Publications by authors named "Adnan Yöney"

35 Publications

Prognostic factors and clinical course of extremity soft-tissue sarcomas.

J Cancer Res Ther 2020 Jul-Sep;16(4):903-908

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Purpose: Although soft tissue constitutes half of the body weight, soft-tissue sarcomas (STSs) are less common than any other types of tumors.

Materials And Methods: In this retrospective study, the prognostic factors and clinical courses of 64 patients with extremity STSs treated at our clinic between 1996 and 2012 were investigated.

Results: Of the 64 patients included in this study, 35 (55%) were male and 29 (45%) were female. By the end of follow-up, 29 (45%) of the patients remained alive while 35 (55%) deceased. The overall survival (OS) time of the patients was 89.1 months, and their 1-, 3-, 5-, and 10-year survival rates were 82.8%, 69.3%, 51.6%, and 39.4%, respectively. Univariate analysis revealed the following variables as prognostic factors: tumor stage (P < 0.001), surgical method applied (P = 0.009), radiotherapy (RT) application (P = 0.018), RT dose (P < 0.001), and development of metastasis during follow-up (P < 0.001). Multivariate analysis revealed only type of surgery to be a prognostic factor (P = 0.016).

Conclusion: Besides surgery, RT plays a crucial role in the multimodal treatment of STSs and increases local control rates and OS. In our study, stage, surgery, and adjuvant RT were found to be effective factors indicating OS. However, more prospective work in this area is necessary.
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http://dx.doi.org/10.4103/jcrt.JCRT_108_18DOI Listing
November 2020

Comparison of Radiation-Induced Secondary Malignancy Risk Between Sequential and Simultaneous Integrated Boost for the Treatment of Nasopharyngeal Carcinoma: Intensity-Modulated Radiotherapy versus Volumetric-Modulated Arc Therapy.

Cancer Manag Res 2020 8;12:2513-2521. Epub 2020 Apr 8.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Purpose: This study aimed to compare the secondary cancer risk (SCR) between the sequential boost (SEQ) technique and simultaneous integrated boost (SIB) technique in intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) in patients with nasopharyngeal carcinoma (NPC) using the concepts of organ equivalent dose (OED) and excess absolute risk (EAR).

Patients And Methods: IMRT-SEQ, VMAT-SEQ, IMRT-SIB, and VMAT-SIB plans were created with identical objective functions for five patients with early-stage NPC. Three different planning tumor volumes (PTVs; PTV, PTV, and PTV) were delineated for each patient, and the prescribed doses were 50 Gy, 60 Gy, and 70 Gy (2 Gy/fraction), respectively, for the SEQ technique and 52.8 Gy, 59.4 Gy, and 69.3 Gy (33 fractions), respectively, for the SIB technique.

Results: All plans were clinically acceptable. There was no difference in most OED-based SCRs between IMRT and VMAT when the same fractionation scheme was used. Compared with the SEQ technique, the SIB technique in IMRT and VMAT was associated with the lowest OEDs for the oral cavity, pharynx, parotids, and submandibular glands, resulting in SCR reduction. SCR for the parotids was much lower than that for the other assessed organs when the SIB technique was used.

Conclusion: Our findings suggest that OED-based SCRs are lower with the SIB technique than with the SEQ technique in IMRT and VMAT in most organs for which SCR was calculated; furthermore, SCR for the parotids is much lower than that for other organs when the SIB technique is used in patients with NPC.
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http://dx.doi.org/10.2147/CMAR.S244901DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152539PMC
April 2020

A case of surgically treated bilateral metachronous malignant pleural mesothelioma.

Turk Gogus Kalp Damar Cerrahisi Derg 2019 Jan 1;27(1):121-124. Epub 2019 Jan 1.

Department of Thoracic Surgery, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, İstanbul, Turkey.

In this article, we present a 59-year-old male patient who was admitted to our hospital with right pleural effusion and right-sided chest pain and diagnosed as malignant pleural mesothelioma with thoracentesis and pleural biopsy. After the patient was determined to be operable, right parietal pleurectomy + pericardial resection + diaphragmatic resection were performed and four cycles of cisplatin and pemetrexed combination as adjuvant treatment were added. The patient was followed-up without any problem for three and a half years. At this time, left-sided chest pain and leftsided effusion were noticed. Tumor was negative in thoracentesis and pleural biopsy. Then, video-assisted thoracoscopic surgery was applied, which resulted in Stage 1a malignant pleural mesothelioma. Thoracoscopic parietal pleurectomy was performed with success. Four cycles of pemetrexed single-agent therapy was performed as an adjuvant treatment. The patient died of chronic obstructive pulmonary disease and heart failure in 57 month of the first and 21 month of the second operation while he was tumor free. To the best of our knowledge, this case is the first operated bilateral metachronous primary malignant pleural mesothelioma in the literature.
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http://dx.doi.org/10.5606/tgkdc.dergisi.2019.16162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021381PMC
January 2019

Secondary cancer risk after whole-breast radiation therapy: field-in-field versus intensity modulated radiation therapy versus volumetric modulated arc therapy.

Br J Radiol 2019 Oct 22;92(1102):20190317. Epub 2019 Jul 22.

Department of Radiation Oncology, Acibadem University, Istanbul, Turkey.

Objective: In this study, we used the concept of organ-equivalent dose (OED) to evaluate the excess absolute risk (EAR) for secondary cancer in various organs after radiation treatment for breast cancer.

Methods: Using CT data set of 12 patients, we generated three different whole-breast radiation treatment plans using 50 Gy in 2 Gy fractions: three-dimensional conformal radiotherapy with a field-in-field (FinF) technique, intensity modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT). The OEDs were calculated from differential dose-volume histograms on the basis of the "linear-exponential," "plateau," and "full mechanistic" dose-response models. Secondary cancer risks of the contralateral breast (CB), contralateral lung (CL), and ipsilateral lung (IL) were estimated and compared.

Results: The lowest EARs for the CB, CL, and IL were achieved with FinF, which reduced the EARs by 77%, 88%, and 56% relative to those with IMRT, and by 77%, 84%, and 58% relative to those with VMAT, respectively. The secondary cancer risk for FinF was significantly lower than those of IMRT and VMAT. OED-based secondary cancer risks for CB and IL were similar when IMRT and VMAT were used, but the risk for CL was statistically lower when VMAT was used.

