Relapse Patterns and Outcomes Following Recurrence of Endometrial Cancer in Northern Thai Women

Kaewpangchan, Phakdee,Cheewakriangkrai, Chalong Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.9

Background: The aim of this study was to analyze the patterns of relapse and survival outcomes in Northern Thai women with recurrent endometrial cancer (EC). Materials and Methods: Medical records were abstracted from EC patients who underwent primary surgery from 1999 to 2012. Data on clinicopathologic variables, sites of first recurrence, time to relapse of disease, and overall survival (OS) was analyzed. Associations between the clinicopathological variables and the rates of disease recurrence were determined. Results: Among 1,204 reviewed records, 42 eligible patients were identified with recurrent disease. The median age was 55 years and the median follow-up time was 26.0 months. The median times to recurrence (TTR) after completion of the initial treatment in the group of local relapse (LR) and distant/combined sites of recurrence (DCSR) was 6.6 (95% CI=4.6 to 8.6 months) and 16.9 months (95% CI=5.6 to 28.2 months), respectively (p=0.36). The 2-year survival and 3-year survival probability in the group of LR was 54.2% (95% CI=27.2 to 81.3%) and 34.7% (95% CI=9.2 to 60.2%), compared to 50.4% (95% CI=41.1 to 59.7%) and 42.1% (95%CI= 24.1 to 60.1%) for those with DCSR. Distant recurrence was the most frequent pattern of relapse. Overall survival was not significantly different in patients with local relapse when compared to those with DCSR (p=0.69). Conclusions: Patients with recurrence of EC after primary treatment had a worse prognosis and clinical aggressiveness. LR and DCSR occurred most during the first three years. The common sites of relapses were vaginal cuff, pelvis, and lungs. No significant clinicopathological predictor for survival outcomes was identified.

Outcome of Single Agent Generic Gemcitabine in Platinum-Resistant Ovarian Cancer, Fallopian Tube Cancer and Primary Peritoneal Adenocarcinoma

Suprasert, Prapaporn,Cheewakriangkrai, Chalong,Manopunya, Manatsawee Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.2

Single original gemcitabine is commonly used as salvage treatment in platinum-resistant ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma (PPA) with a satisfactory outcome. However, efficacy data fro this regimen are limited. We therefore conducted a retrospective study to evaluate the outcome of patients who received single-agent generic gemcitabine (GEMITA) after development of clinical platinum resistance. The study period was between May 2008 and December 2010. Gemcitabine was administered intravenously in two different schedules: 1,000 $mg/m^2$ on day 1,8, and 15 every 28 days; and on days 1 and 8 every 21 days with the same dosage. Administration was until disease progression was noted. The response rate was evaluated using the Gynecologic Cancer Intergroup (GCIG) criteria while toxicity was evaluated according to WHO criteria. Sixty-six patients met the inclusion criteria in the study period. Two-thirds of them received gemcitabine as the second and third line regimen. The overall response rate was 12.1%. The median progression free survival and overall survival was 2 and 10 months, respectively. With the total 550 courses of chemotherapy,the patients developed grades 3 and 4 hematologic toxicity as follows: anemia, 1.5%; leukopenia, 13.7%; neutropenia, 27.3%; and thrombocytopenia, 3.0%. In conclusion, single agent generic gemcitabine revealed a modest efficacy in patients with platinum-resistant ovarian cancer, fallopian tube cancer and PPA without serious toxicity.

Effects of Protected Conjugated Linoleic Acid Supplementation on Milk Fatty Acid in Dairy Cows

Piamphon, N.,Wachirapakorn, Chalong,Wanapat, M.,Navanukraw, C. Asian Australasian Association of Animal Productio 2009 Animal Bioscience Vol.22 No.1

