Omur Karakoyun Celik | Celal Bayar University (original) (raw)
Papers by Omur Karakoyun Celik
Radiotherapy and Oncology, 2001
planning system made the detection of subtle shifts in applicator position possible. In this sele... more planning system made the detection of subtle shifts in applicator position possible. In this selected group of patients, applicator movement occurred in all three dimensions, and particularly in the y and z dimensions. The majority of movement occurred in the first 24 hours of treatment.
Lung Cancer, 2009
... evaluation in 158 patients , 16 May 2008 Serdar Ozkok, Omur Karakoyun-Celik, Tuncay Goksel, N... more ... evaluation in 158 patients , 16 May 2008 Serdar Ozkok, Omur Karakoyun-Celik, Tuncay Goksel, Nesrin Mogulkoc, Deniz Yalman, Gursel Gok, Yasemin Bolukbasi Lung Cancer December 2008 (Vol. 62, Issue 3, Pages 326-333). ...
Poster: "ESTI 2014 / P-0031 / Axillary Lymph Node Involvement with FDG PET/CT In Patients Wi... more Poster: "ESTI 2014 / P-0031 / Axillary Lymph Node Involvement with FDG PET/CT In Patients With Lung Cancer" by: "C. Goktan, O. K. Celik, F. Aras, P. Celik; Manisa/TR"
Lung Cancer, 2005
Oral Sessions / Radiotherapy the whole lungs volume The PTV included the GTV with a standard marg... more Oral Sessions / Radiotherapy the whole lungs volume The PTV included the GTV with a standard margin of 0.5 mm on axial plan and 10 mm on longitudinal direction. All patients were treated with 3 fractions of 15 Gy over 5 days. The dose was prescribed to the 80% isodose line and delivered with 6-8 noncoplanar static multiple fields The average Conformity Index according to RTOG definition was 0.65 (range 0 53-0 76). Dose-Volume Histograms (DVHs), TCP and NTCP (LKB model) were obtained and evaluated for each case RTOG toxicity scoring system was employed. Follow-up included CT scans after 45 days from treatment and then every 3 months, pulmonary function tests after 3 months, PET after 4 months Patients were considered in complete response (CR) if radiologlcally negative, in partial response (PR) if lesion axial diameter was reducted of at least 30%, in stable disease (SD) if no change, in progressive disease (PD) if increased of more than 20% Patients with radlologically evaluable lesions but with negative PET findings were also considered in CR Results: 17 out of 20 patients with primary neoplasms and 12 patients with 13 metastatic tumors were considered for analysis Three patients were excluded due to limited follow up. Median follow up time was 9.5 months (range 1.5-19). Treatment was feasible in all patients regardless the site of lesions (peripheral or central) Two patients experienced grade II subacute radiation pneumonitis, requiring steroid treatment. One was treated for 2 lesions on the same lobe, in the other one a concomitant infection was diagnosed. Local control patients was 94.05% (4 CR, 8 PR, 4 SD) in the 17 NSCLC and 100% (6 CR, 2 PR, 5 SD) in 13 metastlc tumors. Conclusions: Stereotactic radiotherapy for limited-stage primary and metastatic lung cancer is a feasible, safe and effective procedure. It promises high local control rates with a very low toxicity profile.
Turkiye Klinikleri Tip Bilimleri Dergisi, 2004
Journal of Thoracic Oncology, 2017
Lung Cancer, 2008
Introduction: A phase-II study was planned to test the effect of external beam radiotherapy in co... more Introduction: A phase-II study was planned to test the effect of external beam radiotherapy in combination with endobronchial brachytherapy on the local control and survival of stage-III non-small cell lung cancer patients. Materials and methods: Thirty ...
