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JN : J Med Assoc Thai. 2008 Oct;91(10):1571-82.
TI : Dosimetric study of inverse-planed intensity modulated, forward-planned intensity modulated and conventional tangential techniques in breast conserving radiotherapy.
AU : Rongsriyam K, Rojpornpradit P, Lertbutsayanukul C, Sanghangthum T, Oonsiri S.
EN-AB: OBJECTIVE: The authors present the result of a dosimetric comparison of inverse-planed intensity modulated, forward-planned intensity modulated, and conventional tangential technique in breast conserving radiotherapy. METHOD AND MATERIAL: The breasts (Right side: Left side = 1:1), heart, and lungs of 28 patients were contoured on all the computed tomography (CT)-slice. Three different treatment plans were created: (1) inverse IMRT (iIMRT), (2) forward IMRT (fIMRT), and (3) conventional tangential technique (CVT). The total prescribed dose for all plans was 50 Gy/25 fractions. All treatment plans were normalized at 95% of the prescribed dose covered the entire PTV and used inhomogeneity corrections. RESULTS: For the entire group, the mean breast volume was 517 cc. The V105% for iIMRT, fIMRT and conventional plans was 1.12%, 2.36% and 16.81%, which iIMRT better than fIMRT and CVT (p < 0.001) and fIMRT better than CVT (p < 0.05). The Dmax for the iIMRT plan received 105.03%, which was significantly less than those from the fIMRT(106.6%, p < 0.001) and the conventional (110.68%, p < 0.001) plan. The PTV coverage (V95-105%) for the iIMRT, fIMRTand conventional was 96%, 91% and 87%, which iIMRT better than fIMRT and CVT (p < 0.05) and fIMRT better than CVT (p < 0.05). The PTV CI for the iIMRT technique was 0.704, which was significantly more conformity than those from the fIMRT (0.639, p < 0.001) and the conventional (0.539, p < 0.001) techniques. The PTV CI of fIMRT is significantly better than CVT (p < 0.005). Mean ipsilateral lung dose was 642.7 cGy, 747.6 cGy and 882.25 cGy for iIMRT fIMRT and CVT respectively (p < 0.05) The V20Gy reduced from 14.87% for conventional plan to 12.82% for the fIMRT plan, while 0.88% was obtained for the iIMRT plan (P<0.05). The heart V30 Gy value was 3.124%, 4.65%, and 5.84% for iIMRT, fIMRT and conventional plans, respectively (p < 0.05). The mean dose of contralateral breast was 55.86 cGy, 60.33 cGy, 68.57 cGy for iIMRT, fIMRT and conventional plans, respectively (p < 0.05 both). The mean contralateral lung dose was 57.8 cGy, 43.87 cGy, and 32.28 cGy for iIMRT, fIMRT and conventional plans, respectively (p < 0.005 both). CONCLUSION: The iIMRT technique provides significantly improved PTV Dmax, PTV V105%, PTV V110%, target volume coverage, dose homogeneity and dose conformity throughout the target volume of breast and reduced doses to all critical structures, compared to the fIMRT and conventional techniques. In view of fIMRT technique, it significantly improved the dose distribution and reduced dose to OARs compared to conventional technique, although not better than iIMRT technique. (NO 18972902)
JN : J Med Assoc Thai. 2008 Feb;91(2):215-24.
TI : A two-year experience of implementing 3 dimensional radiation therapy and intensity-modulated radiation therapy for 925 patients in King Chulalongkorn Memorial Hospital.
AU : Lertbutsayanukul C, Shotelersuk K, Khorprasert C, Sanghangthum T, Oonsiri S, Ayuthaya II, Jumpangern C, Suriyapee S, Rojpornpradit P.
