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Olacak N, Hazeral Y, Hazeral B, Duran O, Güray G, Alanyali S, Haydaroğlu A. Dosimetric evaluation of different radiotherapy techniques in mastectomized left-sided breast cancer. J Cancer Res Ther 2022. [DOI: 10.4103/jcrt.jcrt_1018_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ece Solmaz A, Yeniay L, Gökmen E, Zekioğlu O, Haydaroğlu A, Bilgen I, Özkınay F, Onay H. Clinical Contribution of Next-Generation Sequencing Multigene Panel Testing for BRCA Negative High-Risk Patients With Breast Cancer. Clin Breast Cancer 2021; 21:e647-e653. [PMID: 33980423 DOI: 10.1016/j.clbc.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 02/19/2021] [Accepted: 04/05/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Breast cancer is the most common malignancy in women and thought to be hereditary in 10% of patients. Recent next-generation sequencing studies have increased the detection of pathogenic or likely pathogenic (P/LP) variants in genes other than BRCA1/2 in patients with breast cancer. This study evaluated pathogenic variants, likely pathogenic variants, and variants of unknown significance in 18 hereditary cancer susceptibility genes in patients with BRCA1/2-negative breast cancer. PATIENTS AND METHODS This retrospective study included 188 high-risk BRCA1/2-negative patients with breast cancer tested with a multigene cancer panel using next-generation sequencing. RESULTS Among 188 proband cases, 18 variants in 21 patients (11.1%) were classified as P/LP in PALB2 (n = 6), CHEK2 (n = 5), MUTYH (n = 4), ATM (n = 3), TP53 (n = 2), BRIP1 (n = 1), and MSH2 (n = 1). Three novel P/LP variants were identified. An additional 28 variants were classified as variants of unknown significance and detected in 30 different patients (15.9%). CONCLUSION This is one of the largest study from Turkey to investigate the mutation spectrum in non-BRCA hereditary breast cancer susceptibility genes. A multigene panel test increased the likelihood of identifying a molecular diagnosis in patients with BRCA 1/2-negative breast cancer at risk for a hereditary breast cancer syndrome. More studies are needed to enable the clinical interpretation of these P/LP variants in hereditary patients with breast cancer.
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Affiliation(s)
- Aslı Ece Solmaz
- Department of Medical Genetic, Ege University Faculty of Medicine, Izmir, Turkey.
| | - Levent Yeniay
- Department of General Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Erhan Gökmen
- Department of Medical Oncology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Osman Zekioğlu
- Department of Pathology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ayfer Haydaroğlu
- Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Işıl Bilgen
- Department of Radiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ferda Özkınay
- Department of Medical Genetic, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hüseyin Onay
- Department of Medical Genetic, Ege University Faculty of Medicine, Izmir, Turkey
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Caner A, Sadıqova A, Erdoğan A, Namlıses D, Nalbantsoy A, Oltulu F, Toz S, Yiğittürk G, Ozkök E, Gunduz C, Ozbel Y, Haydaroğlu A. Targeting of antitumor ımmune responses with live-attenuated Leishmania strains in breast cancer model. Breast Cancer 2020; 27:1082-1095. [PMID: 32472473 DOI: 10.1007/s12282-020-01112-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/16/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cancer is a major cause of death worldwide and most of the therapeutic approaches are relatively ineffective in eliminating cancer especially due to drug resistance. As an alternative, therapy with live microorganisms can induce a robust proinflammatory and anti-cancer immune response in the microenvironment of the tumor. In the present study, we aimed to establish a model for taking the advantages of immune responses against intracellular protozoan parasites for cancer treatment. METHODS Leishmania infantum and L. tropica were used in our study as agents of visceral and cutaneous forms of the infection, respectively. After establishing 4T1 breast cancer in mice groups, live-attenuated L. infantum (At-Li) and live-attenuated L. tropica (At-Lt) treatments were performed and results were evaluated according to tumor volume, immune markers and histological examination. RESULTS Live-attenuated Leishmania strains regressed 4T1-breast cancer in mice and are nonpathogenic, and these strains induce an immune response against 4T1 breast cancer. It is shown that At-Lt is found to be more effective than At-Li in breast cancer treatment using different methods included in the study as analyses of immune parameters, and histopathological examination in tumor tissue besides spleen cells. The tumor grew more slowly by the immune-stimulant effect of live-attenuated Leishmania parasites. CONCLUSION This promising therapy should be investigated for optimization in further studies with different cancer types and L. tropica may be designed to express antigens to enhance tumor antigen-specific responses, which may further improve efficacy and immune memory development.
