Browsing by Author "Suwannee Sirilerttrakul"

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    Determination of irinotecan, SN-38 and SN-38 glucuronide using HPLC/MS/MS: Application in a clinical pharmacokinetic and personalized medicine in colorectal cancer patients
    (2018-01-01) Chalirmporn Atasilp; Pichai Chansriwong; Ekapob Sirachainan; Thanyanan Reungwetwattana; Apichaya Puangpetch; Santirhat Prommas; Suwannee Sirilerttrakul; Budsaba Rerkarmnuaychoke; Sansanee Wongwaisayawan; Chonlaphat Sukasem; Faculty of Medicine, Ramathibodi Hospital, Mahidol University
    © 2017 Wiley Periodicals, Inc. Background: Irinotecan (CPT-11) is chemotherapy used mainly in the metastatic colorectal cancer. The purpose of this study was to develop and validate the LC-MS/MS for the simultaneous determination of CPT-11, SN-38, and SN-38G. Methods: A 100 μL of plasma was prepared after protein precipitation and analyzed on a C18 column using 0.1% acetic acid in water and 0.1% acetic acid in acetonitrile as mobile phases. The mass spectrometer worked with multiple reaction monitoring (MRM) in positive scan mode. The standard curves were linear on a concentration range of 5-10 000 ng/mL for CPT-11, 5-1000 ng/mL for SN-38, and 8-1000 ng/mL for SN-38G. Results: In this assay, the intra and interday precision consisted of ≤9.11% and ≤11.29% for CPT-11, ≤8.70% and 8.31% for SN-38, and ≤9.90 and 9.64% for SN-38G. Conclusion: This method was successfully used to quantify CPT-11, SN-38, and SN-38G and applied to a pharmacokinetic study.
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    Effect of drug metabolizing enzymes and transporters in Thai colorectal cancer patients treated with irinotecan-based chemotherapy
    (2020-12-01) Chalirmporn Atasilp; Phichai Chansriwong; Ekaphop Sirachainan; Thanyanan Reungwetwattana; Suwannee Sirilerttrakul; Monpat Chamnanphon; Apichaya Puangpetch; Chonlaphat Sukasem; Chulalongkorn University; Rangsit University; Faculty of Medicine, Ramathibodi Hospital, Mahidol University
    © 2020, The Author(s). Genetic polymorphisms in drug metabolizing enzymes and drug transporters may affect irinotecan toxicity. Although genetic polymorphisms have been shown to influence the irinotecan toxicity, data are limited in Thai population. Thus, the aim of this study was to assess the allele and genotype frequencies and the relationship between CYP3A4/5, DPYD, UGT1A1, ABCB1, and ABCC2 genetic variations and irinotecan-induced toxicity in Thai colorectal cancer patients. One hundred and thirty-two patients were genotyped, and the effect of genetic variations on irinotecan-induced toxicity was assessed in 66 patients who received irinotecan-based chemotherapy. Allele frequencies of ABCB1 c.1236C > T, ABCB1 c.3435C > T, ABCC2 c.3972C > T, ABCG2 c.421C > A, CYP3A4*1B, CYP3A4*18, CYP3A5*3, DPYD*5, UGT1A1*28, and UGT1A1*6 were 0.67, 0.43, 0.23, 0.27, 0.01, 0.02, 0.64, 0.19, 0.16, and 0.09, respectively. DPYD*2A and DPYD c.1774C > T variants were not detected in our study population. The ABCC2 c.3972C > T was significantly associated with grade 1–4 neutropenia (P < 0.012) at the first cycle. Patients carrying both UGT1A1*28 and *6 were significantly associated with severe neutropenia at the first (P < 0.001) and second (P = 0.017) cycles. In addition, patients carrying UG1A1*28 and *6 had significantly lower absolute neutrophil count (ANC) nadir at first (P < 0.001) and second (P = 0.001) cycles. This finding suggests that UGT1A1*28, *6, and ABCC2 c.3972C > T might be an important predictor for irinotecan-induced severe neutropenia.
