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Puspitaningtyas H, Hutajulu SH, Fachiroh J, Anggorowati N, Sanjaya GY, Lazuardi L, Sripan P. Diverging likelihood of colon and rectal cancer in Yogyakarta, Indonesia: A cross sectional study. PLoS One 2024; 19:e0301191. [PMID: 38547083 PMCID: PMC10977797 DOI: 10.1371/journal.pone.0301191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/11/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES Colon and rectal cancer are associated with different risk factors and prognostic. However, this discrepancy has not been widely explored in the local population. This study aimed to investigate the site-specific likelihood of colorectal cancer (CRC) incidence in the Yogyakarta province, Indonesia. METHODS This cross-sectional study analyses 1,295 CRC cases diagnosed in 2008-2019 registered in the Yogyakarta population-based cancer registry (PBCR) database. Cases were grouped into colon and rectal cancer. Log-binomial regression was used to determine the relative risk of either colon or rectal cancer across different gender, age group, and rurality of residence. The age-specific rates were calculated by age group and temporal trend for each group were analyzed using joinpoint regression. RESULTS Females displayed higher odds of colon cancer (relative risk/RR = 1.20, 95%CI = 1.02-1.41) and lower odds of rectal cancer (RR = 0.92, 95%CI = 0.85-0.99). Elevated odds of colon cancer were observed in younger age group, especially 30-39 (RR = 1.87, 95%CI = 1.10-3.19), while decreased odds of rectal cancer was apparent in age group 30-39 and 40-49 (RR = 0.75, 95%CI = 0.60-0.93 and RR = 0.82, 95%CI = 0.69-0.98, respectively). Living in urban or rural areas did not significantly influence the odds of either having colon (RR = 0.98, 95%CI = 0.82-1.17) or rectal cancer (RR = 1.01, 95%CI = 0.93-1.10). During 2008-2019, trends of colon cancer in age <50 increased by 8.15% annually while rectal cancer displayed a 9.71% increase annually prior to 2017, followed by a 17.23% decrease until 2019. CONCLUSIONS Yogyakarta population shows higher odds of young-onset colon cancer, especially between age 30-39 years old. Overall observation of trend shows increasing incidence in young-onset colon cancer, and non-significant decrease in rectal cancer.
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Affiliation(s)
- Herindita Puspitaningtyas
- Faculty of Medicine, Public Health and Nursing, Doctorate Program of Health and Medical Science, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Susanna Hilda Hutajulu
- Faculty of Medicine, Public Health and Nursing, Department of Internal Medicine, Division of Hematology and Medical Oncology, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Jajah Fachiroh
- Faculty of Medicine, Public Health and Nursing, Department of Histology and Cell Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nungki Anggorowati
- Faculty of Medicine, Public Health and Nursing, of Anatomical Pathology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Guardian Yoki Sanjaya
- Faculty of Medicine, Public Health and Nursing, of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lutfan Lazuardi
- Faculty of Medicine, Public Health and Nursing, of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Kittichet R, Chitapanarux I, Kittidachanan K, Sripan P. A real-life experience of long-term use of pilocarpine in irradiated head and neck cancer patients. Oral Dis 2024. [PMID: 38409744 DOI: 10.1111/odi.14905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/13/2024] [Accepted: 02/06/2024] [Indexed: 02/28/2024]
Abstract
AIMS To assess long-term efficacy and side effects of pilocarpine on irradiated head and neck cancer (HNC) patients in both for prevention and treatment of radiation-induced xerostomia (RIX). METHODS Retrospective observational study was conducted. Eligibility criteria included irradiated HNC patients who received pilocarpine at least 12 weeks either for prevention (group A) or for treatment (group B) of RIX. We collected the documented Late Effect Normal Tissue Task Force-Subjective, Objective, Management, Analytics subjective/objective grades of RIX before (only group B) and the latest visit for pilocarpine prescription, dosage, side effects, duration of treatment, and the cause of discontinuation. RESULTS Between December 2007 and June 2022, 182 patients were enrolled including 95 patients (52%) in group A and 87 patients (48%) in group B. Group A patients reported grades 1, 2, 3, and 4 objective RIX in 0%, 7%, 93%, and 0%. Grade 1, 2, and 3 subjective RIX were 57%, 28%, and 15%. All patients in group B had grade 3 both objective/subjective RIX. The overall improvement of objective/subjective RIX was found in 40%/83%. Discontinuation was found in 51% of patients due to tolerable symptoms or deterioration of the patient's status. CONCLUSIONS Based on this retrospective analysis, long-term use of pilocarpine in irradiated HNC appears feasible for both prevention and treatment of RIX.
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Affiliation(s)
- Rungarun Kittichet
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand
| | - Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, 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
| | - Kittikun Kittidachanan
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Horsakulchai W, Sermprasartkul T, Sumetchoengprachya P, Chummaneekul P, Rungruang N, Uthis P, Sripan P, Srithanaviboonchai K. Factors associated with internalized HIV-related stigma among people living with HIV in Thailand. AIDS Care 2024:1-10. [PMID: 38289537 DOI: 10.1080/09540121.2024.2308742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/10/2024] [Indexed: 03/21/2024]
Abstract
Internalized HIV-related stigma (IHS) among people living with HIV (PLHIV) has been documented as one of the factors contributing to the ongoing AIDS epidemic. The purpose of this study, which was conducted from September 2021 to January 2022, was to measure prevalence and identify factors associated with IHS among research participants who were living with HIV recruited from a research clinic in Chiang Mai, Northern Thailand. Participants were considered to have IHS if they agreed to at least one of the 8 items of the newly developed Thai Internalized HIV-related Stigma Scale (Thai-IHSS). Of the 104 participants, 65.4% were female. The median age was 51.5 years and the duration of known HIV infection was 19.0 years. Fifty-three percent of the participants had IHS as defined by the study. Reduced probability of having IHS was independently associated with certain levels of education (middle or high school education compared with no or primary school) (AOR = 0.30; 95% CI: 0.12-0.77) and increased mental health-related quality of life (AOR = 0.39; 95% CI: 0.18-0.86). The prevalence of IHS among PLHIV in Chiang Mai was high. These findings highlight the requirement for comprehensive mental health care programs for PLHIV to improve their quality of life.
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Affiliation(s)
| | | | | | | | | | - Penpaktr Uthis
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Ong SK, Haruyama R, Yip CH, Ngan TT, Li J, Lai D, Zhang Y, Yi S, Shankar A, Suzanna E, Jung SY, Ho PJ, Yusuf A, Nessa A, Jung KW, Fernando E, Baral S, Bagherian M, Pradhan P, Jugder U, Vongdala C, Yusof SN, Thiri K, Sripan P, Cairo C, Matsuda T, Sangrajran S, Kiak-Mien Tan V, Mehrotra R, Anderson BO. Feasibility of monitoring Global Breast Cancer Initiative Framework key performance indicators in 21 Asian National Cancer Centers Alliance member countries. EClinicalMedicine 2024; 67:102365. [PMID: 38125964 PMCID: PMC10731600 DOI: 10.1016/j.eclinm.2023.102365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Background The Global Breast Cancer Initiative (GBCI) Framework, launched by the World Health Organisation (WHO) in 2023, emphasises assessing, strengthening, and scaling up services for the early detection and management of breast cancer. This study aims to determine the feasibility of monitoring the status of breast cancer control in the 21 Asian National Cancer Centers Alliance (ANCCA) countries based on the three GBCI Framework key performance indicators (KPIs): stage at diagnosis, time to diagnosis, and treatment completion. Methods We reviewed published literature on breast cancer control among 21 ANCCA countries from May to July 2023 to establish data availability and compiled the latest descriptive statistics and sources of the indicators using a standardised data collection form. We performed bivariate Pearson's correlation analysis to measure the strength of correlation between stage at diagnosis, mortality and survival rates, and universal health coverage. Findings Only 12 (57%) ANCCA member countries published national cancer registry reports on breast cancer age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR). Indonesia, Myanmar, and Nepal had provincial data and others relied on WHO's Global Cancer Observatory (GLOBOCAN) estimates. GLOBOCAN data differed from the reported national statistics by 5-10% in Bhutan, Indonesia, Iran, the Republic of Korea, Singapore, and Thailand and >10% in China, India, Malaysia, Mongolia, and Sri Lanka. The proportion of patients diagnosed in stages I and II strongly correlated with the five-year survival rate and with the universal health coverage (UHC) index. Three countries (14%) reported national data with >60% of invasive breast cancer patients diagnosed at stages I and II, and a five-year survival rate of >80%. Over 60% of the ANCCA countries had no published national data on breast cancer staging, the time interval from presentation to diagnosis, and diagnosis to treatment. Five (24%) countries reported data on treatment completion. The definition of delayed diagnosis and treatment completion varied across countries. Interpretation GBCI's Pillar 1 KPI correlates strongly with five-year survival rate and with the UHC index. Most ANCCA countries lacked national data on cancer staging, timely diagnosis, and treatment completion KPIs. While institutional-level data were available in some countries, they may not represent the nationwide status. Strengthening cancer surveillance is crucial for effective breast cancer control. The GBCI Framework indicators warrant more detailed definitions for standardised data collection. Surrogate indicators which are measurable and manageable in country-specific settings, could be considered for monitoring GBCI indicators. Ensuring UHC and addressing health inequalities are essential to early diagnosis and treatment of breast cancer. Funding Funding for this research article's processing fee (APC) will be provided by the affiliated institution to support the open-access publication of this work. The funding body is not involved in the study design; collection, management, analysis and interpretation of data; or the decision to submit for publication. The funding body will be informed of any planned publications, and documentation provided.
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Affiliation(s)
- Sok King Ong
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
| | - Rei Haruyama
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan
| | | | - Tran Thu Ngan
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- Centre for Public Health, Queen's University Belfast, United Kingdom
| | - Jingmei Li
- Women's Health and Genetics, Genome Institute of Singapore, A∗Star, Singapore
| | - Daphne Lai
- School of Digital Science, Universiti Brunei Darussalam, Brunei Darussalam
| | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Siyan Yi
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Abhishek Shankar
- Department of Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Evlina Suzanna
- National Cancer Center Indonesia, Dharmais Cancer Hospital, Jakarta, Indonesia
| | - So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Peh Joo Ho
- Women's Health and Genetics, Genome Institute of Singapore, A∗Star, Singapore
| | - Aasim Yusuf
- Shaukat Khanum Memorial Cancer Hospital and Research Centres, Lahore and Peshawar, Pakistan
| | - Ashrafun Nessa
- Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Kyu-Won Jung
- National Cancer Centre Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Eshani Fernando
- National Cancer Control Programme, Ministry of Health, Sri Lanka
| | | | - Maryam Bagherian
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | | | - Uranbolor Jugder
- Cancer Registry-surveillance and Early Detection Division, National Cancer Center of Mongolia, Ulaanbaatar, Mongolia
| | | | | | - Khin Thiri
- Pink Rose Breast Cancer Patients Support Group, Yangon, Myanmar
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Thailand
| | - Clarito Cairo
- Department of Health, Disease Prevention and Control Bureau, Manila, Philippines
| | - Tomohiro Matsuda
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | | | | | - Ravi Mehrotra
- Indian Cancer Genome Atlas, India & Centre for Health, Innovation and Policy Foundation, India
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Supindham T, Tangmunkongvorakul A, Aurpibul L, Sripan P, Utaipat U, Hongjaisee S, Srithanaviboonchai K. Prevalence and Genotypic Diversity of Human Papillomavirus Infection Among Male and Female Sex Workers in Thailand. Sex Transm Dis 2023; 50:827-833. [PMID: 37824263 DOI: 10.1097/olq.0000000000001875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) is associated with cancer. Female sex workers (FSWs) are known to be at risk for HPV, but little is known about male sex workers (MSWs). METHODS We examined HPV prevalence and associated risk factors in both populations. During 2022, HPV testing using vaginal or penile samples, HIV testing, and interviews were performed among 100 MSWs and 100 FSWs in Chiang Mai, Thailand. RESULTS The prevalence of all HPV types was 63.5% (66% in MSW, 61% in FSW), HPV-16 prevalence was 14%, HPV-52 was 13%, and HPV-18 was 4%. There was no difference between MSW and FSW for these subtypes. The prevalence of HPV-16 or HPV-18 was 17%, and for HPV-16, HPV-18, or HPV-52, it was 26%. HIV-positive participants had a higher prevalence of all HPV types (94% vs. 60%, P = 0.004), HPV-16 or HPV-18 (39% vs. 15%, P = 0.018), and HPV-16, HPV-18, or HPV-52 (50% vs. 23%, P = 0.017). CONCLUSIONS We demonstrated an equally high HPV prevalence across the sexes. Further studies are needed to determine if this indicates an equal risk for cancer. Increased HPV awareness, screening, and vaccination should be considered, regardless of gender.
