Publications by authors named "Meltem Serin"

16 Publications

  • Page 1 of 1

Computed tomography based evaluation of prostatic fiducial marker migration between the periods of insertion and simulation.

Turk J Urol 2017 Dec 1;43(4):451-455. Epub 2017 Dec 1.

Department of Radiation Oncology, Acıbadem University, Acıbadem Adana Hospital, Adana, Turkey.

Objective: The aim of this study was to determine whether significant fiducial marker migration occurs between the periods of prostatic marker insertion and computed tomography (CT) performed for radiotherapy planning and if a waiting period is necessary.

Material And Methods: Thirty-nine patients with prostate adenocarcinoma underwent fiducial marker insertion before radiotherapy between June 2013 and December 2015. Three markers were inserted by one radiologist under the guidance of transrectal ultrasonography. All patients underwent CT three hours after insertion to confirm the number and position of fiducial markers. Radiotherapy planning CT was performed on an average of 11 days (range 7-20) after insertion. CT images were imported into treatment planning system to analyze the position of fiducial markers. Point- based marker match algorithm was used to find the distance of marker migration. The mean and maximum distances between each fiducial markers were calculated.

Results: The mean distance of migration was 1.029±0.42 mm (range 0.23-1.93 mm) and the maximum distance was 1.361±0.59 mm (range 0.25-2.74 mm). The distance of marker migration was not statistically significant for the groups organized according to the timing of marker insertion, prostate volume, patient age, prostate specific antigen level and Gleason score.

Conclusion: According to our results significant fiducial marker migration did not occur during the interval between insertion and treatment planning CT. It should be taken into consideration that performing simulation on the same day as marker insertion might prevent increased cost and delayed radiation therapy by saving the patients from extra visits to the clinic.
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http://dx.doi.org/10.5152/tud.2017.29726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687207PMC
December 2017

Intraoperative sonographic guidance for intracavitary brachytherapy of cervical cancer.

J Clin Ultrasound 2018 Jan 27;46(1):8-13. Epub 2017 Jun 27.

Department of Radiation Oncology, Acibadem University, School of Medicine, Acibadem Adana Hospital, Adana, Turkey.

Background: To describe the role and benefits of intraoperative sonographic (US) guidance in intracavitary brachytherapy of cervical cancer.

Methods: The data of 142 patients who received tandem-based intracavitary brachytherapy for cervical cancer between January 2010 and June 2015 were retrospectively reviewed. US guidance was carried out for tandem selection and appropriate application. The complications and applicator conformity were assessed with planning CT.

Results: Intracavitary brachytherapy was performed under US guidance for 412 insertions in 113 consecutive patients with cervical cancer. Before we started to use US guidance, applications were done in 29 patients: uterine perforation occurred in two patients (6.9%), the tandem length was short in two patients (6.9%), the tandem length was long in four patients (13.8%), and tandem was in myometrium in three patients (10.3%). We then decided to use US guidance routinely. With US guidance, only 1 of 113 patients had uterine perforation (0.9%), tandem length was short in only one patient (0.9%), and tandem was in myometrium in one patient (0.9%).

Conclusions: Real-time US provided safe and effective guidance for intracavitary brachytherapy of cervical cancer resulting in decreased rates of perforations and misplacement of applicators. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46:8-13, 2018.
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http://dx.doi.org/10.1002/jcu.22510DOI Listing
January 2018

Neuroprotective effects of erythropoietin against oxidant injury following brain irradiation: an experimental study.

Arch Med Sci 2016 Dec 24;12(6):1348-1353. Epub 2016 Oct 24.

Department of Radiation Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey.

Introduction: Radiation therapy (RT) is a major treatment modality, and the central nervous system is a dose-limiting organ in clinical RT. This experimental study aims to present the evaluation of the neuroprotective effects of erythropoietin (EPO) against oxidant injury following brain irradiation in rats.