Conclusion: The overall estimation of EAR indicated that the radiation-induced cancer risk of breast radiation therapy was lower with FinF than with IMRT and VMAT. Therefore, when secondary cancer risk is a major concern, FinF is considered to be the preferred treatment option in irradiation of whole-breast.

Advances In Knowledge: Secondary malignancy estimation after breast radiotherapy is becoming an important subject for comparative treatment planning.When secondary cancer risk a major concern, FinF technique is considered the preferred treatment option in whole breast patients.
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http://dx.doi.org/10.1259/bjr.20190317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774602PMC
October 2019

Effect of dose constraint on the thyroid gland during locoregional intensity-modulated radiotherapy in breast cancer patients.

J Appl Clin Med Phys 2019 Jul 24;20(7):135-141. Epub 2019 Jun 24.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

The aim of the present study was to compare radiation dose received by thyroid gland using different radiotherapy (RT) techniques with or without thyroid dose constraint (DC) for breast cancer patients. Computerized tomography (CT) image sets for 10 patients with breast cancer were selected. All patients were treated originally with opposite tangential field-in field (FinF) for the chest wall and anteroposterior fields for the ipsilateral supraclavicular field. The thyroid gland was not contoured on the CT images at the time of the original scheduled treatment. Four new treatment plans were created for each patient, including intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) plans with thyroid DC exclusion and inclusion (IMRT , IMRT , HT , and HT , respectively). Thyroid DCs were used to create acceptable dose limits to avoid hypothyroidism as follows: percentage of thyroid volume exceeding 30 Gy less than 50% (V  < 50%) and mean dose of thyroid (TD ) ≤ 21 Gy. Dose-volume histograms (DVHs) for TD and percentages of thyroid volume exceeding 10, 20, 30, 40, and 50 Gy (V , V , V , V , and V , respectively) were also analyzed. The D of the FinF, IMRT , HT , IMRT and HT plans were 30.56 ± 5.38 Gy, 25.56 ± 6.66 Gy, 27.48 ± 4.16 Gy, 18.57 ± 2.14 Gy, and 17.34 ± 2.70 Gy, respectively. Median V values were 55%, 33%, 36%, 18%, and 17%, for FinF, IMRT , HT , IMRT , and HT , respectively. Differences between treatment plans with or without DC with respect to D and V values were statistically significant (P < 0.05). When thyroid DC during breast cancer RT was applied to IMRT and HT, the TD and V values significantly decreased. Therefore, recognition of the thyroid as an organ at risk (OAR) and the use of DCs during IMRT and HT planning to minimize radiation dose and thyroid volume exposure are recommended.
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http://dx.doi.org/10.1002/acm2.12668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612689PMC
July 2019

Whole Brain Radiotherapy Plus Conventional Boost in Non-Small Cell Lung Cancer Patients with Brain Metastasis: A Retrospective Analysis of Overall Survival.

Turk Neurosurg 2019 ;29(4):464-469

Karadeniz Technical University, Faculty of Medicine, Department of Radiation Oncology, Trabzon, Turkey.

Aim: To evaluate the clinical characteristics and treatment outcomes of non-small cell lung cancer (NSCLC) patients with brain metastasis, who were treated by whole brain radiotherapy with a conventional boost at a single institution.

Material And Methods: A total of 296 patients diagnosed with NSCLC with brain metastasis and referred to our clinic for radiotherapy between 2000 and 2017 were included in this retrospective study.

Results: The median age was 60.8 ± 12.1 years, with a range of 21-85 years. The estimated median survival time for all patients was 7.81 ± 0.66 months (95% CI: 6.52-9.11). The one-year survival, two-year survival and three-year survival rates were 18.8%, 5.8% and 2.9%, respectively. The median survival of patients with solitary brain metastasis who received 45 Gy radiotherapy was 14.70 ± 2.80 months (95% CI: 9.20-20.20). These patients had 6 and 12 months survival rates of 65.4% and 42.6%, respectively. The median survival time of patients with solitary brain metastasis who received > 45 Gy radiotherapywas 13.86 ± 2.56 months (95% CI: 8.08-18.02). These patients had 6 and 12 months survival rates of 66.2% and 27.2%, respectively. There was no significant difference between the two groups (p=0.321). The median survival duration of patients under 65 years was 9.65 ± 1.02 months. The median survival time of patients aged 65 years and overwas 5.15 ± 0.51 months. There was a statistically significant difference in the median survival rates between the groups (p < 0.001).

Conclusion: Patients with solitary metastasis or single metastases tolerated whole brain radiotherapy with a conventional boost. Although the overall survival rates were numerically better in the high dose RT group, the difference was not statistically significant. Prospective studies with a larger sample size are needed to consolidate our results.
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http://dx.doi.org/10.5137/1019-5149.JTN.22896-18.3DOI Listing
October 2019

Radiotherapy in the management of classic Kaposi's sarcoma: A single institution experience from Northeast Turkey.

Dermatol Ther 2018 Jul 6;31(4):e12605. Epub 2018 Apr 6.

Faculty of Medicine, Department of Radiation Oncology, Karadeniz Technical University, Trabzon, Turkey.

Kaposi sarcoma is a rare adult neoplasm and there has been no certain consensus on standard treatment, either local or systemic. Radiotherapy is an effective, suitable treatment modality. Between 1996 and 2016, patients who were diagnosed with Kaposi sarcoma and referred to our clinic for radiotherapy were included in this retrospective study. Ninety-two patients were examined in total and it was diagnosed that all the patients had non-HIV associated Kaposi's sarcoma. There were 36 (39%) females and 56 (61%) males and female to male ratio was 2/3. Median age at presentation was 72 (30-93) years. Sixty-eight patients (77%) were treated with 8 Gy (1 fraction), 15 patients (16%) were treated with 20 Gy (2 Gy/fraction), four patients (4%) were treated 25 Gy (2.5 Gy/fraction), and five patients (6%) were treated 30 Gy (3 Gy/fraction). The median follow-up time was 72 (5-192) months. The complete response at 5 years was 91.6% with >20 Gy and 89.6% with 8 Gy. Radiotherapy is an effective, suitable treatment modality of Classic Kaposi sarcoma and usually, radiotherapy is well tolerated with minimal side effects.
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http://dx.doi.org/10.1111/dth.12605DOI Listing
July 2018

Remission Following Paclitaxel and Cisplatin Treatment in a 15-Year-Old Patient With Unresectable Esophageal Squamous Cell Cancer.