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Hongjaisee S, Chawansuntati K, Sripan P, Rattanathammethee K, Sakkhachornphop S, Chaiwarith R, Sudjaritruk T, Supparatpinyo K, Wipasa J. Comparison of antibody responses following natural infection with Severe Acute Respiratory Syndrome Coronavirus 2 or receipt of CoronaVac or ChAdOx1 (AZD1222) vaccination in Chiang Mai, Thailand. Vaccine X 2023; 14:100305. [PMID: 37155476 PMCID: PMC10119672 DOI: 10.1016/j.jvacx.2023.100305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 05/10/2023] Open
Abstract
Background In Thailand, early vaccination initiatives for SARS-CoV-2 relied on CoronaVac (Sinovac Life Sciences) and ChAdOx1 (Oxford-AstraZeneca) vaccines. However, the data of immunogenicity of these two vaccines in Thai populations is limited. This real time, head-to-head comparative study was conducted to investigate antibody (Ab) responses to SARS-CoV-2 following infection or receipt of either CoronaVac or ChAdOx1 vaccination in Chiang Mai, Thailand. Methods Sera was collected within two months from participants having a history of documented SARS-CoV-2 infection or at one month after the second dose of CoronaVac vaccine. Sera from participants with a history of receiving one dose of ChAdOx1 vaccination was collected twice, at one month following each vaccine dose. Neutralizing antibodies (NAbs) were assessed using the surrogate neutralization test and anti-spike protein antibodies were assessed using an in-house enzyme-linked immunosorbent assay. Results The prevalence of NAbs against SARS-CoV-2 was 92.1 %, 95.7 %, 64.1 % and 100 % in the infection group, CoronaVac group, ChAdOx1 group after 1st dose, and ChAdOx1 group after 2nd dose, respectively. The inhibition rate in individuals receiving two doses of ChAdOx1 vaccine (90.8%) was significantly higher than individuals who had recovered from natural infection (71.7%) or individuals who had received two doses of CoronaVac vaccine (66.7%). The prevalence of anti-spike Abs was 97.4 %, 97.8 %, 97.4 % and 100 % in the infection group, CoronaVac group, ChAdOx1 group after 1st dose, and ChAdOx1 group after 2nd dose, respectively. Significantly higher levels of anti-spike Abs were observed in the ChAdOx1 group after two doses of vaccination (1975 AU/mL) compared to those who had recovered from natural infection (468.5 AU/mL) and individuals who had received CoronaVac (554.4 AU/mL). Neutralizing activity had a statistically significant positive correlation with levels of anti-spike Abs. Conclusions ChAdOx1 vaccine may provide superior immunogenicity than CoronaVac and natural infection.
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Affiliation(s)
- Sayamon Hongjaisee
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Romanee Chaiwarith
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tavitiya Sudjaritruk
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Jiraprapa Wipasa
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Ng B, Puspitaningtyas H, Wiranata JA, Hutajulu SH, Widodo I, Anggorowati N, Sanjaya GY, Lazuardi L, Sripan P. Breast cancer incidence in Yogyakarta, Indonesia from 2008-2019: A cross-sectional study using trend analysis and geographical information system. PLoS One 2023; 18:e0288073. [PMID: 37406000 DOI: 10.1371/journal.pone.0288073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/17/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Breast cancer is a significant public health concern worldwide, including in Indonesia. Little is known about the spatial and temporal patterns of breast cancer incidence in Indonesia. This study aimed to analyze temporal and spatial variations of breast cancer incidence in Yogyakarta Province, Indonesia. METHODS The study used breast cancer case data from the Yogyakarta Population-Based Cancer Registry (PBCR) from 2008 to 2019. The catchment areas of the PBCR included the 48 subdistricts of 3 districts (Sleman, Yogyakarta City, and Bantul). Age-standardized incidence rates (ASR) were calculated for each subdistrict. Joinpoint regression was used to detect any significant changes in trends over time. Global Moran's and Local Indicators of Spatial Association (LISA) analyses were performed to identify any spatial clusters or outliers. RESULTS The subdistricts had a median ASR of 41.9, with a range of 15.3-70.4. The majority of cases were diagnosed at a late stage, with Yogyakarta City having the highest proportion of diagnoses at stage 4. The study observed a significant increasing trend in breast cancer incidence over the study period the fastest of which is in Yogyakarta City with an average annual percentage change of 18.77%, with Sleman having an 18.21% and Bantul having 8.94% average changes each year (p <0.05). We also found a significant positive spatial autocorrelation of breast cancer incidence rates in the province (I = 0.581, p <0.001). LISA analysis identified 11 subdistricts which were high-high clusters in the central area of Yogyakarta City and six low-low clusters in the southeast region of the catchment area in the Bantul and Sleman Districts. No spatial outliers were identified. CONCLUSIONS We found significant spatial clustering of BC ASR in the Yogyakarta Province, and there was a trend of increasing ASR across the region. These findings can inform resource allocation for public health efforts to high-risk areas and develop targeted prevention and early detection strategies. Further res is needed to understand the factors driving the observed temporal and spatial patterns of breast cancer incidence in Yogyakarta Province, Indonesia.
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Affiliation(s)
- Bryant Ng
- Faculty of Medicine, Medicine Study Program, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Herindita Puspitaningtyas
- Faculty of Medicine, Doctorate Program of Health and Medical Science, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Juan Adrian Wiranata
- Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Medicine, Master Program in Clinical Epidemiology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Susanna Hilda Hutajulu
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology and Medical Oncology, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Irianiwati Widodo
- Faculty of Medicine, Department of Anatomical Pathology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nungki Anggorowati
- Faculty of Medicine, Department of Anatomical Pathology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Guardian Yoki Sanjaya
- Faculty of Medicine, Department of Health Policy and Management, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lutfan Lazuardi
- Faculty of Medicine, Department of Health Policy and Management, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Sripan P, Saika K. Projection of the number of new colorectal and anus cancer cases in the world. Jpn J Clin Oncol 2023; 53:633-634. [PMID: 37340772 DOI: 10.1093/jjco/hyad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Affiliation(s)
- Patumrat Sripan
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, Chuo-ku, Tokyo, Japan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kumiko Saika
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, Chuo-ku, Tokyo, Japan
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Angkurawaranon S, Sanorsieng N, Unsrisong K, Inkeaw P, Sripan P, Khumrin P, Angkurawaranon C, Vaniyapong T, Chitapanarux I. A comparison of performance between a deep learning model with residents for localization and classification of intracranial hemorrhage. Sci Rep 2023; 13:9975. [PMID: 37340038 DOI: 10.1038/s41598-023-37114-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/15/2023] [Indexed: 06/22/2023] Open
Abstract
Intracranial hemorrhage (ICH) from traumatic brain injury (TBI) requires prompt radiological investigation and recognition by physicians. Computed tomography (CT) scanning is the investigation of choice for TBI and has become increasingly utilized under the shortage of trained radiology personnel. It is anticipated that deep learning models will be a promising solution for the generation of timely and accurate radiology reports. Our study examines the diagnostic performance of a deep learning model and compares the performance of that with detection, localization and classification of traumatic ICHs involving radiology, emergency medicine, and neurosurgery residents. Our results demonstrate that the high level of accuracy achieved by the deep learning model, (0.89), outperforms the residents with regard to sensitivity (0.82) but still lacks behind in specificity (0.90). Overall, our study suggests that the deep learning model may serve as a potential screening tool aiding the interpretation of head CT scans among traumatic brain injury patients.
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Affiliation(s)
- Salita Angkurawaranon
- Department of Radiology, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai, 50200, Thailand
| | - Nonn Sanorsieng
- Department of Radiology, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kittisak Unsrisong
- Department of Radiology, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Papangkorn Inkeaw
- Department of Computer Science, Faculty of Science, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Piyapong Khumrin
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chaisiri Angkurawaranon
- Global Health and Chronic Conditions Research Group, Chiang Mai, 50200, Thailand
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Tanat Vaniyapong
- Neurosurgery Division, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Imjai Chitapanarux
- Department of Radiology, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Wiranata JA, Puspitaningtyas H, Hutajulu SH, Fachiroh J, Anggorowati N, Sanjaya GY, Lazuardi L, Sripan P. Temporal and spatial analyses of colorectal cancer incidence in Yogyakarta, Indonesia: a cross-sectional study. Geospat Health 2023; 18. [PMID: 37246534 DOI: 10.4081/gh.2023.1186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/26/2023] [Indexed: 05/30/2023]
Abstract
We aimed to explore the district-level temporal dynamics and sub-district level geographical variations of colorectal cancer (CRC) incidence in the Special Region of Yogyakarta Province. We performed a cross-sectional study using data from the Yogyakarta population-based cancer registry (PBCR) comprised of 1,593 CRC cases diagnosed in 2008-2019. The age-standardized rates (ASRs) were determined using 2014 population data. The temporal trend and geographical distribution of cases were analysed using joinpoint regression and Moran's I statistics. During 2008-2019, CRC incidence increased by 13.44% annually. Joinpoints were identified in 2014 and 2017, which were also the periods when annual percentage change (APC) was the highest throughout the observation periods (18.84). Significant APC changes were observed in all districts, with the highest in Kota Yogyakarta (15.57). The ASR of CRC incidence per 100,000 person- years was 7.03 in Sleman, 9.20 in Kota Yogyakarta, and 7.07 in Bantul district. We found a regional variation of CRC ASR with a concentrated pattern of hotspots in the central sub-districts of the catchment areas and a significant positive spatial autocorrelation of CRC incidence rates in the province (I=0.581, p<0.001). The analysis identified four high-high clusters sub-districts in the central catchment areas. This is the first Indonesian study reported from PBCR data, showing an increased annual CRC incidence during an extensive observation period in the Yogyakarta region. A heterogeneous distribution map of CRC incidence is included. These findings may serve as basis for CRC screening implementation and healthcare services improvement.
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Affiliation(s)
- Juan Adrian Wiranata
- Academic Hospital; Master Program in Clinical Epidemiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Herindita Puspitaningtyas
- Doctorate Program of Health and Medical Science, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
| | - Jajah Fachiroh
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Nungki Anggorowati
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta.
| | - Guardian Yoki Sanjaya
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Lutfan Lazuardi
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta.
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai.
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Matsuda T, Sripan P. Projection of the number of new lung cancer cases in the world. Jpn J Clin Oncol 2023:7178016. [PMID: 37232040 DOI: 10.1093/jjco/hyad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Affiliation(s)
- Tomohiro Matsuda
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Patumrat Sripan
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, Chuo-ku, Tokyo, Japan
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Chitapanarux I, Nobnop W, Onchan W, Klunklin P, Nanna T, Sitathanee C, Kulpisitthicharoen S, Sripan P. Hypofractionated whole breast irradiation with simultaneous integrated boost in breast cancer using helical tomotherapy with or without regional nodal irradiation: A report of acute toxicities. Front Oncol 2023; 13:1122093. [PMID: 37007149 PMCID: PMC10064045 DOI: 10.3389/fonc.2023.1122093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/08/2023] [Indexed: 03/19/2023] Open
Abstract
PurposeWe prospectively investigated the acute toxicities focusing on skin and hematologic function in breast cancer patients who received hypofractionated whole breast irradiation with simultaneous integrated boost (HF-WBI-SIB) with helical tomotherapy (HT), with or without regional nodal irradiation (RNI).MethodsThe dose of WBI and RNI was 42.4 Gy in 16 fractions. Tumor bed was prescribed to 49.6 Gy in 16 fractions simultaneously. The association between the worst grade of acute toxicities during treatment and receiving RNI was analyzed. The integral dose to the whole body between the two groups was also compared.ResultsBetween May 2021 and May 2022, 85 patients were enrolled; 61 patients received HF-WBI-SIB only (71.8%) and 24 patients (28.2%) received HF-WBI-SIB with RNI. Grade 2 acute skin toxicity was found in 1.2%. The most frequent grade 2 or more hematologic toxicity was leukopenia, which occurred in 4.8% and 11% in the 2nd and 3rd week, respectively. Mean whole body integral dose was significantly higher in patients treated with RNI compared to patients treated without RNI: 162.8 ± 32.8 vs. 120.3 ± 34.7 Gy-L (p-value < 0.001). There was no statistically significant difference in acute grade 2 or more skin and hematologic toxicities between the two groups.ConclusionsHF-WBI-SIB with or without RNI is feasible with acceptable acute skin and hematologic toxicities. RNI and whole body integral dose were not associated with these acute toxicities.
