Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์

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    Acute toxicity of concurrent chemoradiation with weekly cisplatin in cervical cancer patients
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2011-01-24) tawin chotitanaprasit
    Between January 2009 and August 2009, 19 consecutively previously untreated patients with invasivecervical carcinoma had completed concurrent chemoradiation treatment at Ubonratchathani cancercenter. Clinical stage were IB2 : 2 IIA: 4 IIB : 10 IIIB : 3 . A total of 83 cycles of cisplatin were administeredto the patients ,with a median of 4 cycles (range, 3 - 6 ). Severe hematological occurred in 3 patients (16%)No severe gastrointestinal toxicity occurred, only grade 2 in 1 patients (5 %). The grades of hematologicaland gastrointestinal toxicity were less than other studies. These results may be from lesser numbers ofpatients given cisplatin 6 cycles or more.
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    The effect of contrast agents on dose
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2011-01-24) Warunee Aungthondkamnerd
    The purpose of this study was to evaluate the effect of contrast agents on dose calculation in3-Dimensional Conformal Radiotherapy (3D-CRT) for brain, thorax and upper abdomen region inRamathibodi hospital. Five, six and four cancer patients for brain, thorax and upper abdomen regionrespectively were studied for retrospective study. Each patient took two sets of CT images in the sameposition before and after IV contrast agent injection. To avoid the movement artifact, the CT images ofthorax and upper abdomen regions of without-contrast agent were imitated by overriding the density to the organs or regions using the density obtained from the original without-contrast agent CT images. The approved plan by a radiation oncologist was copied to both with- and without-contrast agent CT images. Both of the plans used the same monitor unit. The doses calculated from two plans were compared with regard to tumor volume and organs at risk volume. The paired sample t-test and gamma evaluation were used to evaluate the differences in dose distributions between two plans. The results of doses of tumor volume and organs at risk volume were not signifi cantly different between with - and without-contrast agent CT images for brain, thorax and upper abdomen region (p \> 0.05), except heart organ in thorax region (p \< 0.05) but the dose differences were less than 1% compared to dose calculated from without-contrast agent CT images. The number of passed pixel was more than 95% and the gamma value was less than 0.5 for dose distributions compared between two sets of CT images. As a result,using contrast agent at the time of CT simulation dose not signifi cantly affect on dose calculation in3D-CRT. 
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    Survival in endometrial cancer
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) Nithinai Tangprasert; Radiation Therapy Unit, National Cancer Institute Thailand; Sukumarn Sanersak Swangvaree; Gynecological Oncology Unit, National Cancer Institute Thailand
    Objective; To identifi ed survival of endometrialcancer patients in National Cancer Institute ofThailand.Material and Method ; This is a retrospective descriptivestudy. All patients with endometrial cancerwho received treatment in National Cancer InstituteFrom 1987-2004 were included.Results ; Five hundred and seventy nine patientswith endometrial cancer that met the study criteriawere included. The median age of the patients were54.13 years. The median overall survival was 93.75months. The 5 year survival of endometrial cancerpatients were 84.1% in stage I, 63.6 % in stage II, 53.5% in stage III, and 13.6% in stage IV. In patient,were received radiotherapy, had overall survivalabout 70.1% at 5 years. In cases of intermediatedto high risk of recurrence endometrial cancer hadno statistically signifi cant in difference of overallsurvival between radiation and non-radiationgroup.Conclusion ; The survival in endometrial cancerpatients were good and radiation in intermediateto high risk of recurrence was not increase overallsurvival.
