I am a Radiation Oncologist and I am interested in brachytherapy treatment.
Many factors affect prognosis in cancer, and machine learning algorithms can be used to determine which factors have a greater effect on survival prognosis, which then allows further research into these factors. In the current study, Gaussian Naive Bayes was identified as the best algorithm for the evaluation of prognosis of nasopharyngeal cancer.
PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval.
The adverse effects of regimes in cancer treatment have forced us to change to new targeted therapy options. Understanding these side effects, which can lead to discontinuation of the new therapy strategies, will allow the clinical management of these side effects and result in continuing therapies with effective medications. Bevacizumab, which is an IgG1 antibody against vascular endothelial growth factor, has side effects such as proteinuria, hypertension, venous and arterial thromboembolic events, and hemorrhage. This is the first reported case of dural sinus vein thrombosis, during the treatment with bevacizumab.
This study aimed to elucidate the clinical and prognostic characteristics of a homogeneous group of patients with cancer of unknown primary (CUP). Between 1999 and 2014, CUP was diagnosed in 159 (1.3%) of 11,742 cancer patients at Trakya University Hospital (Edirne, Turkey). Ninety-seven (61%) of the 159 patients were retrospectively reviewed. Among these, 61 (62.8%) patients with adenocarcinoma were included in this study. The most frequently predicted primary tumor site was the lung (37.7%), and 59% of the patients were smokers. There was a significant relationship between smoking and the lung as a potential primary cancer site (p = 0.042). The most frequent site of metastasis was the liver (60.7%). The median number of metastases per patient was two, but patients with liver metastases had a median of five metastases. The overall median survival time was 7 months. Median survival was significantly longer in patients with a predicted primary site than in patients without the predicted site (7 vs. 6 months, respectively; p = 0.038). When the patients with predicted ovarian and peritoneal tumors were excluded from the comparison, the statistical p value was still close to significant (p = 0.07). Multivariate analysis revealed that smoking, liver metastasis, serum alkaline phosphatase ≥92 U/L, and progression in response to chemotherapy were independent predictors of a poor prognosis. The present study identified several independent prognostic factors in patients with unknown primary adenocarcinomas who received chemotherapy. Smoking, the presence of liver metastasis, and response to chemotherapy were independent risk factors for both progression-free and overall survival.
It is important to predict the patients who will develop acute HT in order to minimize the side effects of treatment. If these cases can be identified in advance, toxicity rates can be reduced by taking necessary precautions. These cases can be predicted with machine learning algorithms.
L-carnitine and amifostine have a noteworthy and similar radioprotective effect against radiation-induced acute ovarian toxicity.
IMRT and VMAT techniques have different advantages in locally advanced lung cancer, and the use of those two techniques as a hybrid can provide a single collection of these advantages.
Spontaneous intracranial hypotension (SICH) is an entity, which is secondary to iatrogenic manipulation and breaching of dura. Postural headache in patients should be suspected, cranial magnetic resonance imaging (MRI) is essential for precise diagnosis. Hallmark of MRI is regular shape of pachymeningeal gadolinium enhancement and subdural effusion. It may mimic central nervous system (CNS) metastasis. Prevention of such cases from receiving cranial radiotherapy by misinterpretation of the gadolinium enhancement as CNS metastasis is an important issue. Capecitabine is an antineoplastic agent, of which metabolites can cross blood-brain barrier in CNS via epithelial tissue. It may cause decrease in CSF production. SICH might be the clinical reflection of this decrease in CSF production. Review of the English literature revealed limited data because of the very little experience with oncologic patients suffering from intracranial hypotension. We report a case of spontaneous intracranial hypotension during capecitabine treatment. Patient was completely well following drug discontinuation and supportive treatment.
The roles of many genes in the pathophysiology of lung cancer have been investigated in different studies. Cyclin D1 (CCND1) gene plays a significant role in the transition from G1 to S phase of the cell cycle and in the phosphorylation of retinoblastoma tumor suppressor protein. In this study, we aimed to identify the relationship between CCND1 A870G gene polymorphism with lung cancer. CCND1 A870G genotypes were determined in 75 patients with lung cancer and in 65 control subjects. DNA was isolated from blood samples and then CCND1 A870G gene polymorphism was identified using PCR and RFLP assay. The distribution of CCND1 A870G polymorphism did not show any significant differences in all lung cancer patients and controls. There was no correlation between CCND1 A870G polymorphism and histopathological findings. However, the AA + AG genotype was significantly higher in metastatic patients, when compared with non-metastatic patients. Thus, the results show that CCND1 gene polymorphism may be a predictor for detecting patients with poor survival who having metastatic disease.
Eccrine porocarcinoma is a rare malignant sweat gland tumor. The lower extremity represents the most common tumor site for this entity. Surgical excision seems to be the best treatment choice. The surgical margins should be free of tumor, otherwise a local recurrence is most likely. Regional lymph node dissection should be performed if there is evidence of lymphadenopathy. Here, we present clinical and pathological findings of a 69 years old woman diagnosed with eccrine porocarcinoma arising from the skin of the trunk.
