Interdigitating dendritic cell sarcoma occured alone in axilla / 대한외과학회지

Interdigitating dendritic cell sarcoma (IDCS) is a very rare disease around the world and its prognosis is known to be aggressive. This reports a case diagnosed as IDCS of the axillary region treated in Soonchunhyang University Hospital. A 57-year-old female visited Soonchunhyang University Hospital with a left axillary mass. The mass was hard and fixed. Computed tomography observed a 7 cm lymph node at the left axilla, and core biopsy suspected sarcoma. In another study, there was no specific finding except the axillary lesion. Left axillary lymph node dissection (level I, II) was conducted and the pathologic report finally showed IDCS. The patient was treated with only radiotherapy and followed up without recurrence for 13 months up to now. IDCS is a very rare sarcoma that is hard to diagnose and progresses fast. Thus, treatment is very difficult. Proper treatment can be better established after more experiences.

Toxicity and Tolerability Study of Adjuvant TAC Regimen Chemotherapy in Korean Patients with Breast Cancer / 한국유방암학회지

PURPOSE: Recent randomized phase III trial by the Breast Cancer International Research Group (BCIRG 001) showed that docetaxel plus doxorubicin and cyclophosphamide (TAC) is superior to fluorouracil plus doxorubicin and cyclophosphamide (FAC) as adjuvant chemotherapy for node-positive operable breast cancer. Unfortunately, TAC was clearly more toxic than FAC not only with respect to neutropenic fever events, but also with respect to many extrahematological side effects. The aim of this study was to evaluate the toxicity and tolerability of Korean patients with breast cancer treated with TAC. METHODS: This study was conducted on 80 patients with breast cancer who underwent primary surgery at the Department of Surgery in Soonchunhyang University (4 affiliated hospitals) from October 2005 to October 2008. The patients received 480 courses consisting of TAC (75/50/500 mg/m2, every 3 weeks for 6 cycles) without prophylactic granulocyte colony-stimulating factor (G-CSF). Toxicity was graded according to the National Cancer Institute Common Toxicity Criteria version 3.0. RESULTS: The main toxicities were hematologic (neutropenia grade 3/4 in 98.8% of patients and 92.3% of cycles; febrile neutropenia in 42.5% of patients and 16.0% of cycles). No cases of septic death occurred. The peak time of occurrence for febrile neutropenia was 7-10 days after receiving chemotherapy (mean duration, 2.05 days). Severe nonhematologic adverse events were as follows: myalgia (30.0%), neurotoxicity (17.5%), fatigue (16.3%), stomatitis (12.5%), and nausea (11.3%). CONCLUSION: An adjuvant TAC regimen without prophylactic G-CSF was tolerable in Korean patients with breast cancer. Although most of the patients developed neutropenia, the nonhematologic toxicities (cardiac toxicity) were tolerable. Further studies on prophylactic G-CSF use to assess the contribution to reduced hematologic toxicities are required in Korean patients with breast cancer.

Inhibitory Effect on Angiogenesis of a Selective Cyclooxygenase-2 Inhibitor with using Mouse Mammary Tumor cells / 한국유방암학회지

PURPOSE: Angiogenesis plays a key role in the growth and metastasis of malignant tumor. Angiogenesis is reportedly enhanced by prostaglandins (PGs). Cyclooxygenase (COX)-2 is an inducible enzyme that catalyzes the formation of PGs from arachidonic acid. The COX enzyme system is composed of two isoenzymes, COX-1 and COX-2. Recent sources of experimental and epidemiological evidence suggest a significant role for the COX enzymes, particularly COX-2, in the pathogenesis of breast cancer. COX-2 overexpression in a murine mammary gland is sufficient to cause tumor formation. We performed our study to determine the effect of COX-2 inhibitor in a in vivo mouse mammary tumor (MMT) cell line. METHODS: In order to test our study, 24 C57BL/6 type mice (Jackson Laboratory, Bar Harbor, USA) were randomized to receive 35 days of either placebo supplemented diet (n=11) or a 1,500ppm celecoxib (CELEBREX, Pfizer Inc. St. Louis, USA) supplemented diet (n=13) beginning at day 0. At 14 days after the beginning day, 30 microliter of a 1% India ink solution that contained 500,000 of MMT cells or dye alone (control) was intradermally inoculated at each flank (day 14). The animals were sacrificed 21 days later (day 35) and skin specimens were harvested/processed for quantification of the microvessel density (MVD) that was associated with each inoculated site. The aortas that were isolated according to each treatment group at the time of animal sacrifice were used to create identical aortic ring angiogenesis assays (media 199 supplemented with 20% FBS). Explants were evaluated for 14 days in culture to determine both the rate of angiogenesis initiation (% of explants exhibiting the angiogenic phenotype) and the neovessel growth rate (using a subjective angiogenic index score for the wells exhibiting initiation). Analysis of variance (ANOVA) was used to evaluate the differences between groups for each assay. RESULTS: According to the immunohistochemical staining, celecoxib administration resulted in a parallel decrease in the MVD at both the control and MMT inoculated sites (22% and 21%, p = 0.025 and p = 0.010 respectively). On the aortic ring assay, the dietary treatment group was not significantly inhibited compared with the placebo group (75% and 63.3%, respectively, p = NS). However, dietary celecoxib administration significantly inhibited the angiogenic index of the neovessel growth rate (5.0 +/- 2.38 and 8.9 +/- 3.44, respectively, p < 0.001). CONCLUSION: These results suggest that a selective COX-2 inhibitor had an antiangiogenic effect on the in vivo tumor cells. We will perform more investigations of a selective COX-2 inhibitors, and these may will be crucial drugs to use as new chemotherapy agents for treating in cancer.