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
The primary aim of this study was to evaluate the risk of osteoporosis (OP) in patients who had r... more The primary aim of this study was to evaluate the risk of osteoporosis (OP) in patients who had received adjuvant chemotherapy for breast cancer. The secondary aim was to investigate the effect of OP on the quality of life of these patients. Twenty-six patients with breast cancer and 21 healthy controls were recruited into the study. All breast cancer patients were treated with 6 cycles of adjuvant chemotherapy. Bone mineral density (BMD) was measured by Dual-energy X-ray absorptiometry (DXA). Short Form-36 (SF-36) questionnaire was used to assess the quality of life. The mean lumbar area BMD value was significantly lower in patients with breast cancer than in healthy controls (p=0.017). There were no significant differences in the femoral area BMD measurements between the groups. OP was more pronounced after 24 months of the last chemotherapy course than in the first 12 months (p=0.04). The most affected domain of the SF-36 in patients with breast cancer was the physical role. Adju...
European journal of gynaecological oncology
The aim of this study was to determine the prognostic factors influencing overall, disease-free a... more 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. 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. 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). Radiotherapy is a highly effective adjuvant treatment providing an excellent locoregional control rate and it should be continued for patients with unfavorable prognostic factors.
European journal of gynaecological oncology, 2007
To evaluate the anxiety levels of women treated for gynecological malignancies using intracavitar... more To evaluate the anxiety levels of women treated for gynecological malignancies using intracavitary brachytherapy. 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. 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 le...
European journal of gynaecological oncology, 2003
To determine the prognostic factors related to local control and survival in 257 patients with ut... more To determine the prognostic factors related to local control and survival in 257 patients with uterine cervical cancer treated with definitive radiotherapy (RT). 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. 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...
Tumori
The aim of the study was to review the current clinical practices of radiation oncologists involv... more The aim of the study was to review the current clinical practices of radiation oncologists involved in the treatment of oropharyngeal cancer. The daily practices of radiation oncology centers for patients diagnosed with oropharyngeal cancer in 2010 were evaluated by a two-part questionnaire that separately assessed the information of the participating center and the charts of the treated patients. A total of 22 centers participated in the study, and 105 oropharyngeal cancer patients reported for our review. The use of positron emission tomography was a common practice in staging and radiotherapy planning. Multidisciplinary head and neck cancer clinics were available in 14 (64%) centers and were absent in 8 centers. Thirty-six of the 105 patients were not evaluated by a multidisciplinary clinic before the initiation of therapy, and adjuvant radiotherapy administration was found to be higher in this group. Percutaneous endoscopic gastrostomy tube placement was not a routine practice i...
The Scientific World Journal, 2012
Solitary plasmacytoma (SP) is characterized by a mass of neoplastic monoclonal plasma cells in ei... more Solitary plasmacytoma (SP) is characterized by a mass of neoplastic monoclonal plasma cells in either bone (SBP) or soft tissue without evidence of systemic disease attributing to myeloma. Biopsy confirmation of a monoclonal plasma cell infiltration from a single site is required for diagnosis. The common presentation of SBP is in the axial skeleton, whereas the extramedullary plasmacytoma (EMP) is usually seen in the head and neck. The ratio of SP seen at males to females is 2 : 1 and the median age of patients is 55 years. The incidence rate of SP in black race is approximately 30% higher than the white race. Incidence rate increases exponentially by advancing age. SBP has a significant higher risk for progression to myeloma, and the choice of treatment is radiotherapy (RT) that is applied with curative intent at min. 4000 cGy. By only RT application, long-term disease-free survival (DFS) is possible for approximately 30% of patients with SBP and 65% of patients with EMP.