Material And Methods: Forty Wistar rats were randomly assigned to four groups ( = 10 each). In group 1 the rats received no EPO and underwent sham RT. The rats in groups 2 and 3 received EPO. In group 2 rats underwent sham RT, while in group 3 rats received RT. The rats in group 4 received no EPO and underwent RT. Rats were irradiated using a Cobalt-60 teletherapy machine using a single fraction of 20 Gy covering the whole brain. Cervical dislocation euthanasia was performed. The nitrite and malondialdehyde (MDA) levels and the superoxide dismutase (SOD) and glutathione peroxidase (GSHPX) activities were evaluated in dissected brain tissues.

Results: The nitrite and MDA levels were higher in the RT group (2.10 ±0.62 ppm, 26.02 ±2.16 nmol/ml; < 0.05) and lower in the EPO + RT group (1.45 ±0.12 ppm, 25.49 ±1.90 nmol/ml; < 0.05). The SOD and GSHPX activity was higher in the EPO + RT group (2.62 ±0.49 U/mg, 1.75 ±0.25 U/mg, < 0.05).

Conclusions: This study supports the probable neuroprotective effects of EPO against oxidant injury following brain irradiation in a rat model, presumably through decreasing free radical production and increasing expression of antioxidant enzymes.
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http://dx.doi.org/10.5114/aoms.2016.58622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5108378PMC
December 2016

Correlation between 18F-FDG Positron-Emission Tomography 18F-FDG Uptake Levels at Diagnosis and Histopathologic and Immunohistochemical Factors in Patients with Breast Cancer.

J Breast Health 2016 Jul 1;12(3):112-118. Epub 2016 Jul 1.

Clinic of General Surgery, Acıbadem Adana Hospital, Adana, Turkey.

Objective: In this study, we aimed to determine the correlation between pretreatment-staging 18F-FDG total body positron-emission tomography/computed tomography (PET/CT) maximum standardized uptake value (SUV) levels and histopathologic and immunohistochemical predictive and prognostic factors in patients with breast cancer.

Materials And Methods: One hundred thirty-nine women with breast cancer who were treated between 2009 and 2015 at our hospital and who had pretreatment-staging PET/CT were included in the study. SUV levels and histopathologic and immunohistochemical results were compared.

Results: The median age was 48 years (range, 29-79 years). The mean tumor diameter was 33.4 mm (range, 7-120 mm). The histology was invasive ductal carcinoma in 80.6% of the patients. In the univariate analysis, SUV levels were significantly higher in patients with invasive ductal carcinoma; in patients with a maximum tumor diameter more than 2 cm; patients who were estrogen, progesterone, and combined hormone receptor-negative, triple-negative patients, and in tumors with higher grades (p<0.05). In HER2-positive patients, SUV levels were higher even if it was not statistically significant. There was no correlation between lymph node metastases and pathologic stage. In multivariate analysis, tumor diameter was an independent factor.

Conclusion: SUV levels are correlated with known histopathologic and immunohistochemical prognostic factors. PET/CT could be useful in preoperative evaluation of patients with breast cancer to predict biologic characteristics of tumors and prognosis.
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http://dx.doi.org/10.5152/tjbh.2016.3031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351480PMC
July 2016

Histopathological evaluation of melatonin as a protective agent in heart injury induced by radiation in a rat model.

Pathol Res Pract 2014 Dec 9;210(12):863-71. Epub 2014 Sep 9.

Sakarya University Medical Faculty, Department of Radiation Oncology, Sakarya, Turkey. Electronic address:

Introduction: Melatonin is a hormone which is known to be a powerful cardioprotective agent due to its free radical-scavenging properties. This study was carried out to evaluate whether melatonin administration prior to irradiation would have a protective effect on cardiac histopathological changes in an experimental rat model.

Methods: Rats were divided into four groups. Single dose of 18 Gy radiation and sham radiation exposure were used in related groups. 50mg/kg dose of melatonin were injected intraperitonally 15 min prior to radiation exposure. Analyses and assessments were performed 6 months after radiation exposure.

Results: Severe myocardial fibrosis was observed prominently in three regions: the apex, tips of papillary muscles and adjacent to the atrioventricular valves. Inflammation was found to be more in irradiated groups. Increased inflammation and fibrosis were in concordance. The number of mast cells was found to be decreased in irradiated groups. Myocyte necrosis and fibrosis were diminished with melatonin while vasculitis was prevented.