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    Evaluation of adverse events and health-related quality of life in patients with colorectal cancer receiving ambulatory home-based chemotherapy in Thailand
    (2021-11-01) Suwannee Sirilerttrakul; Noppaskan Wannakansophon; Pinyo Utthiya; Sineenuch Ckumdee; Patamaporn Tangteerakoon; Phichai Chansriwong; Ramathibodi Hospital; Faculty of Medicine Ramathibodi Hospital, Mahidol University
    Aims: To compare adverse events and health-related quality of life in ambulatory home-based chemotherapy with those in inpatient. Design: Prospective non-randomized observational study. Methods: Participants were divided into two groups according to patients’ preference receiving chemotherapy. Results: Sixty-four participants were enrolled in the inpatient, and 111 were in an ambulatory home-based chemotherapy. The frequency of anaemia, neutropenia and thrombocytopenia was significantly higher in inpatient group than in ambulatory home-based chemotherapy group (p <.001, <.001 and.002, respectively). Nausea, mucositis, and fatigue were more common in ambulatory home-based chemotherapy group than in inpatient group (p <.001,.022, and.005, respectively). Patients in the ambulatory home-based chemotherapy group showed higher social well-being (SWB) scores than inpatient group (coefficient 1.92, 95% confidence interval [CI] 0.65 to 3.19, p.003).
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    Home-based chemotherapy for stage III colon cancer patients in Thailand: Cost-utility and budget impact analyses
    (2020-01-01) Nattanichcha Kulthanachairojana; Phichai Chansriwong; Nintita Sripaiboonkij Thokanit; Suwannee Sirilerttrakul; Nopakan Wannakansophon; Suthira Taychakhoonavudh; Chulalongkorn University; Faculty of Medicine, Ramathibodi Hospital, Mahidol University
    © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. Home-based chemotherapy (HC) is a new treatment alternative to hospital-based chemotherapy treatment (IP) and is administered via portable intravenous pumps at the patient's home. HC reduces the demand for inpatient bed capacity in hospitals and reduces the cost of an infusion. This study takes a societal perspective while conducting the cost-utility and budget impact analyses (BIA) of HC and IP with an mFOLFOX6 regimen on patients with stage III colon cancer. We conducted a cost-utility analysis with a 6-month time horizon. The parameter inputs for the model were gathered from a retrospective cohort study on patients diagnosed with stage III colon cancer at Ramathibodi Hospital, Bangkok. The resource usage of HC and IP was determined based on medical records. The per-unit direct medical, home health service, and adverse events (AE) management costs were gathered from the standard cost list. The health outcome of treatment was measured in terms of quality-adjusted life years. Disutility related to AE was calculated. We conducted a sensitivity analysis for the uncertainty results and performed BIA based on the societal perspective on a 1-year time horizon. HC provided a cost-saving of $1,513.37 per patient for the period of treatment. Thus, assuming 526 patients per year, the use of HC could achieve a cumulative annual cost-saving of $828,436. HC is a cost-saving strategy compared to IP for stage III colon cancer treatment. We recommend that the service reimbursement should include national standardization in chemotherapy regimens as well as practice guidelines and protocols to prevent serious AEs.
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    Paclitaxel and Carboplatin in Combination in the Treatment of Advanced Non-small-cell Lung Cancer (NSCLC) : A Preliminary Study
    (1998-10-01) Vorachai Ratanatharathorn; Manmana Jirajarus; Ekaphop Sirachainan; Suwannee Sirilerttrakul; Anuparp Euaree; Pornchulee Supatchaipisit; Mahidol University
    This study was aimed to determine the activity and toxicity of combination paclitaxel and carboplatin in stage III B and IV NSCLC. Eligibililty required performance status. Paclitaxel was administered at a dose of 200 mg/m2, 3-hour infusion, followed by carboplatin at a tartgeted area under the concentration-time curve (AUC) of 6. Treatment was repeated at 3-week intervals for 6 courses. G-CSF 5 microgram/kg was subcutaneously injected during subsequent courses if there was grade 3-4 leukopenia or granulocytopenia in the previous course. From August 1996 through June 1997, 15 patients were enrolled. The median age was 47 years (range 20-68 years), 60 per cent were female. 73.3 per cent had adenocarcinoma, and 66.7 per cent had stage III B disease. Eighty three courses were administered; 13 patients (86.7%) completed all six cycles. The objective response rate was 53.3 per cent, with 1 (6.7%) complete response and 7 (46.7%) partial responses. Pleural effusion, lung lesion and lymph node were the three most common sites that responded to chemotherapy. The major toxicity was myelosuppression. Grade 3 or 4 granulocytopenia, anemia and thrombocytopenia were observed in 18 per cent, 7.2 per cent and 1.2 per cent, respectively, of 83 courses administered. Four episodes of febrile neutropenia (4.8%) occurred in 3 patients. There was one episode of anaphylaxis during Paclitaxel infusion. Other common toxicities were mild myalgia, paresthesias, alopecia and fatigue. Most of the toxicities showed cumulative effect. Paclitaxel plus carboplatin is a moderately active regimen in advanced NSCLC. Toxicities of this regimen are well tolerated.
