ORCID Profile
0000-0001-9687-4623
Current Organisations
Chulalongkorn University Faculty of Medicine
,
Bangkok Hospital
,
Phramongkutklao Hospital
,
Peter MacCallum Cancer Centre
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Publications
Comparative Survival Assessment of Two-Dimension (2D) versus Three-Dimension (3D) Brachytherapy Treatment in Locally Advanced Cervical Cancer: A Retrospective Case Control Study
Publisher: Medical Association of Thailand
Date: 15-06-2021
DOI: 10.35755/JMEDASSOCTHAI.2021.06.12361
Abstract: Objective: To assess the efficacy as seen as overall survival, local control, progression free survival (PFS) and toxicities, between two-dimension (2D) and three-dimension (3D) computed tomography (CT) guided brachytherapy (BT) without using interstitial needles among patients with cervical cancer. Materials and Methods: A retrospective case control study was performed among patients with FIGO stage IB-IVA cervical cancer treated between March 1990 and August 2018. Concurrent chemoradiation using external beam radiotherapy followed by BT was the treatment method used in all patients. Patients were ided in two groups based on imaging type during BT to compare between 2D and 3D BT techniques. Clinical endpoints were overall survival, local control, progression free survival, acute toxicities, and late toxicities. Results: One hundred two patients with cervical cancer were included, which 52 patients had been treated with 2D and 50 patients with 3D using CT scan BT without interstitial needles. Baseline characteristics were similar between the groups. External beam was used among all patients during the concurrent chemoradiation period before BT. All patients completed the treatment. Similar 3-year overall survival and local control were reported between 2D and 3D techniques. Overall, the 3-year survival rate was 95.7% in 2D and 91.8% in 3D BT (p=0.188). Local control at the 3-year follow-up was 88.6% for 2D and 93.3% for 3D treatment (p-value=0.571). Progression free survival was better in the 2-D rather than the 3D group with 86.13% in 2D versus 27.4% in the 3D group (p-value=0.006). No grade 3 or 4 toxicity regarding the 3D technique was observed whereas 1.9% of grade 3 presented acute gastrointestinal toxicity (p-value=1), and grade 3 late gastrointestinal and genitourinary toxicities in the 2D technique group at 7.7 and 5.8%, respectively (p=1, both). The 3D BT significantly reduced acute grade 1 to 2 gastrointestinal side effect as 23% in the 2D versus 4% in 3D group (p-value=0.003), and grade 1 to 2 late genitourinary side effect as 50% in the 2D versus 16% in the 3D group (p-value=0.001). Conclusion: Using CT guided 3D BT to treat cervical cancer showed similar outcomes in survival and local control but reduced toxicity compared with the 2D technique. Disease progression including metastasis was better in the 2D BT technique group. CT guided BT helped reduce dose to organs at risk and long-term follow-up for survival outcome and toxicities was needed. Keywords: Cervical cancer Brachytherapy technique Brachytherapy 3D brachytherapy 2D brachytherapy
Comparison of dual-energy CT with positron emission tomography for lung perfusion imaging in patients with non-small cell lung cancer
Publisher: IOP Publishing
Date: 27-01-2023
Abstract: Objective. Functional lung avoidance (FLA) radiotherapy treatment aims to spare lung regions identified as functional from imaging. Perfusion contributes to lung function and can be measured from the determination of pulmonary blood volume (PBV). An advantageous alternative to the current determination of PBV from positron emission tomography (PET) may be from dual energy CT (DECT), due to shorter examination time and widespread availability. This study aims to determine the correlation between PBV determined from DECT and PET in the context of FLA radiotherapy. Approach. DECT and PET acquisitions at baseline of patients enrolled in the HI-FIVE clinical trial (ID: NCT03569072) were reviewed. Determination of PBV from PET imaging ( PBV PET ), from DECT imaging generated from a commercial software (Syngo.via, Siemens Healthineers, Forchheim, Germany) with its lowest ( PBV syngo R = 1 ) and highest ( PBV syngo R = 10 ) smoothing level parameter value ( R ), and from a two-material decomposition (TMD) method ( PBV TMD L ) with variable median filter kernel size ( L ) were compared. Deformable image registration between DECT images and the CT component of the PET/CT was applied to PBV maps before res ling to the PET resolution. The Spearman correlation coefficient ( r s ) between PBV determinations was calculated voxel-wise in lung subvolumes. Main results. Of this cohort of 19 patients, 17 had a DECT acquisition at baseline. PBV maps determined from the commercial software and the TMD method were very strongly correlated [ r s ( PBV syngo R = 1 , PBV TMD L = 1 ) = 0.94 ± 0.01 and r s ( PBV syngo R = 10 , PBV TMD L = 9 ) = 0.94 ± 0.02]. PBV PET was strongly correlated with PBV TMD L [ r s ( PBV PET , PBV TMD L = 28 ) = 0.67 ± 0.11]. Perfusion patterns differed along the posterior-anterior direction [ r s ( PBV PET , PBV TMD L = 28 ) = 0.77 ± 0.13/0.57 ± 0.16 in the anterior osterior region]. Significance . A strong correlation between DECT and PET determination of PBV was observed. Streak and smoothing effects in DECT and gravitational artefacts and misregistration in PET reduced the correlation posteriorly.
