Publications by authors named "Meral Kurt"

18 Publications

  • Page 1 of 1

Visual and instrumental color evaluation of computerized color matching system for color reproduction of maxillofacial prostheses.

J Prosthet Dent 2021 Mar 2. Epub 2021 Mar 2.

Professor, Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.

Statement Of Problem: A commercially available computerized color matching system (e-Skin) has been introduced for maxillofacial prostheses. However, studies that have tested its ability to produce an acceptable color match for skin color are lacking.

Purpose: The purpose of this clinical study was to determine the color match acceptability of light and dark skin silicone replicas fabricated with the use of the computerized color matching system.

Material And Methods: Fifteen participants with light skin and 15 participants with dark skin were recruited through personal invitation. These 30 participants (aged around 20 years) voluntarily consented to forearm skin color measurements with a spectrophotometer and a spectrocolorimeter integrated in a computerized color matching system. Silicone skin replicas for each participant were produced from the color formulations provided by the online calculator tool of the system according to the manufacturers' recommendations. The color difference between initial skin color measurements with the spectrophotometer and skin replica color measurements with the spectrophotometer for all participants was calculated by using both the CIELab (ΔE∗ab) and CIEDE2000 (ΔE00) color difference formulas. To compare the instrumental and visual evaluation of color match, 3 observers (a maxillofacial prosthodontist, a prosthodontist, and a postgraduate student) visually evaluated and rated the color match of each silicone replica on a 5-point scale. Statistical analyses were performed by using the Student t, Mann Whitney U, and chi-square tests (α=.05).

Results: No significant differences were detected between the light and dark skin groups in terms of the ΔE∗ab and ΔE00 values obtained between the first skin color measurements and their silicone replica color measurements (P=.573, P=.338, respectively). However, a significant difference was found between light and dark skin groups for the ΔL and Δa values obtained from the same measurements (P=.031, P=.017, respectively). L∗, a∗, and b∗ values of light skin were significantly higher than those of their silicone replications (P=.008, P=.033, P=.046, respectively). Color match ratings of observers did not significantly differ when comparing the ratings of light skin replicas to ratings of dark skin replicas.

Conclusions: The e-Skin system provided skin replicas that matched the skin color within clinically acceptable thresholds and with ratings of at least "good" by experienced dental clinicians.
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http://dx.doi.org/10.1016/j.prosdent.2021.01.009DOI Listing
March 2021

Treatment outcomes of metastasis-directed treatment using Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002).

Strahlenther Onkol 2020 Nov 2;196(11):1034-1043. Epub 2020 Jul 2.

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

Purpose: The aim of this study was to evaluate the outcomes of Ga prostate-specific membrane antigen (Ga-PSMA) positron-emission tomography (PET)/CT-based metastasis-directed treatment (MDT) for oligometastatic prostate cancer (PC).

Methods: In this multi-institutional study, clinical data of 176 PC patients with 353 lesions receiving MDT between 2014 and 2019 were retrospectively evaluated. All patients had biopsy proven PC with ≤5 metastases detected with Ga-PSMA-PET/CT. MDT was delivered with conventional fractionation or stereotactic body radiotherapy (SBRT) techniques. CTCAE v4.0 was used for acute and RTOG/EORTC Late Radiation Morbidity Scoring Schema was used for late toxicity evaluation.

Results: At the time of MDT, 59 patients (33.5%) had synchronous and 117 patients (66.5%) had metachronous metastases. Median number of metastases was one and the MDT technique was SBRT in 73.3% patients. The 2‑year overall survival (OS) and progression-free survival (PFS) rates were 87.6% and 63.1%, respectively. With a median follow-up of 22.9 months, 9 patients had local recurrence at the irradiated site. The 2‑year local control rate at the treated oligometastatic site per patient was 93.2%. In multivariate analysis, an increased number of oligometastases and untreated primary PC were negative predictors for OS; advanced clinical tumor stage, untreated primary PC, BED3 value of ≤108 Gy, and MDT with conventional fractionation were negative predictors for PFS. No patient experienced grade ≥3 acute toxicity, but one patient had a late grade 3 toxicity of compression fracture after spinal SBRT.