Conclusions: Elementary pathological lesions of radiation-induced heart disease (RIHD) are fibrosis, vascular damage, vasculitis and myocyte necrosis. Development of vasculitis was prevented by the use of melatonin. Fibrosis and necrosis were prominently decreased. Prevention of RIHD with the use of melatonin at the long term is encouraging according to the histopathological results.
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http://dx.doi.org/10.1016/j.prp.2014.08.006DOI Listing
December 2014

Bone complications after pelvic radiation therapy: evaluation with MRI.

J Med Imaging Radiat Oncol 2014 9;58(3):334-40. Epub 2014 Apr 9.

Department of Radiation Oncology, Acibadem Adana Hospital, Acibadem University, Adana, Turkey.

Introduction: The purpose of this study was to assess the incidence, distribution and MRI characteristics of pelvic bone complications after radiation therapy.

Methods: The medical charts of 345 patients who received pelvic radiation therapy were retrospectively reviewed. A total of 122 patients, 99 women and 23 men, with a mean age of 57 (range 32-87 years) were included in this study. The MR images were retrospectively reviewed by two radiologists.

Results: Fatty replacement of bone marrow was seen in all patients. Pelvic bone complications and focal red marrow changes were identified in a total of 38 patients (31.1%). Pelvic insufficiency fracture was diagnosed in 17 patients (13.9%, with a total of 64 lesions) and radiation osteitis was diagnosed in 5 patients (4.1%, with a total of 13 lesions). Avascular necrosis of the femoral head was detected in one patient (0.8%). Focal red bone marrow changes were seen in 15 patients (12.3%). The median time from the end of radiotherapy to the diagnosis of pelvic bone complications or changes was 25 months (range 2-45 months). The 1-, 2-, and 3-year cumulative incidences were 22%, 41% and 49%, respectively. The distribution of insufficiency fractures was as follows: sacral ala, sacral body, ilium, acetabulum, pubis and lumbar spinal vertebra. The distribution of radiation osteitis was as follows: sacral ala, ilium and pubis.

Conclusion: Radiation-induced pelvic bone complications are not uncommon, and knowledge of characteristic imaging patterns is essential in order to rule out bone metastases and to avoid inaccurate or excessive treatment.
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http://dx.doi.org/10.1111/1754-9485.12176DOI Listing
April 2015

False Positive 18F-FDG Uptake in Mediastinal Lymph Nodes Detected with Positron Emission Tomography in Breast Cancer: A Case Report.

Case Rep Med 2013 4;2013:459753. Epub 2013 Mar 4.

Department of Radiation Oncology, Acibadem Adana Hospital, Acibadem University School of Medicine, Seyhan, 01130 Adana, Turkey.

Breast cancer is the most frequently diagnosed cancer among females. It is accepted that lymph node involvement with metastatic tumor and the presence of distant metastasis are the most important prognostic factors. Accurate staging is important in determining prognosis and appropriate treatment. Positron emission tomography with computed tomography detects malignancies using 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG PET CT) with high accuracy and they contribute to decisions regarding diagnosis, staging, recurrence, and treatment response. Here, we report a case of false positive metastatic mediastinal lymph nodes that were diagnosed by 18F-FDG PET CT in a 40-year-old breast cancer patient who had undergone preoperative evaluation. Right paratracheal, prevascular, aorticopulmonary, precarinal, subcarinal, hilar, and subhilar multiple conglomerated mediastinal lymph nodes were revealed in addition to left breast mass and axillary lymph nodes. Mediastinoscopy was performed with biopsy and pathology was reported as granulomatous lymphadenitis. In conclusion, any abnormal FDG accumulation in unusual lymph nodes must be evaluated carefully and confirmed histopathologically.
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http://dx.doi.org/10.1155/2013/459753DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603648PMC
March 2013

The effects of methylprednisolone and halofuginone on preventing esophageal and hypopharyngeal fibrosis in delivered radiotherapy.

Eur Arch Otorhinolaryngol 2010 Sep 3;267(9):1429-35. Epub 2010 Apr 3.