J Pediatr Hematol Oncol 2017 05;39(4):323-325

*Pediatric Hematology-Oncology, Division of Pediatric Hematology-Oncology †Pediatric Surgery, Division of Pediatric Surgery §Radiation Oncology, Division of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon ‡Pediatric Hematology-Oncology, Division of Erzurum Regional Training and Research Hospital, Erzurum, Turkey.

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http://dx.doi.org/10.1097/MPH.0000000000000817DOI Listing
May 2017

The choice of multi-beam IMRT for whole breast radiotherapy in early-stage right breast cancer.

Springerplus 2016 28;5(1):688. Epub 2016 May 28.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

The aim of this study was to identify a rational strategy for the selection of multi-beam IMRT in patients with right breast cancer through the comparison of dosimetric parameters of the planning target volume (PTV) and organs at risk (OARs) using five different radiotherapy modalities. This was a retrospective study using computed tomography scans from ten patients with early-stage right breast cancer who had been treated previously. Three dimensional conformal radiotherapy (3DCRT), forward-planned IMRT (for-IMRT), inverse-planned IMRT (inv-IMRT), helical tomotherapy (HT), and volumetric-modulated arc therapy (VMAT) were planned for each patient. The plans were compared according to dose-volume histogram analysis. The most significant impact of inverse-planned multi-beam modalities for right breast cancer was the reduction of Dmax, Dmean, V53.5 and prescribed dose volume (cc) outside of the PTV (breast) (OB-V50) of the PTV. HT decreased the ipsilateral OAR volumes receiving higher doses. In exchange, HT also increased the volumes receiving low doses, which is known to lead to an increased rate of radiation-induced secondary malignancies. The heart, LAD, and contralateral doses for 3DCRT and for-IMRT were significantly lower than those for inv-IMRT, HT, and VMAT. In addition, inv-IMRT demonstrated an increase in exposed volume of heart, LAD, ipsilateral lung, and contralateral lung compared with those parameters for HT or VMAT. Although it is known to reduce cardiac toxicity with breath hold technique in left sided breast cancer, similarly it is possible for 3DCRT and for-IMRT techniques in right sided breast cancer even in free breathing.
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http://dx.doi.org/10.1186/s40064-016-2314-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899391PMC
June 2016

Survival and prognostic factors in limited stage small cell lung cancer: A retrospective study from northeast Turkey.

J Cancer Res Ther 2016 Jan-Mar;12(1):238-43

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Aim Of The Study: The purposes of this retrospective study were to identify survival rates for limited stage small cell lung cancer (LD-SCLC) and analyze treatment outcomes and influencing factors on survival.

Materials And Methods: We conducted data from patients diagnosed with LD.SCLC between January 1998 and December 2012 at our institution. Dermographic information, treatment modalities, pretreatment clinical asessment, were recorded. Most of the patients. (88.4%) were treated with curative intent. The survival probabilties were asessed by Kaplan.Meier analysis. Cox regression was used to assess prognostic factors on overall survival and disease.free survival.

Results: A total of 129 patients were examined as a LD-SCLC. The median age was 60 (range; 31-86). Median follow-up time was 9.4 (SE ± 20.5) months and the median overall survival was 13.9 months [95% cumulative incidence (CI): 10.1-17.6]. On multivariate analysis, concurrent chemotherapy [HZ: 2.7 (95% CI: (1.0-7.2)] (P = 0.037) and doses of radiation therapy (<50, ≥50) [HZ: 1.4 (95% CI: (1.0-2.2)] (P = 0.046) were statistically significant on overall survival. With regard to multivariate anlaysis age (<60, ≥60) [HZ: 2.2 (95% CI: (0.6-3.7)] (P = 0.011), doses of radiation therapy (<50, ≥50) [HZ: 2.7 (95% CI: (1.0-7.2)] (P = 0.046), precense of surgery [HZ: 15.3 (95% CI: (1.5-152)] (P = 0.020), prophilactic cranial radiation therapy (PCI) [HZ: 2.3 (95% CI: (1.1-4.5)] (P = 0.014), and presence of concurrent chemoradiotherapy [HZ: 3.0 (95% CI: (1.3-6.8)] (P = 0.008) were important variable affecting disease-free survival.

Conclusion: For LD-SCLC patients concurrent chemoradiation therapy and 50. Gy and over doses radiation therapy provided improvement on overall and disease.free survival.
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http://dx.doi.org/10.4103/0973-1482.151446DOI Listing
December 2016

Prognostic Factors and Clinical Outcome in Parotid Gland Tumors: a Single Institution Experience from the Eastern Black Sea Region of Turkey.

Asian Pac J Cancer Prev 2016 ;17(3):1169-74

Department of Radiation Oncology, Faculty of Medicine, Trabzon, Karadeniz Technical University, Turkey E-mail :

Purpose: To review clinical characteristics, treatment outcomes and prognostic factors in patients with parotid gland tumors treated with surgery and postoperative radiotherapy.

Materials And Methods: We retrospectively reviewed 69 patients with parotid gland tumors, with a median follow-up of 52 months (range, 2-228 months). and a median radiotherapy dose of 60Gy (range, 30-69 Gy).

Results: There were 24 (35%) females and 45 (65%) males, at a ratio of 1/1.9. Median age at presentation was 58.9±17.2 (range 13-88) years. The most common histology was adenoid cystic carcinoma (33%) and mucoepidermoid carcinoma (28%). The mean overall survival (OS) was 65.3±8 (95% confidence interval [CI], 49.6-81.1) months and the median overall survival was 40.0 ± 7 (95% CI, 26.2-53.7) months. The -1, -3, -5 and -10 year OS rates were 78%, 52.4%, 35.3% and 19.6% respectively. The mean disease free survival (DFS) was 79.2±10 (95% CI, 59.3-97.1) months and the median disease free survival was 38±13 (95% CI, 7.05-88.7) months. The -1,-3,-5 and -10 year DFS rates were 71.9%, 50.1%, 43.7% and 30.1% respectively. On univariate analysis, the OS was significantly better with female sex (p<0.005), < 50 age (p<0.021), T stage (p<0.0001), absence of lymph node involvement (p<0.0001), lower tumor grade (p<0.0001), absence of lymphovascular invasion (p<0.002), absence of perineural invasion (p<0.0001), absence of extracapsuler extension (p<0.0001), surgical margin negativity (p<0.006), ≤60 Gy radiotherapy dose (p<0.0001) and absence of distant metastasis (p<0.027).