Conclusion: Ga-PSMA-PET/CT-based MDT is an efficient and safe treatment for oligometastatic PC patients. Proper patient selection might improve treatment outcomes.
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http://dx.doi.org/10.1007/s00066-020-01660-6DOI Listing
November 2020

Effects of glazing methods on the optical and surface properties of silicate ceramics.

J Prosthodont Res 2020 Apr 11;64(2):202-209. Epub 2019 Nov 11.

Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.

Purpose: This study aims to evaluate the effect of different glazing methods on translucency parameter (TP), contrast ratio (CR), opalescence parameter (OP), surface roughness (Ra) and topography of the silicate ceramics.

Methods: Seventy specimens (10×10×1mm) were fabricated from lithium disilicate (IPS e.max CAD, abbreviated as E) and zirconia-reinforced lithium silicate (Vita Suprinity, abbreviated as VS) ceramics and divided into 7 subgroups (n=10) according to the polishing and glazing procedures: (1) mechanical polishing before-crystallization (m-BC), (2) mechanical polishing after-crystallization (m-AC), (3) glaze powder/liquid after-crystallization (pl-AC), (4) glaze-paste before-crystallization (gp-BC), (5) glaze-paste after-crystallization (gp-AC), (6) glaze-spray before-crystallization (gs-BC), (7) glaze-spray after-crystallization (gs-AC). Color and Ra measurements were performed. CIEL*a*b* and CIEXYZ parameters were recorded and TP, CR, and OP values were calculated. Data were analyzed using two-way ANOVA and Tukey HSD tests (α=0.05).

Results: In E groups, the highest Ra value was found in gs-AC (1.66±0.14μm) while the lowest value was found in pl-AC (0.68±0.08μm). In VS groups, the highest Ra value was found in gp-BC (1.64±0.25μm) while the lowest value was found in m-AC (0.77±0.06μm) (p<0.05). The mean TP value of E (17.62±0.73) was found to be higher than VS (15.37±1.16). The CR (0.72±0.030) and OP (12.06±0.74) values of VS were found higher than CR (0.57±0.02) and OP (6.72±0.40) values of E.

Conclusions: Zirconia-reinforced silicate ceramics have higher opalescence and lower translucency values than lithium disilicate ceramics. Increase in surface roughness reduces translucency. Glaze powder/liquid after-crystallization is the most effective way to reduce surface roughness of lithium disilicate ceramics while that is mechanical polishing after-crystallization for zirconia-reinforced silicate ceramics.
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http://dx.doi.org/10.1016/j.jpor.2019.07.005DOI Listing
April 2020

Effects of accelerated artificial aging on the translucency and color stability of monolithic ceramics with different surface treatments.

J Prosthet Dent 2019 Apr;121(4):712.e1-712.e8

Professor, Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.

Statement Of Problem: Different surface finishing procedures can be applied to monolithic restorations. However, information is limited regarding the long-term performance of these procedures.

Purpose: The purpose of this in vitro study was to evaluate the effect of aging on the translucency and color stability of monolithic ceramics with different surface finishing procedures.

Material And Methods: Disk-shaped (14×1.5 mm) specimens of monolithic zirconia (Zirkonzahn Prettau [ZZ]) and lithium disilicate glass-ceramic (IPS e.max Press [IPS]) were fabricated. The specimens were divided into 3 subgroups according to the surface treatments (n=9, G: glazing, R: rubber polishing system, and P: rubber polishing system followed by polishing paste). Color measurements were made by using a spectrophotometer before and after an ultraviolet aging process. L*, a*, and b* parameters were recorded. ΔE and translucency parameter (TP) values were calculated. One specimen from each subgroup was examined by scanning electron microscopy (×30 000). The data were statistically analyzed using the Mann-Whitney U, Kruskal-Wallis, and post hoc tests (α=.05).