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Affiliation(s)
- Imjai Chitapanarux
- Division of Radiation Oncology, 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
- *Correspondence: Imjai Chitapanarux, ,
| | - Wannapha Nobnop
- Division of Radiation Oncology, 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
| | - Wimrak Onchan
- Division of Radiation Oncology, 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
| | - Pitchayaponne Klunklin
- Division of Radiation Oncology, 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
| | - Thongtra Nanna
- Division of Radiation Oncology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
| | - Chomporn Sitathanee
- Division of Radiation Oncology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
| | | | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Uthis P, Suktrakul S, Wiwatwongwana R, Tangmunkongvorakul A, Sripan P, Srithanaviboonchai K. The Thai Internalized HIV-related Stigma Scale. Front Psychol 2023; 14:1134648. [PMID: 37008845 PMCID: PMC10062318 DOI: 10.3389/fpsyg.2023.1134648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/24/2023] [Indexed: 03/17/2023] Open
Abstract
IntroductionInternalized stigma among people living with HIV has been linked to a range of negative consequences. The current study describes the development and validation of a contextually appropriate internalized HIV-related Stigma Scale for people living with HIV in Thailand.MethodsThe study was carried out in two stages from 2018 to 2019: developing items based on the findings of focus group discussions and pilot testing the original list of items and validating the instrument. In the cross-sectional survey stage, a sample of 400 people living with HIV was used to validate the test items in accordance with their psychometric characteristics.ResultsThe study’s outcome was the 22-item Thai Internalized HIV-related Stigma Scale (Thai-IHSS). The exploratory factor analysis showed that the Thai-IHSS consisted of four components: negative thoughts toward self (5 items), anticipated negative thoughts (7 items), effects of negative thought toward self (6 items), and effects of negative thoughts toward family and access to healthcare services (4 items).DiscussionThe Thai-IHSS had acceptable concurrent, convergent, and congruent validity according to the findings. Additionally, the 8-item Thai-IHSS brief, which included two items for each component, was detailed. The Thai-IHSS is valid and reliable for use in Thailand and other countries with comparable sociocultural environments.
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Affiliation(s)
- Penpaktr Uthis
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | | | | | | | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- *Correspondence: Kriengkrai Srithanaviboonchai,
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Sripan P, Rerkasem A, Pongnikorn D, Chitapanarux I, Tangmunkongvorakul A, Ukranun W, Daoprasert K, Waisri N, Maneesai P, Srithanaviboonchai K, Aurpibul L. Trends in the Incidence of Kaposi's Sarcoma and Non-Hodgkin Lymphoma in Northern Thailand during the Time Period of Universal Access to Antiretroviral Treatment, 1998-2017. Asian Pac J Cancer Prev 2023; 24:1055-1061. [PMID: 36974561 DOI: 10.31557/apjcp.2023.24.3.1055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Indexed: 03/29/2023] Open
Abstract
PURPOSE We evaluated the trends in incidence of Kaposi's sarcoma (KS) and Non-Hodgkin's lymphoma (NHL) over the two decades in northern Thailand during which access to antiretroviral treatments (ART) in Thailand was scaled up. METHODS This is retrospective observational study. Data from 1998 to 2017 of patients diagnosed with KS and NHL from three long-standing, population-based cancer registries in northern Thailand (Chiang Mai, Lampang and Lamphun) were used to describe trends in age-adjusted incidence rate (ASR) of these cancers. The annual percent change (APC) of incidence rates were evaluated over this timeframe. RESULTS The incidence of KS significantly increased from 1998 to 2017 in males (APC of 6.9%) and very low incidence for evaluating change in female. NHL incidence significantly increased from 1998 to 2017, 2.2% and 1.8% per year in males and females, respectively (p<0.001). CONCLUSION In the last two decades, the incidence of KS in male and NHL in both sexes have increased in northern Thailand, while the incidence of KS in female remained low. The change in incidences in opposite to the decline in HIV prevalence and increase ART coverage rate supported that other associated factors attributable to the development of KS and NHL should be looked for i.e., environmental, occupational exposures and other infections.
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Affiliation(s)
- Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Amaraporn Rerkasem
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Imjai Chitapanarux
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Weerawat Ukranun
- Cancer Registry Unit, Lampang Cancer Hospital, Lampang, Thailand
| | | | - Narate Waisri
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Puttachart Maneesai
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Linda Aurpibul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Chitapanarux T, Kongkarnka S, Wannasai K, Sripan P. Prevalence and factors associated with atrophic gastritis and intestinal metaplasia: A multivariate, hospital-based, statistical analysis. Cancer Epidemiol 2023; 82:102309. [PMID: 36470067 DOI: 10.1016/j.canep.2022.102309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Atrophic gastritis (AG) and intestinal metaplasia (IM) play an essential role in gastric carcinogenesis. This study aimed to determine the prevalence of AG and IM and their associated factors. METHODS Subjects who underwent upper endoscopy at Chiang Mai University Hospital from January 2018 to Dec 2021 were included. All participants were interviewed using a structured questionnaire to collect their personal histories. In addition, clinical and histological data and associated factors of AG and IM were analyzed. RESULTS A total of 947 subjects (mean age, 53.61 ± 9.73 years; 60% male) were included. The prevalence of AG and IM, diagnosed by histopathology, was 39% and 19%. Prevalence of AG and IM increased from 28% and 9% in those under 50 years to 43% and 30% in those above 60 (p < 0.05). In a multivariate analysis, Helicobacter pylori (H. pylori) infection, age 50-59 and over 60 years were significantly associated with higher odds of AG (odds ratio (OR), 2.07, 2.06, and 1.98) and IM (OR, 2.07, 2.18, and 4.46), respectively. Conversely, ingestion of spicy food was significantly associated with lower odds of AG and IM (OR, 0.75, and 0.62). CONCLUSIONS This study confirms that age and H. pylori infection are risk factors, whereas spicy food intake is a protective factor against AG and IM, which are common in patients over 50. Therefore, upper endoscopy and gastric mapping sampling are recommended for patients with chronic dyspepsia older than 50 to reduce gastric cancer risk.
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Affiliation(s)
- Taned Chitapanarux
- Gastrohepatology Unit, Department of Internal Medicine, 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.
| | - Sarawut Kongkarnka
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Komson Wannasai
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Patumrat Sripan
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
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Aurpibul L, Sripan P, Paklak W, Tangmunkongvorakul A, Rerkasem A, Rerkasem K, Srithanaviboonchai K. Characteristics, clinical outcomes, and mortality of older adults living with HIV receiving antiretroviral treatment in the sub-urban and rural areas of northern Thailand. PLoS One 2023; 18:e0271152. [PMID: 36952398 PMCID: PMC10035908 DOI: 10.1371/journal.pone.0271152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/28/2023] [Indexed: 03/25/2023] Open
Abstract
Since the introduction of antiretroviral treatment (ART), people living with HIV worldwide live into older age. This observational study described the characteristics, clinical outcomes, and mortality of older adults living with HIV (OALHIV) receiving ART from the National AIDS program in northern Thailand. Participants aged ≥ 50 years were recruited from the HIV clinics in 12 community hospitals. Data were obtained from medical records and face-to-face interviews. In 2015, 362 OALHIV were enrolled; their median (interquartile range) age and ART duration were 57 years (54-61), and 8.8 years (6.4-11.2), respectively. At study entry, 174 (48.1%) had CD4 counts ≥ 500 cells/mm3; 357 of 358 (99.6%) with available HIV RNA results were virologic-suppressed. At the year 5 follow-up, 39 died, 11 were transferred to other hospitals, 3 were lost to follow-up, and 40 did not contribute data for this analysis, but remained in care. Among the 269 who appeared, 149 (55%) had CD4 counts ≥ 500 cells/mm3, and 227/229 tested (99%) were virologic-suppressed. The probability of 5-year overall survival was 89.2% (95% confidence interval, CI 85.4-92.1%). A significantly low 5-year overall survival (66%) was observed in OALHIV with CD4 counts < 200 cells/mm3 at study entry. The most common cause of death was organ failure in 11 (28%), followed by malignancies in 8 (21%), infections in 5 (13%), mental health-related conditions in 2 (5%), and unknown in 13 (33%). In OALHIV with stable HIV treatment outcomes, mortality from non-infectious causes was observed. Monitoring of organ function, cancer surveillance, and mental health screening are warranted.
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Affiliation(s)
- Linda Aurpibul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Wason Paklak
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Amaraporn Rerkasem
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Maláková K, Cabasag CJ, Bardot A, Sangrajrang S, Chitapanarux I, Sripan P, Suwanrungruang K, Pongnikorn D, Thongsuksai P, Sriplung H, Soerjomataram I. Cancer survival in Thailand from 1997 to 2012: Assessing the impact of universal health coverage. J Cancer Policy 2022; 34:100353. [PMID: 36357312 DOI: 10.1016/j.jcpo.2022.100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/22/2022] [Accepted: 08/14/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND In recent decades, many countries worldwide have implemented some form of Universal Health Coverage (UHC). We sought to evaluate incidence and survival trends of breast, cervical, and colorectal cancer before and after the implementation of UHC in Thailand. METHODS The age-standardized incidence rate and 1- and 5-year net survival (NS) were calculated for five Thai provinces, namely Bangkok, Chiang Mai, Khon Kaen, Lampang, and Songkhla for breast, cervix, and colorectal cancer in three study periods (1997-2012): before, during, and after the implementation of UHC. RESULTS The incidence of breast and colorectal cancer has increased over time, while the incidence of cervical cancer has decreased (17.9-29.9, 9.0-13.6, and 19.6-12.3 per 100,000, respectively). Larger proportion of breast cancer were diagnosed with localized stage after UHC implementation compared to the period prior to UHC (31.5 % vs 19.0 %). Overall, The improvement in survival by cancer site varied in magnitude with a 5-year NS increase from 61.3 % to 75.1 % for breast, 55.4-59.5 % for cervical, and 39.9-47.6 % for colorectal cancer. The amount of increase slightly differed across provinces. CONCLUSION Rising incidence for breast and colorectal, and declining cervical cancer may partly be attributable to improved awareness and early detection programs. Additionally, improvement in survival may partly be attributable to increased access to healthcare, availability of treatment, and increased access to cancer screening after UHC was implemented. Thus, continued expansion of UHC package on cancer could potentially contribute to further improvement of cancer control in Thailand. POLICY SUMMARY This study provides important evidence on the impact of UHC in cancer burden and survival for breast, cervical, and colorectal cancer in Thailand. This study serves as an example for other countries where UHC has been recently implemented and guide policymakers in allocating resources towards UHC and cancer control programs.
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Affiliation(s)
- Kateřina Maláková
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France; Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czechia
| | - Citadel J Cabasag
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - Aude Bardot
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Imjai Chitapanarux
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Paramee Thongsuksai
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Hutcha Sriplung
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Jia-Mahasap B, Madla C, Sripan P, Chitapanarux I, Tharavichitkul E, Chakrabandhu S, Klunklin P, Onchan W. Stereotactic radiosurgery for limited brain metastasis using three different techniques: helical tomotherapy, volumetric modulated arc therapy, and cone-based LINAC radiosurgery. Radiat Oncol J 2022; 40:232-241. [PMID: 36606300 PMCID: PMC9830036 DOI: 10.3857/roj.2022.00136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 10/06/2022] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Specific radiation delivered to tumors by stereotactic radiosurgery (SRS) has become widely used in the treatment of brain metastasis. This study aimed to compare radiation therapy planning and its parameters from SRS using three different modalities: helical tomotherapy (HT), volumetric modulated arc therapy (VMAT), and cone-based linac radiosurgery (Cone-based). MATERIALS AND METHODS Each contouring dataset of patents who experienced one to four brain metastasis received SRS in our center was re-planned to create radiation therapy planning in all three treatment systems (HT, VMAT, and Cone-based). The parameters of conformity index (CI), homogeneity index (HI), CI50, and gradient index (CGI) were analyzed to compare the effects of the three techniques. Decision score analysis was used to evaluate the performance on dosimetric and organs-at-risk parameters among the different techniques by applying the Cone-based technique as a benchmark. RESULTS A total of 21 patients with 39 lesions were included in this study. The results from the decision score analysis demonstrated statistically identical CI, CI50, and CGI values between Cone-based and VMAT for single lesions. For multiple lesions, VMAT also provided better CI when compared to Cone-based technique while HT exhibited the poorest dosimetric parameters. Moreover, VMAT exhibited the lowest BrainV5Gy value and displayed the shortest beam-on time calculation. CONCLUSION We have conducted a comprehensive comparison of SRS planning approaches. The Cone-based technique revealed the highest HI value, while VMAT provided the best estimated beam-on time value. HT displayed a feasible SRS modality for single lesions, but not for multiple lesions.