This study aimed to compare the efficacy of topical dimethyl sulfoxide (DMSO), intralesional and systemic carnitine as monotherapy and in combination against ulceration in rats induced by intradermal doxorubicin extravasation. Sixty-nine 3-month-old male Wistar albino rats, weighing between 200-225 g, were used in this study. Rats were applied monotherapy or a combination of topical DMSO, intraperitoneal or intralesional carnitine. Control groups received saline or no drug. The necrotic area was measured and extravasated neutrophil leukocytes were counted in healthy tissue adjacent to necrotic areas. Monotherapy with topical and systemic carnitine did not significantly reduce the size of necrotic areas. However, topical DMSO had reduced necrotic areas and inflammatory cells significantly and the addition of systemic carnitine to topical DMSO had increased the efficacy. DMSO is an effective, safe, and easy-to-apply treatment for doxorubicin-induced extravasation. Further clinical studies are needed to evaluate the use of carnitine in combination with DMSO.
In this study, we aimed to compare the protective effects of melatonin and amifostine on radiation-induced oxidative stress. Fifty female Wistar rats (3-4 months old, weighing 200±25 g) were divided into five groups (with ten rats each) and treated as follows: control (Cont), radiotherapy alone (RT), radiotherapy + amifostine (RT+AMI), radiotherapy + melatonin (RT+MEL), radiotherapy + amifostine + melatonin (RT+AMI+MEL). Rats were irradiated individually with a single dose of 8 Gy and amifostine (200 mg/kg) and melatonin (10 mg/kg) was administered to rats 30 minutes before irradiation. At the end of this follow-up period (72 hours) the rats were sacrificed. Spectrophotometric Analysis has been performed to kidney tissue samples. As a result of statistical comparison between groups after RT, total antioxidant capacity (TAC) decreased, total oxidant status (TOS) and oxidative stress index (OSI) increased, although the statistically significant change was only for OSI (p = 0.030). Addition of AMI or MEL to RT increased TAC and OSI significantly (p = 0.000), but there was no additive effect for TAC and OSI when both drugs were given together (p = 1.000, p = 0.172, respectively). In terms of TOS, statistically significant increasing was only for AMI (p = 0.000). There was protective effect when both drugs were given together against on Radiation-Induced Renal Oxidative Stress.
The trimodality treatment was possible in 25% of cases with operable disease due to the high rate of patient refusal to proceed to surgery following induction radiochemotherapy. No difference in survival was observed between patients treated with surgery and those treated with radiochemotherapy only because of a limited follow-up. So, the benefit of additional surgery is not clear, and a longer follow-up is needed before final conclusions can be drawn.
Low anterior resection, performing total mesorectal excision with appropriate pelvic dissection to prevent local recurrence, is probably the most challenging type of surgery in colorectal surgery, especially in a narrow pelvis. In this study, we aimed to predict the operation difficulty of rectal cancer by comparing the operation time with 2D and 3D pelvimetry. Sixty-six patients who underwent total mesorectal excision after neoadjuvant chemoradiotherapy due to primary rectal cancer located in the middle and lower rectum (10 cm from the anus) were included in the study. Surgery notes were reviewed and data on demographic factors, tumor stage, duration of surgery, and types of surgery were collected, as well as pelvimetric parameters. All protocols had 2D T2-weighted sequences in 3 planes (axial, sagittal, and coronal). Pelvimetric measurements were made by measuring 8 pelvic lengths and 2 angles. Pelvis and tumor volume were measured by manual margin monitoring. In each slice, both pelvis and tumor boundaries were manually drawn individually in the sagittal plane. Pelvis and tumor volumes were calculated from the set of adjacent images by summing slice thickness and products of area measurements within the pelvis and tumor boundaries. In our results, no correlation was observed with operation time, including pelvic volume. Exception for this were interacetabular distance and tumor volume. In the regression test, the only parameter that correlated with the operation time was tumor volume. In conclusion, we believe that tumor volumetric calculations may be useful in predicting difficult distal rectal carcinoma surgeries.
Anketi (EORTC QLQ) C-30, Pittsburgh Uyku Kalitesi indeksi (PUKI), Saysal Ar Deerlendirme skalas kullanlarak topland. rneklem seim ltlerine uyan hastalar (n=23) uygulama ve kontrol gruplarna randomizasyonu yapld. Uygulama grubuna 10,000 lux beyaz k/30 dakika/gn bir hafta sresince uygulanrken, kontrol grubunun istirahat saland. Her iki grup hastann uyku ve yaam
It can be said that it is very important to determine when the radiation-induced brain injury is formed. From a clinical perspective, the patients can be intervened before irreversible functional deficits are formed and may be amenable to treatment.
Objective: The aim of the study was to evaluate the radioprotective efficacy of intrarectal administration of amifostine in radiation-induced proctitis compared to intraperitoneal administration.