Results: ΔE values of group ZZ (5.03) exceeded the clinically acceptable level (3.5); however, the color change was not clinically perceptible for IPS (0.41). The ΔE value of the subgroup P was found to be higher than that of the others for ZZ (P<.001). The ΔE value was not affected by the surface treatment for IPS. Group IPS showed significantly higher translucency than the ZZ group (P<.001). TP values were not affected by the surface treatment in either material and decreased after aging. However, changes in the TP values were too slight to be clinically perceptible.

Conclusions: Lithium disilicate ceramic was found to be more esthetic than monolithic zirconia ceramic in terms of color stability and translucency.
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http://dx.doi.org/10.1016/j.prosdent.2019.01.014DOI Listing
April 2019

Multidisciplinary rehabilitation of eosinophilic granuloma with bone graft surgery and a modified implant-supported hybrid prosthesis: A case report with a 6-year follow-up.

Spec Care Dentist 2019 Jan 15;39(1):45-50. Epub 2018 Nov 15.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey.

Eosinophilic granuloma is the most common form of Langerhans cell histiocytosis and corresponds with bone lesions characterized by pain, rapid growth, and high tendency of recurrence after inadequate curettage. It is a rare disease that is difficult to diagnose clinically and radiographically because it mimics other odontogenic cysts and tumors. In this report, the reconstruction of an osseous defect with an iliac graft and a modified implant-supported hybrid prosthesis after surgical excision of an eosinophilic granuloma in the mandible of a 27-year-old male patient was described. The patient was satisfied with the functional and esthetic results of the implant-supported restoration and a 6-year follow-up showed no sign of recurrence.
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http://dx.doi.org/10.1111/scd.12345DOI Listing
January 2019

An unusual case of adult-onset multi-systemic Langerhans cell histiocytosis with perianal and incident thyroid involvement.

Endocrinol Diabetes Metab Case Rep 2017 2;2017. Epub 2017 Feb 2.

Department of Endocrinology and Metabolism.

Summary: Langerhans cell histiocytosis (LCH) is a rare sporadic disease characterized by histiocytic neoplastic infiltration of various organ systems and a wide spectrum of clinical manifestations, ranging from benign and self-limiting to lethal. Herein, we report a rare case of adult-onset multi-systemic LCH in a 36-year-old male patient with an initial perianal presentation and incidental finding of subsequent thyroid gland involvement in the follow-up period. The patient with a history of perianal LCH treated with surgical excision and local radiotherapy was referred to our Endocrinology Department upon detection of hypermetabolic nodular lesions in the left lateral lobe of thyroid gland on positron emission tomography-computed tomography (PET/CT) scan in the nineth month of follow-up. Current evaluation revealed euthyroid status, a hypoechoic solid lesion of 13 × 9 mm in size with irregular borders in the left thyroid lobe on thyroid USG and cytologic assessment of thyroid nodule. The patient was diagnosed with suspected, oncocytic lesion, Hashimoto thyroiditis or LCH. The patient underwent total thyroidectomy and pathological assessment confirmed the diagnosis of Langerhans cell histiocytosis. Assessments in the sixth month of postoperative follow-up revealed euthyroid status with no thyroid tissue remnants or pathological lymph node on thyroid USG. In view of the multifocal lesions indicating multi-system disease, a systemic chemotherapy protocol with combination of prednisone (PRED) and vinblastine (VBL) has been planned by the hematology department.

Learning Points: Langerhans cell histiocytosis (LCH) shows a wide clinical spectrum and prognosis that ranges from benign and self-limiting single-system disease (with single or multifocal lesions) to a potentially lethal multi-system disease with severe organ dysfunction and death in some cases.It has been stated that the diagnosis is often delayed in perianal LCH unless LCH is specifically considered in the etiology, despite the fact that mucosal involvement may precede systemic involvement.Our findings support the statement that most of patients with LCH were PET positive at the time of initial diagnosis, while also emphasize the inclusion of this imaging modality as a part of the diagnostic workflow as well as in the setting of treatment response evaluation among adult LCH patients.
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http://dx.doi.org/10.1530/EDM-16-0087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404461PMC
February 2017

The evaluation of bcl-2 expression as a prognostic marker in early stage laryngeal cancer.