Conclusions: Employing existing standards of postoperative radiotherapy is a possible treatment that was found to be mainly effective in patients with parotid gland carcinomas.
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http://dx.doi.org/10.7314/apjcp.2016.17.3.1169DOI Listing
January 2017

Comparison of the effects of melatonin and genistein on radiation-induced nephrotoxicity: Results of an experimental study.

Biomed Rep 2016 Jan 24;4(1):45-50. Epub 2015 Nov 24.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.

The aim of the present study was to compare the effects of melatonin and genistein on radiation-induced nephrotoxicity (RIN). A total of 70 Swiss Albino mice were divided into 7 groups. Five control groups were defined, which were sham irradiation (C, G1), radiation therapy only (RT, G2), melatonin (M, G3), genistein (G, G4) and polyethylene glycol-400 (G5), respectively. The co-treatment groups were the RT plus melatonin (RT+M, G6) and RT plus genistein (RT+G, G7) groups. Irradiation was applied using a cobalt-60 teletherapy machine (80-cm fixed source-to-surface distance, 2.5-cm depth). Melatonin was administered (100 mg/kg, intraperitoneal injection) 30 min before the single dose of irradiation, whereas genistein was administered (200 mg/kg, subcutaneous injection) 1 day before the single dose of irradiation. All the mice were sacrificed 6 months after irradiation. As an end point, the extent of renal tubular atrophy for each mouse was quantified with image analysis of histological sections of the kidney. Tissue malondialdehyde (MDA) levels were also measured in each animal. In the histopathological examination of the mouse kidneys, there was a statistically significant reduction (P<0.05) in the presence of tubular atrophy between the RT+M and RT+G groups and the RT group. There was a statistically significant increase in MDA levels in the irradiated versus sham groups (RT vs. C; P<0.05); however, MDA levels were significantly decreased by co-treatment with melatonin or genistein vs. RT alone (RT+M and RT+G vs. RT; P<0.05). In conclusion, the present experimental study showed that melatonin and genistein supplementation prior to irradiation-protected mice against RIN, which may have therapeutic implications for radiation-induced injuries.
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http://dx.doi.org/10.3892/br.2015.547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4726846PMC
January 2016

Olfactory neuroblastoma: A case report.

Oncol Lett 2015 Dec 20;10(6):3651-3654. Epub 2015 Oct 20.

Department of Radiation Oncology, Faculty of Medicine, Kanuni Research and Education Hospital, Trabzon 61040, Turkey.

Olfactory neuroblastoma (ON) is a rare type of malignant neoplasm originating from the olfactory neuroepithelial cells of the nasal cavity. ON is also known as esthesioneuroblastoma or neuroendocrine carcinoma. The malignancy accounts for <3% of tumors originating in the nasal cavity. Through the nasal cavity, ON may infiltrate the sinuses, the orbit and the cranium. The tumor is characterized by a pattern of slow growth and local recurrences. Treatment options are surgical excision or surgery combined with a radiotherapy (RT) and/or chemotherapy combination treatment. The present study reports the case of a 69-year-old patient with a mass in the nasal cavity who was treated by combined surgical excision and RT. The literature for ON and the treatment of the tumor are also discussed.
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http://dx.doi.org/10.3892/ol.2015.3821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665699PMC
December 2015

In Reply to Roos and Smith and an Erratum.

Int J Radiat Oncol Biol Phys 2016 Jan;94(1):212-214

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

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http://dx.doi.org/10.1016/j.ijrobp.2015.10.012DOI Listing
January 2016

Adjuvant radiotherapy in stage 1 seminoma: Evaluation of prognostic factors and results of survival.

J Cancer Res Ther 2015 Apr-Jun;11(2):313-8

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Purpose: The purpose of this study was to evaluate the prognostic factors affecting overall survival (OS), cause-specific survival (CSS), progression-free survival (PFS), and survival among patients undergoing adjuvant radiotherapy (RT) for stage-1 seminoma.

Materials And Methods: Between August 1997 and May 2013, 68 patients diagnosed with stage-1 seminoma were retrospectively evaluated. The median age was 39 (24-74) years. All patients received adjuvant RT after inguinal orchiectomy. Fifty-eight (85.3%) patients received paraaortic RT; 10 (14.7%) received dog-leg field RT. The median RT dose was 23.4 (23.4-30.6) Gy.

Results: The median follow-up period was 77.5 (6.7-198.5) months. During the follow-up period, two patients developed distant metastasis, and none developed local recurrence. Two patients died from seminoma, and three died for other reasons. The 5, 10, and 15-year OS rates were 94.7%, 89.6%, and 89.6%, respectively. The 5, 10, and 15-year CSS rates were 98.5%, 96%, and 96%, respectively. The 5, 10, and 15-year PFS rate was 96.1%. The univariate analysis showed that only histological subtype was significant for OS. The 10-year survival rate was 100% among patients with seminoma histology, 90.8% among patients with a classic seminoma histology, and 50% among patients with an anaplastic seminoma histology (P < 0.001). A multivariate analysis showed that the anaplastic seminoma was a negative prognostic indicator for OS (P = 0.042).

Conclusion: Adjuvant RT resulted in excellent long-term survival and local control in patients with stage-1 seminoma after orchiectomy. During a short follow-up, secondary malignancy (SM) and late cardiovascular morbidity were not observed. Despite those results, concern of SM and late cardiovascular morbidity remains.
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http://dx.doi.org/10.4103/0973-1482.140846DOI Listing
April 2016

Evaluation of outcome and prognostic factors in 739 patients with uterine cervix carcinoma: a single institution experience.

Contemp Oncol (Pozn) 2015 13;19(2):130-6. Epub 2015 May 13.

Okmeydanı Training and Research Hospital, Istanbul, Turkey.

