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Year 2008

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)

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Year 2007

JN : Gynecol Oncol. 2007 Jan;104(1):15-23. Epub 2006 Sep 25.
TI : A randomized phase III trial of concurrent chemoradiotherapy in locally advanced cervical cancer: preliminary results.
AU : Veerasarn V, Lorvidhaya V, Kamnerdsupaphon P, Suntornpong N, Sangruchi S, Lertsanguansinchai P, Khorprasert C, Sookpreedee L, Udompunturak S.
EN-AB: OBJECTIVE: Concurrent chemoradiation is the standard treatment for locally advanced cervical cancer. This study was a preliminary result of a randomized two arms, prospective, open-label phase III trial comparing the activity and safety of the concurrent chemoradiation of Tegafur-Uracil and carboplatin or carboplatin alone in locally advanced cervical cancer. MATERIALS AND METHODS: The stage IIB-IIIB cervical cancer patients were randomized to have Tegafur-Uracil 225 mg/m(2)/day orally, 5 days a week and carboplatin 100 mg/m(2) IV over 30-60 min, weekly on day 1 concurrent with standard radiotherapy (Group A) or carboplatin alone concurrent with standard radiotherapy (Group B). RESULTS: Four hundred and sixty-nine patients were randomized to Group A (n=234) or Group B (n=235). The tumor response at 3-month follow-up time showed no significant difference. The only prognostic factor to improve the complete response rate was the hemoglobin level. The patients in Group A, who had Hb <10 gm/dL had the relatively better change to complete response of 1.48 compared to that in Group B (P 0.025, 95% CI 1.07, 2.04). No severe toxicity or adverse event had been reported. The median follow-up time for Group A and Group B was 12.6 and 11.8 months, respectively. There was no statistical difference in PFS and OS. CONCLUSION: Concurrent chemoradiation by Tegafur-Uracil and carboplatin showed no difference in tumor response rate or treatment toxicity compared to carboplatin alone. The combination drugs might have benefit in poor prognostic patients such as the baseline Hb <10 gm/dL. (NO 16996583)

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Year 2006

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 : J Med Assoc Thai. 2006 Dec;89(12):2056-67.
TI : Effect of Amifostine to prevent radiotherapy-induced acute and late toxicity in head and neck cancer patients who had normal or mild impaired salivary gland function.
AU : Veerasarn V, Phromratanapongse P, Suntornpong N, Lorvidhaya V, Sukthomya V, Chitapanarux I, Tesavibul C, Swangsilpa T, Khorprasert C, Shotelersuk K, Kongthanarat Y, Panichevaluk A, Chiewvit S, Pusuwan P, Aekmahachai M, Ratchadara S, Sirilipoche S, Saengsuda Y.
EN-AB: BACKGROUND: Amifostine has a potential role for salivary gland protection in head and neck cancer patients who had radiotherapy. MATERIAL AND METHOD: Sixty-seven head and neck cancer patients were randomized to receive radiotherapy or radiotherapy plus Amifostine. The efficacy of the treatment was determined by a questionnaire evaluating dryness of mouth and the oral comfort, the RTOG/EORTC acute/late radiation morbidity scoring criteria, collection of the whole saliva and the 99mTc-pertecnetate scintigraphy of the salivary glands. RESULTS: Amifostine significantly reduced the mean questionnaire scores from 6.49 to 3.73, the incidence of grade > or = 2 mucositis from 75% to 36% and acute xerostomia from 82% to 39%. The salivary gland function returned to normal at a rate of 36.3% in the Amifostine group versus 9.1% in the control group. CONCLUSION: Amifostine is effective in reducing the incidence and severity of acute mucositis, acute and late xerostomia in head and neck cancer patients. (NO 17214057)

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Year 2005

JN : J Med Assoc Thai. 2005 Sep;88 Suppl 4:S200-6.
TI : Reducing radiation dose to pelvic small bowel in cervical cancer patients treated with Ir-192 intracavitary brachytherapy by using urinary bladder distension.
AU : Sukhaboon J, Shotelersuk K, Lertsanguansinchai P, Khorprasert C.
EN-AB: OBJECTIVES: Several techniques and devices have been used in an attempt to minimize radiation dose to gastrointestinal tract while giving pelvic radiation. We evaluated the effect of urinary bladder distension to displace pelvic small bowel out of intracavitary brachytherapy field to minimize radiation dose to small bowel in cervical cancer patients. MATERIAL AND METHOD: Eleven cervical cancer patients who received Ir-192 intracavitary brachytherapy with tandem and transverse ovoids were included in this study. Oral contrast material was used to visualize pelvic small bowel. Urinary bladder was distended by injection 125-200 ml. normal saline solution. Pelvic radiograph, anteroposterior and lateral view, was performed before and after bladder distention for brachytherapy treatment planning and comparing radiation dose at small bowel. RESULTS: The average maximum radiation dose at small bowel before and after bladder distension were 3123 cGy and 1998 cGy respectively. The summation of small bowel dose was reduced 54.17% (p = 0.002). CONCLUSION: Urinary bladder distension could effectively displace pelvic small bowel and reduce the radiation dose to small bowel from Ir-192 intracavitary brachytherapy in cervical cancer patients. (NO 16623029)

