Cancer survival in Chiang Mai, Thailand, 1993-1997.

The Chiang Mai tumour registry was established in 1978 as a hospital-based cancer registry, and population-based cancer registration started in 1986, with retrospective data collection on cancer incidence and mortality since 1983. Registration of cases is done by active methods. Data on survival for 36 cancer sites or types registered during 1993-1997 are reported here. Follow-up has been carried out predominantly by active methods, with median follow-up ranging between 1-39 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 28-100%; death certificate only (DCO) cases comprised 0-56%; 33-92% of total registered cases were included for survival analysis. Complete followup at five years ranged from 59-100% for different cancers. The 5-year age-standardized relative survival rates was the highest for Hodgkin lymphoma (70%) followed by thyroid (65%), cervix (57%), breast (56%) and corpus uteri (49%). The 5-year relative survival by age group showed either an inverse relationship or was fluctuating. An overwhelmingly high proportion of cases were diagnosed with a regional spread of disease, ranging between 44-82% for different cancers and survival decreased with increasing extent of disease for all cancers studied.

Cancers in northern Thailand.

A retrospective study was undertaken to assess cancers in northern Thailand using the Chiang Mai Cancer registry and Maharaj Nakorn Chiang Mai Hospital records from January 2001 to December 2005. Maharaj Nakorn Chiang Mai Hospital is the university hospital for the Faculty of Medicine, Chiang Mai University. There were 4,108 new cancer cases being treated at the institution. The distribution of patients were (a) 32% from Chiang Mai, (b) 42% from nearby provinces of Lampoon, Phayao, and Chiang Rai, (c) 20.4% from other northern provinces, and (d) 1.2% from other parts of Thailand. Based on the data, the most common cancers by relative frequency are cancers of the lung, cervix, liver, breast, and non-Hodgkin's lymphoma. The current treatment options used to manage these most common cancers are described in this article.

Preliminary report of the Asian-Oceanian Clinical Oncology Association randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. Asian-Oceanian Clinical Oncology Association Nasopharynx Cancer Study Group.

BACKGROUND: The aim of this trial was to compare the outcome achieved with neoadjuvant chemotherapy followed by radiotherapy to that achieved with radiotherapy alone for patients with locoregionally advanced undifferentiated or poorly differentiated nasopharyngeal carcinoma (NPC) meeting one of the following criteria: Ho's T3 disease, Ho's N2-N3 disease, or lymph node size > or =3 cm. METHODS: Between September 1989 and August 1993, 334 patients were enrolled in the study, with equal numbers of patients randomized to the neoadjuvant chemotherapy arm (CT arm) and the radiotherapy arm (RT arm). Neoadjuvant chemotherapy consisting of 2-3 cycles of cisplatin (60 mg/m2 on Day 1) and epirubicin (110 mg/m2 on Day 1) followed by radiotherapy was given to the CT arm. For radiotherapy, a dose of 66-74 gray (Gy) (median, 71 Gy) was delivered to the primary tumor and 60-76 Gy (median, 66 Gy) to the neck. Two hundred eighty-six eligible patients completed the treatment and were evaluable for treatment response (134 in the CT arm, 152 in the RT arm). All patients were included in the survival analysis based on the intention to treat. The median follow-up was 30 months for the whole cohort and 41 months for the surviving patients. RESULTS: Analysis of the 334 patients based on the intention to treat showed no significant difference in relapse free survival (RFS) or overall survival (OS) between the 2 treatment arms (3-year RFS rate: 48% in the CT arm vs. 42% in the RT arm, P = 0.45; 3-year OS rate: 78% vs. 71%, P = 0.57). In an efficacy analysis based on only the 286 evaluable patients, a trend of improved RFS favoring the CT arm was observed (3-year RFS rate: 58% vs. 46%, P = 0.053), with again no significant difference in OS (3-year OS rate: 80% vs. 72%, P = 0.21). In the subgroup of 49 patients with bulky neck lymph nodes >6 cm, improved RFS (3-year RFS rate: 63% vs. 28%, P = 0.026) and OS (3-year OS rate: 73% vs. 37%, P = 0.057) were observed, favoring the CT arm. CONCLUSIONS: This multicenter randomized study did not demonstrate any benefit with the addition of cisplatin-epirubicin neoadjuvant chemotherapy for patients with locoregionally advanced nasopharyngeal carcinoma; therefore routine administration of neoadjuvant chemotherapy to this target group cannot be recommended. Although the overall incidence of recurrence was reduced with the addition of chemotherapy in the efficacy analysis, the overall survival was not affected. A more effective chemotherapy regimen, the selection of an appropriate target group, and the use of an alternative strategy for combining chemoradiotherapy should be explored in future trials.

Ofloxacin otic solution as treatment of chronic suppurative otitis media and diffuse bacterial otitis externa.

Pseudomonas aeruginosa, Diphtheroid bacilli, Staphylococcus aureus were the major causes of diffuse bacteria otitis externa and chronic suppurative otitis media. This study showed that 0.3 per cent ofloxacin used for 2 weeks gave good clinical and bacteriological control of chronic suppurative otitis media and diffuse bacterial otitis externa without significant side effects.

Carcinoma of the nasopharynx in Chiang Mai University Hospital: a review of 205 cases.

Carcinoma of the nasopharynx is one of the common head and neck cancers in Southeast Asia. We had studied 205 cases of nasopharyngeal cancer who attended the ENT clinic of the Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand from 1980-1984. The majority of the patients were found in stage IV. One hundred and five patients received a curative dose of radiation therapy. The observed actuarial 5 year survival was 34 per cent. There was a significant decrease in survival of patients with T4 disease. Differences in age, sex, histopathology and N-stage did not affect the survival. So far, the only specific treatment we can offer patients is radiation therapy, so an earlier diagnosis must be established in order to get better results of treatment.