EN-AB: BACKGROUND AND OBJECTIVE: Three dimensional conformal radiation therapy (3D CRT) and intensity-modulated radiation therapy (IMRT) have been implemented at Department of Therapeutic Radiation and Oncology, King Chulalongkorn Memorial Hospital (KCMH) since July 2005. This is the first study in Thailand to evaluate the pattern of care and utilization of 3D CRT and IMRT for treatment in each individual cancer. MATERIAL AND METHOD: Between July 2005 and July 2007, 925 newly diagnosed cancer patients underwent IMRT or 3D CRT at KCMH. The authors retrospectively reviewed the experience and utilization of 3D CRT and IMRT for each disease site and region. RESULTS: There were 471 males and 454 females. There were 332 patients (35.9%) treated with IMRT. Among the 332 IMRT patients, there were 100, 32 and 27 nasopharyngeal, lung and prostate cancers, respectively. On the contrary, 593 patients (64.1%) were treated with 3D CRT. Among these, breast, cervix and lung cancers were the most common diseases. Except for head and neck as well as genitourinary cancer 3D CRT was still the main technique used in more than 60% of the patients at KCMH. CONCLUSION: 3D CRT and IMRT have been successfully implemented at KCMH for 2 years. Three dimensional conformal radiation therapy was still the main technique used in more than 60% of the patients at KCMH. Prospective studies evaluating tumor control and treatment sequelae are expected. (NO 18389987)
JN : J Med Assoc Thai. 2006 Dec;89(12):2068-76.
TI : Intensity-modulated radiation therapy in head-and-neck cancer, first report in Thailand.
AU : Lertbutsayanukul C, Khorprasert C, Shotelersuk K, Jumpangern C, Sanghangthum T, Oonsiri S, Ayuthaya II, Suriyapee S, Wadwongtham W, Supanakorn S, Kerekanjanarong V, Rojpornpradit P.
EN-AB: OBJECTIVE: This is the first report in Thailand to evaluate the efficacy of using intensity-modulated radiotherapy (IMRT) in the primary treatment of head-and-neck cancer. MATERIAL AND METHOD: From July 2005 to March 2006, eighteen patients with head and neck cancer were treated with IMRT, fourteen of which were nasopharyngeal cancer. The median age at diagnosis was 52 years (range 23-58 years). The treatment plan composed of two sequential plans for PTV-low risk (50Gy in 25 fractions) and PTV-high risk (20Gy in 10 fractions). Chemotherapy was given to 13 patients with locoregionally advanced disease (stage T3/T4 and N2/3) using cisplatin (n = 3) or carboplatin (n = 10) every 3 weeks during the course of radiation therapy. RESULTS: The median overall treatment time was 49 days (range, 43-57 days), and 77.8 percent of the patients completed 35 fractions within 50 days. The clinical complete response and partial response rates at 3 months after complete radiation were 71.4% and 28.6%, respectively. However at the median follow-up of 5.6 months, the complete response rate increased to 89%. Treatment break during RT range from 3 to 7 days, was observed in three patients. All of them received concurrent chemoradiation. No distant metastasis was noted. CONCLUSION: The authors' experience of using concurrent chemotherapy with IMRT for a cohort of patients with head and neck carcinoma showed a very high rate response rate at early follow-up. Long-term clinical outcome is expected. (NO 17214058)
JN : Int J Radiat Oncol Biol Phys. 2004 Aug 1;59(5):1424-31.
TI : Phase III randomized trial comparing LDR and HDR brachytherapy in treatment of cervical carcinoma.
AU : Lertsanguansinchai P, Lertbutsayanukul C, Shotelersuk K, Khorprasert C, Rojpornpradit P, Chottetanaprasith T, Srisuthep A, Suriyapee S, Jumpangern C, Tresukosol D, Charoonsantikul C.
