Comparative Outcome of Thai Pediatric Osteosarcoma Treated with Two Protocols: the Role of High-Dose Methotrexate (HDMTX) in a Single Institute Experience

Choeyprasert, Worawut,Pakakasama, Samart,Sirachainan, Nongnuch,Songdej, Duantida,Chuansumrit, Ampaiwan,Anurathapan, Usanarat,Hongeng, Suradej,Nartthanarung, Adisak Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.22

Background: High-dose methotrexate (HD-MTX) is recognized as an efficient component of therapy against pediatric osteosarcoma in combination with other drugs such as cisplatin (CDP), carboplatin (CBDCA), doxorubicin (ADM), etoposide (VP-16) and ifosfamide (IFO). Objectives: To demonstrate the feasibility and effectiveness of the HD-MTX/CDP/DOX/VP-16/IFO [MTX(+)] protocol comparable to CDP/ADM/CBDCA/IFO [MTX(-)] for treating childhood osteosarcoma at Ramathibodi Hospital (1999-2014). Materials and Methods: A retrospective analysis was conducted of osteosarcoma patients aged less than 18 years treated with two chemotherapeutic regimens between 1999 and 2014. A total of 45 patients received the MTX(-) and 21 the MTX(+) protocol. Results: Overall limb-salvage and amputation rate were 12.9% and 77.7%, respectively. Kaplan-Meier analysis results for 3-year disease free survival (DFS) and overall survival (OS) regardless of treatment regimens were $43.4{\pm}6.0%$ and $53.2{\pm}6.1%$ respectively. The 3-year DFS and OS were improved significantly with the MTX(+) protocol compared to MTX(-) protocol (p=0.010 and p=0.009, log rank test) [$69.8{\pm}10.5%$, $79.8{\pm}9.1%$ for MTX(+) and $31.1{\pm}6.9%$, $42.2{\pm}7.4%$ for MTX(-) protocol, respectively]. Patients with metastatic osteosarcoma treated with the MTX(+) protocol had statistically significant higher 3-year DFS and OS than those treated with the MTX(-) protocol ($66.7{\pm}13.6%$ and $15.0{\pm}8.0%$ for 3-year DFS, p=0.010, $73.3{\pm}13.2%$ and $20{\pm}8.9%$ for 3-year OS, p=0.006, respectively). The independent risk factors for having inferior 3-year DFS and OS were poor histological response (tumor necrosis <90%) and treatment with the MTX(-) protocol. The multivariate analysis identified only the treatment with the MTX(-) protocol as an independent predictor of inferior OS with a hazard ratio (HR) of 3.53 (95% confidence interval of 1.2-10.41, p=0.022). Conclusions: Our study demonstrated the tolerability, feasibility and efficacy of the HDMTX-based regimen improving the survival rate in pediatric osteosarcoma cases, in line with reports from developed countries.

Carboplatin and Doxorubicin in Treatment of Pediatric Osteosarcoma: A 9-year Single Institute Experience in the Northern Region of Thailand

Choeyprasert, Worawut,Natesirinilkul, Rungrote,Charoenkwan, Pimlak,Sittipreechacharn, Somjai Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.2

Background: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. Objective: To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. Method: A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. Results: Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were $20.2{\pm}7.7%$ and $47.1{\pm}9.5%$ respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis ($28.1{\pm}13%$, $63.1{\pm}12.3%$, respectively, p=0.202). On univariate analysis, age at diagnosis >14 years and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. Conclusions: In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.

[자료] 제2차세계대전 당시 죽음의 철도 한인포로감시원의 운명

워라웃 쑤완다릿(Worawut Suwannarit) 한국근현대사학회 2004 한국 근현대사 연구 Vol.30 No.-

Study of Multi-Walled Carbon Nanotube Synthesis Using Liquid Nitrogen and Post-Process Filtration

Nuttaphong Sornsuwit,Worawut Maaithong 한국정밀공학회 2008 International Journal of Precision Engineering and Vol.9 No.3

The study deals with the effects of parameters in the synthesis of carbon nanotubes in liquid nitrogen to find the most appropriate conditions such as electrical voltage and time that give carbon nanotubes with large volume and less proportion of impurity, which is a non-nanotubed carbon. The experiment employed the method of arcdischarge between graphite cathode and anode which are immersed in liquid nitrogen. The electrical DC current of 60A and 70A were applied with the time period ranging from 10 seconds to 25 seconds. It was found that the electrical current of 60A and 13 seconds arc-discharge time allowed the largest volume of carbon nanotubes generation. The longer time leads to more impurities around the carbon nanotubes. By the filtration of CNTs-suspended solution using 0.2 micrometers porous paper filter and the characterization using TEM. the carbon nanotubes synthesized in the study were approximately 25 layers multi-walled nanotubes with the average diameter of 18.2 nanometers.