International Journal of Radiation Oncology*Biology*Physics, 2008
define regional LN groups by CT. Lymphotrophic nanoparticle enhanced MRI (LN-MRI) allows for radi... more define regional LN groups by CT. Lymphotrophic nanoparticle enhanced MRI (LN-MRI) allows for radiographic identification of LN containing metastasis and also allows visualization of normal regional lymphatics with high accuracy for patients with breast cancer. We seek to determine coverage of malignant and benign breast lymphatics as defined LN-MRI using standard RT fields based on bony anatomy and generally accepted CT nodal volumes. Materials/Methods: Twenty-three patients with pathologically confirmed breast cancer underwent MRI with and without Ferumoxtran-10 administration (Combidex; AMAG Pharmaceuticals, Cambridge, MA). The MRIs were anatomically registered to a reference CT scan and benign and malignant LN according to LN-MRI were contoured. Contoured nodes were resampled in the reference patient, replacing actual LN with 5 mm spherical "reference" LN employing a center-of-mass sampling algorithm to allow for a statistical analysis according to nodal position, removing patient specific bias resulting from variation in volumes. Standard RT fields including tangents, supraclavicular (SCV), and posterior axillary boost (PAB) were placed based on bony anatomy. SCV, level 1-3 LN, and internal mammary LN were contoured on CT. Fields and isodose lines were chosen without visualization of LN-MRI LN. Coverage and contribution of fields were assessed. Results: Eighty-one percent of all LN defined by LN-MRI were covered by the 45 Gy isodose line; 82% of malignant and 79% of benign. The 50 Gy isodose line encompassed only 60% of LN-MRI defined lymphatics; 64% of malignant and 59% benign. For nodal volumes contoured in the absence of a margin, only 70% of malignant LN and 71% of benign LN were within contoured volumes. However, when a 5 mm expansion was added, 95% of malignant LN and 96% of benign LN were included in this volume. Conclusions: An LN-MRI may be a useful tool for better delineating the location of the regional lymphatics for breast cancer patients. These results suggest a margin is advisable when defining nodal volumes by CT. The use of IMRT and trials examining the role of axillary RT in lieu of surgery makes accurately defining the location of breast regional lymphatics of paramount importance.
International Journal of Radiation Oncology*Biology*Physics, 2014
European Journal of Cancer, 2001
S329 32), IVA (n = 8) and IVB (n = 4). Pelvic lymph nodes were present in 24 pts Squamous~cetl ca... more S329 32), IVA (n = 8) and IVB (n = 4). Pelvic lymph nodes were present in 24 pts Squamous~cetl carcfnoma were: grade 1'(40%), 2 (19%)'and 3 (41%). Pelvic external b&m therapy (EBli was t3fdOnned in 99 pts (m&tan total dose = 59 Gy (9-60)) 'and-low dose rate brachytherapy (t3$ in 86 pts. BT was delivered in one time (n = .72), 2 times (n = 13) or 3 times (n = 1). lntracavitary irradiation using person@md mould was associated with iridium implants in 32 applicattons. The median number of sources used for one application was 3 (l-6) with a median total radioactive length of 115 mm. Surgery and chemotherapy were performed in 7 and 5 pts. Results:
International Journal of Radiation Oncology*Biology*Physics, 2005
Purpose/Objective: Cisplatin-DNA adduct formation in normal tissue has been shown to correlate wi... more Purpose/Objective: Cisplatin-DNA adduct formation in normal tissue has been shown to correlate with outcome in patients with NSCLC treated with chemoradiation and in advanced stage solid tumors treated with chemotherapy. The purpose of the present study was to explore relationships between adduct levels in tumor and normal tissue in patients with head and neck squamous cell carcinoma (HNSCC), treated with cisplatin-based chemoradiation and investigate relationships with treatment outcome. Materials/Methods: Patients with stage III/IV HNSCC were treated within a randomized phase III trial, investigating the optimal route of cisplatin administration, concurrently with standard fractionated radiation (70 Gy in 35 fractions, 7 weeks)(RADPLAT). Mode of cisplatin administration was either high dose intra-arterially (IA, 150 mg/m2, with systemic rescue by sodium-thiosulphate, on days 2,9,16 and 23) or standard dose intravenously (IV, 100 mg/m2, on days 1,22,43). In a subgroup of patients, adduct levels were assessed in white blood cells (WBC) and primary tumor before and 23 hours after 1st RADPLAT treatment. 32P-postlabeling technique was used to quantify selectively the major forms of cisplatin-DNA adducts (i.e. intrastrand GG and AG adducts). Levels of adducts were correlated with locoregional tumor control. Results: 35 patients have been included; 21 received standard IV and 14 received high-dose IA cisplatin infusion. At a median follow-up of 21 months (range 5-38) for patients alive at last follow-up, the estimated locoregional (LR) tumor control rates were 74% at 1 year and 69% at 2 years, with no differences between 2 treatment schedules applied. WBC were obtained from all patients, primary tumor from 12 with lesions, accessible for biopsy. The table presents results of adduct-levels in normal and tumor tissue.
