Preoperative chemoradiotherapy in locally advanced rectal cancer: Ramathibodi experience.

A retrospective study of the preoperative chemoradiotherapy in locally advanced rectal cancer performed at Ramathibodi Hospital. The median age of twelve patients was 52 years. The tumor locations (upper-, mid-, lower rectum) were 25%, 50% and 25%, respectively. Eleven patients had clinical stage 111 disease. All received concurrent 5-FU-based chemoradiotherapy followed by surgery (if resectable) and chemotherapy. The most common toxicity of preoperative treatment was gr. 1-2 diarrhea (58.3%). The response rate was 41.7%. Five patients (41.7%) underwent sphincter-sparing surgery. Four patients underwent AP resection. Twenty-five percent achieved pathological complete response. Pathological downstaging occurred in 33.3%. The remaining three patients had unresectable disease. With the median follow up of 13 months, five patients had progressive disease and one has expired. The local failure rate was 16.7%. The one-year recurrence-free survival was 75%. The authors conclude that preoperative chemoradiotherapy is an effective treatment with favorable outcome in locally advanced rectal cancer.

Doxetaxel in previously treated non-small cell lung cancer patients: clinical efficacy and quality of life.

Docetaxel (Taxotere) is one of the most active new generation chemotherapy agents against advanced non-small cell lung cancer (NSCLC). This study aimed to determine the activity, toxicity and impact on the quality of life (QOL) in patients treated with docetaxel after failure with first-line platinum-based combination chemotherapy. Twenty-one patients with advanced NSCLC who had previously received the platinum-containing regimen were treated with docetaxel 75 mg/m2 every 3 weeks. QOL was assessed at intervals during the treatment period using the Functional Assessment of Cancer Treatment - Lung (FACT-L). Of the 21 patients enrolled, 16 were able to be evaluated for response and 20 were included in the toxicity analysis. The median age was 57 (range, 39-75 years). A median of 3 cycles was given (range, 1-9). Of the 16 evaluatable patients, there was one partial response (6.3%) and 4 with stable disease (25%). The median survival time was 8.1 months and the 1-year survival rate was 25%. Myelosuppression and peripheral neuropathy were the major toxicities. Grade 3/4 neutropenia and paresthesia occurred in 6 patients (30%) and 3 patients (15%), respectively. There was no significant improvement or deterioration in the overall FACT-L, TOI (Trial Outcome Index) and lung cancer symptom scores during the treatment. Symptom improvement was noted, in particular for shortness of breath and weight loss in the majority of patients. It is concluded that docetaxel is a well tolerated second-line treatment for recurrent NSCLC. Of particular importance was that the treatment did not negatively impact the overall quality of life, on the contrary, did palliate some of the lung cancer related dash symptoms in many patients.

Mucoepidermoid carcinoma of the lung presenting as a cavitary lesion.

The authors describe a 62-year-old female patient who presented with a progressively enlarging cavitary lesion in the right upper lobe of the lung. Acid-fast bacilli were recovered from a bronchial washing fluid and identified as Mycobacterium tuberculosis. She received antituberculous therapy for 5 months without improvement in her clinical symptoms and chest radiograph. A lobectomy was performed and pathological review demonstrated a high-grade mucoepidermoid lung carcinoma with extensive central necrosis. Staging revealed metastases in her left adrenal gland, kidney and spine. High-grade mucoepidermoid carcinoma of the lung may present as a cavitary lesion. The presence of M. tuberculosis should not preclude clinicians from pursuing adequate diagnostic procedures for a possible malignant lesion.

The European Organization for Research and Treatment of Cancer quality of life questionnaire: translation and reliability study of the Thai version.

In the past decade, increasing attention is being given to more systematic and quantitative ways to evaluate explicitly the impact of disease and medical interventions on quality of life (QOL). Pertaining to the field of oncology, two relatively new instruments--the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the FACT-G, have received growing attention and appear to be excellent QOL instruments in clinical settings. FACT-G has already been validated and has been used in Thailand. Thus in the present study, the English version of the EORTC quality of life questionnaire (QLQ-C30) was translated into Thai and the initial descriptive statistic and scale reliability were reported. Mean score in this study of 75 cancer patients was comparable with the original report. Cronbach's alpha coefficient for multi-item scales range from 0.64 to 0.89. The validity of this translated version will be reported at a later date. The initial findings of the present study indicate that the Thai version of the EORTC QLQ-C30 is reliable. A validating process of this version is in progress with active patients accrual ongoing at present.