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Year 2004

JN : Radiother Oncol. 2004 Nov;73(2):179-85.
TI : Reduced recurrence of late hemorrhagic radiation cystitis by WF10 therapy in cervical cancer patients: a multicenter, randomized, two-arm, open-label trial.
AU : Veerasarn V, Khorprasert C, Lorvidhaya V, Sangruchi S, Tantivatana T, Narkwong L, Kongthanarat Y, Chitapanarux I, Tesavibul C, Panichevaluk A, Puribhat S, Sangkittipaiboon S, Sookpreedee L, Lertsanguansinchai P, Phromratanapongse P, Rungpoka P, Trithratipvikul S, Lojanapiwat B, Ruangdilokrat S, Ngampanprasert P.
EN-AB: BACKGROUND AND PURPOSE: To evaluate the efficacy and the safety of WF10 as adjunct to standard treatment in the management of late hemorrhagic radiation cystitis compared to standard treatment alone. PATIENTS AND METHODS: Cervical cancer patients with Grade 2 or 3 late hemorrhagic radiation cystitis, were randomized and treated with WF10 0.5 ml/kg body weight, diluted in physiological saline or 5% dextrose water 250 ml, intravenous infusions over 2 h on 5 consecutive days, every 3 weeks for 2 cycles plus standard treatment (WF10 group) or standard treatment alone (control group). Fifty patients in each group were evaluated by questioning; urinalysis and cystoscopy during a 1 year follow up. RESULTS: At week 7, 37 patients (74%) in the WF10 group and 32 patients (64%) in the control group showed complete resolution in objective hematuria (P = 0.28). Significantly lower use of antibiotics (P = 0.002) and antispasmodics (P < 0.001) was found in the WF10 group. Among the responders, 24 patients (77%) in the control group experienced recurrent objective hematuria, whereas in the WF10 group only 17 patients (47%) experienced a recurrence (P = 0.01). Recurrence of objective hematuria occurred significantly faster in the control group as evidenced by Kaplan-Meier and log-rank statistics (P = 0.004), suggesting a long-term effect of WF10. Cystoscopy, at the end of the treatment period and after the one year follow up showed overall improvement without significant difference between two groups. No severe toxicity was monitored. CONCLUSIONS: WF10 therapy is a safe, non-invasive and convenient method in the management of late hemorrhagic radiation cystitis. WF10 therapy, as adjunct to standard treatment, has significantly reduced recurrence of objective hematuria, compared to standard treatment alone, during a one year follow up. (NO 15542165)

JN : J Med Assoc Thai. 2004 Sep;87 Suppl 2:S168-74.
TI : Pattern of local-regional recurrence in patient with early breast cancer after mastectomy: an analysis of 357 cases at King Chulalongkorn Memorial Hospital.
AU : Lertsanguansinchai P, Lertbutsayanukul C, Chatamra K, Shotelersuk K, Voravud N, Khorprasert C.
EN-AB: A retrospective review was performed on 357 patients with early stage I-IIIA operable breast cancer who were treated with mastectomy and referred to the clinic at the Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between Jan 1991 and Dec 2001. Patients characteristics, treatment modalities and pattern of local and regional failure were evaluated. The median and mean age in the present study were 49 and 50.2 years, respectively. Stage I, II and IIIA were 10.9%, 79.6% and 9.5%, respectively. One hundred and ninety-seven patients (55.2%) received postoperative radiation therapy (RT). Adjuvant chemotherapy was given in 247 patients (69.2%) while 122 patients (34.2%) received adjuvant hormonal therapy. Sixty one patients (17.1%) received both adjuvant chemotherapy and hormonal therapy. However, 12.6% (45/357) did not receive any adjuvant treatment. Median follow up time was 42.6 months (range 6-136 months). Ipsilateral supraclavicular node and chest wall were the most common sites of local-regional recurrence. The chest wall recurrence rate was 10.4% (37/357), which was 16.9% (27/160) in the non postoperative radiation (No RT) group and 5.1% (10/197) in the postoperative radiation (RT) group. For ispilateral supraclavicular node, the recurrence rate was 10.6% (38/357), which was 15.6% (25/160) and 6.6% (13/197) for non RT and RT groups, respectively. The incidence of ipsilateral axilla, ipsilateral internal mammary node and ipsilateral infraclavicular node recurrence rate were 4.2%, 3.6% and 0.8%, respectively. Overall, chest wall and ipsilateral supraclavicular node were the most common sites of local-regional recurrence in early stage operable breast cancer who underwent mastectomy Postoperative adjuvant radiation therapy decreased the risk of local-regional recurrence. (NO 16083182)