The Value of SUVmax of Gallium-68-PSMA PET/CT in Newly Diagnosed Prostate Cancer
Publisher: Bangkok Dusit Medical Service (BDMS)
Date: 28-02-2023
Metastatic Malignant Melanoma to Colon from Cutaneous Melanoma: A Case Report
Publisher: Bangkok Dusit Medical Service (BDMS)
Date: 26-02-2022
Radiation therapy in chronic hidradenitis suppurativa: case report
Publisher: Korean Society for Therapeutic Radiology and Oncology
Date: 31-03-2022
Abstract: A 26-year-old female presented recurrent painful, carbuncles at both axillae for 10 years. It caused offensive odor and scar. Tissue diagnosis was chronic hidradenitis suppurativa. She was treated using antibiotics followed by multiple excisions with drainage but showed no improvement. Isotretinoin provided no benefit. She was socially isolated and experienced lower quality of life. Consequently, she was sent for radiation therapy. Computed tomography simulation was performed revealing an ulcer with deep chronic pus tracts at her axilla. Three-dimensional conformal radiation therapy was provided with 6 MV photon (7.5 Gy in 3 fractions) covering all ulcers and pus tracts. On the last day of radiation therapy, carbuncles and wounds at the left axilla exhibited much improvement without pus. Three months follow-up showed much improvement of the lesions. The skin was smoother without pus or odor. Radiation therapy was confirmed one treatment option for chronic hidradenitis suppurativa.
The effect of deep inspiration breath-hold technique on left anterior descending coronary artery and heart dose in left breast irradiation.
Publisher: Korean Society for Therapeutic Radiology and Oncology
Date: 30-09-2020
Long-Term Outcomes of TROG 13.01 SAFRON II Randomized Trial of Single- Versus Multifraction Stereotactic Ablative Body Radiotherapy for Pulmonary Oligometastases.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 07-2023
DOI: 10.1200/JCO.23.00150
Abstract: Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. In a randomized phase II clinical trial, the Trans Tasman Radiation Oncology Group compared single- versus multifraction stereotactic ablative body radiotherapy (SABR) in 90 patients with 133 oligometastases to the lung. The study found no differences in safety, efficacy, systemic immunogenicity, or survival between arms, with single-fraction SABR picked as the winner on the basis of cost-effectiveness. In this article, we report the final updated survival outcome analysis. The protocol mandated no concurrent or post-therapy systemic therapy until progression. Modified disease-free survival (mDFS) was defined as any progression not addressable by local therapy, or death. At a median follow-up of 5.4 years, the 3- and 5-year estimates for overall survival (OS) were 70% (95% CI, 59 to 78) and 51% (95% CI, 39 to 61). There were no significant differences between the multi- and single-fraction arms for OS (hazard ratio [HR], 1.1 [95% CI, 0.6 to 2.0] P = .81). The 3- and 5-year estimates for disease-free survival were 24% (95% CI, 16 to 33) and 20% (95% CI, 13 to 29), with no differences between arms (HR, 1.0 [95% CI, 0.6 to 1.6] P = .92). The 3- and 5-year estimates for mDFS were 39% (95% CI, 29 to 49) and 34% (95% CI, 24 to 44), with no differences between arms (HR, 1.0 [95% CI, 0.6 to 1.8] P = .90). In this patient population, where patients receive SABR in lieu of systemic therapy, one-in-three patients are alive without disease in the long term. There were no differences in outcomes by fractionation schedule.
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Related Funding Activities
No related grants have been discovered for Pitchaya Sakyanun.