생존률은 50.6%로 나타났다. 치료에 의한 주된 독성은 백혈구감소로 WHO기준으로 3등급이상이 13명(45%)에서 나타났고 혈소판감소는 3등급이상이 3명(11%)에서 나타났으나 모두 회복되었고, 그밖에 오심과 구토는 대부분의 환자에서 2등급이하이었으며 방사성폐렴은 13명(46%)에서 나타났다. 결 론 : 수술이 불가능한 병기 IIIA 및 악성흉수를 제외한 병기 IIIB기 비소세포폐암환자에서 EP 복합화학요법과 방사선요법을 동시 병행한 치료는 비교적 안전하면서 효과적이었으며, 이에 대한 평가는 방사선요법을 단독으로한 치료와의 3상 연구를 요할 것으로 사료된다. Background : Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC). however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, and survival of concurrent chemotherapy with etoposide and cisplatin(EP) and radiation therapy for unresectable stage III NSCLC. Method : Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide and cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. Results : Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient. The median survival was 12.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia($\geq$ grade 3, 46%). Thrombocytopenia over grade 3 was found in 11%. Radiation pneumonitis occurred in 13 patients(46%). Conclusion : Concurrent chemotherapy(EP) plus radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.

악성 종양 환자에 사용된 중심정맥카테터의 안정성에 대한 임상 연구

김형건(Hyung Gun Kim),손태용(Tae Yong Son),유영진(Young Jin Yuh),이상구(Sang Goo Lee),천은미(Eun Mee Cheon),송재관(Jae Kwan Song),임영혁(Young Hyuck Im),강윤구(Yoon Koo Kang),조재일(Jae Ill Zo),심영목(Young Mog Shim) 대한내과학회 1995 대한내과학회지 Vol.49 No.3

N/A Objectives: As the central venous catheters (CVCs) have been inserted frequent,ly in patients with advanced malignant disease, it becomes necessary to investigate the safety and the complications of the CVCs and to search for the ways to improve them. Methods: The complications related with CVCs and the durations of function of them were analyzed via retrospective review of medical records of 87 patients to whom CVCs were inserted for the treatment of cancer at the departrnent. of internal medicine, Korea Cancer Center Hospital. Results: Acute complications of catheter inser1ion were pneumothorax and pain at the insertion site. Infection, thrombosis and mechanical teraring were the major long term complications. 32(36.8%) catheters were removed by development of complications. Among 87 evaluable cases, CVCs could be maintained with function for 4+to 878+days (median 401 days). There were significantly less infection (40 % vs. 72% ) and longer duration of function(median not. reached vs. 151 days) with Chemoport than with Hickman catheter(p=0.002). Conclusion. CVCs could be inserted and maintained safely for considerahle period of time in patients with advanced malignancy. Further effort should be given to prevent catheter-related complications such as infection and thrombosis and to provide the long term patency.

5-fluorouracil 이 근간이 된 화학요법에 실패한 진행성 위암에서 Docetaxel 과 Cisplatin 복합화학요법

이효락(Hyo Rak Lee),박세훈(Se Hoon Park),송서영(Seo Young Song),박준오(Joon Oh Park),이순일(Soon Il Lee),김기현(Ki Hyun Kim),김원석(Won Seog Kim),정철원(Chul Won Jung),임영혁(Young Hyuck Im),이홍기(Hong Ghi Lee),박근칠(Keun Chil Park 대한내과학회 2002 대한내과학회지 Vol.62 No.1

N/A Background: There is no effective treatment in patients with advanced gastric cancer failed to first-line chemotherapy. Taxane is one of new drugs identified as having substantial activity in gastric cancer. We performed a phase II trial to evaluate the efficacy and toxicity of docetaxel plus cisplatin regimen as a salvage chemotherapy for advanced gastric cancer failed to 5-fluorouracil (5-FU)-based chemotherapy. Methods: Metastatic or recurrent gastric cancer patients failed to 5-FU-based regimen with an Eastern Cooperative Oncology Group (ECOG) performance score≤2 were eligible in this trial. Docetaxel (60mg/㎡) was infused over 1 hour , before cisplatin (60 mg/㎡) infused over 2 hours on day 1, once every 3 weeks until disease progression or unacceptable toxicity was detected. Response to treatment was assessed every two or three cycles. Results: From October 1999 to December 2000, forty-one patients were enrolled in this study. Twenty-eight of forty-one patients were assessable for response. Partial response was observed in seven patients and stable disease in four patients. The response rate was 25.0% (95% confidence interval: 20.4-29.6%) and median duration of response was 22 weeks (range: 11-53 weeks). The median survival of all enrolled patients was 24 weeks (range: 7-65 weeks). For a total of 112 cycles of chemotherapy, grade 3 and 4 toxicity was 8.9% for neutropenia, 4.5% for nausea/vomiting and 1.8% for mucositis. Conclusion: Salvage chemotherapy with docetaxel plus cisplatin regimen in gastric cancer was active with acceptable toxicities. (Korean J Med 62:83-89, 2002)