Department of Otorhinolaryngology, Medical Faculty, Firat University, 23119, Elazig, Turkey.

In this study, we assessed the effects of halofuginone and methylprednisolone on hypopharyngeal and esophageal stricture that can develop following radiation to the head and neck of rats. Rats were divided into four groups randomly and 18 Gy radiation was given to the head and neck regions of all rats except the control group. Group 1 (Control Group): No radiation or drugs were administered. Group 2 (Radiation Group): only radiation was applied without any drugs. Group 3 (Halofuginone Group): halofuginone 100 microg/kg per day was given intraperitoneally. Group 4 (Methylprednisolone Group): methylprednisolone 1 mg/kg per day was administered intramuscularly. In all groups, 90 days after application of radiation, sections of the proximal esophagus and hypopharynx were examined for fibrosis, fibroblast proliferation, vascularization, epithelial atypia, necrosis, polymorphonuclear leukocytes, mononuclear cells, and stenosis index by light microscope and the hydroxyproline levels were assessed biochemically. Fibrosis, epithelial atypia and hydroxyproline levels were found to be significantly higher in the radiation group compared to the control group (P < 0.05). We did not observe fibrosis in either the halofuginone or the control groups. Fibrosis was also significantly lower in the methylprednisolone group than the radiation group (P < 0.05). The differences of the stenosis index scores between the groups were not statistically significant (P < 0.05). Vascularization was similar in all groups. We think that especially halofuginone is a drug that can be used safely to prevent fibrosis due to radiotherapy, but further studies are needed.
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http://dx.doi.org/10.1007/s00405-010-1242-yDOI Listing
September 2010

The effects of irradiation on the blood dynamics.

Clin Hemorheol Microcirc 2009 ;41(4):263-7

Department of Radiation Oncology, Inönü University Faculty of Medicine, Malatya, Turkey.

Aim: The present study evaluates the effects of irradiation on the blood dynamics.

Materials And Methods: Thirty-six volunteers providing written consent participated. A blood sample was transferred into three tubes containing CPDA-1 solution while another blood sample was transferred into three tubes containing heparin. Each tube containing CPDA-1 solution was paired with another tube containing heparin. The first pair was not irradiated, not stored and analyzed immediately (Group 1). The second pair was not irradiated, stored and analyzed at seven days (Group 2). The third pair was irradiated, stored and analyzed at seven days (Group 3). The blood count was performed and the blood viscosity was determined.

Results: The mean hemoglobin contents were 126 g/l for Group 1, 128 g/l for Group 2 and 129 g/l for Group 3. For the mean hemoglobin contents, the difference between Group 1 and Group 3 (P<0.001) and Group 2 and Group 3 (P=0.01) were significant. The mean red blood cell volumes were 81.8 fl for Group 1, 82.1 fl for Group 2 and 82.3 fl for Group 3. For the mean red blood cell volumes, the difference between Group 1 and Group 2 (P=0.003) and Group 1 and Group 3 (P=0.006) were significant. The mean blood viscosities were 2.2 mPa s for Group 1, 2.8 mPa s for Group 2 and 3.2 mPa s for Group 3. For the mean blood viscosities, the difference between Group 1 and Group 2 (P<0.001), Group 1 and Group 3 (P<0.001) and Group 2 and Group 3 (P=0.004) were significant.

Conclusion: The present study indicates that the recommended doses of irradiation for the blood products to be used in attempt to prevent the transfusion associated graft versus host disease leads to marked alterations in the blood dynamics and might decrease the viability of the red blood cells following transfusion.
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http://dx.doi.org/10.3233/CH-2009-1177DOI Listing
May 2009

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

[Chondroradionecrosis in two patients with laryngeal carcinoma].

Kulak Burun Bogaz Ihtis Derg 2007 ;17(4):242-8

Department of Otolaryngology, Medicine Faculty of Inönü University, Malatya, Turkey.