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)

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Year 2003

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)

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Year 2001

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)

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Year 2000

AU : Shotelersuk K, Khorprasert C, Sakdikul S, Pornthanakasem W, Voravud N, Mutirangura A.
TI : Epstein-Barr virus DNA in serum/plasma as a tumor marker for nasopharyngeal cancer.
JN : Clin Cancer Res 2000 Mar ; 6 (3) : 1046-1051
EN-AB: Nasopharyngeal cancer (NPC) constitutes a type of carcinoma encountered frequently in Southern China, among Eskimos of the Arctic region, and to a lesser extent in Southeast Asia. Because EBV DNA present in plasma or serum of NPC patients has proven to represent a promising noninvasive tumor marker, the present study was designed to determine the incidence of serum/plasma EBV DNA by nested PCR during various disease management stages. By this method, we could detect EBV DNA in plasma/serum of 98 of 167 NPC patients prior to treatment, compared with 10 of 77 samples derived from healthy blood donors serving as controls, with a similar prevalence observed in plasma versus serum. Investigation of 13 patients subjected to radiotherapy revealed plasma EBV DNA to persist in the plasma of one case, whereas among the remaining patients, it had vanished during the early phase of treatment. Finally, with 52 samples derived from 37 NPC patients during follow-up, we established 100% specificity and 0% false-positive rate for plasma DNA detection by nested PCR. Moreover, we subjected 24 known EBV DNA-positive serum samples to DNase digestion prior to DNA extraction and amplification to differentiate between free and encapsulated viral DNA, which demonstrated complete absence of the human beta-globin genomic DNA in contrast to EBV DNA detectable in 14 samples. In conclusion, applying this noninvasive method, serum/plasma EBV DNA constitutes a reliable tumor marker prior to, during, and after treatment of NPC. (NO 07062)

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Year 1998

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 : Khorprasert C, Jumpangern C.
TI : High dose rate brachytherapy in benign uterine bleeding disorders.
JN : The Asean Journal of Radiology 1998 ; 4 (3) : 301-303
EN-AB: A case report of benign uterine bleedings (metropathia) was treated with high dose rate brachytherapy. The radiation doses were 2 fractions of 700 cGY at 1 centimeter from the tandem at four weeks interval. The patient had no bleeding in a month after treatment. She could tolerate the treatment well without any complications. High dose rate brachytherapy should be remembered in cases of uterine bleeding resisted to other therapies especially in cases of high risk for operation. However, long term follow-up should be done to evaluate late radiation effect of high dose rate radiation for benign. (NO 05623)

AU : Khorprasert C, Jumpangern C.
TI : 3D conformal brachytherapy.
JN : Chulalongkorn Medical Journal = จุฬาลงกรณ์เวชสาร 1998 Apr ; 42 (4) : 249-254
EN-AB: Three-dimensional (3D) conformal brachytherapy shapes the high dose volume to conform the target volume while minimizing the dose to surrounding normal tissues in the treatment of tumor by radioisotope implantation. 3D treatment planning systems provide a complete 3D representation of the volume to be treated and the dose distribution. The treatment processes which include 2D brachytherapy planning, combination of 2D brachytherapy planning into 3D images, localization of the target volume and critical structures, 3D treatment planning, plan evaluation and plan verification by Plato planning system at Chulalongkorn hospital will be discussed. (NO 05624)

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Year 1997

AU : Supiyaphun P, Snidvongs K, Shuangshoti Shanop, Khowprasert C.
TI : Malignant Transformation in a Benign Encapsulated Schwannoma of Retropharyngeal Space: A Case Report.
JN : Journal of the Medical Association of Thailand 1997 Aug ; 80 (8) : 540-546
EN-AB: Malignant schwannomas are'rare in the head and neck, however benign schwannoma of this area are common. Cases of malignant schwannoma have been reported in the nasal cavity, paranasal sinuses, eye, parapharyngeal space and neck with or without an association of von Recklinghausen disease. We described a case of an asymptomatic solitary malignant schwannoma arising in the retropharyngeal space which was treated by local excision and postoperative radio- therapy. To our knowledge, this case may be the first reported case in the world literature. (NO 02922)

AU : Khorprasert C, Shotelersuk K, Jumpangern C.
TI : Integrated software tools for the calculation in radiotherapy.
JN : Asean Journal of Radiology 1997 Jan-Apr ; 3 (1) : 87-96 (NO 04920)

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Year 1996

AU : Khorprasert C, Apinonkul K, Pataramontree J, Swatdiswane W.
TI : Mechanical and positioning accuracy measurements of modified CTsimulation at Chulalongkorn Hospital.
JN : ว.สมาคมรังสีรักษาแห่งประเทศไทย 1996 ; 2 (1) : 23-32 (NO 04919)

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Year 1993

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)

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