Publications by authors named "Wimrak Onchan"
Aims: To examine the information needs of breast cancer patients during the initial phase of treatment and to analyse the factors that influenced these needs.
Background: Providing comprehensive and timely information during early breast cancer treatment is crucial for informed decision-making and effective coping. Healthcare providers must address these needs to enhance patient support and improve outcomes.
Purpose: Hydrogen (H) gas inhalation might alleviate acute radiotherapy toxicities by scavenging free radicals produced by ionizing radiation and anti-inflammatory properties. This study aimed to investigate the feasibility and safety of H gas inhalation during concurrent chemoradiotherapy (CCRT) in patients with locally advanced head and neck cancer (LAHNC).
Patients And Methods: We designed a pilot prospective study combining CCRT with aerosol inhalation of H gas.
Article Synopsis
- The study examined the relationship between scalp radiation doses and alopecia in patients undergoing conventional treatment for primary brain tumors.
- 48 patients were analyzed, revealing that higher radiation doses significantly correlated with both transient and permanent hair loss, with specific thresholds identified for each type of alopecia.
- The results suggest that the dose to 2% of scalp volume (D2) can serve as a predictive measure for the occurrence and severity of hair loss following radiation therapy.
Objective: This retrospective study evaluated the preliminary outcomes of image-guided vaginal brachytherapy (IG-VBT) in the adjuvant treatment of high intermediate risk endometrial cancer.
Materials And Methods: Data were collected from 48 patients who underwent adjuvant IG-VBT between 2019 and 2022 at the Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University. The vaginal cuff clinical target volume (CTV-VC) is composed of a 4-mm-thick band around vaginal cylinder at the upper 3 cm of the vaginal cuff.
Objective: We retrospectively analyzed the efficacy, focusing on overall survival (OS) and the patterns of failure, along with the toxicities of adjuvant radiotherapy (RT) in endometrial cancer patients.
Methods: Two-hundred and nineteen patients with endometrial cancer patients who received adjuvant radiotherapy ± adjuvant chemotherapy (ACT) from January 2014 to December 2018 were investigated for overall survival (OS), local recurrence-free survival rate (LRFS), regional recurrence-free survival rate (RRFS), and distant metastasis-free survival rate (DMFS).
Result: Two-hundred and fourteen patients were evaluated.
Article Synopsis
- The study tracked 12 years of a quality assurance program in radiation oncology to enhance patient safety and reduce treatment errors.
- The Quality Assurance Program (QUAPRO) included a three-step process to identify near-misses during the treatment phases and transitioned to an electronic system by 2017 for better tracking.
- Results showed that while the rate of near misses initially fluctuated, the integration of electronic records improved detection, ultimately leading to a significant decrease in near misses due to enhancements in the workflow.
Purpose: We 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).
Methods: The dose of WBI and RNI was 42.4 Gy in 16 fractions.
Stereotactic radiosurgery for limited brain metastasis using three different techniques: helical tomotherapy, volumetric modulated arc therapy, and cone-based LINAC radiosurgery.
Radiat Oncol J
December 2022
Article Synopsis
- The study compares three techniques for delivering radiation therapy (helical tomotherapy, volumetric modulated arc therapy, and cone-based radiosurgery) in treating brain metastasis using stereotactic radiosurgery (SRS).
- Researchers analyzed various dosimetric parameters, including conformity and homogeneity indices, on data from 21 patients with brain lesions.
- The findings indicated that while VMAT excelled in treatment efficiency and dosimetry for multiple lesions, cone-based radiosurgery showed the best homogeneity, and helical tomotherapy was less effective for multiple lesions.
Article Synopsis
- Image-based brachytherapy can be done in the same room (IRBT) or require moving patients to a different room (ORBT) for treatment, and this study compares the two methods.
- The researchers looked at how doses and sizes of important organs changed between planning and treatment for both methods and found no big differences in the effects on organs like the bladder and rectum.
- They concluded that ORBT can be used regularly in busy hospitals because it works just as well as IRBT for treatment.
The objective of our study was to evaluate the survival outcome of cervical cancer patients treated using image-guided brachytherapy (IGBT). From 2008 to 2018, 341 patients with cervical cancer were treated by radical radiotherapy. IGBT (by computed tomography [CT] or transabdominal ultrasound [TAUS]) was used to treat all of these patients.
View Article and Find Full Text PDFBackground: Breast cancer incidence in Northern Thailand has shown a continuous increase since records began in 1983. In 2002 the urgency of the situation prompted Maharaj Nakorn Chiang Mai Hospital to initiate the Suandok Breast Cancer Network (SBCN).
Methods: The SBCN is a not-for-profit organization in the university hospital which serves as a training and education center and provides highly specialized medical care for patients in Chiang Mai and in 5 provinces of northern Thailand, with the key mission of improving breast cancer care.
Purpose: This study aimed to evaluate retrospectively the treatment results when using various image-guided adaptive brachytherapy treatments for cervical cancer treated by radical radiotherapy.
Methods And Materials: From 2014 to 2017, 188 patients with cervical carcinoma were treated by whole pelvic radiotherapy plus four fractions of image-guided brachytherapy. Eight patients were excluded because of missing data.