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Affiliation(s)
- Bongkot Jia-Mahasap
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,Correspondence: Bongkot Jia-Mahasap Department of Radiology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, SriPoom, Muang, Chiang Mai, Thailand. Tel: +66(0)53935450 E-mail:
| | - Chakri Madla
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ekkasit Tharavichitkul
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Somvilai Chakrabandhu
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pitchayaponne Klunklin
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wimrak Onchan
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Ditsatham C, Sripan P, Chaiwun B, Klunklin P, Tharavichitkul E, Chakrabandhu S, Muangwong P, Chitapanarux I. Breast Cancer Subtypes in Northern Thailand and Barriers to satisfactory survival outcomes. BMC Cancer 2022; 22:1147. [DOI: 10.1186/s12885-022-10196-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 10/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background:
The incidence of breast cancer (BC) in Thailand has been rising at an alarming rate. The annual incidence of BC in Thailand has doubled over a span of 15 years. A retrospective study was conducted with the primary objective of assessing and comparing survival rates of patients with BC, stratified by subtype of BC.
Methods:
A retrospective study was implemented for a cohort of women receiving a diagnosis of invasive BC with the objective of assessing and comparing their overall survival, stratified by BC subtype. Thai women receiving a diagnosis of their first primary invasive BC between January 2006 and December 2015 at Chiang Mai University Hospital were studied with 3,150 cases meeting the eligible criteria.
Results:
The median follow-up time was 4.9 years (Inter Quartile Range: 2.8–7.7). The most common diagnosed subtype was luminal B-like (n = 1,147, 36.4%). It was still the most prevalent subtype (35.8%) in women younger than 40 years and the 40–60 age-group, The proportion of patients with TNBC is the highest in women aged less than 40 years with 19.3% compared to the other age categories. Finally, among women older than 60 years, the proportion of each subtype was relatively uniform. Most women received a diagnosis of stage II disease. Triple negative subtype increased overall mortality in advanced staging (stages III and IV) (aHR:1.42, 95% CI: 0.96–2.11). The 5-year overall survival rate was found in luminal A-like at 82.8%, luminal B-like at 77.6%, HER-2 enriched at 66.4% and triple negative subtype at 64.2%.
Conclusion:
The histologic subtype, correlated with age and staging influenced the OS. Our results confirmed the association of triple negative BC with poor prognosis especially in advanced stage. The adjuvant medical treatment in our country could not be accessible in some group of patients, so the results of treatment and survival especially HER-2 enriched are lower than other countries without treatment barrier.
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Soo R, Mery L, Bardot A, Kanesvaran R, Keong TC, Pongnikorn D, Prasongsook N, Hutajulu SH, Irawan C, Manan AA, Thiagarajan M, Sripan P, Peters S, Storm H, Bray F, Stahel R. Diagnostic work-up and systemic treatment for advanced non-squamous non-small-cell lung cancer in four Southeast Asian countries. ESMO Open 2022; 7:100560. [PMID: 35988454 PMCID: PMC9588878 DOI: 10.1016/j.esmoop.2022.100560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Lung cancer is the second most common cancer and leading cause of cancer mortality worldwide. Recent advances in molecular testing and targeted therapy have improved survival among patients with metastatic non-small-cell lung cancer (NSCLC). We sought to quantify and describe molecular testing among metastatic non-squamous NSCLC cases in selected Southeast Asian countries and describe first-line therapy chosen. PATIENTS AND METHODS A retrospective study was conducted based on incident lung cancer cases diagnosed between 2017 and 2019 in Lampang (Thailand), Penang (Malaysia), Singapore and Yogyakarta (Indonesia). Cases (n = 3413) were defined using the International Classification of Diseases for Oncology third edition. In Singapore, a clinical series obtained from the National Cancer Centre was used to identify patients, while corresponding population-based cancer registries were used elsewhere. Tumor and clinical information were abstracted by chart review according to a predefined study protocol. Molecular testing of epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK) gene rearrangement, ROS1 gene rearrangement and BRAF V600 mutation was recorded. RESULTS Among 2962 cases with a specified pathological diagnosis (86.8%), most patients had non-squamous NSCLC (75.8%). For cases with staging information (92.1%), the majority presented with metastatic disease (71.3%). Overall, molecular testing rates in the 1528 patients with stage IV non-squamous NSCLC were 67.0% for EGFR, 42.3% for ALK, 39.1% for ROS1, 7.8% for BRAF and 36.1% for PD-L1. Among these patients, first-line systemic treatment included chemotherapy (25.9%), targeted therapy (35.6%) and immunotherapy (5.9%), with 31% of patients having no record of antitumor treatment. Molecular testing and the proportion of patients receiving treatment were highly heterogenous between the regions. CONCLUSIONS This first analysis of data from a clinically annotated registry for lung cancer from four settings in Southeast Asia has demonstrated the feasibility of integrating clinical data within population-based cancer registries. Our study results identify areas where further development could improve patient access to optimal treatment.
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Affiliation(s)
- R Soo
- Department of Hematology-Oncology, National University Hospital, Singapore, Singapore
| | - L Mery
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - A Bardot
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - R Kanesvaran
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - T C Keong
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - D Pongnikorn
- Cancer Registry Unit, Lampang Cancer Hospital, Lampang, Thailand
| | - N Prasongsook
- Medical Oncology Division, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - S H Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - C Irawan
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - A Ab Manan
- Malaysian National Cancer Registry Department, National Cancer Institute, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - M Thiagarajan
- Department of Radiotherapy and Oncology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - P Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiangmai, Thailand
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - H Storm
- Danish Cancer Society, Copenhagen, Denmark
| | - F Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - R Stahel
- ETOP IBCSG Partners Foundation, Bern, Switzerland.
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21
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Aurpibul L, Sripan P, Tangmunkongvorakul A, Chaikan W, Sarachai S, Srithanaviboonchai K. Neurocognitive performance and quality of life of older adults with HIV on antiretroviral treatment in Northern Thailand. J Int AIDS Soc 2022; 25 Suppl 4:e25983. [PMID: 36176022 PMCID: PMC9522635 DOI: 10.1002/jia2.25983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 08/01/2022] [Indexed: 12/16/2022] Open
Abstract
Introduction With virologic suppression and longer life expectancy, older adults with HIV (OAHIV) are at risk for neurocognitive impairment (NCI). This study investigated neurocognitive performance, quality of life (QOL) and the association between OAHIV determinants. Methods This cross‐sectional study was conducted in OAHIV aged ≥ 50 years on antiretroviral treatment at community hospitals in Northern Thailand between September and November 2020. The Montreal Cognitive Assessment Thai Version (MoCA‐T) and the Thai‐validated Medical Outcomes Study HIV (MOS‐HIV) were used. NCI was defined as MoCA‐T scores <25: 16–24 for amnestic mild cognitive impairment (aMCI) and <16 for dementia. For QOL, higher scores meant better QOL; a physical health summary T‐score ≥50 was defined as good QOL. Results Overall, 269 OAHIV were enrolled; 59% were female and 99% had virologic suppression. The current median age was 61.8 years (interquartile range [IQR] 58.9–65.7). The median duration of antiretroviral treatment was 10.5 years (IQR 8.5–13.5). The current median CD4 count (234 tested) was 484 cells/mm3 (IQR 339–634), and 99% had plasma HIV RNA <40 copies/ml (229 tested). The median MoCA‐T score was 20.0 (IQR 16.3–23.0). There were 234 OAHIV (87.3%) with NCI: 182 (67.9%) with aMCI and 52 (19.4%) with dementia. A hundred and ninety (70.6%) had good QOL. Bivariate analysis revealed no correlation between MoCA‐T scores and QOL. Multivariable linear regression analysis revealed that MoCA‐T score was associated with older age (r = –0.144, p = 0.002), lower education (r = 0.629, p < 0.001), lower income (r = 0.797, p = 0.040) and shorter treatment duration (r = 0.189, p = 0.006). Conclusions The vast majority of OAHIV with virologic suppression had NCI. Approximately two‐thirds had a mild impairment and one‐fifth had dementia. Neurocognitive performance and QOL were not correlated. Addressing mild NCI would enable more targeted monitoring. Early intervention and support could minimize functional impairment with increased age.
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Affiliation(s)
- Linda Aurpibul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Wilawan Chaikan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Saowalak Sarachai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.,Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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22
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O’Connor SY, Tangmunkongvorakul A, Srithanaviboonchai K, Sripan P, Banwell C, Kelly M. Association between Sociodemographic Factors and Condom Use among Migrant Sex Workers in Chiang Mai, Northern Thailand. Int J Environ Res Public Health 2022; 19:9830. [PMID: 36011466 PMCID: PMC9408573 DOI: 10.3390/ijerph19169830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/06/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
Thailand has the highest HIV burden in the Asia-Pacific region, with the majority of cases occurring in specific populations. Migrant Sex Workers (MSWs) in Thailand are an important population for HIV risk, yet there has been limited literature on this group and their protective sexual behavior. A cross-sectional study was conducted among 396 MSWs 18−49 years old from 23 sex work-identified venues in Chiang Mai. Participants were surveyed on their own sociodemographic information, health behavior, sexual risk behavior, quality of life, and depression. Male respondents were significantly younger than females (p = 0.003). Most respondents were from Myanmar and were ethnic Shan. In the month preceding the survey, 17.0% of MSWs had consistent condom use with regular partners, 53.7% with casual partners, and 87.9% with clients. Condom use was least practiced with regular partners and most practiced with clients (17% and 87.9%, respectively; p < 0.001). There was a significant positive association between condom use and starting high school (χ2 = 8.08, p = 0.018). Education was the only variable that was significantly correlated with condom use with any sexual partner (OR = 0.41; 95%CI 0.20−0.82). Findings of the study indicate that further efforts are needed to promote condom use among migrant sex workers and their sexual partners in Thailand.
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Affiliation(s)
- Suji Yoo O’Connor
- Department of Global Health, National Centre for Epidemiology and Population Health, Australian National University, Canberra 2601, Australia
| | - Arunrat Tangmunkongvorakul
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavaroros Road, Sri-phum, Muang, Chiang Mai 50200, Thailand
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavaroros Road, Sri-phum, Muang, Chiang Mai 50200, Thailand
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavaroros Road, Sri-phum, Muang, Chiang Mai 50200, Thailand
| | - Cathy Banwell
- Centre for Public Health and Data Policy, National Centre for Epidemiology & Population Health, Australian National University, Canberra 2601, Australia
| | - Matthew Kelly
- Department of Global Health, National Centre for Epidemiology and Population Health, Australian National University, Canberra 2601, Australia
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23
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Bunyatisai W, Chakrabandhu S, Sripan P, Rankantha A, Prasitwattanaseree S, Chitapanarux I. Spatial Distribution of Head and Neck Cancer in Chiang Mai, Thailand. Asian Pac J Cancer Prev 2022; 23:2583-2590. [PMID: 36037110 DOI: 10.31557/apjcp.2022.23.8.2583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The incidence of Head and neck (HN) cancers in Thailand is rising and survival rates not improving. Variations of its incidence among geographical areas may due to various contributing factors. METHODS We focused on data from 25 districts within Chiang Mai province, Thailand. The temporal change was described separately into two periods, 2007-2012 and 2013-2018. The OpenBUGS and the Quantum Geographic Information System were utilized to determine the geographical patterns in the incidence of HN cancer and focus on oropharynx. RESULTS The number of new cases of HN cancer was 1,186, of which 835 cases (70%) were male. Among those patients 548 diagnosed in 2007-2012 and 638 diagnose in 2013-2018. High risk patterns of both overall HN and oropharyngeal cancer incidences were found in the central and southern areas of the province in 2007-2013. However, the geographical patterns of the incidence of oropharyngeal cancer showed the changed pattern, with high RR in central and northern areas in more recent period. Over two periods, the RR of the cancers incidence decrease. The RR of oropharyngeal increased in Fang district and it remained high in Mueang district. CONCLUSION This study have highlighted specific areas with a high risk of head and neck cancer and oropharyngeal cancer incidences in Chiang Mai province, along with the spatial inequalities in their distributions, with cluster formation. These results may be helpful in guiding any strategy put in place to respond to the high risk incidence of the cancers in specific areas.
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Affiliation(s)
- Walaithip Bunyatisai
- Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Somvilai Chakrabandhu
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Apinut Rankantha
- 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.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), 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
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24
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Rerkasem A, Tangmunkongvorakul A, Aurpibul L, Sripan P, Parklak W, Nantakool S, Srithanaviboonchai K, Rerkasem K. Association of cardio-ankle vascular index and future major adverse cardiovascular events in older adults living with HIV. AIDS Care 2022; 35:591-599. [PMID: 35499141 DOI: 10.1080/09540121.2022.2029820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACTIncreased arterial stiffness is an indicator of cardiovascular disease (CVD) and death in the general population. The cardio-ankle vascular index (CAVI) is a novel method for measuring arterial stiffness. This study investigated the utility of CAVI as a prognostic indicator of CVD and death in older adults living with HIV(OALHIV). Patients aged ≥50 taking antiretroviral treatment with no history of cardiovascular events enrolled from multiple centers in Chiang Mai, Thailand. Participants (N = 347) who underwent CAVI were followed up for five years. The primary endpoint was major adverse cardiovascular events (MACE): a composite of total deaths and hospitalizations due to myocardial infarction, coronary revascularization, stroke, and heart failure. Cox regression analysis determined between normal (<8) and high (≥8) CAVI against the incidence of MACE. Forty-five participants (13.0%) were diagnosed with MACE. The risk of MACE was more significant in high CAVI than normal CAVI (adjusted HR = 2.11, 95% confidence interval 1.06-4.20, p = 0.033). In OALHIV, CAVI was an independent prognosis of MACE, in addition to conventional CVD risk factors. CAVI-assisted to help identify high-risk patients showed the benefit of further evaluation and more intensive therapy to prevent CVD and death.
