Arm and body fixator Siriraj B-34: Results of treatment and complications in breast cancer patients.

Twenty-three patients with cancer of the breast were referred to the Department of Radiology, Siriraj Hospital, for breast irradiation. The arm and body fixator Siriraj B-34 was used both during the treatment planning and the radiation treatment. Complications were 4 cases of radiation pneumonitis, 1 of radiation lung fibrosis and 3 of lymphedema of arms. But after supportive and symptomatic treatment these conditions were resolved. After 2-years of follwed-up, one patient had a local recurrence and distant metastasis, and two patients had distant metastases. We conclude that the arm and body fixator Siriraj B-34 is an acceptable & safe aid in the radiation treatment of breast cancer patients.

Carcinoembryonic antigen in patients with carcinoma of cervix.

Seventy two patients with different stages of cervical cancer have attended the Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, for radiation therapy. Before treatment, 38.9 percent of these patients had serum carcinoembryonic antigen (CEA) level above normal range (normal=0-3.38 ng/ml). Among these patients, 48 cases had serial serum CEA determinations through 11-36 months after prognosis within 1 year after treatment. The patients who had pretreatment CEA levels between 3.38-10 ng/ml had better prognosis if CEA declined to normal level within 1-2 months after treatment, since only 15.4 percent had recurrence within 3 years. The patients who had decreasing CEA levels after treatment but increased upon follow up always had distance metastasis. The patients who had adenocarcinoma had slightly higher levels of CEA than those with squamous cell carcinoma. The CEA levels did not correlate with staging of the disease, but rather depend on the natural properties of individual’s cancer cells. The usefulness of serial CEA determinations was found only in the patients who had increased CEA before treatment. We suggest that the serum CEA determination should be performed in every patient with carcinoma of cervix and serially thereafter in those who have pretherapy increment, i.e. immediately or 1-2 months after radiation therapy and later every 3-6 months.