Background: Stereotactic body radiotherapy (SBRT) is a standard treatment for early stage non-small cell lung cancer (esNSCLC) patients who are not eligible for surgery. We aimed to evaluate the prognostic significance of the level of change in SUVmax (ΔSUVmax) between pre and post-treatment PET/CT in esNSCLC patients treated with SBRT. Methods: Between November 2009-February 2018, pathologically proven esNSCLC patients (T1-2N0M0) treated with CyberKnife as primary treatment alone and had pre and post-treatment PET/CT (in 3 weeks before and 12-16 weeks after SBRT) were retrospectively identified. The ΔSUVmax was calculated using formula ΔSUVmax. The area under the curve (AUC) was used to verify the accuracy; the product of maximum sensitivity and specificity was chosen as the cutoff value. Then, we stratified the study cohort above and below AUC and the survival data were estimated by Kaplan Meier method. Univariate and multivariate analyses were carried out by use of a Cox proportional hazards model. Results: All patients’ clinicopathological and treatment characteristics are presented in the table. Median dose was 45 Gy/3 fr (range: 45-60 Gy/3-5 fr). According to EORTC metabolic response criteria, 8 (16.7%) patients achieved complete, and 35 (72.9%) patients achieved partial response. AUC was calculated as 0.62 for cutoff ΔSUVmax (sensitivity 79%, specificity 45%). ΔSUVmax was ≥0.62 in 7 of 8 patients with complete response and <0.62 in progressive 2 patients. At a median follow-up of 23 (range: 6-92) months local, regional and distant relapse had developed in 16 (33.3%), 11 (22.9%), and 16 (33.3%) patients, respectively. 29 (60.4%) patients were still alive at the time of analysis. Median PFS was 15 vs 59 months (p=.012) and median OS was 36 vs 70 months (p=.045). In univariate analysis, we could not find any significant effect of sex, age, KPS, T stage, and BED10 on PFS, and OS. In both univariate and multivariate analysis, the lower ΔSUVmax (as both dichotomous and continuous variable) was determined as a negative prognostic factor on PFS (p=.02, .003 for univatiate and .013 and .003 for multivariate) and it has been showed that the lower ΔSUVmax (only as a dichotomous variable) is a negative prognostic factor on OS in multivariate analysis (p=.009).Table74P Clinicopathological and treatment characteristicsΔSUVmaxp<0.62 n (%)≥0.62 n (%)Gender Female Male2 (6.5) 29 (93.5)2 (11.8) 15 (88.2)NSDAge at diagnosis (years) Median Range67 54-8467 56-82NSDKPS Median Range90 60-10080 60-90NSDTumor Size (mm) Median Range27 15-4320 11-45NSDT stage T1 T221 (67.7) 10 (32.3)13 (76.5) 4 (23.5)NSDNSCLC histology Squamous Adenocarcinoma Other / unidentified13 (41.9) 8 (25.8) 10 (32.3)9 (52.9) 5 (29.4) 3 (17.6)NSDBED10 (Gy) Median Range112.5 100 - 180112.5 100 - 151NSDLocal Failure Yes No12 (38.7) 19 (61.3)4 (23.5) 13 (76.5)0.04Regional Failure Yes No9 (29.0) 22 (71.0)2 (11.8) 15 (88.2)0.02Distant Failure Yes No14 (45.2)) 17 (54.9)2 (11.8) 15 (88.2)0.02Last Situation Alive Exitus16 (51.6) 15 (48.4)13 (76.5) 4 (23.5)0.04 Open table in a new tab Conclusions: ΔSUVmax is a prognostic factor in esNSCLC patients treated with SBRT and patients with higher ΔSUVmax (≥0.62) have better PFS and OS. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Merkel cell carcinoma (MCC) is a very rare high-grade neuroendocrine carcinoma that is frequently located in the skin. Although most cases are associated with Merkel cell polyomavirus, there are also cases in which the virus cannot be detected. The purpose of presenting the case of MCC with primary nodal involvement is due to its rare presentation. 
 A 59-year-old male patient presented to the hospital with painless mass in the neck. Imaging analyses revealed necrotic lymphadenopathies on the neck, measuring up to 4.5 cm in size. After an explorative surgery with preliminary diagnoses of lymphoma and squamous cell carcinoma , samples taken from the excised mass showed high-grade neuroendocrine carcinoma morphology. In addition to neuroendocrine markers, CK7 and CK20 positivity were observed in the immunohistochemical tests performed. As a result, the case was evaluated in favor of MCC with negativity of markers performed to exclude other malignancies. Subsequently, a diagnosis of primary nodal MCC was made due to the absence of a different focus other than lymph node on PET imaging analysis.
 The differential diagnosis should be kept broad due to the histopathological morphology of small round cell malignant tumors. In addition in high-grade neuroendocrine carcinomas, the possibility of MCC should be ruled out especially if CK20 positivity is present. Although is has been reported that primary nodal MCC cases have a better clinical course compared to nodal metastatic cases with a known primary, there are limited case series studies on this topic. A multisystem approach is recommended for proper clinical management.
The correlation between tissue localisation and serum levels of alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) was studied in 20 tissue samples from 18 patients with non-seminomatous testicular tumours. Specific immunoperoxidase stains were used for tissue staining and serum measurements were made by radioimmunoassay. There was a close correlation between the tissue demonstration of AFP and HCG and elevated levels of serum markers. The cellular localisations of AFP and HCG were different and no cell stained concomitantly for both AFP and HCG. From these results and from the demonstration of tumour markers in the tissue of some patients with normal serum marker levels, it was concluded that immunocytochemical localisation of the tumour markers was more sensitive than serum measurements.
