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      유방암에서 유방보존수술 및 수술 후 방사선치료의 결과 = Results of Breast Conserving Surgery and Subsequent Postoperative Radiotherapy for Cases of Breast Cancer

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      https://www.riss.kr/link?id=A82297011

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      부가정보

      국문 초록 (Abstract)

      목 적: 조기유방암의 치료에 있어 과거에는 유방 전적출술이 주된 치료였으나 현재는 유방보존술이 표준 치료방법
      으로 정립되었다. 저자들은 서울대학교병원에서 유방보존수술 및 방사선치료를 받은 환자의 임상적 특성을 조사
      하고 치료결과 및 예후인자를 분석하고자 하였다. 대상 및 방법: 1992년 2월부터 2002년 1월까지 침윤성 유방암으로 유방보존수술 및 수술 후 방사선치료를 받은 424명을 대상으로 후향적으로 분석하였다. 대부분의 환자는 사분절제술 및 액와림프절 청소술을 시행 받았다(396명, 93.4%). 302명이 T1이었고 122명은 T2 병기였으며, 림프절 전이는 107명에서 확인되었다. 방사선치료는 전체 유방에 28회에 걸쳐 50.4 Gy를 조사한 후 종양이 있었던 부위에 10 Gy의 추가조사를 실시하였다. 영역림프절 조사는 57명에서 시행되었다. 항암화학요법은 231명에서 시행되었으며, 그 중 170명이 cyclophosphamide, methotrexate 및 5-fluorouracil을 투여 받았다. 중앙추적기간은 64개월이었다. 결 과: 전체 환자의 5년 국소제어율은 95.6%이었다. 추적관찰 중 15명의 환자에서 국소재발이 확인되었다. 5년 생존율은 93.1%이었고, 병기에 따른 5년 생존율은 I기 94.8%, IIA기 95.0%, IIB기 91.1%, IIIA기 75.9%, IIIC기 57.1% 이었다. 5년 무병생존율은 88.7%이었고, 병기별로는 I기 93.1%, IIA기 89.4%, IIB기 82.8%, IIIA기 62.0%, IIIC기 28.6%이었다. 예후인자 분석에서는 N 병기(p=0.0483)가 생존율에, 연령(p=0.0284)과 N 병기(p=0.0001)가 무병생존율에 각각 유의한 영향을 보였다.
      결 론: 조기유방암에서 유방보존수술 및 수술 후 방사선치료는 우수한 국소제어율 및 생존율을 기대할 수 있는 치료법임을 확인할 수 있었다.
      번역하기

      목 적: 조기유방암의 치료에 있어 과거에는 유방 전적출술이 주된 치료였으나 현재는 유방보존술이 표준 치료방법 으로 정립되었다. 저자들은 서울대학교병원에서 유방보존수술 및 방사선...

      목 적: 조기유방암의 치료에 있어 과거에는 유방 전적출술이 주된 치료였으나 현재는 유방보존술이 표준 치료방법
      으로 정립되었다. 저자들은 서울대학교병원에서 유방보존수술 및 방사선치료를 받은 환자의 임상적 특성을 조사
      하고 치료결과 및 예후인자를 분석하고자 하였다. 대상 및 방법: 1992년 2월부터 2002년 1월까지 침윤성 유방암으로 유방보존수술 및 수술 후 방사선치료를 받은 424명을 대상으로 후향적으로 분석하였다. 대부분의 환자는 사분절제술 및 액와림프절 청소술을 시행 받았다(396명, 93.4%). 302명이 T1이었고 122명은 T2 병기였으며, 림프절 전이는 107명에서 확인되었다. 방사선치료는 전체 유방에 28회에 걸쳐 50.4 Gy를 조사한 후 종양이 있었던 부위에 10 Gy의 추가조사를 실시하였다. 영역림프절 조사는 57명에서 시행되었다. 항암화학요법은 231명에서 시행되었으며, 그 중 170명이 cyclophosphamide, methotrexate 및 5-fluorouracil을 투여 받았다. 중앙추적기간은 64개월이었다. 결 과: 전체 환자의 5년 국소제어율은 95.6%이었다. 추적관찰 중 15명의 환자에서 국소재발이 확인되었다. 5년 생존율은 93.1%이었고, 병기에 따른 5년 생존율은 I기 94.8%, IIA기 95.0%, IIB기 91.1%, IIIA기 75.9%, IIIC기 57.1% 이었다. 5년 무병생존율은 88.7%이었고, 병기별로는 I기 93.1%, IIA기 89.4%, IIB기 82.8%, IIIA기 62.0%, IIIC기 28.6%이었다. 예후인자 분석에서는 N 병기(p=0.0483)가 생존율에, 연령(p=0.0284)과 N 병기(p=0.0001)가 무병생존율에 각각 유의한 영향을 보였다.
      결 론: 조기유방암에서 유방보존수술 및 수술 후 방사선치료는 우수한 국소제어율 및 생존율을 기대할 수 있는 치료법임을 확인할 수 있었다.