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    Myelosuppression in breast cancer patients receiving postoperative radiation
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) Pongsatorn Supaattagorn; Radiation Oncology Department, Ubonratchathani Cancer Center; Tawin Chottetanaprasith; Radiation Oncology Department, Ubonratchathani Cancer Center; Thanut Khuayjarernpanishk; Radiation Oncology Department, Ubonratchathani Cancer Center; Sirilak Ngoeiwikit; Radiation Oncology Outpatient Department, Ubonratchathani Cancer Center; Chuenchom Songyai; Radiation Oncology Outpatient Department, Ubonratchathani Cancer Center; Kanittha Promsumlee; Radiation Oncology Outpatient Department, Ubonratchathani Cancer Center; Mutita Sappsarn; Radiation Oncology Outpatient Department, Ubonratchathani Cancer Center
    The addition of radiation after mastectomy or breast conservative surgery in high risk breast cancer women can reduces the risk of locoregional recurrence. Weekly CBC is a routine monitor during the period of radiation. But the CBC abnormalities or bone marrow suppression is not much observed in our clinical practice.The purpose of this retrospective study was to evaluate the necessary of this routine practice. We had collected the CBC abnormalities in 122 stage I-III breast cancer patients who received postoperative radiation with or without preceding adjuvant chemotherapy in 2008.The finding showed that 27 % ,12.2 % and 2.4 % of patients had Hb \< 10 g% , ANC \< 1,500/mm3 and PLT \< 100,000 /mm3 in any weeks during radiation period. The mean duration between adjuvant chemotherapy and starting date of radiation were 4 weeks and 4.8 weeks in the patients who had abnormal CBC and no abnormal CBC respectively. Most of these abnornormalities occurred in the first 3 weeks of radiation.In our conclusion, routine CBC entired radiation period may not be necessary. CBC monitor in the first few weeks and clinical evaluation may be suffi cient.
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    โครงการ การดูแลผู้ป่วยระยะสุดท้าย
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2011-01-24) อัมภวรรณ์ ใจเปี้ย
    ผู้ป่วยมะเร็ง เป็นผู้ป่วยเรื้อรัง ที่ต้องใช้เวลาในการรักษายาวนาน และต่อเนื่อง ซึ่งมีผลต่อผู้ป่วยและญาติ ทั้งด้านร่างกาย จิตใจ อารมณ์ สังคม และจิตวิญญาณ ผู้ป่วยหรือญาติเมื่อรู้ว่าตัวเองหรือมีบุคคลในครอบครัวป่วยด้วยโรคมะเร็งก็จะเกิดความวิตกกังวล กลัวจะไม่หายจากโรค กลัวตายจากโรคที่เป็น และเมื่อรักษาจนมาถึงจุดจุดหนึ่งซึ่งไม่สามารถรักษาด้วยยา หรือวิธีการอื่นๆแล้ว เจ้าหน้าที่พยาบาลหรือทีมการรักษา ต้องมีการวางแผนให้ผู้ป่วยและญาติมีความเข้าใจ ในสิ่งที่ผู้ป่วยต้องเผชิญ ดังนั้นหอผู้ป่วยรังสีรักษาจึงได้มีโครงการการดูแลผู้ป่วยระยะสุดท้ายขึ้น เพื่อให้ผู้ป่วยระยะสุดท้ายได้รับการตอบสนองทั้งด้านร่างกาย จิตใจ อารมณ์ สังคม และจิตวิญญาณและญาติมีส่วนร่วมในการดูแลรักษา ซึ่งโครงการนี้มีวัตถุประสงค์ เพื่อให้ผู้ป่วยระยะสุดท้ายได้รับการตอบสนองทั้งด้านร่างกาย จิตใจ อารมณ์ สังคม และจิตวิญญาณ และผู้ป่วยและญาติมีความพึงพอใจ โดยมีกลุ่มเป้าหมายเป็นผู้ป่วยมะเร็งที่มีแผนการรักษาตามอาการ (symptomatic treatment) หรือการรักษาเป็นแบบ Palliative care โดยปฏิบัติตามแนวปฏิบัติการดูแลผู้ป่วยระยะสุดท้ายตามที่ได้วางไว้ พบว่ามีผู้ป่วยที่มารับการรักษาทั้งหมด 902 ครั้ง มีผู้เสียชีวิตในหอผู้ป่วยจำนวน 8 ราย นำกลับไปรักษาต่อที่บ้าน จำนวน 9 ราย และญาติมีความพึงพอใจเฉลี่ย 94.79% \ 
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    Palliative Prognostic Index (PPI)
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2011-01-24) niun chotitanaprasit
    PurposeTo evaluate the predictive accuracy of the Palliative Prognostic index (PPI) in patients with advanced cancer at Ubonratchatani cancer center.Patients and MethodsThe PPI (defi ned by performance status, oral intake, edema, dyspnea and delirium) was calculated in 34 consecutive patients with advanced cancer hospitalized at palliative care unit. Patients were classified into three groups: group A (PPI \< 2.0), group B (2.04.0). The survival curves and the 95% confi dence intervals of survival were calculated by the Kaplan-Meier method, and the comparisons among three groups were based on the log-rank test. Cut-off points for survival prediction of shorter than 3 or 6 weeks were determined and the validity of the prediction was examined.ResultsGroup B survived signifi cantly longer than group C, and group A survived signifi cantly longer than either of the others. When a PPI of more than 6 was adopted as a cut-off point, 3 weeks’ survival was predicted with a sensitivity of 79% and a specifi city of 85%. When a PPI of more than 4 was used as a cut-off point, 6 weeks’ survival was predicted with a sensitivity of 72% and a specifi city of 75%.ConclusionThe survival of advanced cancer patients can be acceptably predicted by PPI.