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Affiliation(s)
- Ayse Caner
- Departments of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. .,Department of Basic Oncology, Ege University, Institute of Health Sciences, Izmir, Turkey. .,Department of Parasitology, Ege University Medical School, Izmir, Turkey.
| | - Aygül Sadıqova
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Alper Erdoğan
- Department of Basic Oncology, Ege University, Institute of Health Sciences, Izmir, Turkey
| | - Dünya Namlıses
- Department of Basic Oncology, Ege University, Institute of Health Sciences, Izmir, Turkey
| | - Ayse Nalbantsoy
- Department of Bioengineering, Faculty of Engineering, Ege University, Izmir, Turkey
| | - Fatih Oltulu
- Department of Histology and Embryology, Ege University Medical School, Izmir, Turkey
| | - Seray Toz
- Department of Parasitology, Ege University Medical School, Izmir, Turkey
| | - Gürkan Yiğittürk
- Department of Histology and Embryology, Ege University Medical School, Izmir, Turkey
| | - Emel Ozkök
- Department of Pathology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Cumhur Gunduz
- Department of Medical Biology, Ege University Medical School, Izmir, Turkey
| | - Yusuf Ozbel
- Department of Parasitology, Ege University Medical School, Izmir, Turkey
| | - Ayfer Haydaroğlu
- Department of Basic Oncology, Ege University, Institute of Health Sciences, Izmir, Turkey
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Gürsoy P, Çakar B, Gökmen E, Sarsık Kumbaracı B, Semerci B, Caner A, Sert F, Özkök S, Haydaroğlu A. Ege Üniversitesi Hastanesinde testis kanserlerinin epidemiyolojisi ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.669478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Kaya H, Sabah D, Keçeci B, Doğanavşargil B, Sezak M, Yaman B, Akalın T, Kamer ES, Anacak Y, Haydaroğlu A, Arkun R, Argın M, Tamsel İ, Şanlı UA, Ataseven E, Kantar M. Kemik ve yumuşak doku sarkomları epidemiyolojisi ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.668453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Turan İ, Özütemiz AÖ, Ersöz G, Karasu Z, Günşar F, Tekin F, Çoker A, Sözbilen EM, Ünalp Ö, Uguz A, Göker E, Yılmaz F, Nart D, Caner A, Haydaroğlu A, Akarca US. Karaciğer, safra kesesi ve safra yolu kanserlerinde epidemiyoloji ve sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.668367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Haydaroğlu A, Özsaran Z, Şanlı UA, Zekioğlu O, Yıldırım N, Akman L, Terek C, Özsaran A. Ege Ünı̇versı̇tesı̇ Hastanesı̇nde jinekolojik kanserlerin epidemiyolojik ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.668351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Özgiray E, Çalışkan KE, Çağlı MS, Yurtseven T, Ertan Y, Akalın T, Şanlı AU, Kamer S, Anacak Y, Haydaroğlu A. Ege Üniversitesi Hastanesi merkezi sinir sistemi tümörlerinin epidemiyolojik ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.668489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Haydaroğlu A, Yalman D, Ersin S, Doğanavşargil Yakut B, Karabulut B, Ünal N, Özütemiz Ö. Ege Üniversitesi Hastanesinde gastrointestinal sistem kanserlerinin epidemiyolojik ve sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.668440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Haydaroğlu A, Sert F, Caner A. Ege Üniversitesi Hastanesi veri tabanındaki kanser olgularının epidemiyolojik ve genel sağ kalım özellikler. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.668072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Ünal NG, Coşgun G, Korkut M, Özütemiz AÖ, Doğanavşargil B, Çakar B, Özkök S, Yalman D, Sert F, Sezak M, Yoldaş T, Çalışkan C, Akgün ZE, Osmanoğlu H, Haydaroğlu A. Ege Üniversitesi Tıp Fakültesi veri tabanındaki kolorektal kanserli olguların epidemiyolojik ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.668311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Güzel D, Yıldırım N, Besler A, Akman L, Özdemir N, Zekioğlu O, Özsaran Z, Şanlı UA, Göker E, Haydaroğlu A, Terek MC, Özsaran AA. Over kanserinin epidemiyolojisi ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.669376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Gürsoy P, Çakar B, Gökmen E, Sarsık Kumbaracı B, Şen S, Apaydın E, Çal AÇ, Caner A, Özkök S, Haydaroğlu A. Ege Üniversitesi Hastanesinde renal kanser hastalarının epidemiyolojisi ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.669480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Akman L, Yıldırım N, Terek MC, Özsaran Z, Alanyalı S, Haydaroğlu A, Şanlı UA, Göker E, Zekioğlu O, Özdemir N, Özsaran AA. Korpus uteri kanserlerinin epidemiyoloji ve sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.669448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Yıldırım N, Terek MC, Akman L, Özsaran Z, Alanyalı S, Haydaroğlu A, Şanlı UA, Göker E, Zekioğlu O, Özdemir N, Özsaran AA. Serviks uteri kanserlerinin epidemiyoloji ve sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.669672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Haydaroğlu A, Çakar B, Gökmen E, Özdemir N, Zekioğlu O, Özsaran Z, Alanyalı S, Göktepe B, Yeniay L. Ege Üniversitesi Hastanesi veri tabanında meme kanseri hastalarının epidemiyolojisi ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.669412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Haydaroğlu A, Yalman D, Özkök S, Gökmen E, Şen S, Sarsık Kumbaracı B, Kızılay F, Cüreklibatır İ, Caner A. Ege Üniversitesi Hastanesinde erkek genital sistem kanserlerinin epidemiyolojik ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.669269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Gürsoy P, Çakar B, Gökmen E, Sarsık Kumbaracı B, Semerci B, Caner A, Sert F, Özkök S, Haydaroğlu A. Ege Üniversitesi Hastanesinde testis kanserlerinin epidemiyolojisi ve genel sağ kalım özellikleri. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.669472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Onur Çağlar H, Yılmaz Süslüer S, Gündüz C, Haydaroğlu A. Meme kanseri kanser kök hücrelerinde PD-0332991 uygulanmasının hücre döngüsü düzenleyici genler üzerine etkisi. Ege Tıp Dergisi 2018. [DOI: 10.19161/etd.414615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Çağlar HO, Yılmaz Süslüer S, Kavaklı Ş, Gündüz C, Ertürk B, Özkınay F, Haydaroğlu A. Meme kanseri kök hücrelerinde elajik asit ile indüklenmiş miRNA’ların ifadesi ve elajik asidin apoptoz üzerine etkisi. Ege Tıp Dergisi 2018. [DOI: 10.19161/etd.399234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Eralp Y, Kılıç L, Alço G, Başaran G, Doğan M, Dinçol D, Demirci S, İçli F, Onur H, Saip P, Haydaroğlu A. The Outcome of Patients with Triple Negative Breast Cancer: The Turkish Oncology Group Experience. J Breast Health 2014; 10:209-215. [PMID: 28331673 DOI: 10.5152/tjbh.2014.1904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 06/24/2014] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Triple negative breast cancer (TNBC) is generally considered as a poorer prognostic subgroup, with propensity for earlier relapse and visceral involvement. The aim of this study is to evaluate the outcome of non-metastatic TNBC patients from different centers in Turkey and identify clinical and pathologic variables that may effect survival. MATERIALS AND METHODS Between 1993-2007, from five different centers in Turkey, 316 nonmetastatic triple negative breast cancer patients were identified with follow-up of at least 12 months. The data was collected retrospectively from patient charts. The prognostic impact of several clinical variables were evaluated by the Kaplan-Meier and Cox multivariate anayses. RESULTS Mean age at diagnosis was 49 years (range: 24-82). The majority of the patient group had invasive ductal carcinoma (n: 260, 82.3%) and stage II disease (n: 164; 51.9%). Majority of the patients (87.7%) received adjuvant chemotherapy. 5 year overall survival (OS) and disease-free survival (DFS) rates were 84.6% and 71.6%, respectively. Univariate analysis revealed locally advanced disease (p: 0.001), advanced pathological stage (p: 0.021), larger tumor size (T1&T2 vs T3&T4) (p<0.001), nodal positivity (p: 0.006), and extensive nodal involvement (p<0.001) as significant factors for DFS; whereas, advanced pathological stage (p: 0.017), extensive nodal involvement (p<0.001) and larger tumor size (p: 0,001) and presence of breast cancer-affected member in the family (p=0.05) were identified as prognostic factors with an impact on OS. Multivariate analysis revealed larger tumor size (T3&T4 vs T1&T2) and presence of lymph node metastases (node-positive vs node-negative) as significant independent prognostic factors for DFS (Hazard ratio (HR): 3.03, 95% CI: 1.71-5.35, p<0.001 and HR: 1.77, 95% CI: 1.05-3.0, p=0.03, respectively). Higher tumor stage was the only independent factor affecting overall survival (HR: 2.81; 95% CI, 1.27-6.22, p=0.01). CONCLUSION The outcome of patients with TNBC in this cohort is comparable to other studies including TNBC patients. Tumor size and presence of lymph node metastasis are the major independent factors that have effect on DFS, however higher tumor stage was the only negative prognostic factor for OS.
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Affiliation(s)
- Yeşim Eralp
- Department of Medical Oncology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Leyla Kılıç
- Department of Medical Oncology, Fırat University Hospital, Elazığ, Turkey
| | - Gül Alço
- Department of Radiation Oncology, Florence Nightingale Gayrettepe Hospital, İstanbul, Turkey
| | - Gül Başaran
- Department of Medical Oncology, Acibadem University Faculty of Medicine, İstanbul, Turkey
| | - Mutlu Doğan
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Dilek Dinçol
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Senem Demirci
- Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Fikri İçli
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Handan Onur
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Pınar Saip
- Department of Medical Oncology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Ayfer Haydaroğlu
- Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir, Turkey
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Kara FG, Haydaroğlu A, Eren H, Kitapçıoğlu G. Comparison of Different Techniques in Breast Cancer Radiotherapy Planning. J Breast Health 2014; 10:83-87. [PMID: 28331649 DOI: 10.5152/tjbh.2014.1772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 11/14/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aimed to minimize the radiation dose to organs other than the target tissue during adjuvant therapy applied for breast cancer, by using different planning methods. MATERIALS AND METHODS 30 women with T1-2 N1-3 M0 breast cancer were included in the study. Planning was performed using four different methods to the supraclavicular area, internal, and external tangential fields. All planning was done in a virtual environment by and the requested data was obtained. All patients were treated by the 1st method. Method 1: Different isocenter, complete supraclavicular area, breast half beam. Method 2: Different isocenter, half supraclavicular area, breast half beam. Method 3: Single isocenter, half supraclavicular area, breast half beam. Method 4: Different isocenter, supraclavicular area full beam, breast full beam. RESULTS Evaluation of PTV values showed a statistically significant reduction in D-max, 110% and 115% values by method III. Lower doses in other parameters were not statistically significant. CONCLUSION Based on these results, the application of single isocenter, 3D radiotherapy in breast cancer provides significant advantages especially in PTV and pulmonary dosages.