Abstract Background: Breast cancer (BC) remains the most common cancer in women, and it is the second leading cause of cancer-related death in women. Because of advances in treatment, long life is now possible even in patients with metastatic BC, whereas certain groups of patients survive for a very short time despite being diagnosed at an early stage. In many studies, the triple negative BC subgroup is stated to have the worst prognosis, as such patients are deprived of antihormonal therapy and trastuzumab therapy. While HER2 overexpression was interpreted as a poor prognostic factor before trastuzumab treatment, it was reported to be the worst prognostic subgroup of TNBC in posttrastuzumab publications. In the current study, we aimed to find the worst prognostic subgroup as far as we could by capturing the biodiversity in our series of BC patients, and for this purpose, we compared the treatment results in patients grouped according to their receptor status. Methods: We reviewed the records of patients with BC who were admitted to our department between July 1999 and December 2019. We grouped the patients into four main groups (Luminal A, Luminal B, triple negative, and HER2 enriched) and we recorded patient and treatment characteristics and oncological results. Survival curves were generated using the Kaplan–Meier method, and the significance of survival differences among the selected variables was compared by using the log-rank test. Univariate Cox regression analysis was used to estimate hazard ratios. Then, multivariate Cox regression analysis with the backward elimination method was used to estimate hazard ratios and to identify independent prognostic factors. Results: A total of 2474 patients with BC and after exclusions, statistical analysis was performed on 2017 patients with BC. The HER2 positivity rate was 23.7% and the TNBC patient rate was 11.7% (n = 236). The distribution of the four main groups was 47.1% for Luminal A, 34.1% for Luminal B, 7.1% for HER2 enriched, and 11.7% for the TN subgroup. Age (<35 years); no axillary surgery; Ki67≥15; high tumor grade; high mitotic index; the presence of skin infiltration; advanced T/N stage; the presence of metastasis; nontreatment with chemotherapy; less than 5 years of using TMX or AI; and being in the HER2-enriched subgroup were determined to be negative factors for overall survival as a result of multivariate analysis. Conclusions: The HER2-enriched subgroup had the worst prognosis despite receiving targeted therapy. However, treatment with trastuzumab increased survival 1.5-fold over that of the HER2-enriched subgroup that did not receive it.
Abstract The aim of this study is to compare histopathologically the protective effect of melatonin and amifostine on radiation induced renal damage. 50 female albino rats were divided into five groups: control, radiotherapy alone, radiotherapy+amifostine, radiotherapy+melatonin, radiotherapy+amifostine+melatonin. Intraperitoneal amifostine (200 mg/kg) and intraperitoneal melatonin (10 mg/kg) was administered to 30 minutes before irradiation. Rats were irradiated with a single dose of 8 Gy on whole body. At the end of the follow-up period, percentage of damaged glomeruli was determined by counting damaged glomeruli of kidney cortex as segmental or total necrosis for each animal. The protective effect of each agent has been shown, and there is an advantage in favor of melatonin (p = 0.005). Although there is not an advantage of adding amifostine to melatonin (p = 0.243), there is statistically significant better protective effect in amifostine+melatonin group when compared with amifostine alone (p = 0.003). The protective effect of melatonin on radiation induced acute renal toxicity is histopathologically better than amifostine. Key words: Amifostine, melatonin, acute renal damage, ionizing radiation. Ozet Bu calismanin amaci, erken donemde iyonizer radyasyonun neden oldugu akut bobrek hasari uzerine melatonin ve amifostinin koruyucu etkisinin histopatolojik olarak karsilastirilmasidir. 50 disi albino rat kontrol, yalniz radyoterapi, radyoterapi+amifostin, radyoterapi+melatonin ve radyoterapi+amifostin+melatonin olmak uzere bes gruba ayrildi. Intraperitoneal amifostin (200 mg/kg) ve intraperitoneal melatonin (10 mg/kg) radyoterapiden 30 dakika once uygulandi. Tek tek ratlarin tum vucutlarina 8 Gy eksternal radyopterapi uygulandi. Takip suresinin sonunda her bir hayvan icin segmental veya total nekroz gibi bobrek korteksi glomerul hasari sayilarak hasarli glomerul yuzdesi tespit edildi. Amifostin, melatonin ve amifostin+melatonin'in koruyucu etkisi istatistiksel olarak gosterilmekle birlikte melatonin lehine bir avantaj tespit edilmistir (p = 0.005). Melatonin’e amifostin eklenmesinin tek basina melatonine gore ustunlugu olmamasina karsin (p = 0.243) amifostine melatonin eklenmesinin tek basina amifostine gore istatistiksel ustunlugu gosterilmistir (p = 0.003). Sonuc olarak melatonin’in iyonizer radyasyonun neden oldugu akut bobrek hasari uzerine koruyucu etkisi amifostin’den histopatolojik olarak daha iyidir. Anahtar kelimeler: Amifostin, melatonin, akut renal hasar, iyonizer radyasyon.
A 53-year-old male patient presented with complaints of headache and paresis in left arm. Cranial computerized tomography and magnetic resonance imaging (MRI) demonstrated a mass in the right parietal region. The solitary tumor was removed by craniotomy. Histological examination showed that it was a squamous cell carcinoma metastasis. The patient subsequently underwent whole brain radiotherapy for a total dose of 30 Gy in 10 fractions and conventional external-beam boost irradiation of 10 Gy in 5 fractions to the tumor margins. He remained disease free until 23 months later. He returned to our clinic with left arm paresis after 24 months. In the left parietal lobe a new lesion was determined on his MRI scan. Partial brain reirradiation at a dose of 25 Gy in 10 fractions was performed. There was a partial regression of symptoms after radiotherapy. In the light of this patient, we reviewed the literature and discussed the treatment strategies of patients with solitary brainmetastasis.
Malignant neoplasms are sometimes associated with a variety of paraneoplastic rheumatic syndromes. Hypertrophic osteoarthropathy is one of these syndromes and the vast majority of cases are associated with intra thoracic neoplasms mainly broncogenic cancer. Hypertrophic osteoarthropathy (HOA) is characterized by clubbed fingers and periosteal new bone formation. Etio logically, it can be divided into primary and secondary HOA. The major clinical manifestation was severe bilateral leg pain. The pathogenesis of the disease remains unclear. Bone scintigraphy is a sensitive method to detect HOA. In this case, a 49-yea r-old man who had hypertrophic pulmonary osteoarthropathy associated with advanced stage non-small cell lung carcinoma is presented and a review of the literature is performed.