International Journal of Radiation Oncology Biology Physics, 2005
Purpose: To assess the outcome in patients with olfactory neuroblastoma (ONB). Methods and Materi... more Purpose: To assess the outcome in patients with olfactory neuroblastoma (ONB). Methods and Materials: Seventy-seven patients treated for nonmetastatic ONB between 1971 and 2004 were included. According to Kadish classification, there were 11 patients with Stage A, 29 with Stage B, and 37 with Stage C. T-classification included 9 patients with T1, 26 with T2, 16 with T3, 15 with T4a, and 11 with T4b tumors. Sixtyeight patients presented with N0 (88%) disease. Results: Most of the patients (n = 56, 73%) benefited from surgery (S), and total excision was possible in 44 patients (R0 in 32, R1 in 13, R2 in 11). All but five patients benefited from RT, and chemotherapy was given in 21 (27%). Median follow-up period was 72 months (range, 6-315). The 5-year overall survival (OS), disease-free survival (DFS), locoregional control, and local control were 64%, 57%, 62%, and 70%, respectively. In univariate analyses, favorable factors were Kadish A or B disease, T1-T3 tumors, no nodal involvement, curative surgery, R0/R1 resection, and RT-dose 54 Gy or higher. Multivariate analysis revealed that the best independent factors predicting the outcome were T1-T3, N0, R0/R1 resection, and total RT dose (54 Gy or higher). Conclusion: In this multicenter retrospective study, patients with ONB treated with R0 or R1 surgical resection followed by at least 54-Gy postoperative RT had the best outcome. Novel strategies including concomitant chemotherapy and/or higher dose RT should be prospectively investigated in this rare disease for which local failure remains a problem. Ó
Radiotherapy and Oncology, 2001
planning system made the detection of subtle shifts in applicator position possible. In this sele... more planning system made the detection of subtle shifts in applicator position possible. In this selected group of patients, applicator movement occurred in all three dimensions, and particularly in the y and z dimensions. The majority of movement occurred in the first 24 hours of treatment.
Lung Cancer, 2009
... evaluation in 158 patients , 16 May 2008 Serdar Ozkok, Omur Karakoyun-Celik, Tuncay Goksel, N... more ... evaluation in 158 patients , 16 May 2008 Serdar Ozkok, Omur Karakoyun-Celik, Tuncay Goksel, Nesrin Mogulkoc, Deniz Yalman, Gursel Gok, Yasemin Bolukbasi Lung Cancer December 2008 (Vol. 62, Issue 3, Pages 326-333). ...
