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Abstract Computed Tomography Evaluation of Paraaortic Lymph Nodes in Locally Advanced Cervical Cancer Kanyarat Katanyoo MD* Arcom Rangtaid MD** Marisa Jongthanakorn MD* Thanatip Tantivattana MD* * Radiation Oncology Section, Department of Radiology, BMA Medical College and Vajira Hospital ** Diagnostic Radiology Section, Department of Radiology, BMA Medical College and Vajira Hospital Objectives: To evaluate paraaortic lymph node metastatic rate in locally advanced cervical cancer by computed tomography and outcomes of treatment in the patients with paraaortic lymph nodes metastasis. Study design: Descriptive study. Subjects: All 81 patients with locally advanced cervical cancer (IIB-IVA) who were evaluated by computed tomography of whole abdomen and treated at BMA Medical College and Vajira Hospital between January 2006 - June 2008. Methods: Medical records of the patients including radiation oncology records, out-patient charts and computerized database of the institution were reviewed. Patients' age, histologic type and size of tumor, stage, computed tomography of whole abdomen reports, type of radiation therapy and results of treatment were recorded. Main outcome measures: Paraaortic lymph node metastatic rate by computed tomography, 1-year and 2-year survival rate. Results: Mean age of 81 patients was 54.5 + 10.8 years. Histopathology of cervical cancer were squamous cell carcinoma in 82.7% and adenocarcinoma in 17.3%. Clinical stage of diseases were stage IIB and IIIB in 51.9% and 48.1% respectively. Rate of paraaortic lymph node metastasis by computed tomography was 4.9%. Patients who did not have evidence of paraaortic lymph node metastasis had higher survival rate than the patients who had evidence of paraaortic lymph node metastasis with the 1-and 2-year survival rates of 93.3% and 80.4% compared to 75.0% and 0% respectively (p-value = 0.001). Conclusion: The rate of paraaortic lymph node metastasis by computed tomography of whole abdomen was 4.9%. Overall 1-and 2-year survival rates of these patients were 75.0% and 0 % respectively. Key words: cervical cancer, advanced, computed tomography, paraaortic lymph nodes metastasis, survival rate Vajira Med J 2009 ; 54 : 33 - 40
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Abstract Treatment Outcomes of Radiation Therapy for Locally Advanced Cervical Cancer Thanatip Tantivattana MD Kanyarat Katanyoo MD Marisa Jongthanakorn MD Radiation Oncology Section, Department of Radiology, BMA Medical College and Vajira Hospital Objective: To study the results of radiation therapy in locally advanced cervical cancer (IIB-IVA) in terms of 2- and 5- year survival rates. Prognostic factors and complications of radiation therapy were also evaluated. Study design: Descriptive study. Subjects: A total of 420 patients with locally advanced cervical cancer (IIB-IVA), who were treated by radiation with or without concurrent chemotherapy at Radiation Oncology section, BMA Medical College and Vajira Hospital between January 1998 and December 2005. Methods: Medical records of the patients including radiation oncology records, out-patient charts and computerized data base of the institution were reviewed. Patients' age, histologic type, size of tumor, stage, computed tomography of whole abdomen results, anemia during treatment, types of radiation therapy, complications and results of treatment were recorded. Main outcome measures: Overall 2-and 5-year survival rates. Results: Mean age of 420 patients was 51.8 ± 11.7 years. Cervical cancer histopathology were squamous cell carcinoma in 78.8%, while the rest were adenocarcinoma or adenosquamous cell carcinoma. Clinical stage of diseases were stage IIB 51.4%, IIIA 1.0%, IIIB 45.0% and IVA 2.6%. The overall 2-and 5-year survival rates for all patients were 78.4% and 64.8% respectively. The only significant prognostic factor associated with survival rate from multivariable analysis was tumor stage. Patients in stage IIB had higher survival rate than the patients in stage III (IIIA and IIIB) and IVA with the 5-year survival rate of 72.2%, 56.2% and 47.0% respectively (p-value = 0.001). The late complication of bowel and bladder grade 3-4 were 4.1% and 0.7% respectively. Conclusion: The overall 2- and 5-year survival rates of patients with locally advanced cervical cancer treated with radiation therapy were 78.4% and 64.8% respectively. Tumor stage was the only significant prognostic factor for survival. Vajira Med J 2009 ; 53 : 121-129
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Abstract Prevalence of Malnutrition in New Cancer Patients at Radiation Oncology Unit, BMA Medical College and Vajira Hospital Kanyarat Katanyoo MD Marisa Jongthanakorn MD Thanatip Tantivattana MD Department of Radiology, BMA Medical College and Vajira Hospital Objective: To evaluate the prevalence of malnutrition and its associating factors in new cancer patients at Radiation Oncology unit, BMA Medical College and Vajira Hospital. Study design: Descriptive study. Subjects: One hundred and six new cancer patients at Radiation Oncology unit, BMA Medical College and Vajira Hospital during May and July 2008 were enrolled. Methods: Data including sex, types and stages of cancer, previous treatment, febrile status, serum albumin level, percentage of blood lymphocyte and other symptoms which may be associated with malnutrition were recorded. The nutritional status was evaluated using the nutritional screening questionnaire which consisted of data on body mass index, performance status, quantity of food intake and presence of co-morbidity or other treatments. Main outcome measures: Prevalence of malnutrition in new cancer patients. Results: Out of 106 new cancer patients, 21.7% had malnutrition. The five most common cancers associated with malnutrition were cancers of hepatobiliary system, esophagus, male genitourinary tract, pancreas and head and neck. Factors which significantly associated with the nutritional status were sex, types and stages of cancer. Male and female cancer patients had malnutrition in 35.4% and 10.3% respectively. Malnutrition in early, locally advanced and metastatic stage were 0%, 15.9% and 50.0% respectively. Other factors associated with malnutrition were low serum albumin level and low percentage of blood lymphocyte, in which malnutrition were found in 40.4% and 42.9% respectively. Symptoms of mucositis, taste and food aversion, anorexia, fatigue, pain and dyspnea were also associated with malnutrition in new cancer patients. Conclusion: The prevalence of malnutrition in new cancer patients was 21.7%. Sex, types, stages of cancer, serum albumin level, percentage of blood lymphocyte, mucositis, taste and food aversion, anorexia, fatigue, pain and dyspnea were associated with malnutrition. Vajira Med J 2009 ; 53 : 59 - 67