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Affiliation(s)
- F Gülşen Kara
- Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ayfer Haydaroğlu
- Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Hakan Eren
- Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Gül Kitapçıoğlu
- Department of Biostatistics and Health Informatics, Ege University Faculty of Medicine, İzmir, Turkey
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Kamer S, Esassolak M, Haydaroğlu A, Aras A. Second Primary Tumors in Patients With Nasopharingeal Cancer Treated by Radiotherapy. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kamer S, Ozsaran Z, Celik O, Bildik O, Yalman D, Bölükbaşi Y, Haydaroğlu A. Evaluation of anxiety levels during intracavitary brachytherapy applications in women with gynecological malignancies. EUR J GYNAECOL ONCOL 2007; 28:121-4. [PMID: 17479673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE To evaluate the anxiety levels of women treated for gynecological malignancies using intracavitary brachytherapy. METHODS Anxiety levels prior to and after intracavitary brachytherapy application and factors influencing anxiety levels were evaluated. Women were evaluated for quality of life and psychological status before each brachytherapy application using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0-7 = normal, 8-10 = borderline, 11-21 = abnormal. Women were also questioned about other factors which could affect anxiety levels such as marital status, education level, number of pregnancies and prior surgical history. RESULTS Between January 2003 and August 2004, 146 women with a median age of 56 years were evaluated (range: 27-80). Eighty-six women had cervix uteri carcinoma and 63 had endometrial carcinoma. Sixty-seven women were premenopausal and 85 women were postmenopausal. The median pregnancy number was three (range = 0-10). Eighty-nine women had at least three children. Sixty-seven women had had previous operations. One hundred and twenty-five women were married and 24 women were unmarried or widowed. Before treatment, the anxiety scores were scored as normal in 49 (32%), borderline in 41 (28%), and abnormal in 59 (40%). Anxiety levels were lower in 69 women during the last application as compared with the pretreatment levels (p = 0.00). Marital status and pregnancy number showed a significant correlation with anxiety scores (p = 0.04). Age, level of education or having had a previous operation showed no significant correlation with anxiety level. CONCLUSION These results indicate that intracavitary brachytherapy is associated with anxiety. Women need to be given detailed information before the brachytherapy application to reduce anxiety. Additional studies are needed to determine it.
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Affiliation(s)
- S Kamer
- Department of Radiation Oncology, Ege University Medical School, Izmir
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Kamer S, Anacak Y, Savaş R, Doğanavşargil B, Haydaroğlu A. Giant cell tumor of the bone with an asymptomatic huge solitary lung metastasis; case presentation and literature review. J BUON 2006; 11:87-90. [PMID: 17318959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
A case concerning a man having giant cell tumor (GCT) of the leg and huge lung metastasis is presented. This case is discussed with a brief review of the relevant literature regarding detection and treatment of this care condition.
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Affiliation(s)
- S Kamer
- Department of Radiation Oncology, Ege University Medical School, Izmir, Turkey.
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Esassolak M, Karagöz U, Yalman D, Köse S, Anacak Y, Haydaroğlu A. Evaluation of the effects of radiotherapy to the chiasm and optic nerve by visual psychophysical and electrophysiologic tests in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2004; 58:1141-6. [PMID: 15001256 DOI: 10.1016/j.ijrobp.2003.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2003] [Revised: 07/14/2003] [Accepted: 08/11/2003] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the effects of high-dose radiotherapy (RT) to the chiasm and optic nerves in locally advanced nasopharyngeal carcinoma patients by visual psychophysical and electrophysiologic tests. METHODS AND MATERIALS A series of visual tests, including visual evoked potentials (VEPs), contrast sensitivity, and visual field and visual acuity tests, were administered to 27 patients with locally advanced (T4) nasopharyngeal carcinoma who had undergone RT to high doses 6 to 74 months previously. As a control group, the same tests were administered to 40 unirradiated patients who had been referred to the ophthalmology department for any reason. RESULTS The median values of VEP latency, VEP amplitude, and contrast sensitivity and the rate of visual field defect were significantly worse in the RT group (p = 0.06, p <0.001, p <0.001, and p = 0.005, respectively). No dose-response relationship was found in any tests when 50 Gy was the cutoff value. However, a positive correlation between the interval after RT and VEP latency (r = 0.406, p = 0.003) and a negative correlation between the interval and contrast sensitivity (r = -0.499, p <0.001) was noted; no correlation could be established regarding VEP amplitude and the interval after RT. CONCLUSION Radiation-induced injury to the anterior visual pathways could result in an increase in VEP latency and a decrease in VEP amplitude and contrast sensitivity. This injury seems to be a continuous process developing with time.
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Affiliation(s)
- Mustafa Esassolak
- Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir, Turkey.