Poster: "ESTI 2014 / P-0031 / Axillary Lymph Node Involvement with FDG PET/CT In Patients Wi... more Poster: "ESTI 2014 / P-0031 / Axillary Lymph Node Involvement with FDG PET/CT In Patients With Lung Cancer" by: "C. Goktan, O. K. Celik, F. Aras, P. Celik; Manisa/TR"
Lung Cancer, 2005
Oral Sessions / Radiotherapy the whole lungs volume The PTV included the GTV with a standard marg... more Oral Sessions / Radiotherapy the whole lungs volume The PTV included the GTV with a standard margin of 0.5 mm on axial plan and 10 mm on longitudinal direction. All patients were treated with 3 fractions of 15 Gy over 5 days. The dose was prescribed to the 80% isodose line and delivered with 6-8 noncoplanar static multiple fields The average Conformity Index according to RTOG definition was 0.65 (range 0 53-0 76). Dose-Volume Histograms (DVHs), TCP and NTCP (LKB model) were obtained and evaluated for each case RTOG toxicity scoring system was employed. Follow-up included CT scans after 45 days from treatment and then every 3 months, pulmonary function tests after 3 months, PET after 4 months Patients were considered in complete response (CR) if radiologlcally negative, in partial response (PR) if lesion axial diameter was reducted of at least 30%, in stable disease (SD) if no change, in progressive disease (PD) if increased of more than 20% Patients with radlologically evaluable lesions but with negative PET findings were also considered in CR Results: 17 out of 20 patients with primary neoplasms and 12 patients with 13 metastatic tumors were considered for analysis Three patients were excluded due to limited follow up. Median follow up time was 9.5 months (range 1.5-19). Treatment was feasible in all patients regardless the site of lesions (peripheral or central) Two patients experienced grade II subacute radiation pneumonitis, requiring steroid treatment. One was treated for 2 lesions on the same lobe, in the other one a concomitant infection was diagnosed. Local control patients was 94.05% (4 CR, 8 PR, 4 SD) in the 17 NSCLC and 100% (6 CR, 2 PR, 5 SD) in 13 metastlc tumors. Conclusions: Stereotactic radiotherapy for limited-stage primary and metastatic lung cancer is a feasible, safe and effective procedure. It promises high local control rates with a very low toxicity profile.
Turkiye Klinikleri Tip Bilimleri Dergisi, 2004
Journal of Thoracic Oncology, 2017
Lung Cancer, 2008
Introduction: A phase-II study was planned to test the effect of external beam radiotherapy in co... more Introduction: A phase-II study was planned to test the effect of external beam radiotherapy in combination with endobronchial brachytherapy on the local control and survival of stage-III non-small cell lung cancer patients. Materials and methods: Thirty ...
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
The primary aim of this study was to evaluate the risk of osteoporosis (OP) in patients who had r... more The primary aim of this study was to evaluate the risk of osteoporosis (OP) in patients who had received adjuvant chemotherapy for breast cancer. The secondary aim was to investigate the effect of OP on the quality of life of these patients. Twenty-six patients with breast cancer and 21 healthy controls were recruited into the study. All breast cancer patients were treated with 6 cycles of adjuvant chemotherapy. Bone mineral density (BMD) was measured by Dual-energy X-ray absorptiometry (DXA). Short Form-36 (SF-36) questionnaire was used to assess the quality of life. The mean lumbar area BMD value was significantly lower in patients with breast cancer than in healthy controls (p=0.017). There were no significant differences in the femoral area BMD measurements between the groups. OP was more pronounced after 24 months of the last chemotherapy course than in the first 12 months (p=0.04). The most affected domain of the SF-36 in patients with breast cancer was the physical role. Adju...
European journal of gynaecological oncology
The aim of this study was to determine the prognostic factors influencing overall, disease-free a... more 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. 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. 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). Radiotherapy is a highly effective adjuvant treatment providing an excellent locoregional control rate and it should be continued for patients with unfavorable prognostic factors.
European journal of gynaecological oncology, 2007
To evaluate the anxiety levels of women treated for gynecological malignancies using intracavitar... more To evaluate the anxiety levels of women treated for gynecological malignancies using intracavitary brachytherapy. 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. 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 le...
European journal of gynaecological oncology, 2003
To determine the prognostic factors related to local control and survival in 257 patients with ut... more To determine the prognostic factors related to local control and survival in 257 patients with uterine cervical cancer treated with definitive radiotherapy (RT). 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. 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...
Tumori
The aim of the study was to review the current clinical practices of radiation oncologists involv... more The aim of the study was to review the current clinical practices of radiation oncologists involved in the treatment of oropharyngeal cancer. The daily practices of radiation oncology centers for patients diagnosed with oropharyngeal cancer in 2010 were evaluated by a two-part questionnaire that separately assessed the information of the participating center and the charts of the treated patients. A total of 22 centers participated in the study, and 105 oropharyngeal cancer patients reported for our review. The use of positron emission tomography was a common practice in staging and radiotherapy planning. Multidisciplinary head and neck cancer clinics were available in 14 (64%) centers and were absent in 8 centers. Thirty-six of the 105 patients were not evaluated by a multidisciplinary clinic before the initiation of therapy, and adjuvant radiotherapy administration was found to be higher in this group. Percutaneous endoscopic gastrostomy tube placement was not a routine practice i...
