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Yıldırım HC, Dinçbaş FÖ, Demircan V, Beyzadeoğlu M, Tekçe E, Yazıcı G, Turna M, Çetinayak O, Ensarioğlu Baktır K, Akın M, Canyılmaz E, Altınok A, Delikgöz Soykut E, Akmansu M, Tuğrul F, Ünverdi S, Benli Yavuz B, Kamer S, Düzova M, Duru Birgi S, Özkan EE, Yalçın B, Şahin M, Etiz D, Arslantaş HS, Meydan D, İğdem Ş, Sağınç H, Parvizi M, Altınok P, Anacak Y. Radiotherapy for benign diseases in Turkey: a patterns of care survey of the Turkish Society for Radiation Oncology (TROD 05-002). Strahlenther Onkol 2024; 200:143-150. [PMID: 37796342 DOI: 10.1007/s00066-023-02154-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/01/2023] [Indexed: 10/06/2023]
Abstract
PURPOSE We aimed to investigate the patterns of radiotherapy (RT) care in cases of benign diseases in Turkey. METHODS A questionnaire survey was sent to all radiation oncology (RO) departments in Turkey. The number of patients treated for benign disease between 2015 and 2020 was requested. A list of benign conditions was given, and information on the number of patients per disease, single and total doses prescribed, weekly fractions, radiation type, energy, and device was requested. RESULTS Of the 138 RO departments, 29 (21%) responded. The data received concerned 15 (52%) university, 10 (34%) public, and four (14%) private hospitals. A total of 130,846 patients were treated with RT in these departments. Of these patients, 6346 (4.85%) were treated for benign conditions. The most common benign diseases treated with RT were meningioma (35%), plantar fasciitis (19%), schwannoma (16%), arteriovenous malformation (11%), and pituitary adenoma (7%). Most centers performed RT for paraganglioma, heterotopic ossification, vertebral hemangioma, and Graves' ophthalmopathy, but none treated arthrosis. Wide variations were observed across the departments. Radiosurgery for intracranial pathologies was performed intensively in four centers. By contrast, RT for plantar fasciitis was predominantly treated in five centers, one of which had more than 1000 patients. CONCLUSION The ratio of patients who underwent RT for benign diseases in Turkey among all patients who underwent RT was 4.85%. The common pattern of RT in 72% of patients was radiosurgery for intracranial benign diseases, followed by low-dose RT for plantar fasciitis in 19%.
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Affiliation(s)
- Halil Cumhur Yıldırım
- Department of Radiation Oncology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
- Department of Radiation Oncology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Kocamustafapasa Street No:53, Cerrahpasa, 34098, Fatih/Istanbul, Turkey.
| | - Fazilet Öner Dinçbaş
- Department of Radiation Oncology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Volkan Demircan
- Department of Radiation Oncology, Acibadem Altunizade Hospital, Istanbul, Turkey
| | - Murat Beyzadeoğlu
- Department of Radiation Oncology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ertuğrul Tekçe
- Department of Radiation Oncology, Bezmialem Vakif University Hospital, Istanbul, Turkey
| | - Gözde Yazıcı
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Menekşe Turna
- Department of Radiation Oncology, Anadolu Medical Center, Istanbul, Turkey
| | - Oğuz Çetinayak
- Department of Radiation Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Mustafa Akın
- Department of Radiation Oncology, Balikesir Ataturk City Hospital, Balikesir, Turkey
| | - Emine Canyılmaz
- Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ayse Altınok
- Department of Radiation Oncology, Medical Park Bahcelievler Hospital, Istanbul, Turkey
| | - Ela Delikgöz Soykut
- Department of Radiation Oncology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Müge Akmansu
- Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Fuzuli Tuğrul
- Department of Radiation Oncology, Eskisehir City Hospital, Eskisehir, Turkey
| | - Seda Ünverdi
- Department of Radiation Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Berrin Benli Yavuz
- Department of Radiation Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Serra Kamer
- Department of Radiation Oncology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Mürsel Düzova
- Department of Radiation Oncology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Sumerya Duru Birgi
- Department of Radiation Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Emine Elif Özkan
- Department of Radiation Oncology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Berrin Yalçın
- Department of Radiation Oncology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Merve Şahin
- Department of Radiation Oncology, Erzurum Bolge Training and Research Hospital, Erzurum, Turkey
| | - Durmuş Etiz
- Department of Radiation Oncology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Hasan Suat Arslantaş
- Department of Radiation Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Deniz Meydan
- Department of Radiation Oncology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Şefik İğdem
