Thai cancer journal

Efficacy of Fulvestrant in Metastatic HR+, HER2-low Breast Cancer : An Observational Retrospective Study

2024-09-11T09:07:05+07:00

Recently, there is a new type of breast cancer called HER2-low subtype. The biology and prognosis of this subtype of breast cancer is not well established. The results of previous studies have been inconsistent. This is the first origin article compare the difference in the effectiveness of fulvestrant between HER2-negative and HER2-low breast cancer groups. by retrospective study by collecting data on hormone-positive metastatic breast cancer patients who used fulvestrant at the National Cancer Institute from December 18, 2018 to June 20, 2024. We compared efficacy between HER2-negative versus HER2-low groups. The primary end point was Progression Free Survival (PFS). Survival was analyzed using the Kaplan–Meier (KM) method to compare the differences in survival curves between the 2 population groups. The statistical tests used were log-rank test and multivariable Cox regression modeling. results : A total of 32 patients were included, of which 11 patients (34%) were in the HER2-negative group and 21 patients (66%) were in the HER2-low group. The median PFS in the HER2-negative group was 6.4 months (95% CI 1.16-11.67 months), while the median PFS in the HER2-low group was 9.2 months (95% CI 4.63-12.60 months). P = 0.0863, which was not statistically significant. However, when multivariate analysis was used to exclude other factors that might affect the median PFS, patients in the HER2-low group had a significantly better median PFS than the HER2-negative group (hazard ratio [HR], 0.34; 95%CI, 0.13-0.88; P = .026). The study result showed that metastatic breast cancer patients who used fulvestrant, the HER2-low group tended to have a longer median PFS than the HER2-negative group. This study will help us better understand the biology of HER2-low breast cancer and select the most appropriate medication for treating patients. However, further studies with a larger population are needed to make more accurate conclusions.

Evaluation of the integrative medical cannabis clinic for cancer patients at National Cancer Institute

2024-09-17T15:28:44+07:00

This evaluation research aimed to evaluate the success of the integrative medical cannabis clinic at National Cancer Institute. The evaluation model used Stufflebeam’s CIPP Model framed within context, input, process and product. The population in this study included 3 groups are: 3 hospital administrators, 13 health care staffs who work at cannabis clinic and 104 cancer patients who receiving medical cannabis. The instruments for data collection consisted of 4 set of questionnaires: 1) Opinion about the overall goals or mission 2) Resources about strategies for implementation including structure, system and staff 3) The cancer patient’ satisfaction with the service of clinic 4) Edmonton Symptom Assessment Scale (ESAS). The content validity of questionnaires at the number 1-3 was measured by item-objective congruence index (IOC) yielding a value of 0.73, 0.81 and 0.78 respectively. Quantitative data were analyzed using descriptive statistics, Wilcoxon signed-rank test and qualitative data were analyzed using content analysis. Data were collected during 1 April 2021 to 31 October 2022. The results indicated that for context, the hospital administrators indicated the integrative medical cannabis clinic at NCI was more correspond, especially improving knowledge in cancer care. For input, most of health care staffs gave its appropriateness at high level of structure, system and staff. For process, the satisfaction of cancer patients toward the service of medical cannabis clinic was at a high level. For outcome, after medical cannabis treatment, cancer patients had significantly lower mean scores of pain, insomnia and anxiety levels compared before (P<0.001, P<0.001 and P<0.05, respectively). Side effects were reported by 24.8% of patients, with dry-mouth. The integrative medical cannabis clinic can improve access to complementary treatment option in patients with cancer. Medicinal cannabis can safely relieve cancer symptoms.