Tm skalp nlamas (TSI) yaygn skalp tutulumu yapabilen tmre sahip hastalarda sklkla palyatif amal kullanlmaktadr. Tm skalpte tedavi edici dozun homojen bir ekilde dalm ile birlikte beyin ve dier risk altndaki organlarn korunabilmesi TSI'n hem planlanma hem de uygulamasndaki nemli teknik zorluklardr. Yllar ierisinde tedavi modalitelerindeki teknolojik gelimeler dorultusunda TSI'nda farkl teknikler tanmlanmtr. Fakat st teknolojilere sahip olmayan tedavi merkezleri iin ok fazla farkl seenek bulunmamaktadr. Bu makalemizde yaygn skalp tutulumu olan 88 yanda anjiyosarkom tanl erkek hastamza palyatif amal (45 Gy/15 fr
The aim of this study is to compare histopathologically the protective effect of melatonin and amifostine on radiation induced renal damage. 50 female albino rats were divided into five groups: control, radiotherapy alone, radiotherapy+amifostine, radiotherapy+melatonin, radiotherapy+amifostine+melatonin. Intraperitoneal amifostine (200 mg/kg) and intraperitoneal melatonin (10 mg/kg) was administered to 30 minutes before irradiation. Rats were irradiated with a single dose of 8 Gy on whole body. At the end of the follow-up period, percentage of damaged glomeruli was determined by counting damaged glomeruli of kidney cortex as segmental or total necrosis for each animal. The protective effect of each agent has been shown, and there is an advantage in favor of melatonin (p = 0.005). Although there is not an advantage of adding amifostine to melatonin (p = 0.243), there is statistically significant better protective effect in amifostine+melatonin group when compared with amifostine alone (p = 0.003). The protective effect of melatonin on radiation induced acute
ÖZET: Bu çalışmanın amacı tek beyin metastazına sahip küçükhücreli dışı akciğer kanseri (KHDAK) tanılı hastalarda yoğunluk ayarlıradyoterapi (YART) planlama yöntemi ile tüm beyin radyoterapisi + simültaneentegre boost (TBRT + SEB) tekniğinikullanarak hedef dokuda doz yükseltilmesinin erken dönem sonuçlarınındeğerlendirmesidir. Tek beyin metastazına sahip ve TBRT + SEB tedavisiuygulanan KHDAK tanılı hastalar geriye dönük olarak değerlendirildi. Temmuz2015 - Ocak 2016 arasında toplamda 11 hastaya ulaşıldı. Hasta ve tümöre aitözellikler, demografik veriler, tedavi bilgisi ve özellikleri incelendi. Tedavisüresince tüm hastalara antiödem tedavi rutin başlandı. Hastalarda grade III-IVtoksisite gözlemlenmedi. Hastaların radyoterapiden 1 ay sonra çekilen beyin MRgörüntüleri değerlendirildi ve tedavi öncesi beyin MR görüntüleri ilekarşılaştırılarak 7 (%63) hastada tam yanıt, 4 (%37) hastada ise kısmi yanıtelde tespit edildi. Sonuç olarak TBRT + SEB tekniği radyocerrahi uygulamasınagöre teknik olarak daha basit uygulanabilir, oldukça etkin ve hastalartarafından tolere edilebilir bir yöntemdir.ANAHTAR KELİMELER: tüm beyinradyoterapisi (TBRT), simültane entegre boost(SEB), akciğer kanseri, tek beyin metastazıWHOLE BRAIN RADIOTHERAPY (WBRT) WITHSIMULTANEOUS INTEGRATED BOOST (SIB) IN PATIENTS WITH SINGLE BRAIN METASTASISABSTRACT: The aim ofthis study is to evaluate the early phase treatment results of dose escalationusing by whole brain radiotherapy (WBRT) with simultaneous integrated boost(SIB) in non-small cell lung cancer patients with single brain metastasis. Weevaluated retrospectively non-small cell lung cancer patients treated with WBRT+ SIB. We achieved the data of 11 non-small cell lung cancer patients who weretreated between July 2015 and January 2016. Patient and tumor characteristics,demographic data and treatment features have been evaluated. We prescribedantiedema treatment to all patients in whole duration of radiotherapy. We didnot observe any grade III-IV toxicity. Cranial MRI images in the first monthafter radiotherapy has been evaluated and compared with preradiotherapy images.Complete response was identified in 7 (63%) patients and partial response wasidentified in 4 (37%) patients. In conclusion, WBRT + SIB technique is easierto apply when compared with radiosurgery, an effective and tolerable method forpatients. KEYWORDS: Wholebrain radiotherapy (WBRT), simultaneous integrated boost (SIB), lung cancer,single brain metastasis
Öz: Bu tek merkezli prospektif çalışmada 3 boyutlu konformal radyoterapi (3BKRT) ile tedavi edilen ve normal doz-volüm histogramına (DVH) sahip akciğer kanseri tanılı hastalarda radyasyon pnömonisi (RP) gelişimini etkileyen faktörleri değerlendirmeyi amaçlandı. Çalışmaya Şubat 2012-Temmuz 2013 tarihleri arasında küratif 3BKRT uygulanan 41 akciğer kanseri tanılı hasta dahil edildi. Otuz (%73,2) hastaya eş zamanlı kemoterapi verildi. Sekiz (%19,5) hastaya adjuvant radyoterapi (RT) uygulandı. Medyan RT dozu 60 (30-64) Gy idi. Tedavi sonrası RP gelişimi ile DVH parametreleri, tedavi öncesi karbon monoksit difüzyon kapasitesi (DLCO), serum prokalsitonin, CRP ve TGF-β1 seviyeleri gibi hastaya özgü faktörler arasındaki ilişki analiz edildi. Medyan 8 (6-24) aylık takip süresi içerisinde 15 (%36,6) hastada RP gelişti (11 hastada grade I, 4 hastada grade II) ve sadece 2 hastaya steroid (1 mg/kg/gün metilprednizolon) tedavisi uygulandı. Tek değişkenli analizde lenf nodu tutulumu, DLCO ve tedavi öncesi serum prokalsitonin düzeyinin RP gelişimi üzerine etkisi gösterildi (sırasıyla, p=0.018, 0,045, 0.001). Çok değişkenli analizde sadece tedavi öncesi serum prokalsitonin düzeyi ile istatistiksel anlamlı ilişki mevcut idi (p=0.027). Sonuç olarak tedavi öncesi serum prokalsitonin düzeyi 3BKRT ile tedavi edilen ve normal DVH değerlerine sahip akciğer kanseri tanılı hastalarda RP gelişimini tahmin etmede faydalı olabilir.