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Kamer SA, Yalman D, Ozer E, Sayhan S, Hanhan M, Ozsaran A, Haydaroğlu A. Changes of Ki-67 index in squamous cell carcinoma of the cervix during the early course of radiotherapy and prediction of prognosis. EUR J GYNAECOL ONCOL 2003; 24:287-92. [PMID: 12807242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
PURPOSE To determine whether changes in the Ki-67 index during the early course of radiotherapy could predict the prognosis in squamous cell carcinoma of the uterine cervix and be of value in clinical practice. MATERIALS AND METHODS Biopsy specimens from 23 cases of histologically confirmed squamous cell carcinoma of the cervix were stained with anti-Ki-67 monoclonal antibody prior to radiotherapy and after 9 Gy. The correlation between the Ki-67 index, local control and distant metastasis was determined by Spearman's correlation test. RESULTS Median age of the patients was 49. According to the FIGO staging system four patients had Stage IIA, 16 had Stage IIB, one had Stage IIIA and two had Stage IIIB disease. Among the whole group brachytherapy was applied to 17 patients (17/23) and weekly cisplatin (40 mg/m2) was applied to 15 patients (15/23). The mean Ki-67 index prior to radiotherapy and after 9 Gy for the entire group were 58.5% and 46.0%, respectively. The Ki-67 index after 9 Gy decreased in most of the patients (74%). During a median follow-up of 23 months four patients developed local recurrence and four patients developed distant metastasis. No significant correlation was detected among the local control and changes in Ki-67 index after 9 Gy, whereas there was a moderate correlation between distant metastasis and changes in Ki-67 index after 9 Gy (r = 0.51, p = 0.01). CONCLUSION The Ki-67 index can be used safely as a proliferation marker in cervical carcinomas, and changes in the Ki-67 index during the early course of radiotherapy may predict the metastatic potential. However prospective studies including a large number of patients with long-term follow-up are necessary to confirm the clinical utility of this marker in cervical cancer.
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Affiliation(s)
- S A Kamer
- Department of Radiation Oncology, Ege University School of Medicine, Izmir, Turkey
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Yalman D, Aras AB, Ozkök S, Duransoy A, Celik OK, Ozsaran Z, Haydaroğlu A. Prognostic factors in definitive radiotherapy of uterine cervical cancer. EUR J GYNAECOL ONCOL 2003; 24:309-14. [PMID: 12807246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
PURPOSE To determine the prognostic factors related to local control and survival in 257 patients with uterine cervical cancer treated with definitive radiotherapy (RT). MATERIALS AND METHODS The medical records of 257 patients treated with definitive RT from January 1987 to December 1998 were reviewed retrospectively. Pretreatment and treatment parameters were analyzed to determine their prognostic value onlocal control and survival. Survival analyses were performed using the Kaplan-Meier method. The log-rank test was used for univariate analyses and the Cox regression model was used for multivariate analyses. RESULTS Median age was 55 (range 25-82). Squamous cell carcinoma was the most common histologic type (89.1%). The distribution per FIGO Stage was IIA: 13.2%; IIB: 54.9%; IIIA: 3.9%; IIIB: 19.8%; IVA: 8.2%. Ninety-eight patients (38.1%) were treated with external RT alone; 134 (52.1%) received both external RT and intracavitary brachytherapy; 21 (8.2%) received external RT and chemotherapy and four (1.6%) received external RT, intracavitary brachytherapy and chemotherapy. Median follow-up duration was 50 months (range 24-155 months). The failure rate was 51.8% with 26.5% of patients having only local failure, 16.7% only distant failure and 8.6% both local and distant failure. Five-year local progression-free, disease-free and overall survival rates were 58.1%, 44% and 63.7%, respectively. In univariate analysis the prognostic factors identified for local progression-free survival were histology (p = 0.008), FIGO stage (p < 0.001), initial hemoglobin (Hgb) level (p = 0.001), total radiation dose (p = 0.039), use of brachytherapy (p = 0.001) and of chemotherapy (p = 0.037) and enlarged paraaortic nodes (p = 0.016). In multivariate analysis the prognostic factors were FIGO stage (p = 0.014), initial Hgb level (p = 0.040), and use of brachytherapy (p = 0.013). The prognostic factors identified for disease-free survival were histology (p = 0.011), FIGO stage (p < 0.001), initial Hgb level (p < 0.001), use of brachytherapy (p = 0.001) and of chemotherapy (p = 0.014) in univariate analysis; and FIGO stage (p < 0.001), initial Hgb level (p = 0.017), total tumor dose (p = 0.034), use of brachytherapy (p = 0.006) and of chemotherapy (p = 0.021) in multivariate analysis. Factors influencing overall survival were FIGO stage (p < 0.001), initial Hgb level (p = 0.006), overall treatment time (p = 0.028), total tumor dose (p = 0.007), use of brachytherapy (p < 0.001), enlarged paraaortic (p < 0.001) and pelvic nodes (p = 0.004) in univariate analysis; and FIGO stage (p < 0.001), overall treatment time (p = 0.031), enlarged paraaortic (p = 0.007) and pelvic lymph nodes (p = 0.043) in multivariate analysis. CONCLUSION Definitive RT is an effective treatment for patients with uterine cervical cancer. There are many prognostic factors influencing treatment outcome. Brachytherapy and chemotherapy must be added in appropriate patients to improve the outcome. Future prospective trials should be undertaken to confirm the validity of these factors and to individualize the treatment strategy for every patient.
