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Somsunun K, Prapamontol T, Kuanpan T, Santijitpakdee T, Kohsuwan K, Jeytawan N, Thongjan N. Health Risk Assessment of Heavy Metals in Indoor Household Dust in Urban and Rural Areas of Chiang Mai and Lamphun Provinces, Thailand. TOXICS 2023; 11:1018. [PMID: 38133419 PMCID: PMC10747779 DOI: 10.3390/toxics11121018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/25/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Indoor exposure to heavy metals poses human health risks worldwide, but study reports from Thailand are still limited, particularly in rural and urban areas. We measured the heavy metals in a hundred indoor household dust samples collected from urban and rural areas in Chiang Mai and Lamphun provinces and found a significantly higher concentration of As in rural areas and Cd in urban areas with industrial activities. The source identification of the heavy metals showed significant enrichment from traffic emissions, paint, smoking, and mixed sources with natural soil. From health risk assessment models, children were more vulnerable to noncarcinogenic risks (HI = 1.45), primarily via ingestion (HQ = 1.39). Lifetime cancer risks (LCRs) due to heavy metal exposure were found in adults (LCR = 5.31 × 10-4) and children (LCR = 9.05 × 10-4). The cancer risks from As were higher in rural areas via ingestion, while Cr and Ni were higher in urban areas via inhalation and ingestion, respectively. This study estimated that approximately 5 out of 10,000 adults and 9 out of 10,000 children among the population may develop cancer in their lifetime from exposure to indoor heavy metals in this region.
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Affiliation(s)
- Kawinwut Somsunun
- Environment and Health Research Group, Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; (K.S.); (T.K.); (T.S.); (K.K.); (N.J.); (N.T.)
- PhD Degree Program in Environmental Science, Environmental Science Research Center, Faculty of Science, Chiang University, Chiang Mai 50200, Thailand
| | - Tippawan Prapamontol
- Environment and Health Research Group, Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; (K.S.); (T.K.); (T.S.); (K.K.); (N.J.); (N.T.)
| | - Todsabhorn Kuanpan
- Environment and Health Research Group, Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; (K.S.); (T.K.); (T.S.); (K.K.); (N.J.); (N.T.)
| | - Teetawat Santijitpakdee
- Environment and Health Research Group, Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; (K.S.); (T.K.); (T.S.); (K.K.); (N.J.); (N.T.)
| | - Kanyapak Kohsuwan
- Environment and Health Research Group, Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; (K.S.); (T.K.); (T.S.); (K.K.); (N.J.); (N.T.)
| | - Natwasan Jeytawan
- Environment and Health Research Group, Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; (K.S.); (T.K.); (T.S.); (K.K.); (N.J.); (N.T.)
| | - Nathaporn Thongjan
- Environment and Health Research Group, Research Institute for Health Sciences (RIHES), Chiang Mai University, Chiang Mai 50200, Thailand; (K.S.); (T.K.); (T.S.); (K.K.); (N.J.); (N.T.)
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Geographical risk pattern and temporal trends in incidence of HPV-related cancers in northern Thailand: A population-based study. PLoS One 2022; 17:e0270670. [PMID: 35763509 PMCID: PMC9239466 DOI: 10.1371/journal.pone.0270670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background The burden of HPV-related cancers in different regions worldwide varies according to several factors. This study aims to measure inequality in the risk of incidence of HPV-related cancers in term of geographical risk patterns in northern Thailand using a population-based cancer registry data. Methods Trends in age-standardized HPV-related cancer incidence were calculated for the 2008–2017 time period. The Besag-York-Molli´e model was used to explore the spatial distribution of the relative risk (RR) of HPV-related cancers at the district level. A higher RR reflects a larger disparity. The geographical risk pattern of the diseases in two periods, 2008–2012 and 2013–2017 were described and compared. Results From 2008 to 2017, the incidence of oropharyngeal and anal cancers showed a slightly increased trend in males but remained stable in females, the incidence of vulvar, vaginal and penile cancers were stable while the incidence of cervical cancer decreased. The RR range was closer to 1 in the second period compared to the first period. This suggests a decrease in the disparities of incidence of cervical cancer. However, in some areas near the Thai-Myanmar border, the RR values remained high. Conclusion The incidence rate of most HPV-related cancers remained low and stable over the study period in northern Thailand. For the most common HPV-related malignancy, cervical cancer, the incidence rate steadily decreased but with marked geographic disparities, possibly reflecting health inequity especially in the border areas.