Aggressive 비호즈킨 림프종의 예후인자 분석과 고위험군 환자 선별을 위한 International Prognostic Index Model

김경태(Kyung Tae Kim),김태유(Tae You Kim),임영혁(Young Hyuck Im),강윤구(Yoon Koo Kang),이창희(Chang Hee Lee),곽영임(Young Im Kwak),류백렬(Baek Yeol Ryoo),성주병(Ju Byeung Sung),이영우(Young Wo Lee),장은정(Eun Jung Jang),김재학(Jae Ha 대한내과학회 1997 대한내과학회지 Vol.53 No.3

N/A Objective: Although the therapeutic outcome of aggressive non-Hodgkin's lymphoma (NHL) has been considerably improved by the introduction of combination chemotherapy, many patients still fail to achieve complete response(CR) and/or long-term survival. Because the outcome appears to depend on certain prognostic factors, long term prognosis can be predicted by identification of risk group. And also, the patients in high risk group may benefit from new therapeutic modality. In 1993, the international prognostic index model for aggressive NHL as developed far the purpose of predicting outcome and designing of therapeutic trial. Thus, analysis of prognostic factors was performed to identify independent factors for the end points of CR, overall survival, and disease-free survival. Methods : From 1989 to 1994, total 340 patients were treated with combination chemotherapy and/or radiotherapy for NHL in Korea Cancer Center Hospital. Among 340, informations on eleven prognostic factors(sex, age, performance status, Ann Arbor stage, serum LDH level, tumor size, number of extranodal disease sites, bone marrow involvement, presence of B symptom, sex, time to CR, and histologic grade) were avaliable for 273 patients. Among these, 221 patients with aggressive NHL(NCI clinical schema) were eligible for the prognostic factor analysis for the response and survival. Also, 186 patients were eligible to determine whether International Prognostic Index Model could be applicable for Korean NHL. Results: One hundred fifty patients(68%, 95% CI 62-74%) achieved a complete remission, 43 patients (20%) a partial remission. With a median follow-up of 3,5 years, overall 3 year survival rate was 6396, and 3 year DFS for the 150 CRs was 72%. In a univariate analysis for the CR and survival, Ann Arbor stage, number of extranadal disease, performance status, presence of B symptoms, presence of BM involvement, serum LDH level and histologic grade were found to be statistically significant prognostic factors. Among them, by multivariate analysis, number of extranodal disease(RR 0.2, 95% CI 0.1-0.7), B Symptoms (RR 0.4, 95% CI 0.2-0.9), and histologic grade(RR 0.2, 95% CI 0.08-0.7) showed to be independent adverse prognostic factors for CR. For disease-free survival, Ann Arbor stage(RR 2.6, 95% CI 1.1-6.4) was independent risk factor. For overall survival, number of extranodal involvement(RR 2, 95% CI 1.3-4) and histologic grade(RR 2, 95% CI 1.2-3.7) were independently significant prognostic factors. With these 2 independent prognostic factors for survival, we could establish a prognastic index model which could separate the high risk patients. However, the usefulness of this model should be confirmed in a larger patient population. The dose intensity of cyclophosphamide, during initial 3 months of treatment, was significantly associated with CR rate and overall survival(p=0.01 & 0.03, respectively). When International Prognostic Index Model was applied to our patients, patients in the lower risk groups had significantly better outcome than patients in the higher risk groups(3 year survival and RR: 77% & 1 for low risk group, 61% & 1.9 for low-intermediate risk group, 50% & 2.2 for high-intermediate risk group, and 25% & 6 for high risk group). Conclusion: In this study, we confirmed that features other than the Ann Arbor stage were independently associated with CR and survival, and the International Prognostic Index Model would be an useful tool for the selection of high-risk patients who could be benefited from more aggressive chemotherapy.