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Affiliation(s)
- Amaraporn Rerkasem
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Arunrat Tangmunkongvorakul
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Linda Aurpibul
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Wason Parklak
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sothida Nantakool
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical Surgical Research Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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25
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Thapinta D, Srithanaviboonchai K, Uthis P, Suktrakul S, Wiwatwongnawa R, Tangmunkongvorakul A, Wannachaiyakul S, Sripan P. Association between Internalized Stigma and Depression among People Living with HIV in Thailand. Int J Environ Res Public Health 2022; 19:ijerph19084471. [PMID: 35457339 PMCID: PMC9031422 DOI: 10.3390/ijerph19084471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 12/04/2022]
Abstract
Internalized stigma and depression are among the most common mental health problems in people living with HIV (PLHIV). This study aimed to examine the association between depression and overall internalized stigma, as well as different aspects of internalized stigma in PLHIV. The study included 400 PLHIV receiving care in Bangkok and Chiang Mai, Thailand. Data were analyzed using descriptive statistics, Mann-Whitney U test, and Spearman correlation coefficients. The results indicated the PLHIV with mild depression had lower median scores for the social relationship internalized stigma subscale than PLHIV with major depressive disorder (p = 0.009). Total HIV internalized stigma scores were significantly correlated with PHQ-9 scores in the mild depression group (r = 0.327, p = 0.004). Depression and internalized stigma were prevalent and associated, especially in the area of social relationships. Health personnel should be aware of possible depression in PLHIV who have internalized stigma. Intervention to promote understanding and social support for PLHIV is warranted.
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Affiliation(s)
- Darawan Thapinta
- Faculty of Nursing, Chiang Mai University, Chiang Mai 50200, Thailand; (D.T.); (S.W.)
| | - Kriengkrai Srithanaviboonchai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.T.); (P.S.)
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Correspondence:
| | - Penpaktr Uthis
- Faculty of Nursing, Chulalongkorn University, Bangkok 10330, Thailand; (P.U.); (S.S.)
| | - Sunisa Suktrakul
- Faculty of Nursing, Chulalongkorn University, Bangkok 10330, Thailand; (P.U.); (S.S.)
| | | | - Arunrat Tangmunkongvorakul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.T.); (P.S.)
| | | | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.T.); (P.S.)
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26
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Autsavapromporn N, Klunklin P, Chitapanarux I, Jaikang C, Chewaskulyong B, Sripan P, Hosoda M, Tokonami S. A Potential Serum Biomarker for Screening Lung Cancer Risk in High Level Environmental Radon Areas: A Pilot Study. Life (Basel) 2021; 11:life11111273. [PMID: 34833148 PMCID: PMC8625497 DOI: 10.3390/life11111273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 01/05/2023] Open
Abstract
Radon is a major cause of lung cancer (LC) deaths among non-smokers worldwide. However, no serum biomarker for screening of LC risk in high residential radon (HRR) areas is available. Therefore, the aim of this study was to determine diagnostic values of serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment (Cyfra21-1), human epididymis protein 4 (HE4), interleukin 8 (IL-8), migration inhibitory factor (MIF), tumor nuclear factor-alpha (TNF-α) and vascular endothelial growth factors (VEGF) occurring in high radon areas. Seventy-five LC non-smoker patients and seventy-five healthy controls (HC) were enrolled in this study. Among the HC groups, twenty-five HC were low residential radon (LRR) and fifty HC were HRR. Significantly higher (p < 0.0004) serum levels of CEA, Cyfra21-1, IL-8 and VEGF were found in the LC compared with the LRR and HRR groups. More importantly, significantly higher levels (p < 0.009) of serum CEA, Cyfra21-1 and IL-8 were observed in HRR compared with the LRR group. Likewise, a ROC curve demonstrated that serum CEA and Cyfra21-1 could better distinguish LC risk from HRR groups than IL-8. These results indicated that serum CEA and Cyfra21-1 were significantly increased in the HRR group and may be considered as potential biomarkers for individuals at high-risk to develop LC.
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Affiliation(s)
- Narongchai Autsavapromporn
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.K.); (I.C.)
- Correspondence:
| | - Pitchayaponne Klunklin
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.K.); (I.C.)
| | - Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.K.); (I.C.)
| | - Churdsak Jaikang
- Toxicology Section, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Busyamas Chewaskulyong
- Division of Oncology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Patumrat Sripan
- Research Institute for Health Science, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Masahiro Hosoda
- Graduate School of Health Science, Hirosaki University, Hirosaki, Aomori 036-8564, Japan;
| | - Shinji Tokonami
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Aomori 036-8564, Japan;
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27
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Sripan P, Chitapanarux I, Tharavichitkul E, Muangwong P, Pongnikorn D, Waisri N, Hanpragopsuk C, Maneesai P, Tansiri P, Poungsombat M, Khamsan V. Disparities in the change of cervical cancer mortality rate between urban and rural Chiang Mai in the era of universal health care and the Thai national screening program. Int J Equity Health 2021; 20:175. [PMID: 34325727 PMCID: PMC8323343 DOI: 10.1186/s12939-021-01515-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background The Ministry of Public Health of Thailand established universal health coverage (UHC) in 2002, which also included national-level screening for cervical cancer in 2005. This study examined the changes in mortality of cervical cancer in rural and urban areas in Chiang Mai Province of northern Thailand during the era of UHC and the immediately preceding period. Methods Data of cervical cancer patients in Chiang Mai in northern Thailand, who died from 1998 through 2012, were used to calculate the change in age-standardized rates of mortality (ASMR) using a joinpoint regression model and to calculate estimated annual percent changes (APC). The change in mortality rate by age groups along with changes by geographic area of residence were determined. Results Among the 1177 patients who died from cervical cancer, 13(1%), 713 (61%) and 451 (38%) were in the young age group (aged < 30), the screening target group (aged 30–59) and the elderly group (aged ≥60), respectively. The mortality rate among women aged 30–59 significantly declined by 3% per year from 2003 through 2012 (p < 0.001). By area of residence, the mortality rate in women targeted by the screening program significantly decreased in urban areas but remained stable in more rural areas, APC of − 7.6 (95% CI: − 12.1 to − 2.8) and APC of 3.7 (95% CI: − 2.1 to 9.9), respectively. Conclusion The UHC and national cervical cancer screening program in Thai women may have contributed to the reduction of the mortality rate of cervical cancer in the screening target age group. However, this reduction was primarily in urban areas of Chiang Mai, and there was no significant impact on mortality in more rural areas. These results suggest that the reasons for this disparity need to be further explored to equitably increase access to cervical cancer services of the UHC. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01515-1.
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Affiliation(s)
- Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Imjai Chitapanarux
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. .,Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. .,Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Ekkasit Tharavichitkul
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pooriwat Muangwong
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Narate Waisri
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chirapong Hanpragopsuk
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Puttachart Maneesai
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Panrada Tansiri
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Malisa Poungsombat
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Varunee Khamsan
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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28
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Chitapanarux I, Wongsrita S, Sripan P, Kongsupapsiri P, Phakoetsuk P, Chachvarat S, Kittidachanan K. An underestimated pitfall of oral candidiasis in head and neck cancer patients undergoing radiotherapy: an observation study. BMC Oral Health 2021; 21:353. [PMID: 34271901 PMCID: PMC8285796 DOI: 10.1186/s12903-021-01721-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/07/2021] [Indexed: 12/05/2022] Open
Abstract
Background Oral candidiasis is a common problem associated with head and neck radiation therapy (RT) consequences being pain, burning sensation, taste change, and systemic infection. There are difficulties in differentiating between oral candidiasis and radiation induced oral mucositis. We conducted a prospective study to explore the incidence of clinical oral candidiasis and evaluate the accuracy of diagnosis among head and neck cancer (HNC) patients receiving RT or concurrent chemoradiotherapy (CCRT). Methods This study included 86 HNC patients who had no clinical signs or symptoms of oral candidiasis. Oral mucosa and tongue swabs were carried out and analyzed three times by fungal cultures at the following time points: (1) before RT, (2) at the time of clinically diagnosed candidiasis or during RT at between the 15th–17th fraction (whichever occurred first), and (3) at the end of RT. The accuracy of clinical oral candidiasis was explored and confirmed by fungal colonization techniques. The incidence and risk factors associated with fungal colonization before and throughout the treatment were analyzed. Results The overall incidence of clinical oral candidiasis was 53.5% throughout the course of RT. Confirmation of fungal colonization was found in 39.5%, 65.9%, and 57.7% of cases before RT, during RT, and end of RT, respectively. The accuracy of the diagnosis using only clinical presentation was demonstrated in 60%, 50%, and 52% before RT, during RT, and end of RT, respectively. Logistic regression analysis showed that age, CCRT, and using 2% viscous lidocaine solution were independent risk factors for fungal colonization. Conclusions The results of this study demonstrated an underestimation of clinical oral candidiasis before and throughout the course of radiotherapy from using only clinical sign and symptoms. Crucial attention to detail and testing in the oral examination could improve decision making for detection of oral candidiasis in HNC patients receiving RT or CCRT.
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Affiliation(s)
- Imjai Chitapanarux
- Department of Radiology, 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.
| | - Somying Wongsrita
- Division of Radiation Oncology, Maharaj Nakornratchasima Hospital, Nakornratchasima, Thailand
| | - Patumrat Sripan
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | - Kittikun Kittidachanan
- Department of Radiology, 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
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Rerkasem A, Maessen SE, Wongthanee A, Pruenglampoo S, Mangklabruks A, Sripan P, Derraik JGB, Rerkasem K. Caesarean delivery is associated with increased blood pressure in young adult offspring. Sci Rep 2021; 11:10201. [PMID: 33986334 PMCID: PMC8119414 DOI: 10.1038/s41598-021-89438-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/26/2021] [Indexed: 12/16/2022] Open
Abstract
We examined the associations between caesarean section (CS) delivery and cardiovascular risk factors in young adults in Thailand. Participants were 632 offspring from a birth cohort in Chiang Mai (Northern Thailand), born in 1989–1990 and assessed in 2010 at a mean age of 20.6 years, including 57 individuals (9.0%) born by CS and 575 born vaginally. Clinical assessments included anthropometry, blood pressure (BP), carotid intima-media thickness, and fasting blood glucose, insulin, and lipid profile. Young adults born by CS had systolic BP (SBP) 6.2 mmHg higher (p < 0.001), diastolic BP 3.2 mmHg higher (p = 0.029), and mean arterial pressure (MAP) 4.1 mmHg higher (p = 0.003) than those born vaginally. After covariate adjustments, SBP and MAP remained 4.1 mmHg (p = 0.006) and 2.9 mmHg (p = 0.021) higher, respectively, in the CS group. The prevalence of abnormal SBP (i.e., pre-hypertension or hypertension) in the CS group was 2.5 times that of those born vaginally (25.0% vs 10.3%; p = 0.003), with an adjusted relative risk of abnormal SBP 1.9 times higher (95% CI 1.15, 2.98; p = 0.011). There were no differences in anthropometry (including obesity risk) or other metabolic parameters. In this birth cohort in Thailand, CS delivery was associated with increased blood pressure in young adulthood.
