Araştırma Çıktıları
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Item Bone health in breast cancer patients: A comprehensive statement by CECOG/SAKK Intergroup(CHURCHILL LIVINGSTONE, 2014-01-01) Rordorf, Tamara; Hassan, Azza Adel; Azim, Hamdy; Alexandru, Eniu; Er, Ozlem; Gokmen, Erhan; Gural, Zeynep; Mardiak, Jozef; Minchev, Velko; Peintinger, Florentia; Szendroi, Miklos; Takac, Itzok; Tesarova, Petra; Vorobiof, Daniel; Vrbanec, Damir; Yildiz, Ramazan; Yucel, Serap; Zekri, Jamal; Oyan, BasakBone is the most common site of distant metastases in breast cancer that can cause severe and debilitating skeletal related events (SRE) including hypercalcemia of malignancy, pathologic fracture, spinal cord compression and the need for palliative radiation therapy or surgery to the bone. SRE are associated with substantial pain and morbidity leading to frequent hospitalization, impaired quality of life and poor prognosis. The past 25 years of research on the pathophysiology of bone metastases led to the development of highly effective treatment options to delay or prevent osseous metastases and SRE. Management of bone metastases has become an integral part of cancer treatment requiring expertise of multidisciplinary teams of medical and radiation oncologists, surgeons and radiologists in order to find an optimal treatment for each individual patient. A group of international breast cancer experts attended a Skeletal Care Academy Meeting in November 2012 in Istanbul and discussed current preventive measures and treatment options of SRE, which are summarized in this evidence-based consensus for qualified decision-making in clinical practice. (C) 2014 Elsevier Ltd. All rights reserved.Item National Multi-Center Observational Retrospective Study to Understand Treatment Patterns and Outcomes for Stage III Non-Small Cell Lung Cancer Patients in Turkey: Turkish Society for Radiation Oncology Study, STONE Trial(AKAD DOKTORLAR YAYINEVI, 2022-01-01) Onal, Cem; Demiral, Ayse Nur; Atalar, Banu; Yalman, Deniz; Dagoglu, Nergiz; Hurmuz, Pervin; Erpolat, Petek; Akyurek, Serap; Gul, Sute Karabulut; Berber, Tanju; Guler, Ozan Cem; Umay, Cenk; Sert, Fatma; Karahacioglu, Eray; Birgi, Sumerya Duru; Yaprak, Gokhan; Saglam, Esra KaytanThis study investigated treatment patterns and outcomes in patients with inoperable stage III non-small cell lung cancer (NSCLC) treated with radiotherapy (RT) in Turkey. We included 492 patients with stage III NSCLC in this multi-center retrospective study. Pa-tient demographics, clinical characteristics, and clinical treatment patterns from the time of the initial diagnosis to disease progression were recorded. Additionally, the prognostic factors predicting overall survival (OS) and progression-free survival (PFS) were analyzed. For the initial treatment, 429 patients (89.2\%) received chemotherapy and RT, whereas 53 patients (10.8\%) were treated only with RT. The first disease progression occurred in 288 patients (58.4\%) at 9.3 months (median) after the initial treatment, and 64.6\% re-ceived treatment after first progression. The second disease progression occurred in 30 patients, and 20 patients (66.7\%) received treatment. Median OS and PFS were 27.0 months and 13.4 months, respectively. Age (p< 0.001), stage (p= 0.04), poor performance score (PS) (p= 0.03) and RT doses (p= 0.002) were independent predictors for OS and PFS in our multivariate analysis. Additional significant predictors for OS in the multivariate analysis were gender (p= 0.004), treatment period (0.02), and irradiation technique (p= 0.02). Disease progression occurred in nearly 58\% of the patients, and one-third of these patients remained untreated during the disease progression. These findings indicate a need for additional treatment options in patients with unresectable stage III NSCLC with high-risk features, namely older age, stage IIIB disease, poor PS, and lower RT doses.Item Changes in radiotherapy practice during COVID-19 outbreak in Turkey: A report from the Turkish Society for Radiation Oncology(ELSEVIER IRELAND LTD, 2020-01-01) Anacak, Yavuz; Onal, Cem; Ozyigit, Gokhan; Agaoglu, Fulya; Akboru, Halil; Akyurek, Serap; Gursel, Bilge; Igdem, Sefik; Yalman, Deniz; Yildiz, Ferah; Saglam, Esra KaytanItem Does Lapatinib Increase Pulmonary Toxicity when Concurrently Used with Radiation Therapy? An Experimental Study with Wistar-Albino Rats(AKAD DOKTORLAR YAYINEVI, 2018-01-01) Yetmen Dogan, Ozlem; Guzel, Elif; Coban, Ilker; Suzer, Oner; Bese, NuranLapatinib is an oral receptor tyrosine kinase inhibitor which has shown activity in the treatment of metastatic breast cancer. There is no data regarding the side effects of combination of radiotherapy and Lapatinib. 