Thai cancer journal

Melanoma in situ on nose : A case report

Arunee Kovitpisitsakul — Thu, 13 Jul 2023 00:00:00 +0700

A 59-years-old woman, who was also an accountant. The patient had a pigmented lesion present on her tip of nose for ten years then the lesion appeared larger. She had been following with dermatologist. Superficial shave biopsy was done and pathological report of part of melanoma in situ, at least. The dermatologist made a cancer hospital referral. Full thickness incisional biopsy was done and pathological report of basal hyperpigmentation and scattered basal melanophages. The lesion was excised with a 7 mm. margin and pathological report of hyperpigmentation of basal keratinocytes and no abnormal melanocytic proliferation. Finally, pathological diagnosis after wide excision revealed melanoma in situ. The patient has not been recurred after 2 years of treatment

Anesthesia in patient undergoing whole lung lavage : A case report

Worapat Pancharoen — Thu, 13 Jul 2023 00:00:00 +0700

Pulmonary alveolar proteinosis (PAP) is a rare lung diseases in which there is abnormal accumulation of lung surfactant in alveoli leading to compromised gas exchange. A 75-year-old woman was diagnosed with PAP and planned for whole lung lavage under general anesthesia with limitations of experience and some anesthetic equipments. We described a safe perioperative management included good teamwork with the respiratory physician, preoxygenation, complete lung isolation, one lung ventilation with positive end-expiratory pressure, cautious positioning, closed ventilatory monitoring and temporary postoperative mechanical ventilation

Overall survivals of Thai metastatic triple negative breast cancer patients

Phetcharat Thongdusri, Chidchanok Rungruang, Nutthada Areepium — Tue, 20 Jun 2023 00:00:00 +0700

Triple negative breast cancer (TNBC) is poor prognosis type of breast cancer, especially in patients with metastatic diseases. The treatment options for TNBC are quite limited and overall survival (OS) of metastatic TNBC was shorter compare to other types of breast cancer. There are restricted information regarding to OS of metastatic TNBC in Thais. This study was aimed for finding information about OS and factors related with OS in Thai metastatic TNBC patients. We retrospectively reviewed metastatic TNBC patients’chart in one of university hospital in Bangkok. Relevant information of metastatic TNBC patients who were at least 18 years old who received treatments for their cancer during 1 January to 31 December 2012 to 2016 were collected and analyzed. There were 127 patients included in the study. The average age was 54+13.3 years old, with 78% under 65 years old. The most common metastatic sites were bone and connective tissue, which found 66.1%, followed by lungs, liver at 63.8% and 29.1 %, respectively. Most of patients (38.6%) had 2 metastatic sites and around 64.6% received anthracycline-based regimen as the first line treatment. The second most common chemotherapy for the first line treatment were taxane (19.7%). The median OS in this study was 21.9 months. The survival rate at 1 year, 3 years and 5 years were 45.7%, 10.2% and 3.9 % respectively. The factors which found to associated with OS were metastatic sites. Patients with liver, lungs, or bone metastasis had significantly shorter OS. Moreover, older patients (>65 years old) tended to have longer OS (16.7 vs 13.2 months, P = 0.081). Patients treated with taxane as the first line chemotherapy had longer OS with not statistically significance. We conclude that the factors seem to impact overall survival of Thai metastatic TNBC were metastatic sites and patients’age.