There are controversies about the relation between the peripheral lymphocyte levels and response to neoadjuvant therapy. While some authors have reported that a positive correlation between peripheral lymphocyte levels and tumor response, others have suggested the opposite. In the present study, we aimed to investigate the possible relations between the changes in circulating lymphocyte counts due to neoadjuvant chemoradiotherapy (CRT) and intratumoral lymphocytic response (ILR) and tumor regression grade (TRG) in locally advanced rectal cancers. Lymphocyte levels before, during and after CRT as well as before surgery and pathologic findings including ILRs and TRGs were recorded. Lymphocyte levels before CRT were accepted as absolute values. After the changes in the lymphocyte levels during and after CRT and before the surgery were recorded as ratios to the absolute values, the relation between the changes in lymphocyte levels, ILR and TRG were studied by using Pearson and Spearman correlation tests. There was a positive correlation between changes in peripheral lymphocytic levels after neoadjuvant CRT and ILRs. However, there were no other correlations between changes in lymphocytic levels and TRGs and ILRs. The changes in the peripheral lymphocyte counts after CRT may be predictive for ILR. Further studies may provide more information about the relation between peripheral lymphocytes and TILs and tumor response to neoadjuvant CRT. [Med-Science 2017; 6(4.000): 640-642]
Abstract The prevalence of lung cancer as of the elderly has been increasing parallel to the increase of age average in general population. In addition, widespread use of tomography has been elevating the prevalence of the early stage lung cancer. Surgical intervention cannot be performed in these cases due to co-morbidities. The achievement performed by means of the administration of a classical dose of radiotherapy (RT), concerning the early stage, non-small cell lung cancer (NSCLC), has still been insufficient. Stereotactic Body Radiotherapy (SBRT) delivered in the extracranial area increases the local control rate to 80%. The purpose of this method is to deliver high doses with minimal damage to normal tissues. The success of the technique depends on the achieved stabilization of the patient together with the fact that the tumor remains within the RT portal area during the treatment. Considering SBRT administration, the biological equivalent tumour dose should be ≥100 Gy. Since the treatment period is limited to a few days, it facilitates the practicability of this treatment and provides a number of radiobiological advantages. The aim of the study is to answer questions such as Which patients can be delivered SBRT? What are the success and toxicity rates of the treatment?
Bu çalışmanın amacı, erken dönemde iyonizer radyasyonun neden olduğu akut böbrek hasarı üzerine melatonin ve amifostinin koruyucu etkisinin histopatolojik olarak karşılaştırılmasıdır. 50 dişi albino rat kontrol, yalnız radyoterapi, radyoterapi+amifostin, radyoterapi+melatonin ve radyoterapi+amifostin+melatonin olmak üzere beş gruba ayrıldı. İntraperitoneal amifostin (200 mg/kg) ve intraperitoneal melatonin (10 mg/kg) radyoterapiden 30 dakika önce uygulandı. Tek tek ratların tüm vücutlarına 8 Gy eksternal radyopterapi uygulandı. Takip süresinin sonunda her bir hayvan için segmental veya total nekroz gibi böbrek korteksi glomerul hasarı sayılarak hasarlı glomerul yüzdesi tespit edildi. Amifostin, melatonin ve amifostin+melatonin&#039;in koruyucu etkisi istatistiksel olarak gösterilmekle birlikte melatonin lehine bir avantaj tespit edilmiştir (p = 0.005). Melatonin’e amifostin eklenmesinin tek basına melatonine göre üstünlüğü olmamasına karşın (p = 0.243) amifostine melatonin eklenmesinin tek basına amifostine göre istatistiksel üstünlüğü gösterilmiştir (p = 0.003). Sonuç olarak melatonin’in iyonizer radyasyonun neden olduğu akut böbrek hasarı üzerine koruyucu etkisi amifostin’den histopatolojik olarak daha iyidir.