Tumori 2013 Nov-Dec;99(6):682-8

Aims And Background: To evaluate the effect of bcl-2 expression on the local control and overall survival of patients with early stage laryngeal cancer treated with radiotherapy alone.

Methods And Study Design: We included 53 patients with stage Tis, T1, and T2 laryngeal cancer who were irradiated in our department. Paraffin blocks of all biopsy specimens were subjected to immunohistochemical analysis with a bcl-2 oncoprotein mouse clone 124 Scytek kit.

Results: The mean follow-up time was 61 months (range, 7-166). Local-regional recurrence was observed in 10 (19%) patients. Forty-three patients (81%) had negative bcl-2 staining, 5 patients (9%) had + staining, 3 patients (6%) ++ staining, and 2 patients (4%) +++ staining. No relationship was detected between bcl-2 expression and local control or overall survival. The emergence of a recurrence and a younger age (<50 years) were significantly related to poor overall survival (P = 0.000 and P = 0.021, respectively). Patients with hemoglobin levels in the middle of radiotherapy and at the end of radiotherapy higher than 13 g/dl had improved overall survival in multivariate analyses (P = 0.002 and P = 0.001, respectively). Regarding local control, the following were poor prognostic factors: smoking more than 20 cigarettes a day (P = 0.001) and being younger than 50 years of age (P = 0.001).

Conclusions: No correlation was observed between bcl-2 expression and local control or overall survival. Whereas hemoglobin level, age and existence of a recurrence had a prognostic impact on overall survival, patient age and smoking status influenced local control rates.
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http://dx.doi.org/10.1700/1390.15456DOI Listing
April 2014

Comparison of protracted infusion 5-fluorouracil and capecitabine in adjuvant chemoradiotherapy for rectal cancer.

Hepatogastroenterology 2008 Jul-Aug;55(85):1158-63

Department of Radiation Oncology, Uludag University, Faculty of Medicine, Bursa, Turkey.

Background/aims: 5-Fluorouracil-based chemoradiotherapy is the most widely used treatment modality in the adjuvant treatment of rectal cancer. Capecitabine represents a valuable alternative to 5-Fluorouracil in this situation.

Methodology: Patients with stage II and stage III rectal adenocarcinoma, who were included in this analysis, received adjuvant chemoradiotherapy consisting of external-beam radiotherapy (50.4-54Gy) either with 5-Fluorouracil at a median dose of 300 mg/m2/day by protracted venous infusion for 5 days a week, or capecitabine at a median dose of 1650 mg/m2/day for 5 days a week after surgery. The data concerning the toxicity and the efficacy of the treatments were compared in patients treated with 5-Fluorouracil- and capecitabine-based chemoradiotherapy.

Results: Forty-three patients received 5-Fluorouracil, and 24 patients received capecitabine during adjuvant radiotherapy. Although there were no differences between the groups in terms of toxicity rates, distant metastasis-free survival, disease-free survival, and overall survival rates; a trend for improved loco-regional recurrence-free survival rate was observed in the capecitabine arm (p = 0.063).

Conclusions: Capecitabine is at least as effective as 5-Fluorouracil in the postoperative treatment of rectal adenocarcinoma. Considering the trend for improved loco-regional recurrence-free survival rate in the capecitabine arm, it seems that the drug exerts better synergy with radiotherapy in this situation.
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January 2009

Carcinoma originating from aberrant breast tissue. A case report and review of the literature.

Tumori 2008 May-Jun;94(3):440-3

Department of Radiation Oncology, Uludag University, Faculty of Medicine, Bursa, Turkey.

Carcinoma arising from ectopic breast tissue, either supernumerary breast or aberrant breast tissue, is extremely rare. Carcinoma occurs more frequently in the ectopic breast tissue of the axilla than in extra-axillary ectopic breast tissue. Here we report a case of an invasive lobular carcinoma arising from extra-axillary ectopic breast tissue and presenting as a subcutaneous nodule.
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August 2008

Phase II study of induction chemotherapy with gemcitabine plus 5-fluorouracil followed by gemcitabine-based concurrent chemoradiotherapy for unresectable locally advanced pancreatic cancer.