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Affiliation(s)
- Amaraporn Rerkasem
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sarah E Maessen
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Antika Wongthanee
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sakda Pruenglampoo
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - José G B Derraik
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. .,Liggins Institute, University of Auckland, Auckland, New Zealand. .,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. .,Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Kittipan Rerkasem
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. .,Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Rerkasem A, Sripan P, Pongtam S, Ounjaijean S, Kulprachakarn K, Wongthanee A, Chaiwarith R, Supparatpinyo K, Salee P, Arworn S, Rerkasem K. The Prevalence and Risk Factors for Peripheral Arterial Disease in Adults Living With Human Immunodeficiency Virus. INT J LOW EXTR WOUND 2021; 22:332-338. [PMID: 33900138 DOI: 10.1177/15347346211009404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adult patients with human immunodeficiency virus (HIV) appear to be at high risk of cardiovascular disease (CVD). Peripheral arterial disease (PAD) is particularly concerning as it is associated with myocardial infarction and stroke. Nevertheless, the incidence of PAD is still unknown. The authors prospectively recruited HIV-infected patients from the outpatient clinic of the Department of Internal Medicine in our center. We assessed ankle-brachial index (ABI) using the VaSera system™ (Fukuda Denshi Co., Ltd). Patients were grouped into 3 ABI levels: an ABI ≤0.90 was considered abnormal and evidence of PAD, an ABI 1.0 to 1.40 was considered normal, and 0.91 to 0.99 was considered borderline. Cardiovascular risk factors were compared across all 3 levels of ABI and were analyzed using multivariate ordinal logistic regression. Eight hundred ninety-two patients were recruited. The mean age was 42.9 ± 10.0 years and 458 (51.4%) were males. There were 704, 149, and 39 patients in the normal, borderline, and abnormal ABI groups, respectively. The latter group of 39 patients was considered to have PAD, yielding a prevalence of 4.37% (95% confidence interval [CI] 3.21-5.93). Sex ratio, age, education levels, smoking rate, body mass index (BMI), blood pressure, prevalence of comorbidities with hypertension and coronary heart disease, median triglyceride level, reduced kidney function and HIV-1 RNA undetectable ratio, duration of HIV diagnosis, and duration on antiretroviral treatment were significantly different among 3 ABI subgroups. Independent risk factors associated with PAD were being female (odds ratio [OR]: 2.86; 95% CI: 1.94-4.22), being <30 years of age (OR: 4.66; 95% CI: 2.78-7.81), being overweight (BMI 25-25.9; OR: 0.39; 95% CI: 0.20-0.76), being obese (BMI: 30; OR: 3.53; 95% CI: 1.51-8.22), having a diastolic blood pressure ≥80 mmHg (OR: 0.50; 95% CI: 0.35-0.71), and having detectable HIV-1 RNA ≥20 copies/mL (OR: 1.85; 95% CI: 1.13-3.03). In conclusion, the prevalence of PAD in HIV-infected Thais was 4.37% in infected patients on therapy attending outpatient clinics. For this population, PAD appears to be relatively poorly correlated with traditional risk factors of CVD.
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Affiliation(s)
- Amaraporn Rerkasem
- Research Institute for Health Sciences, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Sasinat Pongtam
- Research Institute for Health Sciences, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Sakaewan Ounjaijean
- Research Institute for Health Sciences, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Kanokwan Kulprachakarn
- Research Institute for Health Sciences, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Antika Wongthanee
- Department of Internal Medicine, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Romanee Chaiwarith
- Department of Internal Medicine, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Khuanchai Supparatpinyo
- Research Institute for Health Sciences, 26682Chiang Mai University, Chiang Mai, Thailand.,Department of Internal Medicine, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Parichat Salee
- Department of Internal Medicine, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Supapong Arworn
- Department of Surgery, Faculty of Medicine, 26682Chiang Mai University Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Research Institute for Health Sciences, 26682Chiang Mai University, Chiang Mai, Thailand.,Department of Surgery, Faculty of Medicine, 26682Chiang Mai University Chiang Mai, Thailand
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Hongjaisee S, Khamduang W, Sripan P, Choyrum S, Thepbundit V, Ngo-Giang-Huong N, Tangmunkongvorakul A. Prevalence and factors associated with hepatitis B and D virus infections among migrant sex workers in Chiangmai, Thailand: A cross-sectional study in 2019. Int J Infect Dis 2020; 100:247-254. [PMID: 32898671 DOI: 10.1016/j.ijid.2020.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 09/02/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To determine the prevalence of hepatitis B surface antigen (HBsAg) and antibody to hepatitis delta virus (anti-HDV) and associated factors among migrant sex workers in Chiangmai, Thailand. METHODS This cross-sectional study was conducted at various sexual entertainment venues in Chiangmai, Thailand, in 2019. Consenting participants were interviewed using a questionnaire, and plasma was tested for hepatitis B virus (HBV) markers (DiaSorin, Italy) and anti-HDV antibody (DIA.PRO Diagnostic Bioprobes, Italy), if HBsAg-positive. Associations between HBsAg positivity or HDV antibody and potential factors were examined using univariable and multivariable logistic regression analysis. RESULTS A total of 396 migrant sex workers, half of them female, were recruited between February and September 2019. Their median age was 25 years (interquartile range 22-30 years) and 95% were Burmese. Overall, HBsAg prevalence was 11.4%; 8.1% in females and 14.7% in males (Chi-square, p = 0.040). One-third were still susceptible to HBV. No HBsAg-positive participants had anti-HDV antibodies. HBsAg positivity was associated with being male (adjusted odds ratio (aOR) 3.01, 95% confidence interval (CI) 1.25-7.68, p = 0.014), having attended school (aOR 4.50, 95% CI 1.26-15.98, p = 0.020), being separated/divorced/widowed (aOR 5.77, 95% CI 1.48-22.52, p = 0.012), and having unprotected sex (aOR 3.38, 95% CI 1.31-8.71, p = 0.012). CONCLUSIONS In this young population, higher HBsAg prevalence in males may be related to sexual transmission, indicating the need for HBV screening programs linked with HBV prevention and care.
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Affiliation(s)
- Sayamon Hongjaisee
- Research Institute for Health Sciences, Chiang Mai University, Chiangmai, Thailand
| | - Woottichai Khamduang
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand; Infectious Diseases Research Unit, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiangmai, Thailand
| | - Sirinath Choyrum
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand
| | - Viraporn Thepbundit
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand
| | - Nicole Ngo-Giang-Huong
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand; Institut de Recherche pour le Développement (IRD), Chiangmai, Thailand; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ponnoprat D, Inkeaw P, Chaijaruwanich J, Traisathit P, Sripan P, Inmutto N, Na Chiangmai W, Pongnikorn D, Chitapanarux I. Classification of hepatocellular carcinoma and intrahepatic cholangiocarcinoma based on multi-phase CT scans. Med Biol Eng Comput 2020; 58:2497-2515. [PMID: 32794015 DOI: 10.1007/s11517-020-02229-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023]
Abstract
Liver and bile duct cancers are leading causes of worldwide cancer death. The most common ones are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Influencing factors and prognosis of HCC and ICC are different. Precise classification of these two liver cancers is essential for treatment and prevention plans. The aim of this study is to develop a machine-based method that differentiates between the two types of liver cancers from multi-phase abdominal computerized tomography (CT) scans. The proposed method consists of two major steps. In the first step, the liver is segmented from the original images using a convolutional neural network model, together with task-specific pre-processing and post-processing techniques. In the second step, by looking at the intensity histograms of the segmented images, we extract features from regions that are discriminating between HCC and ICC, and use them as an input for classification using support vector machine model. By testing on a dataset of labeled multi-phase CT scans provided by Maharaj Nakorn Chiang Mai Hospital, Thailand, we have obtained 88% in classification accuracy. Our proposed method has a great potential in helping radiologists diagnosing liver cancer.
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Affiliation(s)
- Donlapark Ponnoprat
- Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Papangkorn Inkeaw
- Advanced Research Center for Computational Simulation, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Jeerayut Chaijaruwanich
- Data Science Research Center, Department of Computer Science, Faculty of Science, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Patrinee Traisathit
- Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nakarin Inmutto
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Wittanee Na Chiangmai
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Donsuk Pongnikorn
- Cancer Registry Unit, Lampang Cancer Hospital, Lampang, 52000, Thailand
| | - Imjai Chitapanarux
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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Chitapanarux I, Lekawanvijit S, Sripan P, Mahanupab P, Chakrabandhu S, Onchan W, Sittitrai P, Boonlert D, Klibngern H, Samuckkeethum W. The prognostic value of excision repair cross-complementing Group 1 expression in nasopharyngeal cancer patients. J Res Med Sci 2020; 25:34. [PMID: 32582340 PMCID: PMC7306241 DOI: 10.4103/jrms.jrms_787_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/10/2019] [Accepted: 12/30/2019] [Indexed: 11/04/2022]
Abstract
Background Overexpression of excision repair cross-complementing Group 1 (ERCC-1) is related to cisplatin resistance and defective repair of radiation damage. The purpose of this study was to evaluate the clinical significance of excision (ERCC-1) expression in nasopharyngeal cancer (NPC). Materials and Methods We conducted a retrospective review of patients diagnosed with NPC between 2000 and 2013. The archived tissues were analyzed using immunohistochemistry to determine ERCC-1 expression. The ERCC-1 expression level along with other clinical factors and overall survival (OS) were analyzed. Hazard ratio (HR) with a 95% confidence interval was calculated to assess the risk. Results The analysis of ERCC-1 expression was available in 262 NPC patients who had medical records at our hospital. Among those patients, 221 (84%) were treated with curative radiotherapy (RT)/concurrent chemoradiotherapy, 22 (7%) were treated with palliative RT alone, and 19 (9%) were given best supportive care. There was no correlation between ERCC-1 expression and stage of cancer or OS. No difference in 5-year OS was found between patients with low ERCC-1 expression and high ERCC-1 expression (38% vs. 36%; P = 0.981). The adjusted HR (aHR) of cancer death increased with cancer stage (aHR = 2.93 for advanced Stages III-IV; P = 0.001) and age (aHR = 2.11 for age >55; P ≤ 0.001). ERCC-1 expression exhibited no prognostic significance in our study (aHR = 1). Conclusion In this study, ERCC-1 expression has no statistical significance to be considered a prognostic factor for OS among NPC patients. On the other hand, cancer stage, age, and types of treatment can be prognostic factors in NPC patients.
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Affiliation(s)
- Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, 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.,Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suree Lekawanvijit
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), 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.,Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Pongsak Mahanupab
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Somvilai Chakrabandhu
- Division of Radiation Oncology, Department of Radiology, 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
| | - Wimrak Onchan
- Division of Radiation Oncology, Department of Radiology, 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
| | - Pichit Sittitrai
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Donyarat Boonlert
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Hanpon Klibngern
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wisarut Samuckkeethum
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Chitapanarux I, Traisathit P, Chitapanarux T, Jiratrachu R, Chottaweesak P, Chakrabandhu S, Rasio W, Pisprasert V, Sripan P. Arginine, glutamine, and fish oil supplementation in cancer patients treated with concurrent chemoradiotherapy: A randomized control study. Curr Probl Cancer 2020; 44:100482. [DOI: 10.1016/j.currproblcancer.2019.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/15/2019] [Indexed: 11/17/2022]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Kanthawang T, Vaseenon T, Sripan P, Pattamapaspong N. Comparison of three-dimensional and two-dimensional computed tomographies in the classification of acetabular fractures. Emerg Radiol 2019; 27:157-164. [PMID: 31792749 DOI: 10.1007/s10140-019-01744-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/01/2019] [Accepted: 11/06/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE This study compared the accuracy and timeliness of two-dimensional computed tomography (2DCT) and three-dimensional computed tomography (3DCT) in the diagnosis of different types of acetabular fractures and by different groups of interpreters using the Letournel and Judet classification system. METHODS Twenty-five fractures cases, five each of five common types of acetabular fractures, were selected. Nineteen interpreters with different levels of experience (ten graduate trainees and nine radiologists) individually classified the fractures using multiplanar 2D and standardized 3DCT images. The 3DCT image set was comprised of 39 images of rotational views of the entire pelvis and the disarticulated fracture hip. Consensus reading by three experts served as a reference standard. RESULTS Classification accuracy was 66% using 2DCT, increasing to 73% (p = 0.041) when 3DCT was used. Improvement occurred in the interpretation of transverse and posterior wall-type fractures (p < 0.01 and p = 0.015, respectively), but not in T-type, transverse with posterior wall, or both-column fractures. The improvement was noted only in the graduate trainee group (p = 0.016) but not the radiologist group (p = 0.619). Inter-observer reliability in the graduate trainee group improved from poor to moderate with 3DCT, but remained at a moderate level in both 2DCT and 3DCT in the radiologist group. The overall average interpretation time per case with correct diagnosis was 60 s for 2DCT but only 32 s for 3DCT. CONCLUSIONS Standardized 3DCT provides greater reliability and faster diagnosis of acetabular fractures and helps improve the accuracy in transverse- and posterior wall-type fractures. In addition, it helps improve the accuracy of less experienced interpreters.