Postradiotherapy necrosis in the larynx is a rare but serious complication. It must be differentiated from tumor recurrence with radiological and histopathological studies. Herein, we presented two patients with stage II and stage IV larynx carcinoma who developed chondroradionecrosis following radiotherapy. The first patient did not accept surgical treatment and was treated with curative radiotherapy at a dose of 70 Gy. The other one received adjuvant radiotherapy at a dose of 46 Gy following total laryngectomy and bilateral functional neck dissection. The two patients were evaluated with computed tomography and magnetic resonance imaging, respectively. Pathologic examination of multiple biopsies taken from both cases showed coagulation necrosis without malignancy. The first patient had grade IV radionecrosis according to the Chandler classification and underwent total laryngectomy because of non-functional larynx. Histopathologically, there were no malignant cells, but widespread fibrosis and coagulation necrosis. The other patient was treated with conservative treatment and local debridement.
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March 2008

The histopathological evaluation of the effectiveness of melatonin as a protectant against acute lung injury induced by radiation therapy in a rat model.

Int J Radiat Biol 2007 Mar;83(3):187-93

Department of Radiation Oncology, Inönü University, Faculty of Medicine, Malatya, Turkey.

Purpose: This study presents the histopathological evaluation of the effectiveness of melatonin as a protectant against acute lung injury induced by radiation therapy.

Materials And Methods: Thirty-two Wistar rats were divided into four groups. The rats in Group 1 received melatonin and underwent radiation therapy. The rats in Group 2 received no melatonin and underwent radiation therapy. The rats in Group 3 received melatonin and underwent sham radiation therapy. The rats in Group 4 received no melatonin and underwent sham radiation therapy. Melatonin was administered at a dose of 100 mg/kg using an intraperitoneal injection. Radiation therapy was delivered on a Cobalt-60 unit using a single fraction of 18 Gy through an anterior portal covering the right lung in entirety. The rats underwent euthanasia at 6 weeks following radiation therapy. The lungs were dissected and blinded histopathological evaluation was performed.

Results: Concerning the right lung, a decrease in intra-alveolar edema and intra-alveolar erythrocytes was observed despite an increase in activated macrophages, intra-alveolar fibrosis, hyaline arteriosclerosis and alveolar wall thickness for the rats in Group 1 as compared to the rats in Group 2. Concerning the left lung, a decrease in alveolar neutrophils and intra-alveolar erythrocytes was evident despite an increase in activated macrophages, hyaline arteriosclerosis and alveolar wall thickness for the rats in Group 1 as compared to the rats in Group 2.

Conclusions: This study puts forward the histopathological evidence regarding the effectiveness of melatonin as a protectant against acute lung injury induced by radiation therapy through restrained inflammation, regrettably at the expense of promoted fibrosis. The effectiveness of melatonin as a protectant against acute lung injury induced by radiation therapy needs to be evaluated further for the unresolved concerns regarding the safety.
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http://dx.doi.org/10.1080/09553000601129093DOI Listing
March 2007

The effects of granulocyte colony-stimulating factor on the healing of tracheal anastomosis following radiation therapy in rats.

Eur J Cardiothorac Surg 2006 Dec 24;30(6):840-5. Epub 2006 Oct 24.

Department of Thoracic Surgery, Inönü University Faculty of Medicine, Malatya, Turkey.

Objective: This study evaluates the effects of granulocyte colony-stimulating factor on the healing of tracheal anastomosis following radiation therapy in rats.

Methods: Fifty-six male Wistar rats were divided into four groups. Group 1 underwent tracheal anastomosis. Group 2 underwent radiation therapy followed by tracheal anastomosis. Group 3 underwent radiation therapy followed by tracheal anastomosis and received granulocyte colony-stimulating factor. Group 4 underwent sham radiation therapy followed by sham tracheal anastomosis. At 10 days following radiation therapy, the trachea was dissected for histopathological, mechanical and biochemical evaluation.

Results: Median scores for inflammation were three points for Group 1, two points for Group 2, two points for Group 3 and one point for Group 4. Median scores for angiogenesis were four points for Group 1, two points for Group 2, three points for Group 3 and one point for Group 4. Median scores for connective tissue regeneration were four points for Group 1, two points for Group 2, three points for Group 3 and one point for Group 4. Median scores for epithelial regeneration were two points for Group 1, one point for Group 2, one point for Group 3 and one point for Group 4. Mean anastomotic bursting pressures were 853 mmHg for Group 1, 293 mmHg for Group 2, 417 mmHg for Group 3 and 966 mmHg for Group 4. Mean hydroxyproline concentrations were 159 microg/mg for Group 1, 177 microg/mg for Group 2, 120 microg/mg for Group 3 and 117 microg/mg for Group 4.