40 female Wistar-albino rats (WAR) were divided into 4 groupsItem V30 as a predictor for radiation-induced hypothyroidism: a dosimetric analysis in patients who received radiotherapy to the neck(BIOMED CENTRAL LTD, 2014-01-01) Akgun, Zuleyha; Atasoy, Beste M.; Ozen, Zeynep; Yavuz, Dilek; Gulluoglu, Bahadir; Sengoz, Meric; Abacioglu, UfukIntroduction: The purpose of this study is to evaluate the possible predictors of thyroid disorders after neck radiotherapy, with a focus on radiation dose-volume factors. Methods: Thyroid function was measured in 100 patients who had received radiotherapy to the neck, including the thyroid. All radiation-induced thyroid dysfunctions were determined with an endpoint of abnormal thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and thyroxine (fT4) and thyroid peroxidase antibodies and (TPA). The total volume of the thyroid, mean radiation dose to the thyroid (Dmean) and thyroid volume percentage that received radiation doses of 10-50 Gy (V10-V50) were calculated in all patients. The evaluated risk factors for thyroid dysfunction included dose-volume parameters, sex, age, previous surgery, chemotherapy and comorbidity. Results: There were 52 patients with hypothyroidism and V30 (p = 0.03), thyroid volume (p = 0.01) and Dmean (p = 0.03) appeared to be correlated with hypothyroidism in univariate analysis. However, there was not association found in multivariate analysis for these factors. Conclusions: Thyroid disorders after radiation therapy to the neck still represent a clinically underestimated problem. V30 may be a useful tool for evaluating the risk of hypothyroidism when determining an individual patient's treatment.Item LONG-TERM RESULTS OF EXTREMITY SOFT TISSUE SARCOMAS LIMB-SPARING SURGERY AND RADIOTHERAPY(ATHA COMUNICACAO \& EDITORA, 2019-01-01) Dogan, Ozlem Yetmen; Oksuz, Didem Colpan; Atalar, Banu; Dincbas, Fazilet OnerObjective: To assess the prognostic factors and results of limb sparing surgery and postoperative radiotherapy (PORT) in patients with non-metastatic soft tissue sarcomas (STS) of the extremities. Methods: Between 1980-2007, 114 extremity-located STS treated with PORT were analyzed retrospectively. Tumors were mostly localized in the lower extremities (71,9\%). The median radiotherapy (RT) dose was 60.9 Gy. Chemotherapy was administered to 37.7\% of the patients. Tumor sizes were between 3-26 cm (median 7 cm). The three most frequent histological types included undifferentiated pleomorphic sarcoma (26.3\%), liposarcoma (25.4\%), and synovial sarcoma (13.2\%). The median follow-up for all patients was 60 months, and 81 months for survivors. Results: The 5- and 10-year local control (LC) rates were 77\% and 70.4\%, respectivelyItem An extrapulmonary manifestation of lymphangioleiomyomatosis: A rare case report(ELSEVIER SCI LTD, 2017-01-01) Tumay, L. Volkan; Guner, Osman Serhat; Zorluoglu, AbdullahLymphangioleiomyomatosis (LAM) is a rare and fatal disease which occurs almost exclusively in young women. The disease often affects lungs and most of the patients die from respiratory failure. It is often initially misdiagnosed as asthma or chronic obstructive pulmonary disease. The most common presentations of pulmonary LAM (P-LAM) include dyspnea and coughing. Chylothorax and spontaneous pneumothorax may be seen in advanced cases. Although rare, it may present with extrapulmonary LAM (E-LAM). Renal angiomyolipomas and abdominal lymphadenopathies (LAPs) are common in E-LAM cases. Pelvic retroperitoneal masses are very rare and often require exploratory laparotomy. Herein, we report a 36 year-old female case of a rare extrapulmonary manifestation of LAM who was treated with abdominal and thoracic surgery, radiotherapy and finally sirolimus. (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.Item Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses(KOREAN SOC THERAPEUTIC RADIOLOGY \& ONCOLOGY, 2022-01-01) Senkesen, Oznur; Tezcanli, Evrim; Abacioglu, Mehmet Ufuk; Ozen, Zeynep; Cone, Derya; Kucucuk, Halil; Goksel, Evren Ozan; Arifoglu, Alptekin; Sengoz, MericObjective: This study aimed to investigate the tumor volume changes occurring during limited-field radiotherapy (RT) for glioblastoma patients and whether a volume-adapted boost planning approach provided any benefit on tumor coverage and normal tissue sparing. Materials and Methods: Twenty-four patients underwent simulation with magnetic resonance (MR) and computed tomography (CT) scans prior to RT (MR\_initial, CT\_initial) and boost treatment (MR\_adapt, CT\_adapt). For the boost phase, MR\_initial and MR\_adapt images were used to delineate GTV(2) and GTV(2\_adapt), respectively. An initial boost plan (Plan\_initial) created on CT\_initial for PTV2 was then reoptimized on CT\_adapt by keeping the same optimization and normalization values. Plan\_adapt was generated on CT\_adapt for PTV(2\_adapt )volume. Dose volume histogram parameters for target volumes and organs-at-risk were compared using these boost plans generated on CT\_adapt. Plan\_initial and Plan\_adaptive boost plans were summed with the first phase plan and the effect on the total dose was investigated. Results: Target volume expansion was noted in 21 0 /c, of patients while 791b had shrinkage. The average difference for the initial and adaptive gross tumor volume (G1V), clinical target volume (CTV), and planning target volume (PTV) volumes were statistically significant. Maximum dose differences for brainstem and optic chiasm were significant. Healthy brain tissue V-10 and ipsilateral optic nerve maximum doses were found to decrease significantly in Plan\_adaptive. Conclusion: Results of this study confirm occurrence of target volume changes during RT for glioblastoma patients. An adaptive plan can provide better normal tissue sparing for patients with lesion shrinkage and avoid undercoverage of treatment volumes in case of target volume expansion especially when limited-fields are used.