The objective was to determine the effects of supplementation of protected conjugated linoleic acid (CLA), CLA-20 comprising 10% each of cis-9, trans-11 and trans-10, cis-12, on milk production and fatty acid profiles in plasma and milk in lactating dairy cows. Five mid-lactation, multiparous crossbred Holstein Friesian cows with average 402${\pm}$20 kg BW were used in a 5${\times}$5 Latin square design for 21-d periods. Cows were given a total mixed ration (TMR) and supplemented with CLA-20 at 0, 20, 40, 80 and 160 g/d. The results showed that dry matter intake depression occurred in cows supplemented with CLA-20 at 160 g/d. Milk production slightly increased when CLA-20 supplementation was at 20, 40 and 80 g/d. However, 3.5% fat-corrected milk (FCM) was not affected by CLA-20 supplementation. Increased levels of CLA-20 supplementation resulted in a significantly decreased percentage of milk fat. Plasma concentrations of fatty acid were not altered by the amounts of CLA-20 supplementation except for the concentration of trans-10, cis-12 CLA. For all dietary treatments, percentages of fatty acids (C4:0, C6:0, C8:0, C13:0, C14:0 C14:1 C15:0 C15:1 C16:0, C16:1, C18:1n9t, C18:2n6t, C18:2n6c, C20:0, C18:3n6, C18:3n3, C20:1 and C20:3n6) in milk fat were similar. Concentrations of C10:0, C11:0, C12:0 and C18:1n9c were decreased cubically and C18:0 was elevated linearly (p<0.01) according to the increased amounts of CLA-20 supplemented. The linear increase was observed for cis-9, trans-11 CLA (0.62, 1.17, 1.94, 1.87 and 1.82% of total fatty acid), trans-10, cis-12 CLA (0.01, 0.63, 0.67, 0.93 and 0.95% of total fatty acid) and total CLA (0.80, 2.25, 3.16, 3.97 and 3.94% of total fatty acid) in milk fat from 0 to 160 g/d of CLA-20 supplement. In conclusion, concentration of cis-9, trans-11 CLA in milk fat was concomitantly elevated at an increasing rate with the increased amounts of CLA-20. Based on the results in this study, supplementation of CLA-20 at 80 g/d optimally enhanced total CLA in milk fat.

Outcomes of advanced and recurrent cervical cancer treated with cisplatin and generic topotecan: retrospective analysis in a tertiary care hospital in Thailand

Prapaporn Suprasert,Kittipat Charoenkwan,Chalong Cheewakriangkrai 대한부인종양학회 2010 Journal of Gynecologic Oncology Vol.21 No.4

Objective: Retrospective evaluation of the outcome of stage IVB, recurrent or persistent cervical cancer treated with cisplatin and generic topotecan (CT) in a tertiary care hospital in Thailand. Methods: The medical records of patients treated with CT regimen at Chiang Mai University Hospital between January 2005 and December 2007 were reviewed and analyzed. The treatment protocol consisted of IV topotecan 0.75 mg/m2 on days 1, 2, and 3; combined with cisplatin 50 mg/m2 IV on day 1 and repeated every 21 days until progression or unacceptable toxicity for a maximum of 6 cycles. The outcomes were evaluated based on the response rate, progression free survival (PFS), and overall survival (OS) by using the World Health Organization criteria. The adverse effects of the treatments were also determined. Results: Twenty-one cervical cancer patients received the CT regimen. The tumor response rate was 28.6%. The median PFS and OS was 4 and 11 months, respectively. With 87 cycles of chemotherapy, the most common grade 3 &4 hematologic toxicity was neutropenia (57.9%). Conclusion: Advanced and recurrent cervical cancer patients treated with cisplatin and generic topotecan had a favorable outcome with manageable toxicity.

Outcomes with Single Agent LIPO-DOX in Platinum-Resistant Ovarian and Fallopian Tube Cancers and Primary Peritoneal Adenocarcinoma - Chiang Mai University Hospital Experience

Suprasert, Prapaporn,Manopunya, Manatsawee,Cheewakriangkrai, Chalong Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.3

Background: Single pegylated liposomal doxorubicin (PLD) is commonly used as a salvage treatment in platinum-resistant ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma (PPA) with a satisfactory outcome. However, the data for second generation PLD administered in this setting are still limited. We conducted a retrospective study to evaluate the outcome of patients who received single-agent second generation PLD (LIPO-DOX) after the development of clinical platinum resistance. The study period was between March 2008 and March 2013. LIPO-DOX was administered intravenously 40 $mg/m^2$ every 28 days until disease progression, but for not more than six cycles. The response rate was evaluated using the Gynecologic Cancer Intergroup (GCIG) criteria while the toxicity was evaluated according to WHO criteria. Twenty-nine patients met the inclusion criteria in the study period with an overall response rate of 13.8%. The median progression free survival and overall survival were three and eleven months, respectively. With the total of 96 cycles of chemotherapy, the patients developed grades 3 and 4 hematologic toxicity as follows: anemia, 0%, leukopenia, 9.6%, neutropenia, 32.3% and thrombocytopenia, 0%. In conclusion, the single agent second generation PLD demonstrated modest efficacy in patients with platinum-resistant ovarian cancer, fallopian tube cancer and PPA without serious toxicity.