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Affiliation(s)
- D Yalman
- Department of Radiation Oncology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey
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Ozsaran Z, Yalman D, Yürüt V, Aras A, Ozsaran A, Hanhan M, Haydaroğlu A. Radiochemotherapy for patients with locally advanced cervical cancer: early results. EUR J GYNAECOL ONCOL 2003; 24:191-4. [PMID: 12701977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
PURPOSE Radiotherapy is the standard treatment for locally advanced cervical cancer. Recent results of the prospective randomized trials have shown an overall survival and local control advantage for cisplatin-based therapy given concurrently with radiation therapy. Thirty-nine patients who received concurrent chemoradiation between October 1999 and December 2000 were evaluated for treatment response, local control and toxicity. MATERIALS AND METHODS Thirty-nine patients with Stage IB through IVA cervical carcinoma received weekly cisplatin (40 mg/m2) concurrent with radiotherapy. Thirty-two patients received both external and intracavitary radiotherapy and seven patients received only external radiotherapy because of insufficient tumor response for intracavitary application. Total external radiotherapy dose was 64.8 Gy with 1.8 Gy daily fractions in patients who received only external radiotherapy. Midline shielding was performed at 50.4 Gy in patients who were going to receive brachytherapy and the total external radiotherapy dose was 54-59.4 Gy. Brachytherapy was performed with a Rotterdam applicator via the microSelectron HDR machine. A total dose of 8.5-18 Gy was applied to point A. RESULTS Median age was 55. Distribution by stages were as follows: Stage IB 5.1%, IIA 28.2%, IIB 43.6%, IIIA 7.7%, IIIB 12.8% and IVA 2.6%. Histologically 33 (84.6%) were epidermoid carcinoma, one was adenocarcinoma, two were undifferentiated carcinoma, one was malignant epithelial tumor. In two patients histological type could not be specified. The median duration of follow-up was 20 months. Four patients had local recurrence and three developed distant metastases. Thirty patients (76.9%) had complete response, eight had (20.5%) partial response and one had (2.6%) stable disease. During or after radiochemotherapy 46.2% of the patients developed toxicity due to chemotherapy. Early and late radiation morbidity rates were 66.7% and 71.8%, respectively. No grade III-IV toxicity was observed. CONCLUSION Concurrent chemoradiation for locally advanced cervical cancer is the treatment of choice in suitable patients providing high response rates with acceptable toxicity.
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Affiliation(s)
- Z Ozsaran
- Ege University Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey
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Ozsaran Z, Yalman D, Baltalarli B, Anacak Y, Esassolak M, Haydaroğlu A. Radiotherapy in maxillary sinus carcinomas: evaluation of 79 cases. Rhinology 2003; 41:44-8. [PMID: 12677740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
PURPOSE The aim of this study is to evaluate the outcome of patients with maxillary sinus carcinoma after radiotherapy regarding local control, prognostic factors and morbidity of treatment. MATERIALS AND METHODS Between January 1983 and December 1996, 79 cases of maxillary sinus carcinoma without any evidence of distant metastases, were treated with radiotherapy. RESULTS Fifty-two patients (65.8%) were male and 27 (34.2%) were female. The median age was 57. Histologically 62% were epidermoid carcinoma, 32.9% were non-epidermoid carcinoma and 5.1% were unclassified. Sixteen patients (20.5%) had T2, 25 (29.8%) had T3 and 38 (49.7%) had T4 tumour while 13 patients (16.5%) had lymph node metastases. Fifty-nine patients (74.4%) underwent surgical resection followed by postoperative radiotherapy and 20 patients (25.3%) received radiotherapy alone. The median follow-up was 71 months; 5-year overall survival and local control rates were 53% and 54% respectively. Prognostic factors influencing the overall survival were histologic type (epidermoid carcinoma, p = 0.02), advanced T stage (p = 0.04), postoperative residual tumour (p = 0.002) and lymph node involvement (p = 0.01) whereas the factors influencing local control were histologic type (p = 0.05) and postoperative residual tumour (p = 0.005). Late radiation morbidity were cataract (11.4%), loss of vision (8.9%), trismus (5.1%) and hearing loss (2.5%). CONCLUSION In maxillary sinus carcinomas high rates of local control can be achieved with surgery and radiotherapy. Postoperative radiotherapy can have a positive impact on local control and overall survival especially in patients with early stage tumour of non-epidermoid histology and without residual disease after surgery.