NS is significantly higher expressed in grade III tumors than grade II tumors. In difficult cases, it can be used as a useful proliferation marker in the differentiation of grades II and III astrocytomas.
Adenoid Kistik Karsinom, 100000’de 0.1-0.26 görülme insidansı ile oldukça nadir görülen bir hastalıktır. Trakeanın ikinci en sık görülen primer malignitesi olmakla birlikte cerrahi rezeksiyon esas tedavi yöntemidir. Ancak cerrahi olamayacak hastalarda ya da cerrahi sonrası mikroskobik/makroskobik rezidü hastalık varlığında radyoterapi önerilmektedir. Nadir görülen bir tümör olması ve cerrahi sınır pozitifliği nedenleri ile küratif radyoterapi uyguladığımız 38 yaşında kadın olguyu sunmayı amaçladık.
Abstract Background Radiation-induced nephropathy (RIN) is an impairment of function caused by ionizing radiation which develops after6-12 months as acute or after years as chronic period. Methods This paper aims to clarify, whether L-carnitine has a protective effect in the prevention of RIN in an infant rat model. Results Two-week-old forty male Wistar albino rats were divided into four groups such as control (C), L-carnitine alone (LC), irradiation alone (RT), and L-Carnitine before irradiation (L-carnitine + RT), injected with LC (300 mg/kg) i.p., 30 minutes before the irradiation. The rats in the RT and L-Carnitine + RT groups were irradiated individually with a single dose of 8 Gy. All animals underwent both Tc99m DTPA dynamic renal imaging and Tc99m DMSA static renal imaging at the end of three months follow-up period. Proximal tubular degeneration, tubular atrophy, interstitial fibrosis, and glomerular degeneration were assessed histopathologically. While the kidney damage caused by irradiation was shown in line with both scintigraphy and histopathology findings, it was shown that L-carnitine did not have any negative effects on the kidney. Also, we could not demonstrate the protective effect of L-carnitine on radiation-induced kidney damage, both scintigraphically and histopathologically. Conclusion Although kidney damage due to irradiation was created in infantile rats successfully, the protective effect of L-carnitine could not be demonstrated in our study.
INTRODUCTION Radiation-induced nephropathy (RIN) is an impairment of renal function caused by ionizing radiation developing after 6-12 months as acute, or years after chronically. This study aims to clarify whether L-carnitine has a protective effect in the prevention of RIN in an infant rat model or not. MATERIAL-METHOD Two-week-old male forty Wistar albino rats, control (C), L-carnitine alone (LC), irradiation alone (RT), and 30 min before irradiation (L-Carnitine 300 mg/kg, ip + RT) separated into the group. The rats in the RT and L-Carnitine + RT groups were irradiated with a dose of 8 Gy in a single fraction. All animals underwent both Tc99m DTPA dynamic kidney imaging and Tc99m DMSA static kidney imaging at the end of the three-month follow-up period. Histopathologically, proximal tubular degeneration, tubular atrophy, interstitial fibrosis, and glomerular degeneration were also evaluated. RESULTS While the kidney damage caused by irradiation was shown in line with both scintigraphy and histopathology findings, it was shown that L-carnitine did not have any negative effects on the kidney. The protective effect of L-carnitine on radiation-induced kidney damage was demonstrated scintigraphically and histopathologically, even if it was not statistically significant. CONCLUSION L-Carnitine before RT was able to preserve left kidney function. In addition, L-Carnitine before RT resulted in longer survival in statistically significant rats. In infant rats, L-Carnitine may have partially protected the kidney against RT damage and may have increased survival due to its systemic effect.
In this study, we aimed to make dosimetric measurements of the vaginal speculum by producing the upper and lower tongue of the vaginal speculum from polyetheretherketone (PEEK) material and to test its usability in brachytherapy application. METHODSA modular structure of the metallic vaginal speculum, which we use in our routine practice, can be easily separated from the handle of the speculum, has been designed and produced with a 3D printer from PEEK material with a layer thickness of 200 .Dosimetric measurements of speculum tongue made of PEEK material were made using two different dosimetric methods (three different techniques as the treatment planning system ACUROS BV and TG43 algorithms, and the Radiochromic Film Dosimetry system [Gafchromic: EBT3]). RESULTSThe values obtained by all three methods were correlated with each other and the speculum did not affect negatively dose distribution in the dose-distance curves.The dose values obtained by using ACUROS BV and TG43 algorithms at the Dwell position and the dose values obtained in the Gafchromic dosimetry measurements made at these points were found to be correlated with each other (ACUROS BV vs. TG43 p<0.001,ACUROS BV vs. EBT3 p=0.008,TG43 vs. EBT3 p=0.006). CONCLUSIONWhen all the measurement results were examined, it was seen that the values obtained were correlated with each other, and no negative effect of the speculum on the dose distribution was observed in the dose distance curves.
Post-operative radiotherapy (PORT) in non-small cell lung cancer (NSCLC), especially after complete resection, has long been an unresolved dilemma and debated among therapeutic disciplines.We aimed to evaluate the effects of different radiotherapy volumes and techniques on local-regional recurrence patterns and PORT results in patients with NSCLC.