국소 진행된 식도암에 대한 수술 전 동시병용 방사선-항암 화학요법

김해영(Haeyoung Kim),안용찬(Yong Chan Ahn),김관민(Kwan Min Kim),김진국(Jhingook Kim),심영목(Young Mog Shim),임영혁(Young-Hyuck Im) 대한방사선종양학회 2007 Radiation Oncology Journal Vol.25 No.3

목 적: 본 연구는 국소 진행된 식도암 환자들에 대하여 수술 전 동시병용 방사선-항암 화학요법을 적용한 치료 성 적과 예후인자에 대해 알아보고자 하였다. 대상 및 방법: 1998년 3월부터 2005년 5월까지 삼성서울병원에서 식도암으로 진단 받고 수술 전 동시병용 방사선 항암화학요법을 적용한 환자는 모두 68명이었다. 이들 중 원발병변이 흉곽 내 식도에 위치하고, 조직형이 편평상 피암이며 임상병기가 T3이상 또는 N1이상 또는 혈행성 원격전이 없이 절제 가능한 원격 림프절에 전이가 국한되어 있는 M1A/B병기이며 다른 내과적 질환이나 이차암이 없는 61명의 환자들에 대해 분석을 시행하였다. 방사선치료는 임상 검사 등으로 확인된 병변에 대하여 5주 동안 45 Gy를 조사하였고, 항암화학요법은 2 주기의 5-FU (1,000mg/m2/day, days 1-4 & 29-32)와 Cisplatin (60 mg/m2/day, days 1 & 29)을 방사선치료와 동시에 병용하였다. 수술은 방사선-항암화학요법 종료 후 4∼6주경에 계획하였으며 53명에 대해 Ivor-Lewis 술기와 2-영역 혹은 3-영역 림프절 적출술을 시행하였다. 결 과: 57명이 예정된 방사선-항암화학요법을 완료하였고(93.4%) 수술을 거부하거나 수술 전 방사선-항암화학요법 중 질병이 진행된 8명의 환자를 제외한 53명(86.8%)에서 식도 절제술을 시행하였는데, 이 중 49명(92.6%)에서 완전절제가 가능하였으며 38명(71.6%)에서 병기하강을 얻을 수 있었고, 17명(32.0%)에서 병리학적 완전 관해를 얻었다. 1명이 수술 후 호흡기 합병증으로, 1명이 방사선 병용 항암화학치료 연관 폐렴으로 사망하여 치료 연관 사망률은 3.2%였다. 전체 61명의 중앙 생존기간은 30개월, 2년 및 5년 생존율은 각각 59.0%와 38.0%였으며 수술을 시행 한 53명의 중앙 생존기간은 37개월, 2년 및 5년 생존율은 각각 61.6%와 40.1%였고, 중앙 무병 생존기간은 24개월, 2년 및 5년 무병생존율은 각각 53.3%와 41.8%였다. 전체 환자의 생존율에 영향을 미치는 예후인자는 수술 여부였으며 수술을 시행한 환자의 생존율이 단변량 분석(p=0.03)과 다변량 분석(p<0.01)에서 수술을 시행하지 않은 환자의 생존율에 비해 높았다. 수술을 시행한 환자를 대상으로 한 단변량 분석 결과 수술 전 임상병기가 IV병기가 아닌 경우, 수술 후 병리학적 완전관해를 얻은 경우 유의하게 생존율과 무병생존율이 높았으나 다변량 분석에서 의미 있는 예후인자는 없었다. 수술을 시행한 53명 중 5명(9.4%)에서 국소재발이, 10명(18.8%)에서 국소재발및 원격전이가, 12명(22.6%)에서 원격전이가 발생하였다. 결 론: 국소 진행된 병기의 식도암에서 수술 전 동시병용 방사선-항암화학요법으로 양호한 병기 하강률, 장기 생존율을 얻을 수 있었고 원격 림프절 전이가 없는 경우, 수술 후 병리학적 완전관해를 얻은 경우에서 높은 장기 생존율을 보였다. Purpose: This study reports the results of the use of preoperative concurrent radiochemotherapy (CRCT) for the treatment of locoregionally advanced esophageal cancer. Materials and Methods: From 1998 through 2005, 61 patients with intrathoracic esophageal cancer at stages II-IVB (without distant organ metastasis and presumed to be respectable) received preoperative CRCT. CRCT consisted of radiotherapy (45 Gy /25 fractions /5 weeks) and FP chemotherapy (5-FU 1 g/m2/day, days 1-4 and 29-32, Cisplatin 60 mg/m2/day, days 1 and 29). An esophagectomy was planned in 4∼6 weeks after the completion of CRCT. Results: There were two treatment-related deaths. Among the 61 patients, 53 patients underwent surgery and 17 patients achieved a pathological complete response (pCR). The overall survival (OS) rates of all 61 patients at 2 and 5 years were 59.0% and 38.0%, respectively. The rates of OS and disease-free survival (DFS) of the surgically resected patients at 2 and 5 years were 61.6%, 40.1% and 53.3%, 41.8%, respectively. By univariate analysis, achieviement of pCR and a clinically uninvolved distant lymph node (cM0) were favorable prognostic factors for OS and DFS. There were 27 patients that experienced a relapse-a locoregional relapse occurred in 5 patients, a distant metastasis occurred in 12 patients and combined failure occurred in 10 patients. Conclusion: The results of the current study are favorable. pCR and an uninvolved distant lymph node were found to be favorable prognostic factors.