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    ผู้ช่วยศาสตราจารย์แพทย์หญิงประภัสสร รัชตะปีติ
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) admin admin
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    มะเร็งของเต้านมในเพศชาย Male breast cancer
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) ปิยะ ประทีปะเสน
    Male breast cancer is a relatively rare neoplasm. This is a report case of male breast cancer treated by modified radical mastectomy with post operative radiation and chemotherapy using anthracyclin-based regimens. The patient remained well without evidence of disease or serious complication. Several investigators have reported that Male breast cancer occurs at an older age than female breast cancer and is frequently diagnosed at a later stage. Mammography and ultrasonography are useful to distinguish between breast cancer and gynecomastia. Tumors are predominantly estrogen and progesterone positive. Tamoxifen is effective for fi rst-line hormonal therapy. Radiation should be use in patients at high risk for local recurrence. Prognosis is approximately equivalent to that of breast cancer in females when matched for age, stage and hormonal receptors. The literatures are review.
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    Prevention and management of acute radiation dermatitis by the topical agents : A literature review
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) Titaree Suwannalai; Division of Radiology, Uttaradit Hospital
    Objectives: To review historical and current published studies on prevention and management of acuteradiation dermatitis.Data sources: Research studies, Review articles, Standard text booksConclusion: The literature showed no standard recommendation for the use of specifi c topical agentsfor prevention or management of acute radiation dermatitis. The researches studied on aloe vera gel,biafi ne cream, almond ointment, chamomile cream, Thêta-Cream® and topical vitamin E creamdemonstrated negative results for prevention and reduction of radiation induced skin alteration. Someevidence suggested the use of topical steroid, topical sucralfate/ sucralfate derivatives, hyaluronic acidcream and MDS065D. However, more studies are needed to support the fi rm recommendation.
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    Surface dose measurements in clinical 6 MeV-X-photon beams : Comparison of Measurements and MC calculations.
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) J. M. Jensen; CancerCare Manitoba, Winnipeg; G. Asuni; CancerCare Manitoba, Winnipeg; I. Lütjens; Klinik f. Strahlentherapie, UK SH, Campus Kiel
    For radiotherapy of superfi cial lesions, but alsoin intensity modulated radiotherapy (IMRT), 6MeV-X-photon beams are preferred, with relativesurface doses, dependent on fi eld size and SSD,of 8 % to 28 %. Depending on absorption materialwithin the beam this values can vary considerable.The infl uence of a block tray, different metals anda new type of transmission detector on surfacedoses as well as on other beam parameters havebeen investigated. The surface doses as well assome other fi eld parameters have been checkedby means of a plane parallel ionization chamber(Markus chamber, type 23 343, PTW-Freiburg,Germany). Because of specifi c design features thereadings have to be corrected, and the results havebeen verifi ed by Monte Carlo (MC) simulations andcalculations: Measurements agreed well withcalculations within Δ ≈ 3 %. So it could be shownfor the used Markus chamber, type 23 343, that theapplied correction function is suitable for open fi eldsas well as for blocked fi elds at different clinical usedSSDs.
