Browsing by Author "Apasri Lusawat"

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    Carboplatin-based regimen in pediatric intracranial germ-cell tumors (IC-GCTs): Effectiveness and ototoxicity
    (2020-03-19) Rasin Worawongsakul; Nongnuch Sirachainan; Apimid Rojanawatsirivej; Atthaporn Boongird; Arunee Singhsnaeh; Thiti Swangsilpa; Mantana Dhanachai; Putipun Puataweepong; Rawee Ruangkanchanasetr; Samart Pakakasama; Usanarat Anurathapan; Duantida Songdej; Pongpak Pongphitcha; Chaiyos Khongkhatithum; Ake Hansasuta; Nintita Sripaiboonkij Thokanit; Apasri Lusawat; Sarunya Yuthagovit; Samasuk Thammachantha; Danupon Muangruk; Suradej Hongeng; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Prasat Neurological Institute; Loei Hospital
    © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. Background: Induction chemotherapy with carboplatin followed by radiotherapy has been used for many years for treating intracranial germ-cell tumors (IC-GCTs) in Thailand. The objective of this study was to assess treatment outcomes, focusing on survival and ototoxicity. Methods: The outcomes of all patients with IC-GCT treated at Ramathibodi Hospital and the Prasat Neurological Institute between 2000 and 2017 were reviewed and analyzed, including all patient characteristics and treatment modalities. Five-year overall survival (OS) and event-free survival (EFS) were analyzed using the Kaplan-Meier method, and factors affecting survival were compared using the log-rank test. Results: Fifty-three patients age 1-14 years (median, 11 years) were included in this study. The median follow-up time was 63 months. The 5-year EFS and OS rates were 94.3% and 96.2% for all patients, respectively. No statistical difference in OS or EFS was observed between the data of recipients in the carboplatin-based and historical cisplatin-based therapies in our institutes. Concerning radiotherapy, omission of radiotherapy or focal irradiation results in worse long-term survival outcomes, but reduction in dose of radiotherapy to less than 40 Gy did not cause any negative impact on survival rates. Furthermore, carboplatin was associated with lower rates of hearing loss than cisplatin (5.7% vs 87.5%). Conclusions: Induction chemotherapy with carboplatin-based regimens was associated with excellent survival rates and low ototoxicity in patients with IC-GCT. Radiotherapy should be given to all patients with a minimal volume equivalent to whole-ventricular radiotherapy, during which doses of lower than 40 Gy can be effectively used.
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    Factors Affecting the Quality of Life in Children with Epilepsy
    (2021) Arthittaya Kaenkrai; Autchareeya Patoomwan; Suporn Wongvatunyu; Apasri Lusawat; อาทิตยา แก่่นไกร; อัจฉรียา ปทุุมวัน; ศุุภร วงศ์วทัญญู; อาภาศรี ลุุสวัสดิ์์; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Ramathibodi School of Nursing
    Health-related quality of life (HRQOL) is considered as an important clinical outcome, especially in children with chronic illnesses. This predictive, descriptive study aimed at investigating the factors affecting health-related quality of life in children with epilepsy, including epilepsy severity, comorbidity, and family functioning. The sample, which consisted of 90 caregivers of children with epilepsy between the ages of 4 to 15 years, was recruited from the pediatric neurological out-patient clinic and in-patient wards at Prasat Neurological Institute, and Ramathibodi Hospital located in Bangkok, Thailand. Data were collected during June-August 2019. A set of questionnaires was used including demographic characteristics and medical record of illness data of children with epilepsy, the Chulalongkorn Family Inventory (CFI), and the Quality of Life in Childhood Epilepsy (QOLCE-16). Data analysis used descriptive statistics, Pearson’s product-moment correlation coefficient, and multiple regression analysis. The findings revealed that epilepsy severity, comorbidity, and family functioning could jointly predict the overall QOLCE, and accounted for 28.40% of the variance in the overall quality of life of children with epilepsy. Results of this study would help nurses and healthcare professionals provide adequate support and further design the intervention to improve the quality of life among children with epilepsy.
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    PublicationOpen Access
    Factors Influencing Self-Concept of Adolescents with Epilepsy
    (2024) Chuthathip Mongkholkham; Autchareeya Patoomwan; Apasri Lusawat; จุฑาทิพย์ มงคลคำ; อัจฉรียา ปทุมวัน; อาภาศรี ลุสวัสดิ์
    This cross-sectional descriptive study was designed to investigate the self-concept of adolescents with epilepsy and its influencing factors of gender, severity of epilepsy, and family functioning on the self-concept of adolescents with epilepsy guided by Bracken’s Self-Concept Model. A total of 82 adolescents with epilepsy, 12-18 years of age,were selected by purposive sampling from pediatric neurology outpatient clinics from three tertiary care medical centers, who had a minimum standard score above 70 on the Peabody Picture Vocabulary Test, Fourth Edition. Participants completed the Demographic Questionnaire, Epilepsy Severity Scale, Piers-Harris Self-Concept Scale,3rd Edition, and General Functioning 12-item Subscale. Neurology clinic charts were reviewed for the type and frequency of seizures, and the number of antiepileptic drugs.The data were analyzed using descriptive statistics and multiple regression. The findings revealed that the participants had an average level of self-concept overall and in most domains. However, they had a low level in two domains of self-concept: happiness and satisfaction, and intellectual and school status. Epilepsy severity and family functioning could co-predict overall self-concept by 7.10 % significantly, while there was no correlation between gender and self-concept. Based on the study findings, nursing implications should screen individuals' self-concept (particularly happiness and satisfaction, intellectual and school status), and emphasize the severity of epilepsy and family functioning to promote adolescents with epilepsy for a positive self-concept.