Genetic Diversity of mtDNA D-loop Polymorphisms in Laotian Native Fowl Populations

Kawabe, K.,Worawut, R.,Taura, S.,Shimogiri, T.,Nishida, T.,Okamoto, S. Asian Australasian Association of Animal Productio 2014 Animal Bioscience Vol.27 No.1

Here, we studied the genetic diversity of native fowls in Laos by analyzing a mitochondrial DNA (mtDNA) sequence polymorphism. A 546-bp fragment of the mtDNA D-loop region was sequenced in 129 chickens from the areas of Vientiane, Luang Prabang and Pakse. In total, 29 haplotypes were identified and formed five clades. Haplotype diversity and nucleotide diversity of the native fowls in Laos were $0.85536{\pm}0.0172$ and $0.010158{\pm}0.005555$, respectively. Although the Laotian native fowls were distributed across five clades, most of them were clustered in two main clades (A and B), which were originated in China. The other haplotypes were contained in clades D, F, and I, which originated from continental southeast Asia. These results suggest that multiple maternal lineages were involved in the origin of domestic chicken in Laos. Moreover, there appear to be at least two maternal lineages, one from China and the other from the southeast Asian continent.

Study of Multi-Walled Carbon Nanotube Synthesis Using Liquid Nitrogen and Post-Process Filtration

Sornsuwit, Nuttaphong,Maaithong, Worawut Korean Society for Precision Engineering 2008 International Journal of Precision Engineering and Vol.9 No.3

The study deals with the effects of parameters in the synthesis of carbon nanotubes in liquid nitrogen to find the most appropriate conditions such as electrical voltage and time that give carbon nanotubes with large volume and less proportion of impurity, which is a non-nanotubed carbon. The experiment employed the method of arc-discharge between graphite cathode and anode which are immersed in liquid nitrogen. The electrical DC current of 60A and 70A were applied with the time period ranging from 10 seconds to 25 seconds. It was found that the electrical current of 60A and 13 seconds arc-discharge time allowed the largest volume of carbon nanotubes generation. The longer time leads to more impurities around the carbon nanotubes. By the filtration of CNTs-suspended solution using 0.2 micrometers porous paper filter and the characterization using TEM, the carbon nanotubes synthesized in the study were approximately 25 layers multi-walled nanotubes with the average diameter of 18.2 nanometers.

Blood Protein Polymorphisms of Native Fowls in Laos

Okamoto, S.,Tsunekawa, N.,Kawamoto, Y.,Worawut, R.,Kawabe, K.,Maeda, Y.,Nishida, T. Asian Australasian Association of Animal Productio 1999 Animal Bioscience Vol.12 No.7

Blood protein polymorphism of fowls in Laos was analyzed by electrophoresis. Blood samples were collected in the area of Viangchan, Louangphrabang and Pakxe. Out of 17 loci, polymorphism was detected at the following seven loci; ES-1, Amy-1, Akp-akp, Akp-2, Alb, Tf and Pas. The other ten loci; Amy-3, LDH, 6-PGD, PGM, PHI, To, MDH, Es-D, Hb-l, Hb-2 were noted to be monomorphic. The proportion of polymorphic loci $(P_{poly})$, the expected average heterozygosity per individual ($\bar{H}$), and the subdivision index $(G_{ST})$ of the native fowl in Laos was $0.412{\pm}0.123$, 0.106 and 0.026, respectively. Genetic distance between native fowls in Laos, Bangladesh, and Nepal was clustered in one group.

Incidences, Trends and Long Term Outcomes of Retinoblastoma in Three Cancer Registries, Thailand

Wongmas, Piyathida,Jetsrisuparb, Arunee,Komvilaisak, Patcharee,Suwanrungruang, Krittika,Choeyprasert, Worawut,Sriplung, Hutcha,Wiangnon, Surapon Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.16

Background: Retinoblastoma (RB) is rare, albeit the most common primary intraocular malignancy among children. To elucidate the true incidence, trend and survival, we studied incidences and trends of retinoblastoma in a large population with long-term follow-up using data from 3 population-based cancer registries. Objective: To describe the incidence, trends and survival of RB between 1990 and 2009 in Khon Kaen, Songkhla and Chiang Mai, Thailand. Materials and Methods: We sourced the data from the cancer registries in Khon Kaen, Songkhla and Chiang Mai on children with retinoblastoma, diagnosed between 1990 and 2009. Retinoblastoma was defined as per the International Classification of Disease for Oncology version 3 using the code 9510/3. Incidence was analyzed using the standard method with the criteria of the International Association of Cancer Registries. The Kaplan-Meier method was applied to calculate cumulative survival. Trends were calculated using the log rank test. Results: We identified 75 cases of children between 0 and 15 years of age diagnosed with RB (Khon Kaen 31, Chiang Mai 20, Songkhla 24). Males and females were equally affected. The most common age group was 0-4 years. The morphological verification of the disease was 90.7%. The respective ASR in Khon Kaen, Chiang Mai and Songkhla was 4.4, 4.0 and 4.6 per million; for which the overall ASR for all 3 areas was 4.3 per million. The respective trend in incidence was 4, 2.8, 5.8 and 5.4 during 1990-4, 1995-9, 2000-4 and 2005-9. Overall, incidence trended gradually upward by 2% annually. The respective survival rate in Khon Kaen, Chiang Mai and Songkhla was 50, 40 and 75% (differences not significantly different at p=0.14) and the overall survival for all centers was 60%. Conclusions: Over the last two decades, the incidence and overall survival of retinoblastoma has increased. The ASRs and survival in Thailand were less than those in resource-rich countries.