Conclusions: This study suggests that granulocyte colony-stimulating factor contributes to the healing of tracheal anastomosis following radiation therapy through improved connective tissue regeneration.
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http://dx.doi.org/10.1016/j.ejcts.2006.09.023DOI Listing
December 2006

The evaluation of the oxidant injury as a function of time following brain irradiation in a rat model.

Neurochem Res 2006 Oct;31(10):1271-7

Department of Radiation Oncology, Inönü University Faculty of Medicine, 44280, Malatya, Turkey.

This study presents the evaluation of the oxidant injury as a function of time following brain irradiation in a rat model. Thirty-five Wistar rats were divided into seven groups. The rats in Group 1 through Group 6 underwent irradiation, whereas the rats in Group 7 underwent sham irradiation. The rats in Group 1 through Group 6 underwent euthanasia at 1 through 48 h following irradiation, whereas the rats in Group 7 underwent euthanasia immediately following sham irradiation. At the time of euthanasia, the brain tissue was dissected for evaluation of the malondialdehyde (MDA) level and the superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSHPX) activities. The mean MDA levels were increased and the mean SOD, CAT and GSHPX activities were decreased at all of the time points for evaluation for the rats that underwent irradiation as compared to the rats that underwent sham irradiation, substantial for Group 1 and gradually leveling out through Group 6. This study confirms that the oxidant injury is evaluated at its best through the first several hours following brain irradiation.
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http://dx.doi.org/10.1007/s11064-006-9159-yDOI Listing
October 2006

The use of recursive partitioning analysis grouping in patients with brain metastases from non-small-cell lung cancer.

Jpn J Clin Oncol 2006 Apr 12;36(4):193-6. Epub 2006 Apr 12.

MD, Department of Radiation Oncology, Inönü University Faculty of Medicine, Malatya, TR-44280, Turkey.

Background: This study evaluates the use of recursive partitioning analysis (RPA) grouping in an attempt to predict the survival probabilities in patients with brain metastases from non-small-cell lung cancer (NSCLC).

Methods: Seventy-two patients with brain metastases from NSCLC treated with radiation therapy were included in the study. Sixty-three patients were male and nine patients were female. Their median age was 57 years and their median Karnofsky performance status was 70. At the time of brain metastases, there was no evidence of the intrathoracic disease in 27 patients and the extrathoracic disease was limited to the intracranial disease in 42 patients. In accordance with RPA grouping, 12 patients were in Group 1, 24 patients were in Group 2, and 36 patients were in Group 3. Radiation therapy was delivered to the whole brain at a dose of 30 Gy in 10 fractions in most of the patients.

Results: The median survival time was 7 months for Group 1, 5 months for Group 2 and 3 months for Group 3. The survival probability at 1 year was 50% for Group 1, 26% for Group 2 and 14% for Group 3.

Conclusions: This study presents evidence supporting the use of RPA grouping in an attempt to predict the survival probabilities in patients with brain metastases from NSCLC.
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http://dx.doi.org/10.1093/jjco/hyl007DOI Listing
April 2006

Extraskeletal Ewing's sarcoma presenting with multifocal intrathoracic mass lesions associated with mediastinal shift.

Ann Thorac Surg 2006 Apr;81(4):1487-8

Department of Thoracic Surgery, Inönü University Faculty of Medicine, Malatya, Turkey.

Extraskeletal Ewing's sarcoma is an uncommon disease that predominantly involves the soft tissues of the trunk or the extremities. This article presents a patient with multifocal intrathoracic mass lesions involving the mediastinum and the lingula associated with mediastinal shift, eventually diagnosed as extraskeletal Ewing's sarcoma.
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http://dx.doi.org/10.1016/j.athoracsur.2005.03.116DOI Listing
April 2006