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    Flunarizine for prophylactic treatment of childhood migraine
    (2004-12-01) Anannit Visudtibhan; Apasri Lusawat; Surang Chiemchanya; Pongsakdi Visudhiphan; Mahidol University
    Objective: To determine the effectiveness of flunarizine for migraine prophylaxis in children. Patients and Method: Children aged between 7 and 15 years who had the indication for prophylactic treatment of migraine were recruited into a prospective study at the Department of Pediatrics, Ramathibodi Hospital, from January 1st to December 31st 1999. After verbal consent was obtained, flunarizine was administered either at 5-mg daily in those who had never received it or at 10-mg daily in those who previously took this drug within one year. Serial evaluation for the severity of migraine including duration, intensity, and frequency of headache attacks was performed every 2 weeks for 6 months. Results: Twenty-one children (10 boys, 11 girls) with a mean age of 11.3 ± 2.48 years (range 7-15 years) were enrolled in the study. There were ten children who had migraine with aura. Initially, 5-mg daily and 10-mg daily of flunarizine were administered in 19 and 2 patients respectively. The dosage was increased to 10-mg daily after two weeks in 5 patients because of the unresponsiveness to the initial dose. Improvement was observed in 14 patients (66%) including 13 of 14 patients who received 5-mg daily and 1 of 7 patients who received 10 mg daily. Five patients (23%) had no recurrent attack. Nine patients (42%) had more than 50%-reduction of frequency of migraine and 3 of these had either shorter duration or less intensity of the attack. Clinical improvement was observed between 2 and 4 weeks after initiation of treatment. There was no adverse effect observed. Conclusion: This is a preliminary result demonstrating that flunarizine is one of the effective drugs for migraine prophylaxis in children.
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    Mutation screening of the CDKL5 gene in cryptogenic infantile intractable epilepsy and review of clinical sensitivity
    (2011-09-01) Utcharee Intusoma; Fadell Hayeeduereh; Oradawan Plong-On; Thanya Sripo; Punnee Vasiknanonte; Supachai Janjindamai; Apasri Lusawat; Sasipa Thammongkol; Anannit Visudtibhan; Pornprot Limprasert; Prince of Songkla University; Prasat Neurological Institute; Mahidol University
    Purposes: To perform CDKL5 mutation screening in Thai children with cryptogenic infantile intractable epilepsy and to determine the clinical sensitivity of CDKL5 screening when different inclusion criteria were applied. Methods: Children with cryptogenic infantile intractable epilepsy were screened for CDKL5 mutation using multiplex ligation-dependent probe amplification and DNA sequencing. The clinical sensitivity was reviewed by combining the results of studies using similar inclusion screening criteria. Results: Thirty children (19 girls and 11 boys) with a median seizure onset of 7 months were screened. Almost a half had infantile spasms and one fifth had stereotypic hand movements. A novel c.2854C > T (p.R952X) was identified in an ambulatory girl who had severe mental retardation, multiple types of seizures without Rett-like features. Her mother had a mild intellectual disability, yet her grandmother and half sister were normal despite having the same genetic alteration (random X-inactivation patterns). The pathogenicity of p.R952X identified here was uncertain since healthy relatives and 6 female controls also harbor this alteration. The clinical sensitivity of CDKL5 mutation screening among females with Rett-like features and negative MECP2 screening was 7.8% while the clinical sensitivity among females having cryptogenic intractable seizures with an onset before the ages of 12, 6 and 3 months were 4.7, 11.6 and 14.3%, respectively. © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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    Outcome of medulloblastoma in children treated with reduced-dose radiation therapy plus adjuvant chemotherapy
    (2011-04-01) Nongnuch Sirachainan; Issarang Nuchprayoon; Pattra Thanarattanakorn; Samart Pakakasama; Apasri Lusawat; Anannit Visudibhan; Mantana Dhanachai; Noppadol Larbcharoensub; Jiraporn Amornfa; Kanchana Shotelersuk; Kamornwan Katanyuwong; Saipin Tangkaratt; Suradej Hongeng; Mahidol University; Chulalongkorn University; Chiang Mai University; Prasat Neurological Institute; National Cancer Institute Thailand
    Medulloblastoma is the most common malignant brain tumor in children. Post-surgical craniospinal irradiation (CSI; 30-36 Gy) plus local boost radiation therapy (RT; 54-56 Gy) is a standard treatment for children with medulloblastoma who are over 3 years old, resulting in a 5-year overall survival (OS) rate of 46% to 65% in average-risk patients and 50% in high-risk patients. The addition of chemotherapy has the benefit of reducing complications from radiation and improving the OS rate. Using this approach, the estimated 5-year OS rates for patients with average- and high-risk medulloblastomas treated with different protocols are 65% to 85% and 16% to 70%, respectively. In this study, we determined the outcome of patients with average- and high-risk medulloblastomas treated with reduced dosage CSI and chemotherapy with an oral etoposide-based regimen. The study included 49 patients, with a mean age of 7.7 ± 3.4 years. Twenty-six patients (53%) were classified as average-risk and 23 patients (47%) as high-risk. In the average-risk group, the 5-year progression free survival (PFS) rate was 62.9% ± 10% and the 5-year OS rate was 70.4% ± 9.5%. In the high-risk group the 5-year PFS rate was 48.9% ± 13% and the 5-year OS rate was 49.7% ± 13%. In the average-risk group, patients who received CSI of either 24 Gy (n = 20) or 36 Gy (n = 9) showed no difference in their 5-year PFS and OS rates. We found that patients who were ≤10 years old and patients who were female had a significantly better 5-year PFS rate. © 2010 Elsevier Ltd. All rights reserved.