Tumori 2006 Nov-Dec;92(6):481-6

Department of Medical Oncology, Uludag University, Faculty of Medicine, Bursa, Turkey.

Aims And Background: To evaluate the efficacy and tolerability of a new treatment approach including induction chemotherapy (CT) and concurrent chemoradiotherapy (CRT) in unresectable, locally advanced pancreatic cancer (LAPC).

Patients And Methods: Twenty-four patients with LAPC were enrolled in the study. They first received induction CT consisting of 5-fluorouracil (5FU) (500 mg/m2) and gemcitabine (1000 mg/m2), which were given weekly for 3 weeks of every 4. Patients showing a response or disease stabilization after 2 cycles of induction CT received CRT consisting of external beam radiotherapy (50.4-54 Gy in fractions of 1.8 Gy/day) and gemcitabine (350 mg/m2, weekly for 6 weeks). Patients without disease progression received 2 additional cycles of CT consisting of 5FU plus gemcitabine with the same doses and schedule as given in the induction CT.

Results: After the end of the study, 2 (8%) and 5 (21%) patients showed complete and partial responses, respectively. Five patients (21%) had disease stabilization. The grade 3 and 4 toxicities associated with CT were neutropenia (21%) and thrombocytopenia (4%). The grade 3 and 4 toxicities occurring in patients who received CRT were neutropenia (24%), thrombocytopenia (24%), diarrhea (18%), and nausea (12%). The median progression-free survival for all patients was 6 months (95% CI, 3.6-8.4), and the median overall survival was 11 months (95% CI, 8.16-13.84).

Conclusions: The CRT approach of this study is moderately active and has an acceptable toxicity profile. However, the incorporation of combination CT into CRT at the present schedule could not produce any additional benefit over CRT alone. Newer agents with more systemic activity are clearly warranted.
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February 2007

Factors influencing axillary node metastasis in breast cancer.

Tumori 2006 Sep-Oct;92(5):416-22

Department of Radiation Oncology, Uludağ University Medical College Görükle, Bursa, Turkey.

Aims And Background: The status of the axillary lymph nodes at the time of diagnosis has been accepted as one of the most important prognostic factors for the overall and disease-free survival of patients with breast cancer. The aim of our study was to determine which factors influence axillary node involvement in invasive breast cancer.

Methods: The data presented here were obtained from 344 patients who were treated for invasive breast cancer at the Department of Radiation Oncology, Uludağ University Medical College, Bursa, Turkey. Possible prognostic factors were categorized as patient related and tumor related. The Mann-Whitney U test was used for univariate analysis and logistic regression was used for multivariate analysis.

Results: In univariate analysis, a familial cancer history (P = 0.0042), age < 40 years (P = 0.0276), higher T stage (P < 0.0000), nipple involvement (P = 0.0345), skin involvement (P = 0.0270), perineural invasion (P = 0.0231), and lymphatic vessel invasion (P < 0.0000) were correlated with increased axillary node involvement. A higher incidence of > or = 4 involved lymph nodes was associated with higher T stage (P = 0.0004), nipple involvement (P = 0.0292), presence of an extensive intraductal component (P = 0.0023), skin involvement (P = 0.0008), perineural invasion (P = 0.0523), and lymphatic vessel invasion (P < 0.0000) in univariate analysis. In multivariate analysis, age < 40 years (P = 0.0454), cancer history within the family (P = 0.0024), higher T stage (P = 0.0339), lymphatic vessel invasion (P = 0.0003), and perineural invasion (P = 0.0408) were found to be independent factors for axillary lymph node positivity. Age < 40 years (P = 0.0221), perineural invasion (P = 0.0408), and an extensive intraductal component (P = 0.0132) were associated with an increased incidence of > or = 4 involved nodes in the logistic regression analysis. In patients with breast cancer, the incidence of axillary lymph node involvement was independently influenced by age < 40 years, presence of cancer history within the family, higher T stage, lymphatic vessel invasion, and perineural invasion.