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    Output factors for squared, rectangular and elongated photon fi elds of linear accelerators : A supplement to Stirling’ formula.
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) J. M. Jensen; Dept. Medical Physics, CancerCare Manitoba, 675 McDermot Ave., Winnipeg, Canada
    For dose calculation in radiation therapy with photons a variety of basic beam data are required,such as percentage depth doses, dose profi les, and output factors (OF) for open as well as forwedged beams. In contrast to profi le measurements, output factors have to be measured for all squared,rectangular and also for extremely elongated fi eld sizes. To realize smooth output factor functions, atleast 100 different fi eld sizes with small increments in length and width have to be measured.A simple modification of the Stirling’ formula, taking into consideration the collimator exchangeeffect, allows an accurate prediction of the output factors for all fi eld sizes, based on the experimentaldata survey for the minimum, the maximum and the reference fi eld size (10 x 10 cm2) only. The ratio ofthe calculated OF and the measured one’s stays within 1.0025 ± 0.009, even for elongated and wedgedfi eld sizes. All major vendors of medical linear accelerators have been included in this study.
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    Simultaneous Integrated Boost (SIB) รังสีสามมิติแบบง่ายๆ
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) พรทิพย์ เอี่ยมพงษ์ไพบูลย์; สาขาวิชารังสีรักษา ภาควิชารังสีวิทยา คณะแพทยศาสตร์ศิริราชพยาบาล มหาวิทยาลัยมหิดล; นวลเพ็ญ ดำรงกิจอุดม; ภาควิชารังสีเทคนิค คณะเทคนิคการแพทย์ มหาวิทยาลัยมหิดล
    Not available.
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    Investigation of Dose Delivery
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2011-01-24) Chumpot Kakanaporn
    Introduction: fi cantly increasethe dose to the patient’s normal tissues.Objective: fi xed technical setting for head and neck and pelvic scans.Materials and Methods: filters for head and pelvic area, respectively. The technical setting of 100 kV, 20 mA and 20 ms for headregion and 125 kV, 80 mA and 13 ms for pelvic were used. TLDs-100H were used for Rando phantomskin dose measurement at the point of interest for head and neck and pelvic area. Organ doses werealso measured inside Rando phantom.Results: Conclusions:  The use of CBCT for treatment verifi cation provided a high dose to the patient. It isimportant to consider about the optimal protocol and amount of times to verify the patient position tokeep additional doses as low as reasonably practicable.For head and neck CBCT, The lateral surface dose was higher than anterior ( include criticalorgan such as eyes, lip, chin and neck). The peripheral organ dose at Lt. lat area dose (0.28 cGy) wasless than central dose ( 0.4 cGy), but Right lateral area such as temporal and parotid was about thesame as the central dose (brainstem). For pelvic CBCT, The lateral surface dose was not symmetrical,with Left lateral side being ~ 20% higher than Rt. Lat. The anterior (AP) surface dose was higher thanlateral especially at the pubic area (5.2 cGy). The dose at bladder, rectum and bowl were about thesame as the central dose (~ 3 cGy). The highest dose was in the left hip joint region up to 7 cGy.CBCT scans were acquired in full-fan and half-fan mode with full and half bowtieTo investigate the skin and organ dose from the CBCT system from the clinical protocolsetup, withThe Varian 23EX Clinac at Siriraj Hospital is a linear accelerator with integrated On-BoardImager (OBI) system capable of producing cone beam computed tomography (CBCT) images of thepatient in the treatment position. The increased use of CBCT for patient setup may signi
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    Instruction for author
    (Journal of Thai Society of Therapeutic Radiology and Oncology - วารสารมะเร็งวิวัฒน์, 2010-04-18) admin admin