Aim Of The Study: The aim of this retrospective chart review was to determine the long-term outcomes and identify prognostic factors that impact the survival of patients with cervical cancer.

Material And Methods: A retrospective chart review of 739 patients with International Federation of Gynaecology and Obstetrics (FIGO) stage I-IV cervical cancer treated with surgery, radiation or chemoradiation was performed. Patient charts were evaluated in terms of demographics, clinical outcomes, and survival. Disease-free survival (DFS) and overall survival (OS) were calculated with the Kaplan-Meier method, and differences in survival were compared with the log-rank test. Multivariate analysis was performed with a Cox proportional hazards model to determine the estimated hazard ratios (HR) with 95% confidence intervals (CI) for each prognostic factor.

Results: The Cox proportional hazards model demonstrated that pelvic nodal metastasis (p = 0.018), parametrial invasion (p = 0.015), and presence of disease in the surgical margin (p = 0.011) were all independent prognostic factors for OS. The 5-year OS rate of patients with negative pelvic lymph nodes was 67.1%, which was higher than the rate for those with positive nodes at 49.0% (p < 0.05). The 5-year OS rate was 54.3% for patients with metastasis to the parametrium, 79.2% with a cancer-free parametrium, 60.9% with a cancer-positive surgical margin, 85.4% with a cancer-negative surgical margin, and 64.3% with a 1-3 mm close surgical margin (p < 0.05).

Conclusions: Assessing pelvic lymph nodes, the parametrium, and surgical margins is important for survival and may aid in better identifying patients who would derive greater benefits from receiving adjuvant therapies and more aggressive treatments.
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http://dx.doi.org/10.5114/wo.2015.51418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444446PMC
June 2015

Long-term results of a concomitant boost radiotherapy technique for elderly patients with muscle-ınvasive bladder cancer.

J Geriatr Oncol 2015 07 8;6(4):316-23. Epub 2015 May 8.

Department of Radiation Oncology, Faculty of Medicine, Akdeniz University, Antalya,Turkey. Electronic address:

Objectives: To evaluate the long-term clinical efficacy and toxicity of concomitant boost radiotherapy (CBRT) in elderly patients with invasive bladder cancer.

Methods And Materials: Elderly patients (n=188; mean 75-year-old, range 70-91 years; 88.3% male/11.7% female) with T1-T4a bladder carcinoma were irradiated with CBRT. A total of 24 (12.8%) patients were diagnosed at stage T1, 117 (62.2%) were at stage T2, 28 (14.9%) at were stage T3a, 14 (7.4%) were stage T3b, and 5 (2.7%) were stage T4a. A dose of 45Gy in 1.8Gy fractions was administered to the whole pelvis 5 days/week over 5 weeks. A concomitant boost limited to the bladder tumor area plus margin or whole bladder of 22.5Gy in 1.5Gy fractions was administered from weeks 3×5. Thus, irradiation totalled 67.5Gy over 5 weeks. The interfraction interval was ≥6h/treatment day. We assessed prognostic factors for overall survival (OS), cause-specific survival (CSS) and relapse-free survival (RFS).

Results: Median follow-up was 46.2 months (range 4.7-155.7 months). Median overall survival was 27 months (95% CI:21-33 months). In this study, 146 (77.7%) patients had complete response, 39 (20.7%) had residual disease and 4 (1.6%) had progressive disease. The mean 3-, 5- and 10-year OS rates were respectively 41.2% (S.E.±0.036), 29% (S.E.±0.034), and 13.8% (S.E.±0.031). Significant prognostic factors for OS and CSS, by multivariate analysis, were tumor T-stage and urothelial obstruction.

Conclusion: This CBRT protocol provided excellent results with a high complete response rate and good tolerance. This approach may therefore be particularly appropriate for elderly patients with invasive bladder cancer.
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http://dx.doi.org/10.1016/j.jgo.2015.04.004DOI Listing
July 2015

Prospective Randomized Comparison of the Effectiveness of Radiation Therapy and Local Steroid Injection for the Treatment of Plantar Fasciitis.

Int J Radiat Oncol Biol Phys 2015 Jul 28;92(3):659-66. Epub 2015 Apr 28.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Purpose: The purpose of this study was to conduct a randomized trial of radiation therapy for plantar fasciitis and to compare radiation therapy with local steroid injections.

Methods And Materials: Between March 2013 and April 2014, 128 patients with plantar fasciitis were randomized to receive radiation therapy (total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy three times a week) or local corticosteroid injections a 1 ml injection of 40 mg methylprednisolone and 0.5 ml 1% lidocaine under the guidance of palpation. The results were measured using a visual analog scale, a modified von Pannewitz scale, and a 5-level function score. The fundamental phase of the study was 3 months, with a follow-up period of up to 6 months.

Results: The median follow-up period for all patients was 12.5 months (range, 6.5-18.6 months). For the radiation therapy patients, the median follow-up period was 13 months (range, 6.5-18.5 months), whereas in the palpation-guided (PG) steroid injection arm, it was 12.1 months (range, 6.5-18.6 months). After 3 months, results in the radiation therapy arm were significantly superior to those in the PG steroid injection arm (visual analog scale, P<.001; modified von Pannewitz scale, P<.001; 5-level function score, P<.001). Requirements for a second treatment did not significantly differ between the 2 groups, but the time interval for the second treatment was significantly shorter in the PG steroid injection group (P=.045).

Conclusion: This study confirms the superior analgesic effect of radiation therapy compared to mean PG steroid injection on plantar fasciitis for at least 6 months after treatment.
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http://dx.doi.org/10.1016/j.ijrobp.2015.02.009DOI Listing
July 2015

Comparison of dose distributions hippocampus in high grade gliomas irradiation with linac-based imrt and volumetric arc therapy: a dosimetric study.