Aims:The purpose of this study was to investigate the impact of various radiation doses on cellular elements using electron microscopy and to determine if non-irradiated cells in the same environment were also affected.Radiotherapy treatment is widely used for different types of cancers as it can prevent cell division and death through direct and indirect mechanisms.Methods: To conduct the study, standard strain Escherichia coli bacteria were reproduced in six Petri dishes, with one serving as the control.The other dishes were divided into two halves, and increasing radiation doses (2, 3, 6, 10, and 20 Gray) were administered to one side of each dish.Using a transmission electron microscope, the samples were examined, and changes in the cell elements were recorded.Results: The findings indicated that as the radiation doses increased, the negative effects on the bacteria were more pronounced.In the samples exposed to higher doses of 10 and 20 Gray, the bacteria's integrity was significantly impaired, resulting in a mud-like structure that made the evaluation of cell elements challenging.Furthermore, the non-irradiated area showed similar morphological deteriorations but at a lesser rate.Conclusion: This study demonstrated the effects of various radiation doses on Escherichia coli bacteria and the impact on non-irradiated cells in the same environment, as seen through transmission electron microscopy.
Introduction: Radiation-induced nephropathy (RIN) is an impairment of renal function caused by ionizing radiation developing after 6-12 months as acute, or years after chronically. This study aims to clarify whether L-carnitine has a protective effect in the prevention of RIN in an infant rat model or not. Material-Method: Two-week-old male forty Wistar albino rats, control (C), L-carnitine alone (LC), irradiation alone (RT), and 30 min before irradiation (L-Carnitine 300 mg/kg, ip + RT) separated into the group. The rats in the RT and L-Carnitine + RT groups were irradiated with a dose of 8 Gy in a single fraction. All animals underwent both Tc99m DTPA dynamic kidney imaging and Tc99m DMSA static kidney imaging at the end of the three-month follow-up period. Histopathologically, proximal tubular degeneration, tubular atrophy, interstitial fibrosis and glomerular degeneration were also evaluated. Results: While the kidney damage caused by irradiation was shown in line with both scintigraphy and histopathology findings, it was shown that L-carnitine did not have any negative effects on the kidney. The protective effect of L-carnitine on radiation-induced kidney damage was demonstrated scintigraphically and histopathologically, even if it was not statistically significant. Conclusion: L-Carnitine before RT was able to preserve left kidney function. In addition, L-Carnitine before RT resulted in longer survival in statistically significant rats. In infant rats, L-Carnitine may have partially protected the kidney against RT damage and may have increased survival due to its systemic effect.
<b><i>Background:</i></b> The quality of a scientific meeting can be quantified by the rate of full publications arising from the presented abstracts and the impact factor of the journals in which the studies were published. <b><i>Objectives:</i></b> The aim of this study was to investigate the publication rates of presentations from the 2013 World Society for Stereotactic and Functional Neurosurgery (WSSFN) quadrennial meeting. <b><i>Methods:</i></b> Scopus and PubMed databases were searched for the authors of the presentations to identify full publications arising from the relevant abstracts. Author and content matching were used to match an abstract with a full publication. Mann-Whitney U and Kruskal-Wallis tests were used for statistical analysis. <b><i>Results:</i></b> In total, 77% (57/74), 56% (44/79), and 50% (79/157) of the paper, flash, and poster presentations, respectively, have been published, with an overall publication rate of 58% (180/310). Articles received a total of 5,227 citations, with an average of 29 ± 64.1 citations per article. The first authors who published their studies had a significantly higher <i>h</i>-index than those who did not publish (<i>p</i> = 0.003). The most preferred journals for publication were <i>Journal of Neurosurgery</i>, <i>Acta Neurochirurgica,</i> and <i>Stereotactic and Functional Neurosurgery.</i> The majority of the articles (117/180 [65%]) were published in a quartile 1 or 2 journal. The average journal impact factor (JIF) was 4.5 for all presentations, and 7.8 for paper session presentations. Studies presented in paper sessions were published in significantly higher-impact factor journals than those presented in poster sessions (<i>p</i> < 0.001). <b><i>Conclusions:</i></b> The WSSFN Congress had a relatively high overall publication rate (58%) compared to both other neurosurgical congresses and congresses in other scientific fields. The average JIF of 7.8 is a reflection of the high quality and high impact of the paper session presentations.
Negative PSMA PET/CT does not reliably exclude microscopic pelvic lymph node metastases in intermediate- and high/very high-risk prostate cancer. These findings demonstrate a biologically relevant false-negative rate for PSMA-based nodal staging. While this study does not assess radiotherapy outcomes, the presence of occult nodal disease in PSMA-negative patients supports a cautious, risk-adapted approach to treatment de-escalation strategies involving pelvic nodal irradiation.
The roles of many genes in the pathophysiology of lung cancer have been investigated in different studies. Cyclin D1 (CCND1) gene plays a significant role in the transition from G1 to S phase of the cell cycle and in the phosphorylation of retinoblastoma tumor suppressor protein. In this study, we aimed to identify the relationship between CCND1 A870G gene polymorphism with lung cancer. CCND1 A870G genotypes were determined in 75 patients with lung cancer and in 65 control subjects. DNA was isolated from blood samples and then CCND1 A870G gene polymorphism was identified using PCR and RFLP assay. The distribution of CCND1 A870G polymorphism did not show any significant differences in all lung cancer patients and controls. There was no correlation between CCND1 A870G polymorphism and histopathological findings. However, the AA + AG genotype was significantly higher in metastatic patients, when compared with non-metastatic patients. Thus, the results show that CCND1 gene polymorphism may be a predictor for detecting patients with poor survival who having metastatic disease.
This project aims to design and produce a prototype of a helical (spiral) endorectal HDR brachytherapy applicator that can be used in patie…