Thai cancer journal

Efficacy of improvement procurement management in Targeted therapy National Cancer Institute of Thailand October 2016 - June 2019

Waranya Krongkaew — Fri, 29 Apr 2022 00:00:00 +0700

The targeted therapy is the highest cost group of drug purchasing 22.92% (29.49 MBaht) from use Activity Based Costing (ABC) analysis with drug procurement data in 2017.The objective of this research was to compare the change in Key Performance indicators (KPIs) of drug procurement and inventory management after the policy has been applied. This is the Descriptive study designed using purchasing drug data at the National Cancer Institute of Thailand during the fiscal year 2017-2019. One Way ANOVA was used to describe the efficacy after the policies have been applied. After the policies have been applied in the fiscal year 2018-2019 overall cost remaining of targeted therapy, purchasing/dispensing cost, and inventory ratio have been decreased significantly from the baseline year 2017. The policies have been applied to the procurement of targeted therapy groups and the announcement of drug reference prices from the National Drug System Development committee. The cost of drug purchasing from Pharmaceutical companies was decreased over the fiscal year 2017-2019. In addition, the development of drug inventory in the hospital should be implemented for other high purchasing groups such as chemotherapy or Non-essential hepatitis groups. Furthermore, the drug selection policy should consider the extended expiration date. This policy will save the hospital’s budget and staff for solving this problem.

Retrospective study of human papilloma virus infection in Thailand: A Systematic Review

Thainsang Phansri, krittika Boonmark, Jarunya Ngamkham — Fri, 29 Apr 2022 00:00:00 +0700

This study aimed to estimate the prevalence and Human papillomavirus (HPV) genotypes detected in pre-cancerous and cancer cells/tissues in the Thai population undergoing treatment at clinics, hospitals, or university hospitals in Thailand. From 1989-to 2020, with 64,323 cases, the prevalence of HPV in the Thai population is 40.47%. Percent of HPV in the cells/tissues of the cervix, vulva and vaginal, ovaries, breast, head and neck, Anal, and penis about 44.79, 46.54, 27.44, 3.57, 8.89, 50.99 and 84.09, respectively.The most common HPV types in Thailand were HPV16, followed by HPV18, HPV52, HPV58, HPV31, and HPV39, respectively. A retrospective study following HPV infection in the three periods every ten years during 1989-2018; In 2009-2018; the prevalence of HPV infection in Cell/Tissues of Cervical, Vulva &Vagina, Ovary, Breast, Head and Neck, Anus, and Penile was 31.22 %. The most common genotypes were HPV16, HPV18, HPV52, HPV58, HPV51, and HPV72. From 1999-to 2008, the prevalence of HPV infection was 56.35 %, and the most common genotypes were HPV16, followed by HPV18,HPV52, HPV31, HPV72, and HPV58, respectively. From 1989 to 1998, the prevalence of HPV infection was 40.77%, and the most common genotypes were HPV16, followed by HPV18, HPV33, HPV31, HPV39 and HPV35, respectively. However, HPV52 and HPV58 were found to have a higher prevalence of HPV from 1999 to 2018. However, a database can be used to vaccine guidelines in the country and reduce the risk of cancer-related HPV infection in the Thai population.

Patient-Specific Quality Assurance of Volumetric Modulated Arc Therapy (VMAT): Amorphous Silicon Type Compared with Diode 3D Array Phantom