Results of Three-Dimensional Conformal Radiation Therapy for the Treatment of a Solitary Sternal Relapse of Breast Cancer

Haeyoung Kim(김해영),Seung Jae Huh(허승재),Won Park(박원),Do Ho Choi(최두호),Min Kyu Kang(강민규),Jung-Hyun Yang(양정현),Seok-Jin Nam(남석진),Young-Hyuck Im(임영혁) 대한방사선종양학회 2008 Radiation Oncology Journal Vol.26 No.2

목 적: 본 연구는 흉골에 단독 전이된 유방암 환자들에 대하여 삼차원 입체조형 방사선요법을 적용한 치료 성적에 대 해 알아보고자 하였다. 대상 및 방법: 1996년 5월부터 2005년 6월까지 유방암의 흉골 단독 전이 병변에 대해 구제적 방사선 치료를 받은 17명의 환자를 분석하였다. 방사선 치료 범위는 종양으로부터 2 cm 여유를 두었으며 치료 선량은 하루 1.8∼3 Gy로 총35.0∼61.5 Gy이었다. 종양 반응은 방사선 치료 종료 후 1∼3개월에 시행한 컴퓨터 전산화 단층촬영영상으로 평가하였다. 결 과: 전체 환자 중, 5명이 완전반응을, 12명이 부분반응을 보여, 모든 환자들이 방사선 치료에 객관적 반응을 보였다. 환자들의 5년 생존율은 51.9%, 중앙 생존기간은 27개월이었다. 환자들의 생존율은 유방암의 초기 수술일로부터 흉골 전이가 발견되기까지의 무병 생존기간에 영향을 받았는데, 무병 생존기간이 12개월 이상인 환자들의 5년 생존율은 61.8%이었던 반면, 무병 생존기간이 12개월 미만인 환자들의 5년 생존율은 0.0%였다(p=0.03). 결 론: 흉골에 단독 전이된 유방암 환자들의 방사선 치료에 대한 반응은 우수하였다. 유방암의 초기 수술로부터 흉골 재발이 발생하기까지의 무병 생존기간이 긴 환자에서 방사선 치료 후 생존율이 양호한 것으로 나타났다. Purpose: To evaluate the response and survival rate after three-dimensional conformal radiation therapy (3D-CRT) of patients with a solitary sternal relapse of breast cancer. Materials and Methods: Seventeen patients between May 1996 and June 2005 were evaluated with the salvage 3D-CRT treatment of a solitary sternal relapse of breast cancer. The treatment fields included the gross tumor volume with 2 cm margins. The total radiation dose was 35.0∼61.5 Gy (biologic effective dose of 43.7 ∼76.9 Gy10 using an α/β ratio of 10 Gy), with a daily dose of 1.8∼3.0 Gy. The tumor response was evaluated by the change in maximum tumor size via follow up CT scans 1∼3 months after the completion of treatment. Results: An objective tumor response was achieved in all patients, with a complete response in 5 patients and a partial response in 12 patients. The 5-year overall survival rate was 51.9% (median survival time: 27 months), and the most important factor affecting overall survival was the disease-free interval (interval from primary surgery of breast cancer to the development of sternal metastasis): The 5-year overall survival rate was 61.8% for patients with a disease-free interval ≥12 months and 0.0% for patients with disease-free interval <12 months (p=0.03). Conclusion: The response to 3D-CRT was good in patients with solitary sternal relapse of breast cancer. Particularly, patients with long disease-free interval from primary surgery survived significantly longer than patients with short disease-free interval from primary surgery.