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    Phase II trial of paclitaxel, carboplatin, and concurrent radiation therapy for locally advanced non-small-cell lung cancer
    (2001-02-10) Vorachai Ratanatharathorn; Vicharn Lorvidhaya; Savitree Maoleekoonpairoj; Pramook Phromratanapongse; Suwannee Sirilerttrakul; Puangthong Kraipiboon; Arkom Cheirsilpa; Saipin Tangkaratt; Vichien Srimuninnimit; Pitayapoon Pattaranutaporn; Mahidol University; Chiang Mai University; Pramongkutklao Hospital; National Cancer Institute Thailand
    We conducted a phase II trial to investigate the efficacy of concurrent chemoradiation in patients with stage III non-small-cell lung cancer (NSCLC). Thirty patients with inoperable NSCLC were enrolled onto a multicenter phase II trial of concurrent chemoradiation therapy. Patients received six weekly cycles of paclitaxel 45 mg/m2over 1 h; carboplatin at (area under the curve) AUC 2; and radiation therapy of 60 Gy. Radiation was administered to the primary tumor and regional lymph nodes (40 Gy over 4 weeks) followed by a boost to the primary tumor (20 Gy in 2 weeks). After the initial phase of concurrent chemoradiation, patients received an additional four cycles of paclitaxel 175 mg/m2over 3 h and carboplatin at AUC 6 every 3 weeks. The overall objective response rate of 30 assessable patients was 76.7%. At the median follow-up time of 13.1 months, the median survival time was 14.5 months (95% CI, 10.59-18.48). The median progression-free survival was 10.5 months (95% CI, 7.72-13.28). The major toxicity was hematologic. The incidence of grade 3 esophagitis was 10%. In conclusion, this chemoradiation regimen is well tolerated and shows significant clinical results for locally advanced NSCLC. Locoregional failure rate remains an important issue with this newer chemotherapeutic regimen. A novel chemotherapy and radiation therapy is clearly needed. Copyright © 2001 Elsevier Science Ireland Ltd.
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    Quality of life in gynecologic cancer survivors compared to healthy check-up women
    (2011-08-29) Sarikapan Wilailak; Arb aroon Lertkhachonsuk; Nawaporn Lohacharoenvanich; Suteera Chukkul Luengsukcharoen; Manmana Jirajaras; Puchong Likitanasombat; Suwannee Sirilerttrakul; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Mahidol University
    Objective: The primary objective of this study was to compare quality of life of disease-free patients after therapy for gynecologic malignancies at follow-up in comparison with healthy check-up patients. Our second objective was to assess correlation between demographic data, disease and treatment factors and quality of life scores. Methods: Patients completed the Functional Assessment of Cancer Therapy-General (FACT-G) quality of life questionnaire at least 6 months after treatment for a gynecologic malignancy. Responses were compared to unmatched healthy women who were seen for standard gynecologic screening examinations. Statistical calculation was done using chi-squared tests, Wilcoxon rank-sum, and Kruskal-Wallis one-way analysis and Spearman rank correlations. Factors associated with FACT-G scores were evaluated using univariate and multivariate analyses. Results: Eight hundred and seventy patients were recruited. The median time since therapy was 61 months (range, 6 to 173 months). The overall FACT-G scores were higher in the patient group than in the healthy group (p < 0.05). The scores of each subscale measuring physical, functional, social/family and emotional well-being were also higher in the patient group (p < 0.05). Multivariate analysis revealed correlation between Eastern Cooperative Oncology Group performance status, educational level, care giver, presence of economic problems and FACT-G scores. Conclusion: The quality of life scores were higher in gynecologic cancer patients after treatment. And the factors that associated with the higher score in the patient group are having husband as a caregiver, no financial problem, Eastern Cooperative Oncology Group score 0 or 1 and having high school or higher education. © 2011. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology and Colposcopy.