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Affiliation(s)
- Zeynep Ozsaran
- Ege University, Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey
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Haydaroğlu A, Yürüt V, Arican A, Yalman D, Bülent Aras A, Esassolak M, Ozkök S. The impact of the haemoglobin level on the response to radiotherapy. J BUON 2002; 7:31-4. [PMID: 17577257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE To define the impact of preradiotherapy haemoglobin (Hb) levels on the response rate of radiotherapy in patients with head and neck, uterine cervix and lung cancer. PATIENTS AND METHODS One hundred thirteen patients- 38 with head and neck cancer, 43 with carcinona of the uterine cervix and 32 with lung cancer- were retrospectively evaluated to determine the correlation between tumor response and preradiotherapy Hb levels. Hb level of 11 g/dl was taken as cut-off value for anemia. Patients were divided in two groups according to their objective response to radiotherapy. RESULTS Histologically 30 of the head and neck cancers, 36 of the cervical cancers and 17 of the lung cancers were squamous-cell carcinomas. Tumor response of the epidermoid carcinomas were significantly correlated with preradiotherapy Hb levels (p < 0.001). Tumor response in patients with head and neck and cervical cancers was significantly correlated with pretreatment Hb levels while in patients with lung cancer this correlation did not reach statistical significance (p=0.059). CONCLUSION Preradiotherapy Hb level is an important factor in determining the efficacy of radiotherapy. Raising the Hb level before radiotherapy may have a beneficial impact on the response to radiotherapy.
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Affiliation(s)
- A Haydaroğlu
- Ege University Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey
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Arun Kamer S, Yalman D, Ozer E, Sayhan S, Hanhan M, Ozsaran A, Haydaroğlu A. Changes of Ki-67 index in squamous cell carcinoma of the cervix during the early course of radiotherapy and prediction of radiotherapy response. Int J Radiat Oncol Biol Phys 2001. [DOI: 10.1016/s0360-3016(01)02425-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Anacak Y, Yalman D, Ozsaran Z, Haydaroğlu A. Late radiation effects to the rectum and bladder in gynecologic cancer patients: the comparison of LENT/SOMA and RTOG/EORTC late-effects scoring systems. Int J Radiat Oncol Biol Phys 2001; 50:1107-12. [PMID: 11483319 DOI: 10.1016/s0360-3016(01)01527-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To test the correlation of LENT/SOMA and RTOG/EORTC late-effect scales for rectum and bladder, 116 cases with gynecologic malignancies that were treated with radiotherapy were assessed with both scales. METHODS AND MATERIALS All cases had been treated at least 6 months before the date of assessment with external beam radiotherapy (50--54 Gy to midline) and 1--2 fractions of HDR brachytherapy (2 x 8.5 Gy to point-A for 32 inoperable cases; 1 x 9.25 Gy to 5--9 mm from the ovoid surface for 84 postoperative cases). The patients were questioned with both scales, and the correlation between the two scales was analyzed by Spearman's rho (rank correlation) test. RESULTS There were 64 cases with uterine cervix carcinoma and 52 cases with endometrium carcinoma, The overall (external + brachy) doses to ICRU points were 57.8 +/- 3.8 Gy for rectum and 59.3 +/- 4.9 Gy for bladder. The statistical analysis of LENT/SOMA and RTOG/EORTC scales revealed a very good correlation for rectum (r = 0.81; p < 0.01) and a good correlation for bladder (r = 0.72; p < 0.01). CONCLUSION The LENT/SOMA system is a further step on the reporting of late radiation effects. Some modifications will improve its precision, and multicentric randomized studies are needed to test its validity.
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Affiliation(s)
- Y Anacak
- Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir, Turkey.
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Yalman D, Ozsaran Z, Anacak Y, Celik OK, Ozkök S, Ozsaran A, Hanhan M, Haydaroğlu A. Postoperative radiotherapy in endometrial carcinoma: analysis of prognostic factors in 440 cases. EUR J GYNAECOL ONCOL 2001; 21:311-5. [PMID: 10949404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
PURPOSE The aim of this study was to determine the prognostic factors influencing overall, disease-free and local recurrence-free survival in patients treated postoperatively with adjuvant radiotherapy for endometrial carcinoma. METHODS The records of 440 patients with endometrial carcinoma treated by postoperative radiotherapy between January 1985 and June 1997 were reviewed retrospectively. All patients received postoperative external radiotherapy with 1.8-2.0 Gy daily fractions up to 36-68 Gy (median 54 Gy). Intracavitary brachytherapy was applied to 61.8% of the cases. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. RESULTS Median age of the patients was 57 (range: 35-83). Histologically 80.2% were adenocarcinoma, 5.7% adenosquamous carcinoma, 5.2% clear-cell carcinoma and 4.3% serous papillary carcinoma. The distribution by stages were: 62.2% Stage I, 20.0% Stage II, 14.9% Stage III, 2.8% Stage IV. Median follow-up time was 53 months (7-173 months). Total failure rate was 15.2% with 2.7% of patients having only local failure, 2.0% local and distant failure and 10.5% distant failure only. Five-year overall, disease-free and local recurrence-free survival rates were 81.6%, 80.7% and 94.6%, respectively. According to univariate analysis prognostic factors influencing disease-free survival were histologic type (p=0.0067), histologic grade (p=0.0015), stage (p<0.0001), myometrial invasion (p<0.0001), peritoneal cytology (p=0.0013) and cervical involvement (p=0.0106) while the prognostic factors affecting local recurrence-free survival were stage (p=0.0277), myometrial invasion (p=0.0054), peritoneal cytology (p=0.0427). According to multivariate analysis prognostic factors influencing disease-free survival were histologic type (p=0.0194), myometrial invasion (p=0.0021), and histologic grade (p=0.0303) while the only prognostic factor influencing local recurrence-free survival was myometrial invasion (p=0.0241). CONCLUSION Radiotherapy is a highly effective adjuvant treatment providing an excellent locoregional control rate and it should be continued for patients with unfavorable prognostic factors.