Springerplus 2015 5;4:114. Epub 2015 Mar 5.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

The aim of this study was to assess the feasibility of sparing contralateral hippocampus during partial brain radiotherapy in high grade gliomas. 20 previously treated patients were replanned to 60 Gy in 30 fractions with sparing intensity-modulated radiotherapy (IMRT) and volumetric modulated arctherapy (VMAT) using the following planning objectives: 100 % of PTV covered by 95% isodose without violating organs at risk (OAR) and hot spot dose constraints. For each, standard intensity-modulated radiotherapy (IMRT) plans were generated, as well as sparing IMRT and VMAT plans which spared contralateral (hemispheric cases) hippocampus. When the three plans were compared, there was equivalent PTV coverage, homogeneity, and conformality. Sparing IMRT significantly reduced maximum, mean, V20, V30 and V40 hippocampus doses compared with standart IMRT and VMAT (p < 0.05). VMAT significantly reduced maximum left lens and mean eye doses compared with standart IMRT and sparing IMRT (p < 0.05). Brainstem, chiasm, left and right optic nerves, right eyes and lens doses were similar. VMAT significantly reduced monitor units compared with standart IMRT and sparing IMRT (p < 0.05). It is possible to spare contralateral hippocampus during PBRT for high grade gliomas using IMRT. This approach may reduce late cognitive sequelae of cranial radiotherapy.
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http://dx.doi.org/10.1186/s40064-015-0894-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366430PMC
March 2015

Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and volumetric arc therapy.

Phys Med 2015 Jun 26;31(4):360-7. Epub 2015 Feb 26.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. Electronic address:

Purpose: This study evaluated the dose distribution and homogeneity of four different types of intensity-modulated radiotherapy (IMRT) in comparison with standard wedged tangential-beam three-dimensional conformal radiotherapy (3DCRT) of the left breast in patients who had undergone lumpectomy.

Materials And Methods: Five radiotherapy treatment plans, including 3DCRT, forward-planned IMRT (for-IMRT), inverse IMRT (inv-IMRT), helical tomotherapy (HT) and volumetric-modulated arc therapy (VMAT), were created for 15 consecutive patients.

Results: All modalities presented similar target coverage. Target max doses were reduced with for-IMRT compared to 3DCRT, and these doses were further reduced with inv-IMRT and HT. HT resulted in the lowest max doses delivered to the heart, left anterior descending artery (LAD), and ipsilateral lung, but had higher mean, max, and low doses delivered to contralateral breast. HT resulted in increased low doses to a large volume of healthy tissue. Compared to other techniques, all inverse-planned modalities significantly improved conformity number; however, VMAT had worse homogeneity. The for-IMRT plan significantly lowered monitor unit (MU) compared to the inverse-planned techniques.

Conclusion: All modalities evaluated provide adequate coverage of the whole breast. For-IMRT improves target homogeneity compared with 3DCRT, but to a lesser degree than the inverse-planned inv-IMRT and HT. HT decreases the ipsilateral OAR volumes receiving higher and mean doses with an increase in the volumes receiving low doses, which is known to lead to an increased rate of radiation-induced secondary malignancies.
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http://dx.doi.org/10.1016/j.ejmp.2015.02.005DOI Listing
June 2015

Evaluation of prognostic factors and survival results in gastric carcinoma: single center experience from Northeast Turkey.

Int J Clin Exp Med 2014 15;7(9):2656-66. Epub 2014 Sep 15.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey.

Objective: To evaluate the prognostic factors affecting overall survival (OS), disease-free survival (DFS), and survival among patients undergoing chemoradiotherapy (CRT) for locally advanced gastric carcinoma.

Methods: Between January 2001 and May 2014, 257 patients who presented to our clinic with a diagnosis of stage I-IIIC gastric cancer were evaluated. The male/female ratio of the cases was 2.02:1 and the median age was 55.16±11.8 (20-80) years. Four of the cases (1.6%) were stage IA, 13 (5.1%) were stage 1B, 41 (16%) were stage IIA, 40 (15.6%) were stage IIB, 50 (19.5%) were stage IIIA, 51 (19.8%) were stage IIIB, and 58 (22.6%) were stage IIIC.

Results: The mean follow-up time was 22.5 months (3.3-155.0); loco-regional recurrence was noted in 34 (13.2%) patients who underwent postoperative chemoradiotherapy, and metastases were observed in 108 (42%) patients. The median OS duration was 26.7 months (95% confidence interval, 20-33.5) and the 2-, 5-, and 10-year OS was 52.8% (standard error [S.E.] 0.032), 36.1% (S.E. 0.032), and 26.9% (S.E. 0.034) respectively. The median DFS was 53.7 months and the 2-, 5-, and 10-year DFS were 58.9% (S.E. 0.034), 47.4% (S.E. 0.037), and 40.7% (S.E. 0.042), respectively. In multivariate analysis of prognostic factors, advanced T stage (p<0.0001), advanced nodal stage (p=0.001), and surgical margin status (p<0.0001) were related to decreased OS and DFS.

Conclusion: R1 resection, advanced T stage, and advanced nodal stage were adverse prognostic factors in gastric cancer patients who had undergone CRT after the operation.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211773PMC
October 2014

Long-term outcomes in treatment of invasive bladder cancer with concomitant boost and accelerated hyperfractionated radiation therapy.

Int J Radiat Oncol Biol Phys 2014 Nov 23;90(3):562-9. Epub 2014 Aug 23.

Department of Radiation Oncology, Karadeniz Technical University, Trabzon, Turkey.

Purpose: The aim of this study was to evaluate the long-term clinical efficacy and toxicity of concomitant boost and accelerated hyperfractionated radiation therapy (CBAHRT) in patients with invasive bladder cancer.

Methods And Materials: Between October 1997 and September 2012, 334 patients with diagnoses of invasive bladder cancer were selected. These patients received CBAHRT as a bladder-conserving approach. The treatment consisted of a dose of 45 Gy/1.8 Gy to the whole pelvis with a daily concomitant boost of 1.5 Gy to the tumor. Total dose was 67.5 Gy in 5 weeks. A total of 32 patients (10.3%) had a diagnosis of stage T1, 202 (64.3%) were at stage T2, 46 (14.6%) were at stage T3a, 22 (7%) were at stage T3b, and 12 (3.8%) were at stage T4a.