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      다국어 초록 (Multilingual Abstract)

      Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by
      postoperative radiotherapy. Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.
      번역하기

      Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy. Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postopera...

      Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by
      postoperative radiotherapy. Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.

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      목차 (Table of Contents)

      • 서 론
      • 대상 및 방법
      • 결 과
      • 고안 및 결론
      • 서 론
      • 대상 및 방법
      • 결 과
      • 고안 및 결론
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      참고문헌 (Reference)

      1 Zhou P, "Young age and outcome for women with early-stage invasive breast carcinoma" 101 : 1264-1274, 2004

      2 Fisher B, "Twenty-year followup of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer" 1233-1241, 2002

      3 Veronesi U, "Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer" 1227-1232, 2002

      4 Hankey BF, "Trends in breast cancer in younger women in contrast to older women" 16 : 7-14, 1994

      5 Kim KJ, "Treatment results and prognostic factors of early breast cancer treated with a breast conserving operation and radiotherapy" 35 : 126-133, 2005

      6 Cox JD, "Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)" 31 : 1341-1346, 1995

      7 Koh KW, "The results of primary radiotherapy following breast-conserving surgery for early breast cancer" 13 : 163-171, 1995

      8 Ahn SH, "The Korean Breast Cancer Society. Chronological changes of clinical characteristics in 31115 new breast cancer patients among Koreans during 1996-2004" 99 : 209-214, 2006

      9 Fyles AW, "Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer" 963-970, 2004

      10 Suh CO, "Risk factors for recurrence after conservative treatment in early breast cancer: preliminary report" 12 : 337-347, 1994

      1 Zhou P, "Young age and outcome for women with early-stage invasive breast carcinoma" 101 : 1264-1274, 2004

      2 Fisher B, "Twenty-year followup of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer" 1233-1241, 2002

      3 Veronesi U, "Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer" 1227-1232, 2002

      4 Hankey BF, "Trends in breast cancer in younger women in contrast to older women" 16 : 7-14, 1994

      5 Kim KJ, "Treatment results and prognostic factors of early breast cancer treated with a breast conserving operation and radiotherapy" 35 : 126-133, 2005

      6 Cox JD, "Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)" 31 : 1341-1346, 1995

      7 Koh KW, "The results of primary radiotherapy following breast-conserving surgery for early breast cancer" 13 : 163-171, 1995

      8 Ahn SH, "The Korean Breast Cancer Society. Chronological changes of clinical characteristics in 31115 new breast cancer patients among Koreans during 1996-2004" 99 : 209-214, 2006

      9 Fyles AW, "Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer" 963-970, 2004

      10 Suh CO, "Risk factors for recurrence after conservative treatment in early breast cancer: preliminary report" 12 : 337-347, 1994

      11 Nixon AJ, "Relationship of patient age to pathologic features of the tumor and prognosis for patients with stage I or II breast cancer" 12 : 888-894, 1994

      12 Nattinger AB, "Relationship of distance from a radiotherapy facility and initial breast cancer treatment" 93 : 1344-1346, 2001

      13 Veronesi U, "Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trial" 12 : 997-1003, 2001

      14 Lee MZ, "Radiation therapy for operable breast cancer after conservative surgery" 20 : 309-315, 2004

      15 Lee SH, "Radiation therapy and chemotherapy after breast conserving surgery for invasive breast cancer: an intermediate result" 25 : 16-25, 2007