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Impact of Residential Concentration of PM2.5 Analyzed as Time-Varying Covariate on the Survival Rate of Lung Cancer Patients: A 15-Year Hospital-Based Study in Upper Northern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084521. [PMID: 35457386 PMCID: PMC9026284 DOI: 10.3390/ijerph19084521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 02/01/2023]
Abstract
Air pollutants, especially particulate matter (PM) ≤ 2.5 µm (PM2.5) and PM ≤ 10 µm (PM10), are a major concern in upper northern Thailand. Data from a retrospective cohort comprising 9820 lung cancer patients diagnosed from 2003 to 2018 were obtained from the Chiang Mai Cancer Registry, and used to evaluate mortality and survival rates. Cox proportional hazard models were used to identify the association between the risk of death and risk factors including gender, age, cancer stage, smoking history, alcohol-use history, calendar year of enrollment, and time-updated PM2.5, PM10, NO2 and O3 concentrations. The mortality rate was 68.2 per 100 persons per year of follow-up. In a multivariate analysis, gender, age, cancer stage, calendar year of enrollment, and time-varying residential concentration of PM2.5 were independently associated with the risk of death. The lower the annually averaged PM2.5 and PM10 concentrations, the higher the survival probability of the patient. As PM2.5 and PM10 were factors associated with a higher risk of death, lung cancer patients who are inhabitant in the area should reduce their exposure to high concentrations of PM2.5 and PM10 to increase survival rates.
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Estimation of lung cancer deaths attributable to indoor radon exposure in upper northern Thailand. Sci Rep 2022; 12:5169. [PMID: 35338199 PMCID: PMC8956686 DOI: 10.1038/s41598-022-09122-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/17/2022] [Indexed: 01/09/2023] Open
Abstract
Radon exposure is the second leading cause of lung cancer, after smoking. In upper northern Thailand (UNT), lung cancer incidence was frequently reported by Thailand National Cancer Institute. Besides smoking, radon exposure may also influence the high lung cancer incidence in this region. Indoor radon concentrations were measured in 192 houses in eight provinces of UNT. Indoor radon concentrations ranged from 11 to 405 Bq m−3 and estimated annual effective dose ranged from 0.44 to 12.18 mSv y−1. There were significant differences in indoor radon concentrations between the houses of lung cancer cases and healthy controls (p = 0.033). We estimated that 26% of lung cancer deaths in males and 28% in females were attributable to indoor radon exposure in this region. Other factors influencing indoor radon levels included house characteristics and ventilation. The open window-to-wall ratio was negatively associated with indoor radon levels (B = −0.69, 95% CI −1.37, −0.02) while the bedroom location in the house and building material showed no association. Indoor radon hence induced the fractal proportion of lung cancer deaths in UNT.
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Exploring the value of pleural fluid biomarkers for complementary pleural effusion disease examination. Comput Biol Chem 2021; 94:107559. [PMID: 34412001 DOI: 10.1016/j.compbiolchem.2021.107559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 07/08/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Pleural fluid biomarkers are beneficial for the complementary diagnosis of pleural effusion etiologies. This study focuses on the multidimensional evaluation of deep learning to investigate the pleural effusion biomarkers value and the diagnostic utility of combining these markers, in distinguishing pleural effusion etiologies. METHODS Pleural effusion were divided into three groups according to the diagnosis and treatment guidelines: malignant pleural effusion (MPE), parapneumonic effusion (PPE), and congestive heart failure (CHF). First, the value of the biomarker was analyzed by a receiver operating characteristic (ROC) curve. Then by utilizing deep learning and entropy weight method (EWM), the clinical value of biomarkers was computed multidimensionally for complementary diagnosis of pleural effusion diseases. RESULTS There were significant differences in the six biomarkers, TP, ADA, CEA, CYFRA211, NSE, MNC% (p < 0.05) and no significant differences in three physical characteristics including color, transparency, specific gravity and six other biomarkers such as WBC, PNC%, MTC%, pH level, GLU, LDH (p > 0.05) among the three pleural effusion groups. The comprehensive test of pleural fluid biomarkers based on deep learning is of high accuracy. The clinical value of cytomorphology biomarkers WBC, MNC %, PNC %, MTC % was higher among pleural fluid biomarkers. CONCLUSION The clinical value of multi-dimensional analysis of biomarkers by deep learning and entropy weight method is different from the ROC curve analysis. It is suggested that during the clinical examination process, more attention should be paid to the cell morphology biomarkers, but the physical properties of the pleural fluid are less clinical significance.