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Affiliation(s)
- Thanat Kanthawang
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Tanawat Vaseenon
- Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Patumrat Sripan
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nuttaya Pattamapaspong
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Sripan P, Chitapanarux I, Fidler-Benaoudia MM, Miranda-Filho A, Bardot A, Pongnikorn D, Maneesai P, Waisri N, Hanpragopsuk C, Tharavichitkul E, Soerjomataram I. Impact of universal health care and screening on incidence and survival of Thai women with cervical cancer: A population-based study of the Chiang Mai Province. Cancer Epidemiol 2019; 63:101594. [PMID: 31539716 DOI: 10.1016/j.canep.2019.101594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/23/2019] [Accepted: 08/30/2019] [Indexed: 11/21/2022]
Abstract
Universal Health Coverage (UHC) was implemented in Thailand in 2002. This study aims to compare cervical cancer incidence and survival before and after the implementation of UHC, including the national screening program, in the Chiang Mai population in Northern Thailand. Data of women diagnosed with in situ or malignant cervical cancer in Chiang Mai during 1998-2012 were used in our analysis. Annual age-standardized incidence rates (ASR) and age-adjusted relative survival (RS) were estimated for the following three diagnosis periods: period I: 1998-2002 (before UHC), period II: 2003-2007 (UHC implementation) and period III: 2008-2012 (after UHC). The ASR peaked in 2001 at 38 per 100,000, and then subsequently declined to 23 per 100,000 in 2012. The proportion of in situ and localized tumors increased in all age groups, while regional tumors declined. In all women (aged 15-89) with malignant cervical cancer or in situ, the 5-year RS in Period I, Period II and Period III was 73%, 74% and 77%, respectively; when only malignant cases were considered, the RS was 63%, 61% and 62%, respectively. In the screening target women (aged 30-59) with malignant or in situ tumors, the 5-year RS was 84%, 88% and 90%, respectively, in the three periods, while the RS was 71%, 74% and 75%, respectively, in only those with malignant cancers. The introduction of UHC including national cervical cancer screening program has likely reduced the magnitude and severity of cervical cancer and improved the survival of cervical cancer in the screening target age group.
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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, Thailand; Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Thailand
| | - Imjai Chitapanarux
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Thailand.
| | - Miranda M Fidler-Benaoudia
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France; Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Canada
| | | | - Aude Bardot
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | | | - Puttachart Maneesai
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Narate Waisri
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chirapong Hanpragopsuk
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ekkasit Tharavichitkul
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Mery L, Bray F, Sripan P, Soo R, Storm H, Stahel R. Evaluating medical oncology outcomes: An Asian lung cancer study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz432.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chitapanarux I, Klunklin P, Pinitpatcharalert A, Sripan P, Tharavichitkul E, Nobnop W, Onchan W, Chakrabandhu S, Jia-Mahasap B, Euathrongchit J, Wannasopha Y, Srisuwan T. Conventional versus hypofractionated postmastectomy radiotherapy: a report on long-term outcomes and late toxicity. Radiat Oncol 2019; 14:175. [PMID: 31610801 PMCID: PMC6790998 DOI: 10.1186/s13014-019-1378-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/10/2019] [Indexed: 12/25/2022] Open
Abstract
Objective We evaluated the long-term outcomes and late toxicity of conventional fractionated (CF) and hypofractionated (HF) postmastectomy radiotherapy (PMRT) in terms of locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), overall survival (OS), and late toxicity. Methods A cohort of 1640 of breast cancer patients receiving PMRT between January 2004 and December 2014 were enrolled. Nine hundred eighty patients were treated with HF-PMRT: 2.65 Gy/fraction to a total of 42.4–53 Gy and 660 patients were treated with CF-PMRT: 2 Gy/fraction to a total of 50–60 Gy. Results The median follow-up time was 71.8 months (range 41.5–115.9 months). No significant difference was found in the rates of 5-year LRRFS, DFS, and OS of HF-PMRT vs CF-PMRT; 96% vs. 94% (p = 0.373), 70% vs. 72% (p = 0.849), and 73% vs. 74% (p = 0.463), respectively. We identified a cohort of 937 eligible breast cancer patients who could receive late toxicities assessment. With a median follow-up time of this patient cohort of 106.3 months (range 76–134 months), there was a significant higher incidence of grade 2 or more late skin (4% vs 1%) and subcutaneous (7% vs 2%) toxicity in patients treated with HF-PMRT vs CF-PMRT. Patients who received additional radiation boost were significantly higher in the HF-PMRT group. Grade 2 or more late RTOG/EORTC lung toxicity was significant lesser in HF-PMRT vs CF-PMRT (9% vs 16%). Grade 1 brachial plexopathy was also significant lesser in HF-PMRT vs CF-PMRT (2% vs 8%). Heart toxicity and lymphedema were similar in both groups. Conclusions HF-PMRT is feasible to deliver with comparable long-term efficacy to CF-PMRT. HF-PMRT had higher grade 2 or more skin and subcutaneous toxicity but less lung and brachial plexus toxicity.
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Affiliation(s)
- Imjai Chitapanarux
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, 110 Intawarorose Road, Chiang Mai, 50200, Thailand. .,Northern Thai Research Group of Radiation Oncology (NTRG-RO), 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.
| | - Pitchayaponne Klunklin
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, 110 Intawarorose Road, Chiang Mai, 50200, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Patumrat Sripan
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, 110 Intawarorose Road, Chiang Mai, 50200, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), 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
| | - Ekkasit Tharavichitkul
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, 110 Intawarorose Road, Chiang Mai, 50200, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wannapha Nobnop
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, 110 Intawarorose Road, Chiang Mai, 50200, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wimrak Onchan
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, 110 Intawarorose Road, Chiang Mai, 50200, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Somvilai Chakrabandhu
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, 110 Intawarorose Road, Chiang Mai, 50200, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Bongkot Jia-Mahasap
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, 110 Intawarorose Road, Chiang Mai, 50200, Thailand.,Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Juntima Euathrongchit
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Yutthaphan Wannasopha
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tanop Srisuwan
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Chitapanarux I, Sripan P, Somwangprasert A, Charoentum C, Onchan W, Watcharachan K, Wongmaneerung P, Kongmebhol P, Jia-Mahasap B, Huntrakul L. Stage-Specific Survival Rate of Breast Cancer Patients in Northern Thailand in Accordance with Two Different Staging Systems. Asian Pac J Cancer Prev 2019; 20:2699-2706. [PMID: 31554366 PMCID: PMC6976831 DOI: 10.31557/apjcp.2019.20.9.2699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 09/03/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: This study was attempted to investigate overall survival by stage at diagnosis in female breast cancer patients in Northern Thailand by using 2 different staging systems; namely, American Joint Committee on Cancer (AJCC) Tumor (T), Nodal (N) and Metastatic (M) staging system and Surveillance Epidemiology and End Results (SEER) summary staging system. Methods: We studies female breast cancer patients whose data were registered in Chiang Mai cancer registries between January 2006 and December 2015. Data were recorded in SEER summary staging system. The TNM AJCC staging was searched in the medical records. Results: A total of 3,873 female breast cancer patients were diagnosed from 2006-2015. All data sets were recorded in SEER summary stage 2000. Early stage was the most prevalent stage at the time of diagnosis (58%), followed by loco-regional advanced stage (32%), and metastatic breast cancer (10%). The 5-year overall survival rate of early, loco-regional advanced, and metastatic stages were 85.3%, 66.4%, and 26.2%, respectively. After examining the medical records, we excluded patients who had no data on T, N, and M in their records. Finally, only 3,251 patients were analyzed for AJCC stage-specific survival. The 5-year overall survival rate in stages I, II, III, and IV were 94.4%, 85.0%, 56.6%, and 28.3%, respectively. Conclusion: Comparing to more stable economic countries, the 5-year overall survival rate for a specific stage of breast cancer in Northern Thailand was slightly lower in early stage and stage I-II in accordance with AJCC, but much lower in loco-regional stage and stage III with respect to AJCC. Nevertheless, it was similar in metastatic stage and stage IV according to AJCC.
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Affiliation(s)
- Imjai Chitapanarux
- Division of Radiation Oncology, 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
- Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Division of Radiation Oncology, 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
- Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Chaiyut Charoentum
- Oncology Unit, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wimrak Onchan
- Division of Radiation Oncology, 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
| | - Kirati Watcharachan
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Pailin Kongmebhol
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Bongkot Jia-Mahasap
- Division of Radiation Oncology, 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
| | - Lalita Huntrakul
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Chitapanarux I, Tovanabutra N, Chiewchanvit S, Sripan P, Chumachote A, Nobnop W, Tippanya D, Khamchompoo D. Emulsion of Olive Oil and Calcium Hydroxide for the Prevention of Radiation Dermatitis in Hypofractionation Post-Mastectomy Radiotherapy: A Randomized Controlled Trial. Breast Care (Basel) 2019; 14:394-400. [PMID: 31933586 DOI: 10.1159/000496062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Most of the patients who have been treated by post-mastectomy radiotherapy (PMRT) experience skin toxicity. There have been few studies on acute radiation dermatitis in breast cancer patients who received hypofractionation PMRT. Methods 62 patients were randomized to receive a general skin care regimen with or without the addition of an emulsion of olive oil and calcium hydroxide twice a day, from the initiation of PMRT to 2 weeks after radiotherapy. Adverse skin reactions and the Skindex-16 score were assessed. Results At the 8th, 13th, and 16th fraction of PMRT, grade 1 dermatitis was found in 42, 90, and 90% of the control group and in 16, 30, and 71% of the intervention group. At the end of the study, the mean Skindex-16 score of the intervention group was significantly better than that of the control group (p = 0.019). Conclusions Addition of an emulsion of olive oil and calcium hydroxide for patients undergoing hypofractionation PMRT yielded superior preventive results over a general skin care regimen alone, in terms of delaying skin toxicity, reducing the severity of acute radiation dermatitis, and a better quality of life in the intervention group. However, a larger number of patients will be required to confirm this result.
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Affiliation(s)
- Imjai Chitapanarux
- Division of Radiation Oncology.,Northern Thai Research Group of Radiation Oncology (NTRG-RO).,Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital
| | - Napatra Tovanabutra
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Siri Chiewchanvit
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Division of Radiation Oncology.,Northern Thai Research Group of Radiation Oncology (NTRG-RO).,Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital
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Chitapanarux I, Nobnop W, Tippanya D, Sripan P, Chakrabandhu S, Klunklin P, Onchan W, Jia-Mahasap B, Tharavichitkul E. Clinical outcomes and dosimetric study of hypofractionated Helical TomoTherapy in breast cancer patients. PLoS One 2019; 14:e0211578. [PMID: 30703145 PMCID: PMC6355009 DOI: 10.1371/journal.pone.0211578] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 01/16/2019] [Indexed: 11/23/2022] Open
Abstract
We present a single center’s experience of treatment outcomes and dosimetric parameters for breast cancer patients treated with hypofractionated Helical TomoTherapy (HT). This is a retrospective study of one hundred and thirty-six patients with invasive breast cancer treated between March 2012 and October 2016. Dosimetric parameters and 3-year loco-regional failure free survival (LRFFS) were analyzed. Dose to ipsilateral lung, heart and contralateral breast as well as acute and late toxicities were recorded. The median follow-up time is 45 months (range: 5–83). Two patients had loco-regional failure. The 3-year LRFFS was 99%. Acute grade 1 and 2 skin toxicities occurred in 95% and 1%, respectively. Coverage of the target volumes was achieved with the mean ± standard deviation (SD) of homogeneity and conformity index being 0.1 ± 0.04, and 0.8 ± 0.07, respectively. Dose to ipsilateral lung, contralateral breast, and heart was also within the limited constraints regardless of the complexity of target volumes. Only two percent of patients experienced late grade 2 skin toxicity. No late grade 2 subcutaneous tissue toxicity was found. Nine percent of patients developed late grade 1 lung toxicity. Hypofractionated radiotherapy using Helical TomoTherapy in breast irradiation provides excellent 3-year LRFFS and minimal acute and late toxicities. A careful, longer follow-up of healthy tissue effects to lung, heart, and contralateral breast is warranted.
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Affiliation(s)
- Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, 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.,Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wannapha Nobnop
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Damrongsak Tippanya
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Somvilai Chakrabandhu
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pitchayaponne Klunklin
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wimrak Onchan
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Bongkot Jia-Mahasap
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ekkasit Tharavichitkul
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Nobnop W, Chitapanarux I, Wanwilairat S, Tharavichitkul E, Lorvidhaya V, Sripan P. Effect of Deformation Methods on the Accuracy of Deformable Image Registration From Kilovoltage CT to Tomotherapy Megavoltage CT. Technol Cancer Res Treat 2019; 18:1533033818821186. [PMID: 30803375 PMCID: PMC6373993 DOI: 10.1177/1533033818821186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The registration accuracy of megavoltage computed tomography images is limited by low image contrast when compared to that of kilovoltage computed tomography images. Such issues may degrade the deformable image registration accuracy. This study evaluates the deformable image registration from kilovoltage to megavoltage images when using different deformation methods and assessing nasopharyngeal carcinoma patient images. METHODS The kilovoltage and the megavoltage images from the first day and the 20th fractions of the treatment day of 12 patients with nasopharyngeal carcinoma were used to evaluate the deformable image registration application. The deformable image registration image procedures were classified into 3 groups, including kilovoltage to kilovoltage, megavoltage to megavoltage, and kilovoltage to megavoltage. Three deformable image registration methods were employed using the deformable image registration and adaptive radiotherapy software. The validation was compared by volume-based, intensity-based, and deformation field analyses. RESULTS The use of different deformation methods greatly affected the deformable image registration accuracy from kilovoltage to megavoltage. The asymmetric transformation with the demon method was significantly better than other methods and illustrated satisfactory value for adaptive applications. The deformable image registration accuracy from kilovoltage to megavoltage showed no significant difference from the kilovoltage to kilovoltage images when using the appropriate method of registration. CONCLUSIONS The choice of deformation method should be considered when applying the deformable image registration from kilovoltage to megavoltage images. The deformable image registration accuracy from kilovoltage to megavoltage revealed a good agreement in terms of intensity-based, volume-based, and deformation field analyses and showed clinically useful methods for nasopharyngeal carcinoma adaptive radiotherapy in tomotherapy applications.