EN-AB: PURPOSE: Intracavitary brachytherapy plays an important role in the treatment of cervical carcinoma. Previous results have shown controversy between the effect of dose rate on tumor control and the occurrence of complications. We performed a prospective randomized clinical trial to compare the clinical outcomes between low-dose-rate (LDR) and high-dose-rate (HDR) intracavitary brachytherapy for treatment of invasive uterine cervical carcinoma. METHODS AND MATERIALS: A total of 237 patients with previously untreated invasive carcinoma of the uterine cervix treated at King Chulalongkorn Memorial Hospital were randomized between June 1995 and December 2001. Excluding ineligible, incomplete treatment, and incomplete data patients, 109 and 112 patients were in the LDR and HDR groups, respectively. All patients were treated with external beam radiotherapy and LDR or HDR intracavitary brachytherapy using the Chulalongkorn treatment schedule. RESULTS: The median follow-up for the LDR and HDR groups was 40.2 and 37.2 months, respectively. The actuarial 3-year overall and relapse-free survival rate for all patients was 69.6% and 70%, respectively. The 3-year overall survival rate in the LDR and HDR groups was 70.9% and 68.4% (p = 0.75) and the 3-year pelvic control rate was 89.1% and 86.4% (p = 0.51), respectively. The 3-year relapse-free survival rate in both groups was 69.9% (p = 0.35). Most recurrences were distant metastases, especially in Stage IIB and IIIB patients. Grade 3 and 4 complications were found in 2.8% and 7.1% of the LDR and HDR groups (p = 0.23). CONCLUSION: Comparable outcomes were demonstrated between LDR and HDR intracavitary brachytherapy. Concerning patient convenience, the lower number of medical personnel needed, and decreased radiation to health care workers, HDR intracavitary brachytherapy is an alternative to conventional LDR brachytherapy. The high number of distant failure suggests that other modalities such as systemic concurrent or adjuvant chemotherapy might lower this high recurrence, especially in Stage IIB and IIIB. (NO 15275728)
JN : J Med Assoc Thai. 2003 Jul;86(7):603-11.
TI : Intracranial germ cell tumors: experience in King Chulalongkorn Memorial Hospital.
AU : Shotelersuk K, Rojpornpradit P, Chottetanaprasit T, Lertbutsayanukul C, Lertsanguansinchai P, Khorprasert C, Asavametha N, Suriyapee S, Jumpangern C.
EN-AB: A retrospective study was performed on 69 patients with intracranial germ cell tumors who were treated at the Division of Radiation Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital from 1990 to 2000. Median age was 15 years. Forty-two cases (60.87%) had histologically confirmed germinoma or nongerminomatous germ cell tumors. Germinoma was the predominate histology followed by mixed germ cell tumors. Pineal and suprasellar regions were the two leading sites, hydrocephalus (85.5%) and diplopia (57.97%) were the two most common clinical presentations. Only 13 cases had the result of cerebrospinal fluid (CSF) cytology or magnetic resonance imagine (MRI) of the spine before initial treatment. Serum tumor markers, Alpha fetoprotein and beta-human chorionic gonadotropin, were available in 66.67 per cent. Total or partial tumor removal were feasible in 24 cases. Whole brain irradiation was given in almost all cases with the median dose of 3,600 cGy. The median total tumor dose was 5,400 cGy. Whole spine radiation was utilized in 17 cases. The mean follow-up time was 41 months. The five-year disease free survival was 73.59 per cent. Overall 3 and 5 year survival rates were 86.45 per cent and 81.64 per cent, respectively. (NO 12948253)
AU : Lertsanguansinchai P, Chottetanaprasith T, Chatamra K, Sampatanukul P, Wannakrairot P, Rojpornpradit P, Shotelersuk K, Lertbutsayanukul C, Boonjunwetwat D, Vajragupta L.
TI : Estrogen and progesterone receptors status in Thai female breast cancer patients : an analysis of 399 cases at King Chulalongkorn Memorial Hospital.
JN : J Med Assoc Thai 2002 Jun ; 85 (Suppl 1) : S193-S202
EN-AB: A retrospective review was performed on 576 patients who have been diagnosed breast cancer and referred to Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between January 1995-September 2001. There were three hundred ninety nine cases of invasive breast cancer that available for estrogen (ER) and/or progesterone (PR) receptor status. The mean and median age in our study were 49.6 year and 49.0 year respectively. About 60.9 per cent of the patients were pre and peri-menopause and 37.8 per cent were post-menopause. Most of the histological cell type were invasive ductal carcinoma which comprised of 92.7 per cent. Histologic grading were nearly equal for moderately and poorly differentiated grade: 43.66 per cent and 40.66 per cent. The results of our study showed 53.4 per cent of 399 patients had ER positive and 42.1 per cent of 380 patients had PR positive. The proportion of ER+PR+, ER+PR-, ER-PR+, and ER-PR- were 36.31 per cent, 15.53 per cent, 5.79 per cent and 42.37 per cent respectively. Older age and post-menopause women had higher ER+. While patients with increase tumor size, poorly differentiated grading, increase positivity of axillary lymph nodes and higher stage have more chance of ER negative and PR negative. (NO 07577)
AU : Shotelersuk K, Rojpornpradit P, Khorprasert C, Lertsanguansinchai P, Asavametha N.