Survival of Thai Metastasis Cholangiocarcinoma Patients Treated with Chemotherapy, Targeted Therapy or Immunotherapy

2024-09-17T15:09:21+07:00

Cholangiocarcinoma is a type of cancer which incidence and mortality worldwide are increasing every year. The world’s highest incidence of bile duct cancer is found in Thailand. Chemotherapy is the primary treatment choice at the moment. The first line treatment is the cisplatin/gemcitabine combination. Additionally, targeted therapy may be used. However, there is a lack of information regarding the efficacy and safety of chemotherapy, targeted therapy or immunotherapy in Thai patients with advanced cholangiocarcinoma. The purpose of the research was to study the effectiveness and safety of using chemotherapy and/or targeted drugs in the treatment of advanced cholangiocarcinoma in Thai patients. This is a descriptive retrospective study that collected data from medical records of patients at King Chulalongkorn Memorial Hospital, from January 1, 2015, to December 31, 2021. Sixty seven patients met the eligible criteria, most patients were male (62.69) with an average age of 63.07±9.30 years. For effectiveness, the median progression-free survival was 9 months (95% CI, 6.7-11.2), and the median overall survival was 14 months (95% CI, 11.0-16.9). Adverse events for cisplatin/gemcitabine were reported in 57 out of 59 patients, and the most common adverse events were nausea/vomiting in 57 cases (99.6, constipation in 39 cases (66.1%), and diarrhea in 33 cases (55.9%). The median overall survival of cholangiocarcinoma patients receiving chemotherapy and/or targeted therapy was higher when compared to previous studies. The median progression-free survival was comparable. However, Thai patients experienced more adverse events.

Patients with Colorectal Cancer and Anastomosis leakage After Surgery: Cases Report

2024-09-17T14:15:44+07:00

This report presents a study of patients who have undergone surgery for colorectal cancer and experienced anastomosis leakage. This study aims to analyze the health issues these patients face and provide guidelines for nursing care and evaluate of patients with colorectal cancer and anastomosis leakage following surgery. Method out of the seven colorectal cancer patients who had postoperative anastomosis leakage between 2020-2022, only four were selected based on specific criteria. These four patients were chosen for further analysis or treatment. Result after surgery, the possibility of joint leaks depends on several patient factors, including age, gender, malnutrition, and a history of smoking or drinking. Additionally, factors such as lengthy surgery time and blood loss during surgery cannot be altered. Nonetheless, early evaluation is crucial to prevent severe complications.

Nursing Care of Patients with Chemotherapy Extravasation

2024-09-16T14:39:13+07:00

Chemotherapy is a type of cancer treatment that uses chemicals to kill cancer cells throughout the body. The major complication of intravenous chemotherapy administration is the extravasation of chemotherapy into the surrounding tissues where the chemotherapy drugs were administered. Extravasation can cause pain, inflammation, tissue damage and necrosis. The severity of tissue injury is dependent on the type and concentrations of chemotherapy drugs causing the patient to be admitted to the hospital for a longer period of time and increase medical expenses. Therefore, nurses play an important role in the assessment, prevention and nursing management for chemotherapy extravasation. Nurses need to have knowledge, skills and experience in caring for patients. The objective of this article is a guideline for nursing care and management of chemotherapy for the safe administration of chemotherapy to patients.

Comprehensive Strategies to Mitigate PM 2.5-Induced Lung Cancer and Address Public Health Challenges

2024-09-16T09:04:16+07:00

Particulate matter (PM2.5) pollution poses a significant global health challenge, linked to adverse respiratory outcomes and increased lung cancer mortality. Although researchers widely acknowledge this association, they have limited understanding of how PM2.5 concentration and socioeconomic factors influence the spatial dynamics of lung cancer incidence. Research in eastern China and Brazil highlights the correlation between PM2.5 exposure, education levels and heightened cancer mortality risk. However, clear strategies to prevent lung cancer caused by PM2.5 are still lacking and require a thorough synthesis of evidence. Effective management and prevention of PM2.5-induced lung cancer require a holistic approach, encompassing health education, personalized symptom management, regular monitoring, smoking cessation support, environmental modifications, comprehensive care coordination and public health advocacy. By implementing these evidence-based strategies, healthcare providers can mitigate the adverse health effects of PM2.5 pollution and promote respiratory health globally. In conclusion, addressing PM2.5 pollution and its association with lung cancer mortality demands a multifaceted approach, emphasizing collaboration and evidence-based interventions to improve public health outcomes.