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Affiliation(s)
- Wannapha Nobnop
- 1 Division of Radiation Oncology, Department of Radiology, Chiang Mai University, Chiang Mai, Thailand
| | - Imjai Chitapanarux
- 1 Division of Radiation Oncology, Department of Radiology, Chiang Mai University, Chiang Mai, Thailand
| | - Somsak Wanwilairat
- 1 Division of Radiation Oncology, Department of Radiology, Chiang Mai University, Chiang Mai, Thailand
| | - Ekkasit Tharavichitkul
- 1 Division of Radiation Oncology, Department of Radiology, Chiang Mai University, Chiang Mai, Thailand
| | - Vicharn Lorvidhaya
- 1 Division of Radiation Oncology, Department of Radiology, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- 1 Division of Radiation Oncology, Department of Radiology, Chiang Mai University, Chiang Mai, 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Ditsatham C, Chitapanarux I, Somwangprasert A, Watcharachan K, Wongmaneerung P, Charoentum C, Chewaskulyong B, Chakrabandhu S, Onchan W, Teeyasuntranonn A, Sripan P. Outcome of eribulin as a late treatment line for Thai metastatic breast cancer patients. Onco Targets Ther 2018; 11:4443-4447. [PMID: 30104885 PMCID: PMC6074808 DOI: 10.2147/ott.s166399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background We report the safety and efficacy of eribulin as a late treatment line in Thai metastatic breast cancer (MBC) patients. Patients and methods A total of 30 MBC patients treated with eribulin between January 2014 and January 2017 were retrospectively analyzed. The patients were scheduled to receive 1.4 mg/m2 of eribulin on day 1, day 8 and subsequently every 21 days. All patients had previously received at least three chemotherapy regimens including anthracycline and taxane. Response rate and progression-free survival (PFS) were analyzed. Results The median age was 56 years (range, 40–74 years), with a median follow-up time of 5.7 months (range, 0.2–25 months). The overall response rate was 30% (nine patients): four patients had triple-negative breast cancer, three patients had luminal B breast cancer and two patients had luminal A breast cancer. The median PFS was 2.9 months (range, 0.2–14 months). The median number of previous chemotherapy regimens was 4 (range, 3–9). Univariate analysis showed that the number of regimens (four or fewer) prior to eribulin was statistically associated with superior PFS (P = 0.009). Multivariate analysis also showed similar statistical association between number of prior regimens (four or fewer) and better PFS adjusted by age group (≥50 years; hazard ratio = 1.29; 95% CI: 1.0–1.65; P = 0.046). There were no toxic deaths or grade 4 toxicities. Nine (30%) patients had grade 3 anemia toxicities, and the other common toxicities were leukopenia and neutropenia. Four (13%) patients required dose reduction and 16 (53%) patients required dose delay because of toxicities. Conclusion Eribulin is an effective drug for heavily pretreated MBC patients with tolerable toxicities. The benefit was superior in patients who received fewer than four previous chemotherapy regimens.
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Affiliation(s)
| | - Imjai Chitapanarux
- Division of Radiation Oncology, .,Northern Thai Research Group of Radiation Oncology, .,Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital,
| | | | | | | | | | | | | | | | - Anongnart Teeyasuntranonn
- Pharmacy Division, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Tharavichitkul E, Chakrabandhu S, Klunklin P, Onchan W, Jia-Mahasap B, Wanwilairat S, Tippanya D, Jayasvasti R, Sripan P, Galalae RM, Chitapanarux I. Intermediate-term results of trans-abdominal ultrasound (TAUS)-guided brachytherapy in cervical cancer. Gynecol Oncol 2018; 148:468-473. [DOI: 10.1016/j.ygyno.2018.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/11/2018] [Accepted: 01/14/2018] [Indexed: 10/18/2022]
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47
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Virani S, Sriplung H, Bilheem S, Sripan P, Maneesai P, Waisri N, Chitapanarux I. Effect of the national screening program on malignancy status of cervical cancer in Northern Thailand. Int J Public Health 2018; 63:377-385. [PMID: 29362857 DOI: 10.1007/s00038-018-1077-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 12/07/2017] [Accepted: 01/11/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Cervical cancer has posed a serious problem in Thailand for decades. In 2002, a systematic screening program was implemented under universal healthcare coverage for all Thai women. However, there has been little research on how screening affected particular aspects of cervical cancer, such as stage distribution. This screening program has a target group; therefore, it is necessary to assess stage and incidence trends by age of those within and outside the screening target group. METHODS Using trend analysis, we assess in situ and malignant cervical cancers in Northern Thailand to measure changes after implementation of the national screening program. RESULTS While incidence of malignant cancers is decreasing and incidence of in situ tumors is increasing across all age groups, women above age 60 still experience a high incidence of malignant tumors. CONCLUSIONS The screening program is successful in the target group at downshifting the stage distribution of malignant tumors and reducing incidence of malignant tumors with in situ cases being captured. However, the high incidence of malignant tumors in women over age 60 will continue to be clinically relevant for cervical cancer management until younger generations undergoing screening enter this age group.
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Affiliation(s)
- Shama Virani
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Surichai Bilheem
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Patumrat Sripan
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, 110 Intrawarorose road, Chiang Mai, 50200, Thailand.,Chiang Mai Cancer Registry, 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
| | - Puttachart Maneesai
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Narate Waisri
- Chiang Mai Cancer Registry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, 110 Intrawarorose road, Chiang Mai, 50200, Thailand. .,Chiang Mai Cancer Registry, 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.
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Sripan P, Chitapanarux I, Sruamsiri R, Klunklin P. Cost-effectiveness analysis of exemestane versus chemotherapy in post-menopausal hormonal responsive advanced breast cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx654.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Chitapanarux I, Nobnop W, Sripan P, Chumachote A, Tharavichitkul E, Chakrabandhu S, Klunklin P, Onchan W, Jia-Mahasap B, Janlaor S, Kayan P, Traisathit P, Van Gestel D. The Outcome of the First 100 Nasopharyngeal Cancer Patients in Thailand Treated by Helical Tomotherapy. Radiol Oncol 2017; 51:351-356. [PMID: 28959172 PMCID: PMC5612000 DOI: 10.1515/raon-2017-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 02/18/2017] [Indexed: 11/17/2022] Open
Abstract
Background The aim of the study was to analyse of two-year loco-regional failure free survival (LRFFS), distant metastasis free survival (DMFS), overall survival (OS), and toxicity outcomes of the first 100 nasopharyngeal carcinoma patients in Thailand treated by helical tomotherapy. Patients and methods Between March 2012 and December 2015, 100 patients with non-metastatic nasopharyngeal carcinoma were treated by helical tomotherapy. All patients were treated by platinum-based concurrent chemoradiotherapy and adjuvant or neo-adjuvant chemotherapy. Results The median age was 51 years (interquartile ranges [IQR]: 42.5–57.0). The mean ± SD of D95% of planning target volume (PTV) 70, 59.4 and 54 were 70.2 ± 0.5, 59.8 ± 0.6, and 54.3 ± 0.8 Gy, respectively. The mean ± SD of conformity index, and homogeneity index were 0.89 ± 0.13 and 0.06 ± 0.07. Mean ± SD of D2 % of spinal cord and brainstem were 34.1 ± 4.4 and 53.3 ±6.3 Gy. Mean ± SD of D50 of contralateral and ipsilateral parotid gland were 28.4 ± 6.7 and 38.5 ± 11.2 Gy. At a median follow-up of 33 months (IQR: 25–41), the 2-year LRFFS, DMFS, OS were 94% (95%CI: 87–98%), 96% (95% CI: 89–98%), and 99% (95% CI: 93–100%), respectively. Acute grade 3 dermatitis, pharyngoesophagitis, and mucositis occurred in 5%, 51%, and 37%, respectively. Late pharyngoesophagitis grade 0 and 1 were found in 98% and 2% of patients. Late xerostomia grade 0, 1 and 2 were found in 17%, 78% and 5%, respectively. Conclusions Helical tomotherapy offers good dosimetric performance and achieves excellent treatment outcome in nasopharyngeal carcinoma patients.
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Affiliation(s)
- Imjai Chitapanarux
- Division of Radiation Oncology, 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
| | - Wannapha Nobnop
- Division of Radiation Oncology, 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
| | - Patumrat Sripan
- Division of Radiation Oncology, 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
| | - Ausareeya Chumachote
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ekkasit Tharavichitkul
- Division of Radiation Oncology, 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
| | - Somvilai Chakrabandhu
- Division of Radiation Oncology, 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
| | - Pitchayaponne Klunklin
- Division of Radiation Oncology, 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
| | - Wimrak Onchan
- Division of Radiation Oncology, 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
| | - Bongkot Jia-Mahasap
- Division of Radiation Oncology, 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
| | - Suwapim Janlaor
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patcharawadee Kayan
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Dirk Van Gestel
- Department of Radiation Oncology, Institut Jules Bordet, Université libre de Bruxelles, Brussels, Belgium
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Chitapanarux I, Tungkasamit T, Petsuksiri J, Kannarunimit D, Katanyoo K, Chakkabat C, Setakornnukul J, Wongsrita S, Jirawatwarakul N, Lertbusayanukul C, Sripan P, Traisathit P. Randomized control trial of benzydamine HCl versus sodium bicarbonate for prophylaxis of concurrent chemoradiation-induced oral mucositis. Support Care Cancer 2017; 26:879-886. [PMID: 28942587 DOI: 10.1007/s00520-017-3904-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/18/2017] [Indexed: 01/18/2023]
Abstract
PURPOSE The purpose of the study is to compare the efficacy of benzydamine HCl with sodium bicarbonate in the prevention of concurrent chemoradiation-induced oral mucositis in head and neck cancer patients. METHODS Sixty locally advanced head and neck cancer patients treated with high-dose radiotherapy concurrently with platinum-based chemotherapy were randomly assigned to receive either benzydamine HCl or sodium bicarbonate from the first day of treatment to 2 weeks after the completion of treatment. The total score for mucositis, based on the Oral Mucositis Assessment Scale (OMAS), was used for the assessment, conducted weekly during the treatment period and at the fourth week of the follow-up. Pain score, all prescribed medications, and tube feeding needs were also recorded and compared. RESULTS The median of total OMAS score was statistically significant lower in patients who received benzydamine HCl during concurrent chemo-radiotherapy (CCRT) than in those who received sodium bicarbonate, (p value < 0.001). There was no difference in median pain score, (p value = 0.52). Nineteen percent of patients in sodium bicarbonate arm needed oral antifungal agents whereas none in the benzydamine HCl arm required such medications, (p value = 0.06). Tube feeding needs and the compliance of CCRT were not different between the two study arms. CONCLUSIONS For patients undergoing high-dose radiotherapy concurrently with platinum-based chemotherapy, using benzydamine HCl mouthwash as a preventive approach was superior to basic oral care using sodium bicarbonate mouthwash in terms of reducing the severity of oral mucositis and encouraging trend for the less need of oral antifungal drugs.
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Affiliation(s)
- Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. .,Northern Thai Research Group of Therapeutic Radiology and Oncology (NTRG-TRO), 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.
| | | | - Janjira Petsuksiri
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Danita Kannarunimit
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Kanyarat Katanyoo
- Radiation Oncology Unit, Department of Radiology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Chakkapong Chakkabat
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Jiraporn Setakornnukul
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Somying Wongsrita
- Division of Radiation Oncology, Maharaj Nakornratchasima Hospital, Nakornratchasima, Thailand
| | | | - Chawalit Lertbusayanukul
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Patumrat Sripan
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Northern Thai Research Group of Therapeutic Radiology and Oncology (NTRG-TRO), 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
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand.,Center of Excellence in Bioresources for Agriculture, Industry and Medicine, Chiang Mai University, Chiang Mai, Thailand
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