TI : A 11-year experience of radiation therepy for Medulloblastoma at King Chulalongkorn Memorial Hospital.
JN : Chula Med J 2001 Sep ; 45 (9) : 755-765 (NO 06828)
AU : Lertbutsayanukul C, Lertsanguansinchai P, Shotelersuk K, Khorprasert C, Rojpornpradit P, Asavametha N, Pataramontree J, Suriyapee S, Tresukosol D, Termrungruanglert W.
TI : Results of radiation therapy in stage 1B cervical carcinoma at King Chulalongkorn Memorial Hospital : fifteen-year experience.
JN : J Med Assoc Thai 2001 Jun ; 84 (Suppl 1) : S216-27
EN-AB: A retrospective study was performed on 131 patients with stage 1B cervical carcinoma who were referred and treated with external beam radiation and intracavitary brachytherapy at the Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between February 1985 and February 2000. Primary outcomes were overall survival rate, progression free survival rate, recurrence, and treatment-related complications. The treatment results from different sources of intracavitary radiation therapy were secondary endpoints. The number of patients treated with Ra-226, Cs-137, and Ir-192 intracavitary irradiation were 12, 84, and 35 patients respectively. The median follow-up times were 69, 59, and 21 months for Ra-226, Cs-137, and Ir-192, respectively. Actuarial 5-year overall survival rate was 89 per cent. The 5-year progression free survival rate was 80 per cent. Actuarial 5-year survival and progression free survival rate were comparable among different sources of intracavitary brachytherapy (p = 0.553 and p=0.793, respectively). The overall recurrent rate was 16.8 per cent. Of the recurrence; 40.9 per cent was locoregional, 54.6 per cent was distant failure, and 4.5 per cent was combined locoregional and distant failure. The overall complication rate was 25.95 per cent. The severe complication rates (Grade III-V) from treatment occurred in the urinary bladder (0.76%) and in the small bowel (0.76%.) These results suggest that radiation therapy alone is an effective treatment for stage 1B cervical carcinoma. Additionally, all types of intracavitary brachytherapy provide comparable clinical results. (NO 07282)
AU : Rojpornpradit P, Khorprasert C, Shotelersuk K, Lertsanguansinchai P.
TI : Results of radiation therapy for glottic cancer.
JN : จุฬาลงกรณ์เวชสาร = Chulalongkorn Medical Journal 1998 Jul ; 42 (7) : 495-504
EN-AB: Background : Cure and voice preservation are the primary concerns for patients seeking treatment for glottic cancer. The efficacy of radiation therapy, either alone or in combination with surgery, in glottic cancer was assessed. Objective : To review the results of radiation treatment in patients with glottic cancer. Setting : Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University. Subjects : Seventy-eight patients with histologically proven squamous cell carcinoma of the glottis, from January 1983-December 1989. Design : Retrospective study. Patients : The records of 78 patients with age-range of 33-84 (mean age equal 60.3) were reviewed There were 74 (94.9 per cent) males and 4 (5.1 per cent) females. The male to female ratio was 18.5:1. All had histologically proven squamous cell carcinoma. Method : The survival rate was calculated using the product limit estimate of Kaplan and Meier. Comparions of survival were made using the log rank test. A p-value of less than or equal to 0.05 was considered significant. Results : Seventy-eight glottic cancers had been treated by radiotherapy (RT). Either alone or in combination with surgery (S+RT). The overall 5-Year survival rate was 91.3 per cent for T1N0M0, 50.6 per cent for T3N0M0 and 53.5 per cent for any TN1-3M0. The locoregional control rates for patients treated with RT for the corresponding groups were 92.0 per cent, 28.6 per cent and 40.0 per cent with surgical salvage rate of 100.0 per cent, 60.0 per cent and 0 per cent respectively. For patients treated with S+RT the locoregional control rate was 71.4 per cent for T3N0M0 and 41.7 per cent for any TN1-3M0 with radiation salvage rate of 25.0 per cent and 14.4 per cent respectively. The rates of laryngeal voice preservation in the RT group were 92.0 per cent for T1N0M0, 75.0 per cent for T2N0M0, 64.3 per cent for T3N0M0 did not influence the survival. The number of patients in T2N0M0, T4N0M0 and anyTanyNM1 were too small to obtain any meaningful analysis. Death from intercurrent disease was found to be 42.9 per cent. Conclusion : Glottic cancer is radiocurable. Preservation of the larynx can be achieved with radiotherapy without jeopardizing survival. (NO 05619)
AU : Rojpornpradit P, Thitathan S, Lertsanguansinchai P, Rajatapiti P, Phunrassami T.
