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Brain Metastases from Cholangiocarcinoma: a First Case Series in Thailand
Chindaprasirt, Jarin,Sookprasert, Aumkhae,Sawanyawisuth, Kittisak,Limpawattana, Panita,Tiamkao, Somsak Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5
Background: Brain metastasis from cholangiocarcinoma (CCA) is a rare but fatal event. To the best of our knowledge, only few cases have been reported. Herein, we report the incident rate and a first case series of brain metastases from CCA. Methods: Between January 2006 and December 2010 5,164 patients were treated at Srinagarind hospital, Khon Kaen University; of those, 8 patients developed brain metastasis. Here we reviewed clinical data and survival times. Results: The incident rate of brain metastases from CCA was 0.15%. The median age of the patients was 60 years. Tumor subtypes were intrahepatic in 6 and hilar in 2 patients. All suffered from symptoms related to brain metastasis. Three patients were treated with whole-brain radiation therapy (WBRT), one of whom also underwent surgery. The median survival after the diagnosis of brain metastasis was 9.5 weeks (1-28 weeks). The longest survival observed in a patient in RPA class I with two brain lesions and received WBRT. Conclusion: This is a first case series of brain metastases from CCA with the incident rate of 0.15%. It is rare and associated with short survival time.
Burdens among Caregivers of Older Adults with Advanced Cancer and Risk Factors
Chindaprasirt, Jarin,Limpawattana, Panita,Pakkaratho, Pornvaree,Wirasorn, Kosin,Sookprasert, Aumkhae,Kongbunkiat, Kannikar,Sawanyawisuth, Kittisak Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.4
Family caregivers of older cancer patients face many challenges in managing illness. The burden impacts physical, emotional, spiritual, and social health. The objective of this study was to identify burden among caregivers of older patients with advanced cancer, and associated factors. Materials and Methods: Caregivers of older cancer patients were randomly interviewed from March-September 2012. Information on baseline characteristics and caregiver burden using the Zarit Burden Inventory (ZBI) was collected. Descriptive statistics were used to analyze baseline data, with univariate and multiple linear regression to analyze factors associated with higher burden. Results: One hundred and fifty participants were assessed. The mean ZBI was $19.2{\pm}12.9$ (95%CI, 17.1, 21.2). Two-thirds of caregivers reported no burden (63%) and the main impact variable on ZBI was guilt. High burdens were associated with single caregiver, relationship with the patient as siblings, presence of migraines, and cancer types of the patients. Conclusions: Caregiver burden of Thai cancer patients is low. This unexpected small number could be the result of the socio-cultural viewpoint. Assessment of caregivers and focusing on related factors should be incorporated into treatment plans.
Chindaprasirt, Jarin,Wanitpongpun, Chinadol,Limpawattana, Panita,Thepsuthammarat, Kaewjai,Sripakdee, Warunsuda,Wirasorn, Kosin,Sookprasert, Aumkhae Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.2
Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.
Predictors for Obesity Hypoventilation Syndrome in Thai Population
sarunya saeseow,Kittisak Sawanyawisuth,Sittichai khamsai,Panita Limpawattana,Jarin Chindaprasirt,Berajit Chotmonkol,Songkwan Silaruks,Vichai Senthong,paiboon chattkul 대한수면학회 2019 sleep medicine research Vol.10 No.1
Background and ObjectiveaaObesity Hypoventilation Syndrome (OHS), is a condition with high morbidity and mortality. Body Mass Index (BMI) of more than 30 kg/m2 is used, to diagnose OHS. As BMI for obesity for Thais is 25 kg/m2, BMI more than 25 kg/m2 is used in our institution, to diagnose OHS. The purpose of this study was to evaluate if BMI of 25 kg/m2 is appropriate crite- rion for OHS in Thai patients. MethodsaaThis study was a retrospective study conducted at Khon Kaen University. Inclusion criteria were adult patients diagnosed with OHS in 2016. Patients diagnosed with obstructive sleep apnea (OSA), were randomly selected as control subjects. The ratio of OHS:OSA, was 1:4. Clinical factors associated with OHS were examined, using multivariate logistic regression analysis. ResultsaaDuring the study period, there were 25 OHS and 108 OSA patients. The OHS group had a significantly higher average BMI (48.9 kg/m2 vs. 29.2 kg/m2), than the OSA group. The OHS group also had higher proportions of patients with pulmonary hypertension (50% vs. 2%), and heart failure (76% vs. 6.5%). There were two independent predictors for OHS, including BMI and serum bicarbonate levels. Adjusted odds ratio (95% CI) for each of these factors was 1.08 (1.01, 1.17) and 1.96 (1.15, 3.34), respectively. Body mass index greater than 25 kg/m2 and serum bicar- bonate more than 25 mEq/L, yielded 100% sensitivity for OHS. ConclusionsaaAppropriate diagnostic criteria for OHS for the Thai population, may be different from those for populations in Western countries.
Treatment Outcome and Predictors of Survival in Thai Adult Rhabdomyosarcoma Cases
Sookprasert, Aumkhae,Ungareewittaya, Piti,Manotepitipongse, Areesa,Wirasorn, Kosin,Chindaprasirt, Jarin Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3
Background: Adult rhabdomyosarcoma (RMS) is a rare and aggressive disease with limited data compared with pediatric RMS. The goal of this study was to determine the treatment outcome and identify factors related to survival outcome in Thailand. Materials and Methods: Adult patients (${\geq}15$ years old) with the pathological diagnosis of RMS between 1985 and 2010 were reviewed. The data were retrospectively reviewed from the pathological results and medical records from Srinagarind Hospital, Khon Kaen University. Results: A total of 34 patients were identified in the study. The median age at diagnosis was 35.5 years and the most common primary sites were extremity and the head and neck region. The incidence of pleomorphic RMS increased with age and none was found in those aged younger than 20 years old. The median survival time was 9.33 months (95%CI: 5.6-13.1). The 1- and 5- year survival rates were 38.2% (22.3-54.0) and 20.6% (9.1-35.3). On multivariate analysis, age and size of tumor did not predict better outcome while chemotherapy and surgery were significantly associated with longer survival. Conclusions: Outcome of adult RMS was poor. Surgery and chemotherapy are strongly associated with better prognosis and multimodality treatment should be incorporated in the clinic.