Two-year outcome of concurrent chemoradiation with carboplatin with or without adjuvant carboplatin/fluorouracil in nasopharyngeal cancer: A multicenter randomized trial.
Curr Probl Cancer
February 2021
Background: According to the noninferiority result of chemoradiation with carboplatin in our previous nasopharyngeal carcinoma (NPC) study along with the inconclusive data on the efficacy of adjuvant chemotherapy (AC) following concurrent chemoradiotherapy (CCRT), we designed to assess the role of adjuvant carboplatin/fluorouracil following CCRT with carboplatin in locoregionally advanced NPC.
Materials And Methods: A multicenter randomized trial was conducted at 5 cancer centers in Thailand. We enrolled in stage T2N0M0-T4N2M0 (American Joint Cancer Committee 7th edition) WHO Type 2 NPC patients.
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.
Article Synopsis
- The study assessed long-term outcomes and late toxicity of two types of postmastectomy radiotherapy: conventional fractionated (CF) and hypofractionated (HF) treatment.
- A patient cohort of 1640 breast cancer cases was tracked over a median follow-up of about 72 months, finding no significant differences in locoregional recurrence-free survival, disease-free survival, or overall survival between the two treatment types.
- While HF-PMRT showed higher late skin and subcutaneous toxicity, it resulted in lower incidents of lung and brachial plexus toxicity compared to CF-PMRT, indicating HF-PMRT's feasibility with similar effectiveness and some varying side effects.
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.
View Article and Find Full Text PDFWe 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.
View Article and Find Full Text PDFBackground: 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.
Article Synopsis
- The study evaluated the effectiveness and safety of trans-abdominal ultrasound (TAUS)-guided brachytherapy in treating cervical cancer over intermediate-term follow-up.
- Ninety-two patients received a combination of whole pelvic radiotherapy and TAUS-guided brachytherapy, with positive outcomes including 84.8% pelvic control and 75% disease-free survival rates at a median follow-up of 41.2 months.
- The results indicate that this treatment approach is feasible, providing good tumor control and acceptable toxicity levels, with only a small number of patients experiencing significant side effects.
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.
Background: To report the results of combined chemoradiation (CCRT) with cisplatin versus carboplatin in locally advanced cervical carcinoma.
Methods: From 2009 to 2013, 255 patients with stage IIB-IVA cervical carcinoma, according to FIGO staging were prospectively assigned to be treated with pelvic radiotherapy followed by brachytherapy given concurrently with cisplatin or carboplatin in the treatment of locally advanced cervical cancer. Treatment outcomes and toxicitiy were evaluated.
We present a case of cervical cancer treated by concurrent chemoradiation. In radiation therapy part, the combination of the whole pelvic helical tomotherapy plus image-guided brachytherapy with megavoltage computed tomography of helical tomotherapy was performed. We propose this therapeutic approach could be considered in a curative setting in some problematic situation as our institution.
View Article and Find Full Text PDFArticle Synopsis
- The study assessed a two-phase adaptive intensity-modulated radiotherapy (IMRT) protocol for patients with locally advanced nasopharyngeal cancer to determine its dosimetric advantages.
- A total of 17 patients underwent a follow-up CT scan after initial treatment, allowing for a refined treatment plan that was compared to a non-adapted hybrid plan.
- Results showed that the adaptive plan significantly decreased radiation exposure to critical organs while enhancing dose delivery to the cancerous areas, leading to improved patient outcomes.
Purpose: To report the preliminary results of transabdominal ultrasound (TAUS)-guided brachytherapy (BT) in cervical cancer.
Methods And Materials: Twenty-nine patients with cervical cancer Stage IB-IVA according to The International Federation of Gynecology and Obstetrics staging were treated by radical radiotherapy from February 2012 to December 2012. Treatment was composed of WPRT to 50 Gy in 25 fractions and central shielding after 44 Gy in combination with TAUS-guided BT to optimize the total dose (equivalent dose of 2 Gy [EQD2]) to the minimal dose at cervical points (in EQD2 concepts) defined by TAUS ≥80 Gy while maintaining low doses to the ICRU report no.
The association of rectal equivalent dose in 2 Gy fractions (EQD2) to late rectal toxicity in locally advanced cervical cancer patients who were evaluated by rectosigmoidoscopy in Faculty of Medicine, Chiang Mai University.
Radiat Oncol J
June 2014
Purpose: To evaluate association between equivalent dose in 2 Gy (EQD2) to rectal point dose and gastrointestinal toxicity from whole pelvic radiotherapy (WPRT) and intracavitary brachytherapy (ICBT) in cervical cancer patients who were evaluated by rectosigmoidoscopy in Faculty of Medicine, Chiang Mai University.
Materials And Methods: Retrospective study was designed for the patients with locally advanced cervical cancer, treated by radical radiotherapy from 2004 to 2009 and were evaluated by rectosigmoidoscopy. The cumulative doses of WPRT and ICBT to the maximally rectal point were calculated to the EQD2 and evaluated the association of toxicities.