Conclusions: In conclusion, absence of familial cancer history, presence of lymphatic vessel invasion, higher T stage, and age below 40 years independently increased the risk of axillary node involvement. Presence of perineural invasion and lymphatic vessel invasion, age below 40, and an extensive intraductal component of more than 25% independently affected the risk of having > or = 4 nodes involved. Patients characterized by these factors may be classified into a higher risk group for nodal involvement, but more data are needed to define factors that can help in the decision-making regarding the omission of axillary treatment.
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December 2006

Synchronous breast cancer in spouses.

Tumori 2006 May-Jun;92(3):244-5

Department of Radiation Oncology, School of Medicine, Uluda, University, Bursa, Turkey.

Breast cancer in both spouses is extremely rare. There are 7 metachronous cases and 1 synchronous case in the English literature. No case has been reported in which 1 of the spouses had bilateral breast cancer. In this paper, we report a synchronous pair of cases where 1 of the spouses (wife) had bilateral breast cancer and the other (husband) had breast cancer.
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August 2006

Gastric metastasis of signet ring cell carcinoma of the breast.

Saudi Med J 2006 Feb;27(2):259-61

Department of Radiation Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey.

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February 2006

Postoperative concomitant chemoradiotherapy in locally advanced rectal cancer.

Hepatogastroenterology 2005 Sep-Oct;52(65):1411-5

Department of Radiation Oncology, Uludag University Medical School, Bursa, Turkey.

Background/aims: To gain maximal effectiveness while decreasing toxicity by giving 5-fluorouracil for 45 minutes starting just within 5 minutes after the completion of radiotherapy thrice weekly.

Methodology: Thirty-eight patients with locally advanced rectal cancer were enrolled in the study. Ranges of total radiation doses were between 50.4 Gy and 61.2 Gy with a median of 59.4 Gy with fraction size of 1.8 Gy five times weekly. 5-fluorouracil was administered thrice weekly with the dose of 250-300mg/m2/day concomitantly with radiation therapy.

Results: Median follow-up time was 30 months. Administration of chemotherapy concomitant with radiotherapy (p=0.089), AJCC stage III (p=0.079), Duke's stage C (p=0.079), presence of lymph node involvement (p=0.079) and presence of local recurrence (p=0.066) appeared to be effecting distant metastasis although differences did not reach statistically significance. Mean overall survival was 46 months in patients without any distant metastasis (SD: 3.28; 95% CI: 39.46 and 52.31) while it was 35 months in patients with distant metastasis (SD: 5.71; 95% CI: 23.52 and 45.90, p=0.016).

Conclusions: Our results have provided further evidence of the ability of postoperative chemoradiotherapy to delay and prevent local recurrence and metastasis of rectal cancer.
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November 2005

Preoperative chemoradiotherapy in patients with locally advanced rectal cancer.

Hepatogastroenterology 2005 Jul-Aug;52(64):1095-100

Department of Radiation Oncology, Uludag University Medical School, Bursa, Turkey.

Background/aims: To determine the percentage of responders and the resectability rate for patients with locally advanced carcinoma of the rectum treated by infusional 5-fluorouracil chemotherapy and pelvic radiation.

Methodology: Twenty-four patients with a diagnosis of locally advanced unresectable rectal cancer received preoperative 5-fluorouracil by intravenous infusion at the dose of 250-300mg/m2/day concurrent with pelvic radiation (median 50.4 Gy/28 fractions). Surgery was performed with a mean delay of 15 days after completion of irradiation and included 11 abdominoperineal resections and five anal sphincter-preserving procedures.

Results: The median follow-up was 22 months. Complete histological response occurred in 6%, and tumor down-staging in 58% of cases. There was a significant difference in the rate of local control based on the distance of the tumor from the anal verge (>5.4cm; p=0.046). Our results have suggested the importance of the total dose on the local control (p=0.061). Higher local failure rate has been observed with prolonged treatment time (p=0.018). With metastasis-free survival as the endpoint, only stage (p=0.027) was a statistically significant prognostic factor.

Conclusions: The favorable influence of higher doses of preoperative radiotherapy on pathologic stage has been observed. Even after preoperative radiotherapy, postoperative staging remained a prognostic factor.
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August 2005