Preface for the Special Issue on Computational Intelligence Technologies Meets Medical informatics

Chang, Chi-Chang,Lu, Chi-Jie,Cheewarkriangkrai, Chalong Korean Institute of Information Scientists and Eng 2017 Journal of Computing Science and Engineering Vol.11 No.4

Outcome of the Gynecologic Oncology Patients Surveillance Network Program

Suprasert, Prapaporn,Suwansirikul, Songkiat,Charoenkwan, Kittipat,Cheewakriangkrai, Chalong,Suwansirikul, Songkiat Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.12

The gynecologic oncology patients surveillance network program was conducted with the collaboration of 5 provincial hospitals located in the north of Thailand (Chiang Rai, Lamphun Nan, Phayao and Phrae). The aim was to identify ways of reducing the burden and the cost to the gynecologic cancer patients who needed to travel to the tertiary care hospital for follow up. The clinical data of each patient was transferred to the provincial hospital by the internet via the website www.gogcmu.or.th. All the general gynecologists who participated in this project attended the training course set up for the program. From January 2011 to February 2014, 854 patients who were willing to have their next follow-up at the network hospitals close to their home were enrolled this project. Almost of them were residents in Chiang Rai province and the most common disease was cervical cancer. After the project had been running for 1 year, 604 of the enrolled patients and 21 health-care personnel who had participated in this project were interviewed to assess its success. Some 85.3% of the patients and 100% of the health-care personnel were satisfied with this project. However, 60 patients had withdrawn, the most common reason being the lack of confidence in the follow up at the local provincial hospital. In conclusion, it is possible to initiate a gynecologic oncology patients' surveillance network program and the initiation could reduce the problems associated with and the cost the patients incurred as they journeyed to the tertiary care hospital.

Preface for the Special Issue on Computational Intelligence Technologies Meets Medical informatics

Chi-Chang Chang,Chi-Jie Lu,Chalong Cheewarkriangkrai 한국정보과학회 2017 Journal of Computing Science and Engineering Vol.11 No.4

Treatment outcomes of high-dose chemotherapy plus stem cell rescue in high-risk neuroblastoma patients in Thailand

Suwannaying Kunanya,Techavichit Piti,Komvilaisak Patcharee,Laoaroon Napat,Narkbunnam Nattee,Sanpakit Kleebsabai,Chiengthong Kanhatai,Chotsampancharoen Thirachit,Sathitsamitphong Lalita,Santong Chalong 대한소아청소년과학회 2022 Clinical and Experimental Pediatrics (CEP) Vol.65 No.9

Background: In 2013, the Thai Pediatric Oncology Group (ThaiPOG) introduced a national protocol in which high-dose chemotherapy plus stem cell rescue is performed without immunotherapy.Methods: This study aimed to elucidate the outcomes of high-risk neuroblastoma (HR-NB) patients treated with the ThaiPOG protocol. This retrospective cohort review included 48 patients (30 males, 18 females) with a median age of 3 years (range, 8 months to 18 years) who were treated at 5 ThaiPOG treatment centers in Thailand in 2000–2018.Results: Eight of the 48 patients showed MYCN amplification. Twenty-three patients (48%) received 131I-meta-iodobenzylguanidine prior to high-dose chemotherapy and stem cell rescue. The majority of patients achieved a complete or very good response prior to consolidation treatment. The 5-year overall survival (OS) and event-free survival (EFS) rates were 45.1% and 40.4%, respectively. Patients aged >2 years had a nonsignificantly higher mortality risk (hazard ratio [HR], 2.66; 95% confidence interval [CI], 0.92–7.68; P=0.07). The MYCN amplification group had lower OS and EFS rates than the MYCN nonamplification group, but the difference was not statistically significant (45% OS and 37.5% EFS vs. 33.3% OS and 16.6% EFS; P=0.67 and P=0.67, respectively). Cis-retinoic acid treatment for 12 months was a strong prognostic factor that could reduce mortality rates among HR-NB patients (HR, 0.27; 95% CI, 0.09–0.785; P=0.01).Conclusion: High-dose chemotherapy plus stem cell rescue followed by cis-retinoic acid for 12 months was well tolerated and could improve the survival rates of patients with HR-NB.