Publications by authors named "Ilknur Cetin"

5 Publications

  • Page 1 of 1

Lymph node ratio as an independent prognostic factor for breast cancer-related mortality in patients with node-positive breast cancer.

J Cancer Res Ther 2020 Oct-Dec;16(6):1387-1392

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

Aim: This study assessed whether prognostic information could be obtained in patients with lymph node (LN)-positive breast cancer based on their LN ratios (LNRs) and explored the relationships between other potential prognostic factors and survival.

Setting And Design: This was a retrospective clinical study.

Materials And Methods: This study included 608 women with node-positive nonmetastatic breast cancer. Clinical and pathologic data were retrospectively evaluated. The median age was 51 years (range: 23-84 years). All patients received adjuvant radiotherapy after radical surgery. A total dose of 50 Gy was administered to the chest wall or breast and LN regions with 2 Gy daily fractions. A 10-Gy boost was administered to the breast tumor bed. The cutoff value of LNR was defined as low risk (<0.21) in 278 patients, intermediate risk (0.21-0.65) in 217 patients, and high risk (>0.65) in 113 patients. Prognostic variables included patient characteristics, disease characteristics, and interventional factors. The primary endpoint was overall survival and the secondary endpoint was breast cancer-related mortality.

Statistical Analysis Used: Statistical analyses were performed using the Kaplan-Meier method, log-rank test, and Cox regression analysis. P value was required to be <0.05.

Results: Within a median follow-up period of 95.4 months (range: 5-232.4 months), overall survival rates for 10 and 15 years were 66% and 53%, respectively. Multivariate analysis revealed that LNR (P = 0.026), estrogen receptor status (ERS) (P = 0.021), age (P = 0.04), and smoking (P = 0.024) were independent significant prognostic factors for overall survival. Breast cancer-related mortality rates at 10 and 15 years were 70.7% and 60%, respectively. LNR (P = 0.03) and ERS (P = 0.002) were independent significant prognostic factors for breast cancer-related mortality.

Conclusions: LNR and ERS were significant prognostic factors for survival at all endpoints.
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December 2020

Treatment outcomes of prostate cancer patients with Gleason score 8-10 treated with definitive radiotherapy : TROD 09-001 multi-institutional study.

Strahlenther Onkol 2019 Oct 29;195(10):882-893. Epub 2019 May 29.

Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100, Ankara, Turkey.

Purpose: To validate the clinical outcomes and prognostic factors in prostate cancer (PCa) patients with Gleason score (GS) 8-10 disease treated with external beam radiotherapy (EBRT) + androgen deprivation therapy (ADT) in the modern era.

Methods: Institutional databases of biopsy proven 641 patients with GS 8-10 PCa treated between 2000 and 2015 were collected from 11 institutions. In this multi-institutional Turkish Radiation Oncology Group study, a standard database sheet was sent to each institution for patient enrollment. The inclusion criteria were, T1-T3N0M0 disease according to AJCC (American Joint Committee on Cancer) 2010 Staging System, no prior diagnosis of malignancy, at least 70 Gy total irradiation dose to prostate ± seminal vesicles delivered with either three-dimensional conformal RT or intensity-modulated RT and patients receiving ADT.

Results: The median follow-up time was 5.9 years (range 0.4-18.2 years); 5‑year overall survival (OS), biochemical relapse-free survival (BRFS) and distant metastases-free survival (DMFS) rates were 88%, 78%, and 79%, respectively. Higher RT doses (≥78 Gy) and longer ADT duration (≥2 years) were significant predictors for improved DMFS, whereas advanced stage was a negative prognosticator for DMFS in patients with GS 9-10.

Conclusions: Our results validated the fact that oncologic outcomes after radical EBRT significantly differ in men with GS 8 versus those with GS 9-10 prostate cancer. We found that EBRT dose was important predictive factor regardless of ADT period. Patients receiving 'non-optimal treatment' (RT doses <78 Gy and ADT period <2 years) had the worst treatment outcomes.
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October 2019

Dosimetric comparison of anterior posterior-posterior anterior 2-field three-dimensional conformal radiotherapy, 4-field three-dimensional conformal radiotherapy and "forward" plan intensity modulated radiotherapy techniques in female lymphoma patients irradiated to neck and mediastinum.

J Cancer Res Ther 2018 Oct-Dec;14(6):1389-1396

Department of Radiation Oncology, Dokuz Eylül University Medical Faculty, Izmir, Turkey.

Aim: Dosimetric comparison of three different techniques in female lymphoma patients who had radiotherapy (RT) to the neck and mediastinum.

Setting And Design: Retrospective clinical study.

