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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 : 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 : Intragumtornchai T, Asawametha N, O'Charoen R, Swasdikul D.
TI : Successful autografting in a patient with chronic myelogenous leukemia using Philadelphia negative blood stem cells obtained after interferon-induced cytogenetic remission (Abstract).
JN : ว.โลหิตวิทยาและเวชศาสตร์บริการโลหิต = Thai Journal of Hematology and Transfusion Medicine 1996 Jul-Sep ; 6 (3) : 244
EN-AB: Allogeneic bone marrow transplantation probably cures two-third of patients with chronic myelogenous leukemia (CML). Unfortunately, 70 per cent of patients are not eligible for the procedures. Although interferon may be an optimal initial approach in these patients, the drug does not eradicate residual disease even in cytogenetic responders. The rationale of autografting is thus rapidly expanded in order to attain an overall higher survival rate. In practice, combination chemotherapy with or without growth factors are most commonly used to mobilize Philadelphia-negative stem cells for autograft. We reported herein a successful autograft in a patient with CML who had obtained a complete cytogenetic remission after interferon-alpha therapy. G-CSF 10 ug/kg/day was given subcutaneously and stem cell collection was performed on day 4-7. CD 34+ cells in the graft was 0.71 x 10 exponent 6 /kg. Preparative regimen consisted of fractionated total body irradiation 12 Gy and cyclophosphamide. The granulocyte (ANC greater than 0.5 x 10 exponent 9/1) and platelet (greater than 20 x 10 exponent 9/1) recovery occurred on day 9 and day 15 post-transplant. The transplantation course was unevenful and the patient was discharged on day 16 Bone marrow examination on day revealed normocellularity with trilineage engraftment. The cytogenetic analysis showed normal karyoptype. Stem cell graft obtained after interferon therapy generate a rapid marrow recovery after high-dose chemoradiotherapy. Autografting after interferon-induced cytogenetic remission might be another therapeutic optain for patients with CML. (NO 03131)
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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