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Affiliation(s)
- D Yalman
- Ege University Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey
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Esassolak M, Yalman D, Anacak Y, Ozkök S, Haydaroğlu A. Accelerated fractionation (AF) in head and neck cancers. Radiother Oncol 1998; 47:103-4. [PMID: 9632302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Esassolak M, Yalman D, Özsaran Z, Arican A, Haydaroğlu A. Postoperative adjuvant radiotherapy in stage IB carcinomas of the uterine cervix. Radiography (Lond) 1998. [DOI: 10.1016/s1078-8174(98)80029-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Anacak Y, Esassolak M, Aydin A, Aras A, Olacak I, Haydaroğlu A. Effect of geometrical optimization on the treatment volumes and the dose homogeneity of biplane interstitial brachytherapy implants. Radiother Oncol 1997; 45:71-6. [PMID: 9364634 DOI: 10.1016/s0167-8140(97)00143-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE The isodose distributions of HDR stepping source brachytherapy implants can be modified by changing dwell times and this procedure is called optimization. The purpose of this study is to evaluate the effect of geometrical optimization on the brachytherapy volumes and the dose homogeneity inside the implant and to compare them with non-optimized counterparts. MATERIAL AND METHODS A set of biplane breast implants consisting of 84 different configurations have been digitized by the planning computer and volumetric analysis was performed for both non-optimized and geometrically optimized implants. Treated length (TL), treated volume (V100), irradiated volume (V50), overdose volume (V200) and quality index (QI) have been calculated for every non-optimized implant and compared to its corresponding geometrically optimized implant having a similar configuration and covering the same target length. RESULTS The mean TL was 74.48% of the active length (AL) for non-optimized implants and was 91.87% for optimized implants (P < 0.001). The mean QI was 1.83 for non-optimized implants and 2.17 for optimized implants (P < 0.001). The mean V50/V100 value was 2.71 for non-optimized implants and 2.65 for optimized implants (P < 0.001) and the mean V200/V100 value was 0.09 for non-optimized implants and 0.10 for optimized implants (P < 0.001). CONCLUSIONS By performing geometrical optimization it is possible to implant shorter needles for a given tumour to adequately cover the target volume with the reference isodose and thus surgical damage is reduced. The amount of healthy tissues outside the target receiving considerable radiation is significantly reduced due to the decrease in irradiated volume. Dose homogeneity inside the implant is significantly improved. Although there is a slight increase of overdose volume inside the implant, this increase is considered to be negligible in clinical applications.
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Affiliation(s)
- Y Anacak
- Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir, Turkey
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Ozkök S, Aras AB, Esassolak MA, Arican AH, Yalman D, Haydaroğlu A. Hyperfractionated radiotherapy combined with simultaneous chemotherapy in inoperable non-small cell lung cancer: a pilot study. Monaldi Arch Chest Dis 1995; 50:443-7. [PMID: 8834953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Between March 1992 and February 1993, hyperfractionated radiotherapy (HRT) (1.2 Gy.fraction-1, twice a day, total dosage of 69.6 Gy) and simultaneous cisplatin (70 mg.m-2, 3rd and 23rd days of HRT) and etoposide (70 mg.m-2, 1-3rd and 20-23rd days of HRT) were applied to 27 patients with inoperable non-small cell lung cancer (NSCLC). Their Karnofsky performance statuses were 70-90%, and mean age was 52 (36-63). Two cases were stage II (one of the patients refused the operation and the other was medically inoperable because of insufficient ventilation), eight were stage IIIA and 17 were stage IIIB. No severe life-threatening grade IV acute toxicity findings were observed. Generally, acute side-effects were transient and did not require discontinuation of treatment. Tumour responses were as follows: complete response in six cases (23%); partial response in 19 cases (70%); and stable disease in two (7%). When complete response rates were compared according to stage, histological type, age group and weight loss, no statistically significant difference was found. Median overall and disease-free survival times were 14 months (95% confidence interval) (95% CI) 11-17 months and 10 months (95% CI 7-13 months), respectively. Twelve and 24 months overall and disease-free survival rates were 56 and 30%, and 36 and 24% respectively. No statistically significant difference was found in overall survival rates among epidermoid and nonepidermoid types, while the difference in disease-free survival was statistically significant. The acute and late complications of our HRT and simultaneous chemotherapy protocol were tolerable and the survival rates were encouraging.
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Affiliation(s)
- S Ozkök
- Dept of Radiation Oncology, Ege University Medical Facultyu, Izmir, Turkey
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Abstract
A ten-year-old girl was admitted to our hospital with a mass in the left breast after a local recurrence following a resection done in a district hospital three months earlier. A modified radical mastectomy with axillary lymph node dissection was performed in our department. Histological examination revealed a lipid secreting carcinoma (lipid-rich carcinoma) of the breast. To our knowledge she is the first case in childhood in the literature and is therefore reported.
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Affiliation(s)
- E Balik
- Department of Pediatric Surgery, Ege University Faculty of Medicine, Izmir, Turkey
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