PURPOSE:We present a retrospective analysis of long-term therapeutic results for patients treated in our institution to evaluate the efficacy of breast-conserving therapy (BCT).PATIENTS AND METHODS:The study population was 99 patients (102 breasts) with stage 0, I, and II breast cancer who underwent breast conservation therapy between April 1990 and November 1997. The entire breast was irradiated to a median dose of 50 Gy (range, 50-60 Gy) in 25-30 fractions. An additional 10 Gy in five fractions with 6-12 MeV electrons was given to 23 breasts (23%) with positive surgical margins.RESULTS:The 5-/10-year overall survival, cause-specific survival, relapse-free rate, local recurrence, and regional recurrence rates were 94.6/93.3%, 95.7/94.5%, 88.2/77.5%, 4.2/8.5%, and 2.0/6.3%, respectively. In both uni- and multivariate analyses, age < 40 years was a significant prognostic factor for local recurrence. No severe morbidity was observed.CONCLUSION:The long-term clinical outcome of BCT for early breast carcinoma patients in our department was favorable. Patient age <40 was the most important factor associated with an increased risk of local recurrence in the ipsilateral breast.

BACKGROUND:We constructed a remote radiotherapy planning system, and we examined the usefulness of and faults in our system in this study.METHODS:Two identical radiotherapy planning systems, one installed at our institution and the other installed at an affiliated hospital, were used for radiotherapy planning. The two systems were connected by a wide area network (WAN), using a leased line. Beam data for the linear accelerator at the affiliated hospital were installed in the two systems. During the period from December 2001 to December 2002, 43 remote radiotherapy plans were made using this system.RESULTS:Data were transmitted using a file transfer protocol (FTP) software program. The 43 radiotherapy plans examined in this study consisted of 13 ordinary radiotherapy plans, 28 radiotherapy plans sent to provide assistance for medical residents, and 2 radiotherapy plans for emergency cases. There were ten minor planning changes made in radiotherapy plans sent to provide assistance for medical residents.CONCLUSION:Our remote radiotherapy planning system based on WAN using a leased line is useful for remote radiotherapy, with advantages for both radiation oncologists and medical residents.

Postoperative irradiation for curative resection of esophageal carcinoma has been used in order to eradicate micro-dissemination and micro-metastases. Generally, a long T-shaped field is employed for postoperative irradiation, and the risk of radiation myelopathy increases even at low doses when the irradiated volume of the spinal cord enlarges. Some questions arise about the postoperative irradiation: First, whether its effectiveness outweighs the risk; second, for which patients it is indispensable; third, what is the optimal dose of irradiation; fourth, whether combined chemotherapy improves the prognosis; and fifth, what the actual incidence of radiation myelopathy is. We analyzed data compiled over the last decade.