Fri, 29 Apr 2022 00:00:00 +0700

Purpose: To compare the results of amorphous silicon pre-treatment QA type and diode 3D array phantom for delivery pre-treatment quality assurance of head and neck and prostate Volumetric Modulated Arc Therapy (VMAT) with various gamma criteria evaluation. Materials and Methods: The Varian amorphous silicon (aSi) Portal Imaging Devices and its software was used for portal dosimetry system (PDs). A diode 3D array cylindrical phantom (ArcCheck) was used for the studies. Eclipse-TPS with VMAT treatment planning and portal dose prediction software was used for planar dose calculations. The 30 VMAT patient plans of head and neck site and prostate site from the radiotherapy department, Lopburi Cancer Hospital, were created for verification plan on two different QA system PDs and ArcCheck.Thirty patients' treatment plans, each with 2 or 3 arcs, were delivered on the EPIDs of the Varian Linac iX (PDs) and ArcCheck, respectively. The measured planar dose matrices were compared with the planned dose and analysed using global gamma evaluation with 3%/3mm, 3%/2mm, and 2%/2mm. Results: All head and neck plans measured by PDs and ArcCheck had the average passing rate using 3%/3mm of 97.91%±0.93 and 97.81%±0.81, respecttively. When using 3%/2mm and 2%/2mm, the average passing rate measured by PD was 95.65%±0.83 and 76.48±2.55, while the results measured by ArcCheck were 96.63% ± 0.77 and 79.77±2, respectively. All prostate plans measured by PDs and ArcCheck using 3%/3 mm criteria have the average gamma passing rate of 99.10±0.86 and 99.56±0.47, respectively. The average gamma passing rate when using 3%/2mm was 98.11%±1.02 for PD and 98.67% ± 0.90 for ArcCheck, while the passing rate decreased to 97.05%±0.82 for PD and 97.46%±0.68 for ArcCheck when using 2%/2mm.The prostate cases illustrated no significant difference for all gamma criteria with a P-value greater than 0.05. Conclusion: The PDs system and ArcCheck can be considered QA tools for the verification plan of VMAT. The results of planning verification were comparable for the criteria of 3%/3mm and 3%/2mm.

Ultrasound guided needle mark to trachea for unidentified tracheal landmark tracheostomy case : A case series

Danupat Ratanavaraha — Fri, 29 Apr 2022 00:00:00 +0700

Generally, tracheostomy was a simple procedure for the otorhinolaryngologist, head and neck surgeon. Nevertheless, sometimes, the patient neck area, especially in head and neck cancer patients, might involve a large tumor and/or fibrosis that entirely precludes the surgical landmark of the trachea.Therefore, the author invented and developed the ultrasound- guided needle mark to the trachea for unidentified tracheal landmark technique to solve those problems. The method was simple and effective. However, there were limitations, such as when the procedure was done under local anesthesia, there was patient movement. Moreover, the surgeon's ultrasound-guided procedure skill was also a critical success factor. Therefore, we need to improve the surgical technique, tools, and surgeon skills to make this technique more effective and widely used.

The role of PTEN on breast cancer

Adisorn Jedpiyawongse, Anantnuch Sakapiboonnan, Phuwasit Wararatrueangwut — Fri, 29 Apr 2022 00:00:00 +0700

Phosphatase and tensin homolog on chromosome 10 (PTEN) are tumor suppressors with phosphatase activity against phospholipids and proteins. The tumor suppressor activity of PTEN is attributed to its lipid phosphatase activity against PI (3,4,5) P3 (PIP3). The PIP3 is the phospholipid product of phosphoinositide-3-kinase (PI3K), the crucial signal transduction pathway.The PTEN is the essential negative regulator of PI3K and AKT pathway.The PTEN dephosphorylates PIP3 to PIP2, PTEN reverses the action of PI3K. PTEN plays significant roles in regulating biological processes, including growth, adhesion, migration, invasion, apoptosis, cancer, and other diseases. Therefore, level and function of PTEN are tightly regulated at transcription, post-transcription, and post-translation levels. Protein-protein interactions and their locations also regulate PTEN. Besides a tumor suppressor, PTEN is also a guardian of the genome frequently mutated and deleted in human cancer, including breast cancer. PTEN deficiency disrupts the fundamental processes of genetic transmission. Cells lacking PTEN have cell cycle deregulation and cell fate reprogramming. Breast cancer patients with PTEN loss had significantly poorer responses to trastuzumab-base therapy than those with normal PTEN. Thus PTEN loss is a powerful predictor of trastuzumab resistance. In addition, that PI3K-targeting therapies rescued PTEN loss-induced trastuzumab resistance. The understanding of the biological role of PTEN, the PTEN expression and activity are regulated, and PTEN dysregulation in human cancer, including breast cancer, could provide new strategies for cancer therapies.