Five years survival result of twenty-two breast cancers treated by breast conserving therapy at NCI Bangkok.

From November 1984 to July 1992 Breast Conserving Therapy (BCT) has been offered to clinical stage 1 & 2 breast cancers. Twenty two breast cancers were treated and passed the five year period. Only one patient was lost in follow-up. The treatment consisted of tumorectomy, full axillary nodal dissection and total breast irradiation with a booster dose at the biopsy site. Adjuvant chemotherapy is administered in cases of positive axillary nodes. There are seventeen living and four deaths. The 5 year survival was 80.95 per cent. The four deaths were node negative and in the young age group (under 36 years of age). Three out of four who died of distant metastasis showed precedent local recurrence. Local recurrence was noted in four patients (19.04%). Second primary breast cancers were found in four patients and two of them died of distant metastasis and one of these two had local recurrence in the first breast carcinoma. There were two survivors from distant metastasis, one with single pulmonary metastasis and another with spine and pelvic bony metastases. Slight to moderate arm edema was found in 5 patients. (22.73%). From our study we have been convinced that BCT seems to give poorer results in terms of survival in the young age group (especially under 36 years of age). Those who are under 36 years of age and have T2 lesion with negative node or local recurrence as well as second primary breast carcinoma should receive adjuvant chemotherapy.

Differential radiosensitization of radioresistant human cancer cells by caffeine.

The effect of caffeine, the methylated xanthine, in sensitizing the lethal action of ionizing radiation in vitro was investigated in human cancer cells which were clinically known to be radioincurable. The tumor lines were hepatocellular carcinoma and colon adenocarcinoma. Plateau phase cultures, after absorbing doses of 2 Gy, survived at a rate of 56.30 per cent for colon cancer and at 66.05 per cent for liver cancer. Both lines were radiosensitized by caffeine but at different potencies. Noteworthily, hepatocellular carcinoma whilst less radiosensitive than colon adenocarcinoma was 4 times more susceptible to caffeine. The lowest effective caffeine concentration for liver cancer was 2 mM which slightly exceeded the anticipated lethal concentration in humans. Research on radiosensitizing effect of methylated xanthines on hepatoma system still remains intriguing. Future work should be pursued with the use of less toxic compounds, such as theobromine.