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Mathur P, Sathishkumar K, Chaturvedi M, Das P, Sudarshan KL, Santhappan S, Nallasamy V, John A, Narasimhan S, Roselind FS. Cancer Statistics, 2020: Report From National Cancer Registry Programme, India. JCO Glob Oncol 2021; 6:1063-1075. [PMID: 32673076 PMCID: PMC7392737 DOI: 10.1200/go.20.00122] [Citation(s) in RCA: 374] [Impact Index Per Article: 124.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The systematic collection of data on cancer is being performed by various population-based cancer registries (PBCRs) and hospital-based cancer registries (HBCRs) across India under the National Cancer Registry Programme–National Centre for Disease Informatics and Research of Indian Council of Medical Research since 1982. METHODS This study examined the cancer incidence, patterns, trends, projections, and mortality from 28 PBCRs and also the stage at presentation and type of treatment of patients with cancer from 58 HBCRs (N = 667,666) from the pooled analysis for the composite period 2012-2016. Time trends in cancer incidence rate were generated as annual percent change from 16 PBCRs (those with a minimum of 10 years of continuous good data available) using Joinpoint regression. RESULTS Aizawl district (269.4) and Papumpare district (219.8) had the highest age-adjusted incidence rates among males and females, respectively. The projected number of patients with cancer in India is 1,392,179 for the year 2020, and the common 5 leading sites are breast, lung, mouth, cervix uteri, and tongue. Trends in cancer incidence rate showed an increase in all sites of cancer in both sexes and were high in Kamrup urban (annual percent change, 3.8%; P < .05). The majority of the patients with cancer were diagnosed at the locally advanced stage for breast (57.0%), cervix uteri (60.0%), head and neck (66.6%), and stomach (50.8%) cancer, whereas in lung cancer, distant metastasis was predominant among males (44.0%) and females (47.6%). CONCLUSION This study provides a framework for assessing the status and trends of cancer in India. It shall guide appropriate support for action to strengthen efforts to improve cancer prevention and control to achieve the national noncommunicable disease targets and the sustainable development goals.
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Affiliation(s)
- Prashant Mathur
- National Centre for Disease Informatics and Research, Bengaluru, India
| | | | - Meesha Chaturvedi
- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Priyanka Das
- National Centre for Disease Informatics and Research, Bengaluru, India
| | | | | | - Vinodh Nallasamy
- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Anish John
- National Centre for Disease Informatics and Research, Bengaluru, India
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Argirion I, Zarins KR, Defever K, Suwanrungruang K, Chang JT, Pongnikorn D, Chitapanarux I, Sriplung H, Vatanasapt P, Rozek LS. Temporal Changes in Head and Neck Cancer Incidence in Thailand Suggest Changing Oropharyngeal Epidemiology in the Region. J Glob Oncol 2020; 5:1-11. [PMID: 30860955 PMCID: PMC6449079 DOI: 10.1200/jgo.18.00219] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Head and neck cancer is the sixth most common cancer in the world, and the largest burden occurs in developing countries. Although the primary risk factors have been well characterized, little is known about temporal trends in head and neck cancer across Thailand. METHODS Head and neck squamous cell carcinoma (HNSCC) occurrences diagnosed between 1990 and 2014 were selected by International Classification of Diseases (10th revision; ICD10) code from the Songkhla, Lampang, Chiang Mai, and Khon Kaen cancer registries and the US SEER program for oral cavity (ICD10 codes 00, 03-06), tongue (ICD10 codes 01-02), pharynx (ICD10 codes 09-10, 12-14), and larynx (ICD10 code 32). The data were analyzed using R and Joinpoint regression software to determine age-standardized incidence rates and trends of annual percent change (APC). Incidence rates were standardized using the Segi (1960) population. Stratified linear regression models were conducted to assess temporal trends in early-onset HNSCC across 20-year age groups. RESULTS Although overall HNSCC rates are decreasing across all registries, subsite analyses demonstrate consistent decreases in both larynx and oral cavity cancers but suggest increases in tongue cancers among both sexes in the United States (APCmen, 2.36; APCwomen, 0.77) and in pharyngeal cancer in Khon Kaen and US men (APC, 2.1 and 2.23, respectively). Age-stratified APC analyses to assess young-onset (< 60 years old) trends demonstrated increased incidence in tongue cancer in Thailand and the United States as well as in pharyngeal cancers in Khon Kaen men age 40 to 59 years and US men age 50 to 59 years. CONCLUSION Although overall trends in HNSCC are decreasing across both Thailand and the United States, there is reason to believe that the etiologic shift to oropharyngeal cancers in the United States may be occurring in Thailand.
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Affiliation(s)
- Ilona Argirion
- University of Michigan School of Public Health, Ann Arbor, MI
| | - Katie R Zarins
- University of Michigan School of Public Health, Ann Arbor, MI
| | - Kali Defever
- University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Joanne T Chang
- University of Michigan School of Public Health, Ann Arbor, MI
| | | | | | | | - Patravoot Vatanasapt
- Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.,Khon Kaen University, Thailand
| | - Laura S Rozek
- University of Michigan School of Public Health, Ann Arbor, MI
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Sripan P, Sriplung H, Pongnikorn D, Bilheem S, Virani S, Waisri N, Hanpragopsuk C, Maneesai P, Tansiri P, Chitapanarux I. Clinical subtypes of breast cancer in Thai women: a population-based study of Chiang Mai province. ASIAN BIOMED 2019. [DOI: 10.1515/abm-2019-0034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
The change over time of distribution of breast cancer subtypes using population-based data has not been reported.