The Scientific World Journal, 2012
Solitary plasmacytoma (SP) is characterized by a mass of neoplastic monoclonal plasma cells in ei... more Solitary plasmacytoma (SP) is characterized by a mass of neoplastic monoclonal plasma cells in either bone (SBP) or soft tissue without evidence of systemic disease attributing to myeloma. Biopsy confirmation of a monoclonal plasma cell infiltration from a single site is required for diagnosis. The common presentation of SBP is in the axial skeleton, whereas the extramedullary plasmacytoma (EMP) is usually seen in the head and neck. The ratio of SP seen at males to females is 2 : 1 and the median age of patients is 55 years. The incidence rate of SP in black race is approximately 30% higher than the white race. Incidence rate increases exponentially by advancing age. SBP has a significant higher risk for progression to myeloma, and the choice of treatment is radiotherapy (RT) that is applied with curative intent at min. 4000 cGy. By only RT application, long-term disease-free survival (DFS) is possible for approximately 30% of patients with SBP and 65% of patients with EMP.
International Journal of Radiation Oncology*Biology*Physics, 2008
define regional LN groups by CT. Lymphotrophic nanoparticle enhanced MRI (LN-MRI) allows for radi... more define regional LN groups by CT. Lymphotrophic nanoparticle enhanced MRI (LN-MRI) allows for radiographic identification of LN containing metastasis and also allows visualization of normal regional lymphatics with high accuracy for patients with breast cancer. We seek to determine coverage of malignant and benign breast lymphatics as defined LN-MRI using standard RT fields based on bony anatomy and generally accepted CT nodal volumes. Materials/Methods: Twenty-three patients with pathologically confirmed breast cancer underwent MRI with and without Ferumoxtran-10 administration (Combidex; AMAG Pharmaceuticals, Cambridge, MA). The MRIs were anatomically registered to a reference CT scan and benign and malignant LN according to LN-MRI were contoured. Contoured nodes were resampled in the reference patient, replacing actual LN with 5 mm spherical "reference" LN employing a center-of-mass sampling algorithm to allow for a statistical analysis according to nodal position, removing patient specific bias resulting from variation in volumes. Standard RT fields including tangents, supraclavicular (SCV), and posterior axillary boost (PAB) were placed based on bony anatomy. SCV, level 1-3 LN, and internal mammary LN were contoured on CT. Fields and isodose lines were chosen without visualization of LN-MRI LN. Coverage and contribution of fields were assessed. Results: Eighty-one percent of all LN defined by LN-MRI were covered by the 45 Gy isodose line; 82% of malignant and 79% of benign. The 50 Gy isodose line encompassed only 60% of LN-MRI defined lymphatics; 64% of malignant and 59% benign. For nodal volumes contoured in the absence of a margin, only 70% of malignant LN and 71% of benign LN were within contoured volumes. However, when a 5 mm expansion was added, 95% of malignant LN and 96% of benign LN were included in this volume. Conclusions: An LN-MRI may be a useful tool for better delineating the location of the regional lymphatics for breast cancer patients. These results suggest a margin is advisable when defining nodal volumes by CT. The use of IMRT and trials examining the role of axillary RT in lieu of surgery makes accurately defining the location of breast regional lymphatics of paramount importance.