      16 Veronesi U, "Quadrantectomy vs. lumpectomy for small size breast cancer" 26 : 671-673, 1990

      17 Bartelink H, "Psychological effects of breast conserving therapy in comparison with radical mastectomy" 11 : 381-385, 1985

      18 Cianfrocca M, "Prognostic and predictive factors in early-stage breast cancer" 9 : 606-616, 2004

      19 van der Hage JA, "Preoperativechemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902" 19 : 4224-4237, 2001

      20 Wolmark N, "Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18" 30 : 96-102, 2001

      21 Freedman G, "Patients with early stage invasive cancer with close or positive margins treated with conservative surgery and radiation have an increased risk of breast recurrence that is delayed by adjuvant systemic therapy" 44 : 1005-1015, 1999

      22 Park CC, "Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and ystemic therapy on local recurrence" 18 : 1688-1675, 2000

      23 Goldhirsch A, "Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2005" 16 : 1569-1583, 2005

      24 Hughes K, "Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer" 971-977, 2004

      25 van Dongen JA, "Longterm results of a randomized trial comparing breastconserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial" 92 : 1143-1150, 2000

      26 Joslyn SA, "Geographic differences in treatment of early stage breast cancer" 5 : 29-35, 1999

      27 Poggi MM, "Eighteenyear results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial" 98 : 697-702, 2003

      28 Early Breast Cancer Trialists' Collaborative Group (EBCTCG), "Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomized trials" 2087-2106, 2005

      29 Leong C, "Effect of margins on ipsilateral breast tumor recurrence after breast conservation therapy for lymph node-negative breast carcinoma" 100 : 1823-1832, 2004

      30 Blichert-Toft M, "Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life-table analysis" 11 : 19-25, 1992

      31 Arriagada R, "Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave- Roussy Breast Cancer Group" 14 : 1558-1564, 1996

      32 National Institutes of Health Consensus Development Panel, "Consensus statement: Treatment of early-stage breast cancer" 11 : 1-5, 1992

      33 Kim JH, "Breast conserving operation and radiation therapy in early breast cancer: interim analysis" 19 : 27-33, 2001

      34 Kim YS, "Breast conservation therapy versus mastectomy: preliminary results of pattern of failure and survival rate in early breast cancer" 22 : 115-123, 2004

      35 Solin LJ, "Age as a prognostic factor for patients treated with definitive irradiation for early stage breast cancer" 16 : 373-381, 1989

      36 American Joint Committee on Cancer (AJCC), "AJCC Cancer Staging Manual. 6th ed." Springer-Verlag 223-240, 2002

      37 Ministry of Health and Welfare, "2002 Annual Report of the Korea Central Cancer Registry (Published in 2003)"

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      학술지 이력

      학술지 이력
      연월일 이력구분 이력상세 등재구분
      2024 평가예정 해외DB학술지평가 신청대상 (해외등재 학술지 평가)
      2021-01-01 평가 등재학술지 선정 (해외등재 학술지 평가) KCI등재
      2020-12-01 평가 등재후보로 하락 (해외등재 학술지 평가) KCI등재후보
      2015-01-01 평가 SCOPUS 등재 (기타) KCI등재
      2013-01-01 평가 등재후보 1차 FAIL (등재후보1차) KCI등재후보
      2012-04-01 평가 등재후보로 하락 (기타) KCI등재후보
      2012-01-01 평가 등재후보학술지 유지 (기타) KCI등재후보
      2011-12-30 학회명변경 영문명 : The Korean Society For Therapeutic Radiology And Oncology -> The Korean Society for Radiation Oncology KCI등재
      2011-08-22 학술지명변경 한글명 : 대한방사선종양학회지 -> Radiation oncology journal
      외국어명 : The Journal of the Korean Society for Therapeutic Radiology and Oncology -> Radiation oncology journal
      KCI등재
      2009-01-01 평가 등재 1차 FAIL (등재유지) KCI등재
      2006-01-01 평가 등재학술지 선정 (등재후보2차) KCI등재
      2005-01-01 평가 등재후보 1차 PASS (등재후보1차) KCI등재후보
      2004-01-01 평가 등재후보학술지 유지 (등재후보1차) KCI등재후보
      2002-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
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      학술지 인용정보

      학술지 인용정보
      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 0.31 0.31 0.25
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
      0.23 0.22 0.864 0.05
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