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    การพัฒนาแนวทางปฎิบัติการพยาบาลคลินิกการดูแลผู้ป่วยที่มีสายสวนหลอดเลือดดำชนิดฝังอยู่ใต้ผิวหนัง: การใช้หลักฐานเชิงประจักษ์
    (2551) ปานจิตร โชคพิชิต; จิราพร ชลธิชาชลาลักษณ์; จริยา ตันติธรรม; ฐิติมา เกียงไกรอุดม; แม้นมนา จิระจรัส; สุวรรณี สิริเลิศตระกูล; Panchit Chokephichit; Jiraporn Chontichachalalauk; Chariya Tantitham; Thitima Kaiengkraiudom; Manmana Jirajarus; Suwannee Sirilerttrakul; มหาวิทยาลัยมหิดล. คณะแพทยศาสตร์โรงพยาบาลรามาธิบดี. ภาควิชาพยาบาลศาสตร์
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    บทบาทของพยาบาลหน่วยบริการพยาบาลผู้ป่วยที่บ้านในการดูแลผู้ป่วยที่ได้รับยาเคมีบำบัดทางสายสวนหลอดเลือดดำส่วนกลางที่บ้าน
    (2562) ภิญโญ อุทธิยา; นิชธิมา เสรีวิชยสวัสดิ์; สุวรรณี สิริเลิศตระกูล; นพกาญจน์ วรรณกิจโสภณ; Pinyo Utthiya; Nitchatima Sereewichayasawad; Suwannee Sirilerttrakul; Noppakan Wannakansophon; มหาวิทยาลัยมหิดล. คณะแพทยศาสตร์โรงพยาบาลรามาธิบดี
    โรคมะเร็งเป็นปัญหาสาธารณสุขที่สำคัญระดับโลก เนื่องจากความรุนแรงรวมถึงปัญหา ภาระ เรื่องโรค ก่อให้เกิดผลกระทบต่อคุณภาพชีวิตของผู้ป่วยและครอบครัวจึงจำเป็นต้องมีการ พัฒนา การดูแลรักษาให้ครอบคลุมและทันต่อการเปลี่ยนแปลงของสังคมในปัจจุบัน การรักษา ด้วยยาเคมีบำบัดเป็นหนึ่งในการรักษาหลักที่ใช้รักษาผู้ป่วยโรคมะเร็งจำนวนมากในปัจจุบัน แต่จากปัญหาผู้ป่วยที่มากขึ้น และจำนวนเตียงนอนในโรงพยาบาลที่มีจำกัด โรงพยาบาลรามาธิบดี จึงได้มีโครงการบริหารยาเคมีบำบัดทางหลอดเลือดดำส่วนกลางที่บ้าน ที่เรียกว่า รามาโมเดล ด้วยความร่วมมือของสหสาขาวิชาชีพ และพยาบาลหน่วยบริการพยาบาลผู้ป่วยที่บ้านเป็นบุคลากร สำคัญในทีมมีบทบาทดังนี้ 1) วางแผนจำหน่ายผู้ป่วยก่อนออกจากโรงพยาบาล 2) การติดตาม เยี่ยมบ้าน 3) การติดตามทางโทรศัพท์ และ 4) การส่งต่อศูนย์บริการสาธารณสุข การให้บริการ พยาบาลผู้ป่วยที่ได้รับยาเคมีบำบัดทางสายสวนหลอดเลือดดำที่บ้าน เป็นบทบาทใหม่ที่มีความ สำคัญและเป็นความท้าทายของพยาบาลหน่วยบริการพยาบาลผู้ป่วยที่บ้าน ที่ส่งผลต่อคุณภาพ การดูแลรักษา ผู้ป่วยได้รับยาเคมีบำบัดตรงตามแผนการรักษา ได้รับการดูแลอย่างต่อเนื่อง เพิ่มคุณภาพชีวิต อีกทั้งสามารถตอบสนองนโยบายทั้งระดับโรงพยาบาลและระดับประเทศในการ ลดจำนวนการครองเตียง