Results: The follow-up period was 33.1 months (range, 4.3-223.3 months). Grade 3 late intestinal toxicity was observed in 9 patients (2.9%), whereas grade 3 late urinary toxicity was observed in 8 patients (2.5%). The median overall survival (OS) was 26.3 months (95% confidence interval [CI]: 21.4-31.2). The 5-, 10, and 15-year OS rates were 32.1% (standard error [SE], ± 0.027), 17.9% (SE, ± 0.025) and 12.5% (SE, ± 0.028), respectively. The median cause-specific survival (CSS) was 42.1 months (95% CI: 28.7-55.5). The 5-, 10-, and 15-year CSS rates were 43.2% (SE, ± 0.03), 30.3% (SE, ± 0.03), and 28% (SE, ± 0.04), respectively. The median relapse-free survival (RFS) was 111.8 months (95% CI: 99.6-124). The 5-, 10-, and 15-year RFS rates were 61.9% (SE, ± 0.03), 57.6% (SE, ± 0.04), and 48.2% (SE, ± 0.07), respectively.

Conclusions: The CBAHRT technique demonstrated acceptable toxicity and local control rates in patients with invasive bladder cancer, and this therapy facilitated bladder conservation. In selected patients, the CBAHRT technique is a practical alternative treatment option with acceptable 5-, 10-, and 15-year results in patients undergoing cystectomy as well as concurrent chemoradiation therapy.
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http://dx.doi.org/10.1016/j.ijrobp.2014.06.055DOI Listing
November 2014

Giant cell tumor of the occipital bone: A case report and review of the literature.

Oncol Lett 2014 Jul 25;8(1):151-154. Epub 2014 Apr 25.

Department of Radiology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey.

Giant cell tumors (GCTs) are usually found in the epiphysis of the long bones, and represent ~5% of all bone tumors. Only <1% of GCTs are localized in the cranium. When localized in the cranium, GCTs are commonly observed in the sphenoid or temporal bones, and rarely in the parietal or frontal bones. Occipital bone posterior fossa involvement is an extremely rare occurrence. The current study presents a 22-year-old female patient was admitted to the Department of Radiation Oncology (Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey) with complaints of neck pain and headache. The patients cranial magnetic resonance images showed a 2.5 6-cm mass in the occipital bone, which was subtotally excised. The patient was treated with radiotherapy following the surgery. At present, the patient has shown no progression after 20 months of follow-up.
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http://dx.doi.org/10.3892/ol.2014.2086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063638PMC
July 2014

Adenoid cystic carcinoma of the breast: A case report and literature review.

Oncol Lett 2014 May 6;7(5):1599-1601. Epub 2014 Mar 6.

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Adenoid cystic carcinoma (ACC) is a rare malignant tumor of the breast that occurs in <0.1% of all patients diagnosed with breast cancer. The mean patient age at the time of diagnosis is 50-60 years. Typically, the tumor presents as a subareolar mass or as pain in the breast. While the radiological appearances of ACC are generally non-specific, the diagnosis can be made on fine-needle aspiration cytology. In the present study, a 58-year-old female patient was admitted to the Department of Radiation Oncology (Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey) with complaints of pain in the upper outer quadrant of the right breast. An excision biopsy of a lump in the upper outer quadrant revealed ACC, and perineural invasion was present. Subsequently, the patient underwent breast conservation surgery and sentinel lymph node dissection. Pathology from the second surgery depicted ACC in the form of microscopic foci around the initial surgical cavity, with two reactive sentinel lymph nodes and the closest negative margin at 2 mm. The patient was treated with radiotherapy following the surgery. No recurrence and metastasis were found after 20 months of follow-up. In conclusion, mammary ACC is a rare malignant neoplasm of the breast. Although surgery is the main treatment, the optimal adjuvant treatment of ACC of the breast has not yet been determined due to its low incidence.
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http://dx.doi.org/10.3892/ol.2014.1945DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997715PMC
May 2014

Lack of any impact of histopathology type on prognosis in patients with early-stage adenocarcinoma and squamous cell carcinoma of the uterine cervix.

Asian Pac J Cancer Prev 2014 ;15(6):2815-9

Department of Radiation Oncology, Faculty of Medicine, Dicle University, Turkey E-mail :

Background: The aim of this study was to evaluate the prognosis of patients with stage IA-IIB cervical carcinoma and to investigate a possible correlation of histology with prognosis.

Materials And Methods: Two hundred fifty one patients with adenocarcinoma and squamous cell carcinoma (SCC) histology for FIGO (International Federation of Gynecology and Obstetrics) stage IA-IIB uterine cervical carcinomas at the Radiation Oncology Clinic of GH Okmeydani Training and Research Hospital between January 1996 and December 2006 were selected, analyzed retrospectively and evaluated in terms of general characteristics and survival. Disease-free survival (DFS) and overall survival (OS) was calculated using the Kaplan-Meier method and differences were compared with the log-rank test. Multivariate analysis using a Cox-proportional hazards model was used to adjust for prognostic factors and to estimate hazard ratio (HR) with 95% confidence interval (CI).

Results: There was no differences between the two tumour types in age, stage, pelvic nodal metastasis, parametrial invasion, surgical margin status, DSI, LVSI, maximal tumor diameter, grade, and treatment modalities. 5-year OS and DFS were 73% and 77%, versus 64% and 69%, for SCC and adenocarcinoma, respectively (p> 0.05). Multivariate analysis revealed independent prognostic factors including pelvic nodal metastasis and resection margin status for OS (p=0.008, p=0.002, respectively).

Conclusions: Prognosis of FIGO stage IA-IIB cervical cancer patients was found to be the same for those with adenocarcinoma and SCC.
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http://dx.doi.org/10.7314/apjcp.2014.15.6.2815DOI Listing
January 2015

Preoperative chemoradiation in locally advanced rectal cancer: a comparison of bolus 5-fluorouracil/leucovorin and capecitabine.

Saudi J Gastroenterol 2014 Mar-Apr;20(2):102-7

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Purpose: To compare the acute toxicities, pathologic response, surgical margins, downstaging, local control, disease-free survival (DFS), and overall survival (OS) in locally advanced rectal cancer patients with preoperative radiotherapy (RT) with either concurrent bolus 5-fluorouracil (5-FU)/leucovorin (LV) or capecitabine (CA).

Materials And Methods: Sixty patients who presented to our department with a diagnosis of locally advanced rectal cancer were treated with surgery following preoperative RT with either concurrent 5-FU/LV or CA between January 2008 and December 2011 were analyzed.