TI : Radiation therapy for carcinoma of the endometrium. our experience during the period 1977-1983.
JN : Chulalongkorn Medical Journal 1993 ; 37 (3) : 173-182
EN-AB: The authors evaluated 106 cases of endometrial carcinoma. The median age at presentation was 57 years. Seventeen patients (16 per cent) were hypertensive and 13 (12 per cent) were diabetic. The most common presenting symptom was abnormal vaginal bleeding which constituted 76 per cent of the patients. The distribution of the disease by stage was: stage I equal 59 per cent, stage II equal 15 per cent, stage III equal 12 per cent, stage IV equal 3 per cent, unknown stage equal 11 per cent. The most common histology was adenocarcinoma which accounted for 85.9 percent of the patients. Thirty-five patients (36 per cent) were treated by radiation alone. Pre-and post-operative radiation was used in 28 patients (29 per cent) and 33 patients (34 per cent), respectively. Overall five-year survival was 78.6 per cent. The survival rates for stages I, II, III and IV were 88.8 per cent, 79.4 per cent, 36.9 per cent and 0 per cent, respectively. Statistical analysis showed the age of the patients at presentation significantly influenced survival (p 0.025). Radiation method, histologic grade and uterine length could not be shown to influence survival. Measures to prevent patients lost to follow-up were proposed. (NO 02771)
AU : Lertsanguansinchai P, Thitathan S, Rojpornpradit P, Rajatapiti P.
TI : Phase III study of radiotherapy alone versus combination of mitomycin-C and 5-FU plus radiation in locally advanced cervical cancer. preliminary results.
JN : Chulalongkorn Medical Journal 1993 ; 37 (7) : 461-468
EN-AB: Between November 1988 and September 1990, 52 cases of advanced stage IIB and IIIB cancer of the uterine cervix at the Radiotherapy Unit, Department of Radiology, Chulalongkorn University Hospital were divided into 2 treatment groups; 25 patients were treated by conventional irradiation alone while another 27 patients were treated by combination of mitomycin C and 5-FU concomittently with conventional irradiation. There were no obvious benefits in locoregional control, but there were decreased in distant metastases in the chemotherapy arm. Median disease-free survival rate (31.3 mo) was 32 per cent for control group as compared to 51.9 per cent (28.3 mo) for chemotherapy group. There were more immediate adverse events in the chemotherapy arm than the radiotherapy arm. (NO 02783)
AU : Rojpornpradit P, Thitathan S, Lertsanguansinchai P, Rajatapiti P, Asavametha P, Khorprasert C.
TI : Results of radical and adjunctive radiotherapy of esophageal carcinoma.
JN : Chulalongkorn Medical Journal 1993 ; 37 (10) : 631-638
EN-AB: A retrospective analysis of 62 patients with various types of localized esophageal cancer treated with radical or adjunctive radiotherapy was carried out; 71 per cent were males, 29.0 percent females. The median age of presentation was 61 years, ranging from 33 to 81 for the entire sample. The most common presenting symptom (90.4 per cent) was dysphagia. The distribution of the disease by site was: upper esophagus 24.2 per cent, mid-esophagus 64.5 per cent,lower esophagus 11.3 per cent. In all 62 patients, the histology of the tumors was squamous cell carcinoma. Twenty-nine per cent of the patients had well-differentiated carcinoma; in 32.3 per cent it was moderately differentiated and in 12.9 per cent poorly differentiated. Tumor lengths were: up to 5.0 cm 17.7 per cent, between 5.0 and 10.0 cm 38.7 per cent, and more than 10.0 cm 9.7 per cent. The overall two-year survival rate was 21.0 per cent; median survival was five months. Sex, patient age, tumor location, tumor length and histological grade was found not to influence survival. Types of surgical treatment and radiation dose were found to be significant prognostic factors in survival. Patients treated by radical surgery plus radiotherapy or radiotherapy alone had superior survival rates, i.e. 31.8 per cent and 23.7 per cent, respectively, compared with patients who received palliative surgery plus radiotherapy (p less than 0.05). A TDF greater than 82 had an obviously better survival rate (30.4 per cent) than a TDF equal to or less than 82 (p less than 0.25). Prospects for improvement in radiotherapy were proposed. (NO 02796)
AU : Rojpornpradit P, Lertsanguansinchai P, Thitathan S, Rajatapiti P, Wangsupachat S.