Objective
To describe the change over time of the distribution of female breast cancer by clinical subtype among the population in Chiang Mai, Thailand.
Methods
Data of breast cancer patients from Chiang Mai Cancer Registry, diagnosed from 2004 to 2013 were combined with immunohistochemical status from medical record, and used to describe the proportions of clinical breast cancer subtypes: (1) luminal A-like (ER+/PR+ and HER2-), (2) luminal B-like (ER+/PR+ and HER2+), (3) HER2 (ER- and PR- and HER2+), (4) triple-negative (ER- and PR- and HER2-). The distribution of breast cancer subtypes by age group was also described.
Results
Among 3,228 female breast cancer cases diagnosed during 2004–2013, the median age was 52 years and most patients presented at the regional stage. The unknown tumor subtype was lower than 25% in the periods 2008– 2009, 2010–2011, and 2012–2013. In those periods, the proportions of luminal A-like were 33%, 36%, and 48%; the proportions of luminal B-like were 14%, 20%, and 16%, the proportions of HER2 were 15%, 14%, and 13%; and the proportions of triple-negative were 16%, 14%, and 13%, respectively. In comparison with other groups, women aged ≥60 years had a significantly higher proportion of luminal A-like (P = 0.001), while women aged <40 years tended to have a higher proportion of triple-negative (P = 0.10).
Conclusions
The proportion of breast cancer with luminal subtypes is increasing. Thus, in the future, treatment protocols with a variety of hormone therapies should be provided in order to improve efficacy and coverage of treatment for this population.
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Affiliation(s)
- Patumrat Sripan
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
- Research Institute for Health Sciences, Chiang Mai University , Chiang Mai 50200 , Thailand
| | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University , Songkhla 90110 , Thailand
| | - Donsuk Pongnikorn
- Cancer Registry Unit, Lampang Cancer Hospital , Lampang 52000 , Thailand
| | - Surichai Bilheem
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University , Songkhla 90110 , Thailand
| | - Shama Virani
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University , Songkhla 90110 , Thailand
| | - Narate Waisri
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
| | - Chirapong Hanpragopsuk
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
| | - Puttachart Maneesai
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
| | - Panrada Tansiri
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
| | - Imjai Chitapanarux
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University , Chiang Mai 50200 , Thailand
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Rankantha A, Chitapanarux I, Pongnikorn D, Prasitwattanaseree S, Bunyatisai W, Sripan P, Traisathit P. Risk patterns of lung cancer mortality in northern Thailand. BMC Public Health 2018; 18:1138. [PMID: 30249219 PMCID: PMC6154807 DOI: 10.1186/s12889-018-6025-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/09/2018] [Indexed: 12/18/2022] Open
Abstract
Background Over the past decade, lung cancers have exhibited a disproportionately high mortality and increasing mortality trend in Thailand, especially in the northern region, and prevention strategies have consequently become more important in this region. Spatial analysis studies may be helpful in guiding any strategy put in place to respond to the risk of lung cancer mortality in specific areas. The aim of our study was to identify risk patterns for lung cancer mortality within the northern region of Thailand. Methods In the spatial analysis, the relative risk (RR) was used as a measure of the risk of lung cancer mortality in 81 districts of northern Thailand between 2008 and 2017. The RR was estimated according to the Besag-York-Mollié autoregressive spatial model performed using the OpenBUGS routine in the R statistical software package. We presented the overall and gender specific lung cancer mortality risk patterns of the region using the Quantum Geographic Information System. Results The overall risk of lung cancer mortality was the highest in the west of northern Thailand, especially in the Hang Dong, Doi Lo, and San Pa Tong districts. For both genders, the risk patterns of lung cancer mortality indicated a high risk in the west of northern Thailand, with females being at a higher risk than males. Conclusions There was distinct geographical variation in risk patterns of lung cancer mortality in Thailand. Differences could be related to differences in risk factors such as ground-based radon and air pollution. This study provides a starting point for estimating the spatial pattern of the risk of lung cancer mortality and for examining associations between geographic risk factors and lung mortality for further studies. Electronic supplementary material The online version of this article (10.1186/s12889-018-6025-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Apinut Rankantha
- Graduate School, Chiang Mai University, Chiang Mai, Thailand.,Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Walaithip Bunyatisai
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand. .,Center of Excellence in Bioresources for Agriculture, Industry and Medicine, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand.
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