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Halil Sağınç
- Department of Radiation Oncology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Murtaza Parvizi
- Department of Radiation Oncology, Manisa City Hospital, Manisa, Turkey
| | - Pelin Altınok
- Department of Radiation Oncology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Yavuz Anacak
- Department of Radiation Oncology, Faculty of Medicine, Ege University, Izmir, Turkey
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Alvarez B, Montero A, Hernando O, Ciervide R, Garcia J, Lopez M, Garcia-Aranda M, Chen X, Flores I, Sanchez E, Valero J, Prado A, Alonso R, Alonso L, Fernandez-Leton P, Rubio C. Radiotherapy CT-based contouring atlas for non-malignant skeletal and soft tissue disorders: a practical proposal from Spanish experience. Br J Radiol 2021; 94:20200809. [PMID: 34282948 PMCID: PMC8764913 DOI: 10.1259/bjr.20200809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 05/26/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Interest in low-dose radiotherapy (LD-RT) for the symptomatic treatment of nonmalignant conditions, including inflammatory and degenerative disorders of the joints and para-articular soft tissues, has increased substantially in recent years. In the present document, we provide a CT-based contouring atlas to help identify and delineate the most common osteoarticular regions susceptible to LD-RT. METHODS The clinical efficacy of LD-RT is supported by a large body of evidence. However, there is no consensus on the parameters for contouring the planning target volume (PTV). Moreover, 3D simulation and planning should be the standard of care even for nonmalignant disorders. For this reason, the present guidelines were prepared to help guide PTV contouring based on CT images, with the same quality criteria for patient immobilization, treatment simulation, planning and delivery as those routinely applied for cancer radiotherapy. RESULTS PTV for radiotherapy requires precise identification of the target areas based on CT and other imaging techniques. Using a series of cases treated at our institution, we have defined the PTVs for each location on the simulation CT to establish the relationship between the image and the anatomical structures to be treated. We also specify the immobilization systems used to ensure treatment accuracy and reproducibility. CONCLUSIONS This comprehensive atlas based on CT images may be of value to radiation oncologists who wish to use LD-RT for the symptomatic treatment of degenerative or inflammatory osteoarticular diseases. ADVANCES IN KNOWLEDGE The recommendations and contouring atlas described in this article provide an eminently practical tool for LD-RT in non-malignant conditions, based on the same quality criteria recommended for all modern radiotherapy treatments in Spain.
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Affiliation(s)
- Beatriz Alvarez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Ovidio Hernando
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Raquel Ciervide
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Juan Garcia
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - Mercedes Lopez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Xin Chen
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Ines Flores
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - Emilio Sanchez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | | | - Rosa Alonso
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Leyre Alonso
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Carmen Rubio
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
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Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. J Anat 2017; 230:743-751. [PMID: 28369929 DOI: 10.1111/joa.12607] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 12/15/2022] Open
Abstract
The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. Historically, authors have described the intrinsic muscles of the foot and/or the plantar fascia as attaching to the PCS. In this article we review the relationship between the PCS and surrounding soft tissues as well as examining the histology of the PCS. We identify a number of key associations with PCS, including age, weight, gender, arthritides, plantar fasciitis and foot position; these factors may function as risk factors in PCS formation. The etiology of these spurs is a contentious issue and it has been explained through a number of theories including the degenerative, inflammatory, traction, repetitive trauma, bone-formers and vertical compression theories. We review these and finish by looking clinically at the evidence that PCS causes heel pain.
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Affiliation(s)
- Joshua Kirkpatrick
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Omid Yassaie
- Department of Orthopedic Surgery, Wellington Hospital, Wellington, New Zealand
| | - Seyed Ali Mirjalili
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
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