Results: Median follow-up period was 38 months (range 3-61). Four patients (6.7%) had grade 3 gastrointestinal (GIS) toxicity during the course of chemoradiotherapy. The pathologic complete response rates were 8% with 5-FU/LV and 8.6% with CA (P = 0.844). Also, 60% of the patients treated with 5-FU/LV and 37.1% with CA had downstaging of the T stage after chemoradiotherapy (P = 0.026). The 5-year local control (P = 0.510), distant control (P = 0.721), DFS (P = 0.08), and OS (P = 0.09) rates were 80%, 80%, 59.4%, and 64.4%, respectively, for patients treated with 5-FU/LV and 85.7%, 82.9%, 74.8%, and 75.1%, respectively, for patients treated with CA.

Conclusion: No significant differences were seen in the local control and distant recurrences and the survival among patients treated with pre-op RT and concurrent 5-FU/LV compared with those treated with pre-op RT and concurrent CA, except toxicities.
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http://dx.doi.org/10.4103/1319-3767.129474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987149PMC
December 2014

Evaluation of prognostic factors and survival results in pancreatic carcinomas in Turkey.

Asian Pac J Cancer Prev 2014 Jan;14(11):6573-8

Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey E-mail :

Background: The goal of this retrospective study was to evaluate patient characteristics, treatment modalities and prognostic factors in Turkish patients with pancreatic cancer.

Materials And Methods: Between January 1997 and December 2012, 64 patients who presented to the Department of Radiation Oncology, Karadeniz Technical University, Faculty of Medicine with a diagnosis of pancreatic cancer were evaluated. The E/K ratio of the cases was 2.4/1 and the median age was 59.6 (32-80) years, respectively. Some 11 cases (18%) were stage 1, 21 (34.4%) were stage 2, 10 (16.4%) were stage 3, and 19 (31.1%) were metastatic.

Results: The mean follow-up time was 15.7 months (0.7-117.5) and loco-regional recurrence was noted in 11 (40.7%) who underwent surgery while metastases were observed in 41 patients (66.1%). The median overall survival (OS) was 11.2 months and the 1, 3 and 5-year OS rates were 41.7%, 9.9% and 7.9% respectively. The median disease-free survival (DFS) was 5.2 month and the1, 2 and 5 year DFS were 22.6%, 7.6% and 3.8% respectively. On univariate analysis, prognostic factors affecting OS included status of the operation (p<0.001), tumor stage (p=0.008), ECOG performance status (p=0.005) and CEA level (p=0.017).On multivariate analysis, prognostic factors affecting survival included status of the operation (p=0.033) and age (p= 0.023).

Conclusions: In the current study, age and operation status were independent prognostic factors for overall survival with pancreatic patients. Thus, the patients early diagnosis and treatment ars essential. However, prospective studies with more patients are needed for confirmation.
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http://dx.doi.org/10.7314/apjcp.2013.14.11.6573DOI Listing
January 2014

Can capecitabine be used instead of concurrent bolus 5-FU in postoperative chemoradiotherapy for gastric adenocarcinoma?

Asian Pac J Cancer Prev 2013 ;14(9):5127-31

Karadeniz Technical University, Faculty of Medicine, Department of Radiation Oncology, Trabzon, Turkey E-mail :

Background: 5-fluoro-uracil (FU) is a common agent in postoperative chemoradiation in gastric adenocarcinoma. However, FU is not well tolerated in a significant proportion of patients. Capecitabine (CA) is an orally administered fluoropyrimidine carbamate which is preferentially converted to active 5-FU and is one of the agents used instead of FU in such cases. We compared the toxicity, local and distant control and survival rates with FU or oral CA during the course of concurrent radiotherapy to assess the role of CA used instead of FU.

Materials And Methods: We conducted an analysis of survival, disease control and toxicity data in 46 patients treated with postoperative chemoradiation following total or subtotal gastrectomy for gastric adenocarcinoma with either FU or CA between January 2008 and December 2012.

Results: Median follow-up was 19 months (range: 3-59), median survival time was 23 (± 6.08) months and 1-3 years overall survival (OS) rates were 64.9- 39% for all patients. Compared with the CA regimen, the incidence of treatment interruption was higher with FU (p=0.023), but no significant differences were seen in local control (p=0.510), distant recurrences (p=0.721) and survival rates (p=0.866) among patients.

Conclusions: Concurrent CA with radiotherapy seems to be a more tolerable and an equally effective regimen for the postoperative treatment of gastric adenocarcinoma when compared to FU.
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http://dx.doi.org/10.7314/apjcp.2013.14.9.5127DOI Listing
December 2014

Patterns of care for lung cancer in radiation oncology departments of Turkey.

Int J Radiat Oncol Biol Phys 2008 Dec 15;72(5):1530-7. Epub 2008 Aug 15.

Dokuz Eylul University Medical School, Department of Radiation Oncology, Izmir, Turkey.

Purpose: To determine the patterns of care for lung cancer in Turkish radiation oncology centers.

Methods And Materials: Questionnaire forms from 21 of 24 (87.5%) centers that responded were evaluated.

Results: The most frequent histology was non-small cell lung cancer (NSCLC) (81%). The most common postoperative radiotherapy (RT) indications were close/(+) surgical margins (95%) and presence of pN2 disease (91%). The most common indications for postoperative chemotherapy (CHT) were ">/= IB" disease (19%) and the presence of pN2 disease (19%). In Stage IIIA potentially resectable NSCLC, the most frequent treatment approach was neoadjuvant concomitant chemoradiotherapy (CHRT) (57%). In Stage IIIA unresectable and Stage IIIB disease, the most frequent approach was definitive concomitant CHRT (91%). In limited SCLC, the most common treatment approach was concomitant CHRT with cisplatin+etoposide for cycles 1-3, completion of CHT to cycles 4-6, and finally prophylactic cranial irradiation in patients with complete response (71%). Six cycles of cisplatin + etoposide CHT and palliative thoracic RT, when required, was the most commonly used treatment (81%) in extensive SCLC. Sixty-two percent of centers did not have endobronchial brachytherapy (EBB) facilities.

Conclusion: There is great variation in diagnostic testing, treatment strategies, indications for postoperative RT and CHT, RT features, and EBB availability for LC cases. To establish standards, national guidelines should be prepared using a multidisciplinary approach.
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http://dx.doi.org/10.1016/j.ijrobp.2008.03.035DOI Listing
December 2008