International Journal of Radiation Oncology*Biology*Physics, 2014
European Journal of Cancer, 2001
S329 32), IVA (n = 8) and IVB (n = 4). Pelvic lymph nodes were present in 24 pts Squamous~cetl ca... more S329 32), IVA (n = 8) and IVB (n = 4). Pelvic lymph nodes were present in 24 pts Squamous~cetl carcfnoma were: grade 1'(40%), 2 (19%)'and 3 (41%). Pelvic external b&m therapy (EBli was t3fdOnned in 99 pts (m&tan total dose = 59 Gy (9-60)) 'and-low dose rate brachytherapy (t3$ in 86 pts. BT was delivered in one time (n = .72), 2 times (n = 13) or 3 times (n = 1). lntracavitary irradiation using person@md mould was associated with iridium implants in 32 applicattons. The median number of sources used for one application was 3 (l-6) with a median total radioactive length of 115 mm. Surgery and chemotherapy were performed in 7 and 5 pts. Results:
International Journal of Radiation Oncology*Biology*Physics, 2005
Purpose/Objective: Cisplatin-DNA adduct formation in normal tissue has been shown to correlate wi... more Purpose/Objective: Cisplatin-DNA adduct formation in normal tissue has been shown to correlate with outcome in patients with NSCLC treated with chemoradiation and in advanced stage solid tumors treated with chemotherapy. The purpose of the present study was to explore relationships between adduct levels in tumor and normal tissue in patients with head and neck squamous cell carcinoma (HNSCC), treated with cisplatin-based chemoradiation and investigate relationships with treatment outcome. Materials/Methods: Patients with stage III/IV HNSCC were treated within a randomized phase III trial, investigating the optimal route of cisplatin administration, concurrently with standard fractionated radiation (70 Gy in 35 fractions, 7 weeks)(RADPLAT). Mode of cisplatin administration was either high dose intra-arterially (IA, 150 mg/m2, with systemic rescue by sodium-thiosulphate, on days 2,9,16 and 23) or standard dose intravenously (IV, 100 mg/m2, on days 1,22,43). In a subgroup of patients, adduct levels were assessed in white blood cells (WBC) and primary tumor before and 23 hours after 1st RADPLAT treatment. 32P-postlabeling technique was used to quantify selectively the major forms of cisplatin-DNA adducts (i.e. intrastrand GG and AG adducts). Levels of adducts were correlated with locoregional tumor control. Results: 35 patients have been included; 21 received standard IV and 14 received high-dose IA cisplatin infusion. At a median follow-up of 21 months (range 5-38) for patients alive at last follow-up, the estimated locoregional (LR) tumor control rates were 74% at 1 year and 69% at 2 years, with no differences between 2 treatment schedules applied. WBC were obtained from all patients, primary tumor from 12 with lesions, accessible for biopsy. The table presents results of adduct-levels in normal and tumor tissue.
International Journal of Radiation Oncology Biology Physics, 2005
Purpose: To assess the outcome in patients with olfactory neuroblastoma (ONB). Methods and Materi... more Purpose: To assess the outcome in patients with olfactory neuroblastoma (ONB). Methods and Materials: Seventy-seven patients treated for nonmetastatic ONB between 1971 and 2004 were included. According to Kadish classification, there were 11 patients with Stage A, 29 with Stage B, and 37 with Stage C. T-classification included 9 patients with T1, 26 with T2, 16 with T3, 15 with T4a, and 11 with T4b tumors. Sixtyeight patients presented with N0 (88%) disease. Results: Most of the patients (n = 56, 73%) benefited from surgery (S), and total excision was possible in 44 patients (R0 in 32, R1 in 13, R2 in 11). All but five patients benefited from RT, and chemotherapy was given in 21 (27%). Median follow-up period was 72 months (range, 6-315). The 5-year overall survival (OS), disease-free survival (DFS), locoregional control, and local control were 64%, 57%, 62%, and 70%, respectively. In univariate analyses, favorable factors were Kadish A or B disease, T1-T3 tumors, no nodal involvement, curative surgery, R0/R1 resection, and RT-dose 54 Gy or higher. Multivariate analysis revealed that the best independent factors predicting the outcome were T1-T3, N0, R0/R1 resection, and total RT dose (54 Gy or higher). Conclusion: In this multicenter retrospective study, patients with ONB treated with R0 or R1 surgical resection followed by at least 54-Gy postoperative RT had the best outcome. Novel strategies including concomitant chemotherapy and/or higher dose RT should be prospectively investigated in this rare disease for which local failure remains a problem. Ó