TI : Adjuvant chemotherapy for non-metastatic osteosarcoma of the extremity a preliminary report.
JN : Chulalongkorn Medical Journal 1993 ; 37 (12) : 735-741
EN-AB: Nine cases seven males and two females of non-metastatic osteosarcoma of the extremity were treated with chemotherapy in an adjuvant fashion. The primary lesion was in the distal femur in five patients, the proximal tibia in two, and one each in the distal tibia and proximal femur. Pre-operative chemotherapy with intra-arterial cisplatin (100 mglm2) and intravenous dexorubicin (60 mglm2) was administered in two patients. Post-operatively, cisplatin (100 mglm2) and dexorubicin (60 mglm2) were given intravenously for one year. Doxorubicin was given until the dose reached a total of 450 mglm'. Surgery consisted of limb-sparing surgery in four of the cases, above-knee amputation in three, and one each of hip-disarticulation and below-knee-amputation. Four of the nine patients were disease-free past 24 months. The two-year disease-free survival rate was 50.1 per cent and overall survival was 87.5 per cent. Refinements in treatment and more thorough pre-treatment investigations are discussed. (NO 02806)
AU : Lertsanguansinchai P, Thithathan S, Rojpornpradit P, Rajatapiti P.
TI : Nasopharyngeal carcinoma (NPC). a retrospective review of 184 patients treated with radiotherapy.
JN : Chulalongkorn Medical Journal 1992 ; 36 (11) : 829-837
EN-AB: One hundred and eighty-four patients with nasopharyngeal carcinoma (NPC) were treated with radiation therapy at the Division of Radiotherapy, Department of Radiology, Chulalongkorn Hospital, Thailand, from Jan. 1982 to Dec. 1986. The study comprised 121 males and 63 females ranging in age from 13 to 76 years (mean equal 45.6 years). The majority (72.2 per cent) of the patients presented in stage IV. Three-year actuarial survival rates according to stage were as follows: Stage I, 62.7 per cent; Stage II, 100; stage III, 50.8 per cent and stage IV, 49.6 per cent. The overall three-year actuarial survival rate and disease-free survival (DFS) rate were 52.8 per cent and 49.4 per cent respectively. There was no difference in the survival rate between the T 1-2 category and T3-4 category (52.6 per cent and 53.1 per cent, P greater than 0.5). The N-category showed a higher survival rate for the N-negative (NO) group than the N-positive (n1-3) group (79.4 per cent and 39.1 per cent less than .001). Regarding the incidence of distant metastasis correlated with the nodal status, body metastasis was the most common. (NO 02735)
AU : Pholshivin P, Thitathan S, Rojpornpradit P, Rachatapiti P, Pattaramontri J, Suriyapee S.
TI : Survival in stage III non-small-cell lung cancer.
JN : จุฬาลงกรณ์เวชสาร = Chulalongkorn Medical Journal 1992 Mar ; 36 (3) : 207-215
EN-AB: This retrospective study compared the survival results of 59 stage III non-small-cell lung cancer patients treated by radiotherapy - chemotherapy and combined modality. The onew and two-year survival rates of radical dose radiotherapy +/- chemotherapy were significantly superior to palliative doses, but no significant difference was seen when comparing between radiotherapy alone and combined modality. These, we recommend the use of radiotherapy, especially with curative doses, in cases of unresectable stage III non-small-cell lung cancer. Performance status, treated volume and fractionation schemes also play a role in the patients survival.