Antibiogram in cancer patients

Wed, 28 Jun 2023 00:00:00 +0700

Antibiogram is an important data regarding to antimicrobial selection during microbial culture procedure (empirical therapy). This data can be use to monitoring trends of antimicrobial resistance in hospital. The objective of this retrospective study is to monitoring trend of antimicrobial resistance among bacterial pathogens in cancer patients at The National Cancer Institute during 2019 - 2021. Data were analyzed by descriptive statistical method which are 95% Confidence interval , Odds ratio and Chi-square test. The data of culture and sensitivity test in microbiology laboratory which specimen were urine, sputum, pus, body fluid and blood culture found 2,100 isolations. Top 5 of common isolations were E. coli (23%), P. aeruginosa (12%) followed by K. pneumoniae (11%) Enterococcus spp.(7%) and Acinetobacter spp (4%). E. coli were susceptible to carbapenem, TZP and AN mostly 90% and trend of antimicrobial sensitivity to AMC and GM were increase significantly (OR; 1.77, 95%CI; 1.10 - 2.87, P=0.019) and (OR; 2.61 95%CI; 1.59– 4.28, P< 0.001) respectively. P. aeruginosa were susceptible to CT mostly 99% and trend of antimicrobial to IPM were increase significantly (OR; 2.42 95%CI; 1.23 - 4.75, P=0.010). K. pneumoniae were susceptible to AN mostly 90% and trend of antimicrobial resistant significant to CAZ, CTX, CRO, FEP, DOR, IPM, MEM, CIP and SXT were decrease (OR; 0.3 - 0.4, 95%CI; 0.23-0.91, 0.24-0.94, 0.20-0.80, 0.21-0.86, 0.12-0.98, 0.21-1.24,0.21-1.24,0.23-0.89, 0.23 - 0.91 respectively, P<0.05). Enterococcus spp were susceptible to VA mostly 88% trend of antimicrobial to CIP and E were increase significantly (OR; 3.909, 95%CI; 1.20 - 12.76, P= 0.024) and (OR; 4.929, 95%CI; 1.01 - 24.126, P= 0.049) respectively. In 2021 sensitivity trend to P and AMP decrease (OR;0.385, 95%CI; 0.15 – 0.97, P= 0.042) and (OR;0.309, 95%CI; 0.12-0.81, P= 0.017) respectively. Acinetobacter spp. were suscep- tible to CT mostly 95% and trend of antimicrobial sensitivity to DOR in 2020 - 2021 decrease significantly (OR;0.257, 95%CI; 0.07 - 0.89, P= 0.033) and (OR;0.148, 95%CI; 0.04 – 0.60, P= 0.008) respectively.ฤ

Effect of Surgical Mask in Head and Neck Cancer on Setup Error in Radiotherapy

Wannapa Rongmuang — Thu, 13 Jul 2023 00:00:00 +0700

Background: With the widespread prevalence of Corona Virus Disease 2019 (COVID-19), cancer patients are suggested to wear a surgical mask during radiation to prevent disease for both patients and staff. Objective: The purpose of this study was to compare the setup error and KV image times taken for pre-radiation positioning for patients with head and neck irradiation between patients who wore a surgical mask plus a thermoplastic mask and those who did not a surgical mask was applied to a thermoplastic mask. Method: The setup errors in 3 directions of Vrt., Lng. and Lat. and KV-image times data were collected from 216 head and neck cancer patients with a surgical mask group with a thermoplastic mask and the patients without a surgical mask group with a thermoplastic mask who received radiation treatment with intensity modulated-radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) from varian Clinac IX and Vital beam in Radiotherapy department, Lopburi cancer center hospital during January 2020 to October 2021. The setup errors and KV-image times of patients were calculated. A t-test was performed to detect whether it was statistically significant. Results: The average of KV-image times to positioning setup before radiation therapy was longer than the patients without a surgical mask group with thermo plastic mask. There was no statistical difference (P=0.066). Average of setup errors in Vrt., Lng.and Lat.for patients irradiated with head and neck cancer were 0.19+0.09 cm.,0.23+0.11 cm. and 0.18+0.09 cm., respectively, in the group of patients wearing a surgical mask with thermoplastic mask and were 0.18+0.08 cm., 0.20+0.08 cm. And 0.16+0.66cm., respectively, in the group of patients who without a surgical mask with thermoplastic mask.A statistical comparison revealed that the pre-radiation positioning setup error for head and neck cancer patients with surgical mask and thermoplastic mask was not used with thermoplastic mask, most were not statistically different (P=0.617, 0.058) in Lng. and Lat., respectively, except in Vrt., they were statistically different (P=0.024). The PTV Margins in Vrt., Lng. and Lat. were 0.35, 0.40 and 0.28 cm., respectively, in the group of patients wearing a surgical mask with thermoplastic mask and were 0.30, 0.31 and 0.34 cm. respectively, in the group of patients who without a surgical mask with thermoplastic mask.Conclusion: The results of this study show that the addition of surgical mask and thermoplastic mask in patients irradiated with head and neck cancer affects the pre-radiation positioning error. The objectives of this research were to study for a guideline the prevention and control of the coronavirus disease 2019 (COVID-19).