Materials And Methods: Computerized tomography-simulator images of eight patients were obtained retrospectively. Using 6 MV-X photon energy, RT plans were formed with three different techniques (anterior posterior-posterior anterior 2-field three-dimensional conformal RT [AP-PA 2-field 3D-CRT], 4-field 3D-CRT and "forward" plan intensity modulated RT [FPIMRT]). Comparisons were in terms of homogeneity index (HI), conformity index (CI), and inhomogeneity coefficient for planning target volume (PTV); mean lung dose, V, V, V, V for lung; D, V, V, V for heart; D, V, V, V for breast; D for spine; D, V, V, V, V for thyroid.

Statistical Analysis Used: Since nonparametric tests had to be used due to the study population being < 30, Friedman and Wilcoxon signed-rank tests were implemented in trilateral and bilateral comparison of techniques, respectively. For statistical significance, P value was required to be <0.05.

Results: When FPIMRT was compared with AP-PA and 4-field techniques with respect to, HI (AP-PA/FPIMRT P: 0.017; 4-field/FPIMRT P: 0.03) and CI (AP-PA/FPIMRT P: 0.018; 4-field/FPIMRT P: 0.042), FPIMRT was more advantageous. In addition, FPIMRT was found more useful in terms of D (AP-PA/FPIMRT P: 0.012; 4-Field/FPIMRT P: 0.012) for spinal cord and D (AP-PA/FPIMRT P: 0.012; 4-field/FPIMRT P: 0.012) for thyroid.

Conclusion: FPIMRT was superior in terms of PTV homogeneity and conformity. However, it was observed that for normal tissues, FPIMRT was advantageous only for spinal cord and thyroid; but it was not the most advantageous technique for some of the dose-volume parameters of the breast, lung, and heart.
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February 2019

Metastasis to paranasal sinuses and orbita of breast cancer with a rare metachronous tumor of the uterine cervix.

J Craniofac Surg 2013 Jan;24(1):e64-5

Department of Radiation Oncology, Division of Medical Oncology, School of Medicine, Marmara University, Istanbul, Turkey.

Breast cancer metastases are rarely seen in paranasal sinuses or orbit with a poor prognosis, and these cases were published as case reports. Moreover, metachronous tumors following breast cancer diagnosis are somewhat common, but uterine cervix is infrequent in them. In the present case, we report a 61-year-old female patient who had a biopsy-proven metastatic breast cancer to paranasal sinuses and orbita. She also had a cervical uterine cancer which is also unusually diagnosed following breast cancer. Palliative radiotherapy to paranasal sinuses (30 Gy) achieved a good response. However, she died due to leptomeningeal progression.
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January 2013

PSA bouncing after external beam radiation for prostate cancer with or without hormonal treatment.

Eur Urol 2003 May;43(5):473-7

Department of Radiation Oncology, Marmara University Hospital, Tophanelioglu cad. 13/15, Altunizade, 34660, Istanbul, Turkey.

Objectives: The purpose of this study was to find out the frequency of PSA bouncing and the factors effecting PSA bounce after external beam radiation treatment (EBRT) with or without hormonal treatment (HT) for prostate cancer and to identify any possible relationship with biochemical control.

Methods: Between March 1997 and November 2000, 72 consecutive patients with clinically localised prostate cancer were treated by EBRT with or without HT. All patients had a pretreatment PSA level, at least six post-treatment PSA levels and minimum two years of follow-up. Median follow-up for all patients was 51 months (range 25-69 months). Median radiation dose given to the center of the prostate was 70Gy (range 63-74Gy). Fifty-nine patients (82%) received adjuvant HT with median duration of six months. PSA bounce was defined as a minimal rise of 0.4ng/ml over six months (monthly rise > or =0.07 ng/ml), followed by any decrease. Biochemical failure was defined in accordance with the ASTRO consensus guidelines.

Results: Seventeen patients (24%) experienced at least one PSA bounce. PSA bounces were more frequent in patients with T1-2 stage, pretreatment PSA <10 ng/ml, small field irradiation, radiation dose < or =70 Gy, PSA nadir > or =0.2 ng/ml and without HT. PSA bounce occurred in 54% of patients treated by EBRT only, and 17% of patients treated by EBRT and HT. Logistic regression model for multivariate analysis revealed the radiation field size as the only independent predictive factor for PSA bounce. Five-year biochemical control rates were 82% for non-bouncers and 88% for bouncers (p=0.5).

Conclusions: PSA bouncing occurs in approximately a quarter of patients treated with EBRT with or without HT. It is associated with pretreatment and treatment characteristics, but we did not observe any relationship with biochemical failure.
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May 2003