TH-AB: เป็นการศึกษาย้อนหลังเปรียบเทียบอัตราการรอดชีวิตผู้ป่วยมะเร็งปอด ระ ยะที่ 3 ชนิดไม่ใช่เซลล์เล็กที่รักษาด้วยรังสี +/- เคมีบำบัด เทียบกั บวิธีรักษาร่วมในผู้ป่วย 59 ราย ผลการศึกษา พบว่าผู้ป่วยที่ได้รับรัง สีในขนาดที่หายขาด (time-dose-fractionation มากกว่า 82) จะมีอัตราการรอดชีวิตสูงกว่ากลุ่มที่ได้รับรังสีขนาดบรรเ ทาอาการ (time-dose-fractionation น้อยกว่าหรือเท่ากับ 82) อย่างมีนัยสำคัญทา งสถิติ แต่ผู้ป่วยกลุ่มที่ได้รับรังสีรักษาเพียงอย่างเดียวไม่พบว่าอั ตราการรอดชีวิต ต่างกับกลุ่มที่ใช้วิธีรักษาร่วม ผู้เขียนจึงแนะนำให้ รักษาผู้ป่วยมะเร็งปอดระยะที่ 3 ชนิด ไม่ใช่เซลล์เล็ก ที่ไม่สามารถผ่ าตัดได้หมด ด้วยรังสีรักษาโดยเฉพาะให้ปริมาณรังสีในขนาดที่หายขาด ส่ว นสภาพทั่วไปของผู้ป่วยก่อนรักษา, ขอบเขตที่ฉายรังสีและลักษณะการให้รั งสี ก็เป็นปัจจัยที่สำคัญต่ออัตราการอยู่รอดของผู้ป่วยซึ่งต้องการการ ศึกษาต่อไป. (NO 02961)
AU : Lertsanguansinchai P, Rojpornpradit P, Thitathan S, Rajatapiti P, Kambhu Na-Ayudhya P, Pataramontree J, Suriyapee S.
TI : Analysis of 515 cases of cervical carcinoma treated with radiotherapy at Chulalongkorn Hospital.
JN : Chula Med J = จุฬาลงกรณ์เวชสารChulalongkorn Medical Journal 1990 Jan ; 34 (1) : 31-40
EN-AB: From January 98 to December 1983, 515 patients with cervical carcinoma had completed radiation treatment at the Radiotherapy Unit, Department of Radiology, Chulalongkorn University Hospital. Of 515 patients, 482 had completed the follow-up. The majority of patients were FIGO stage II and III. All patients had been followed for at least 5 years or until death. Local recurrences for stage II and III were 16.35% and 30.58% respectively. Distant metastases were 12.98% in stage II and 21.49% in stage III with the lung being the most frequent site for metastases. The 5-year actuarial survival rate in stage I, II, III and IV were 85.4%, 7.4%, 41.3% and 0% respectively, with a mean of 56.1%. Most treatment complications were grade 1, grade 3 complications were found in 2.70%. Rectum is the major site of treatment complication. (NO 04927)
AU : Lertsanguansinchai P, Kamphu-Na-Ayudhya P, Thitathan S, Rajatapiti P, Rojanapornpradit P.
TI : Treatment of carcinoma of the cervix with Co-60 and Cs-137.
JN : Chula Med J 1989 Mar ; 33 (3) : 195-205
EN-AB: From May 1985 to December 1986 a total of 174 cases of carcinoma of the cervix had completed treatment with Co-60 whole pelvic irradiation combined with intracavitary insertion by remote control afterloading system with Cs-137 (dose rate at point A 196.05 cGy/hr). The maximum dose aimed at point A was not more than 7500 cGy. The results of the minimum 20 months follow up showed that locoregional failure for stage 2 and stage 3 were 15.48 per cent and 32.20 per cent respectively. Complication occurred mostly in the rectum but were mild in all cases (Grade 1). (NO 01607)
AU : Suriyapee S, Kamphu-Na-Ayudhya P, Rojpornpradit P.
TI : Studying the dose distribution of afterloading radium applicator.
JN : Thai J Radiol 1983 Oct ; 20 (2) : 75-80
EN-AB: The dose distribution of Fletcher afterloading radium applicator in wax phantom was studied by the method of the thermoluminescent dosimeter. The measured dose at various points using two different manufactured applicators are 8 percent lower than the calculated ones due to the absorption of the metallic wall of the applicator. From the radiograph of the two colpostats, one of them is shielded by tungsten at both ends and gives a 10-15 percent lower dose rate than the other one which is not shielded. This decrease in dose rate is of clinical significant and should be checked before using (NO 00155)
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