Ferah Yildiz | Hacettepe University (original) (raw)
Papers by Ferah Yildiz
Radiotherapy and Oncology, 2001
Poslcrs conformation ratio. Results: 28 pts obtained an objective response two months after treat... more Poslcrs conformation ratio. Results: 28 pts obtained an objective response two months after treatment. for an overall response rate of 80%. 20 pts achieved complete clinical responses. After a mean follow-up of 18 months crude survival is 85%. 26 pts (74%) are alive without evidence of disease, 3 pts are alive with tumour and 5 pts have died of tumour. 10% of the pts developed G3-4 haematological toxicity. No renal, neurological gastrointestinal or genitourinary Gill-IV toxicity was detected. There was no toxicity-related death. Conclusions: haematological toxicity after concomitant chemotherapy with CDDP and EBRT-PDRBT in cervical cancers is low to moderate, with no increase in gastrointestinal or urinary toxicity. Concurrent PTX-and CDDPbased chemo-radiation is an effective and feasible option with an excellent compliance for the primary treatment of cervical carcinoma. DFS was 74% for a median follow up of 18 months. PBRBT was technically feasible and gave no additional toxicity to this schedule.
International Journal of Gynecological Cancer, 2008
Yildiz F, Atahan IL, Ö zyar E, Karcaaltıncaba M, Cengiz M, Ozyigit G, Aydın A, Usubü tü n A, Ayha... more Yildiz F, Atahan IL, Ö zyar E, Karcaaltıncaba M, Cengiz M, Ozyigit G, Aydın A, Usubü tü n A, Ayhan A. Radiotherapy in congenital vulvar lymphangioma circumscriptum. Int J Gynecol Cancer 2008;18:556-559.
Radiotherapy and Oncology, 2004
Background and purposeThe objective of this study is to analyze the mode of recurrence patterns a... more Background and purposeThe objective of this study is to analyze the mode of recurrence patterns and survival of our 96 non-metastatic stage IVA and IVB nasopharyngeal carcinoma (NPC) patients.
British Journal of Dermatology, 2000
The Breast, 2014
In this study, we tried to evaluate the efficacy of locoregional treatment (LRT) in patients with... more In this study, we tried to evaluate the efficacy of locoregional treatment (LRT) in patients with metastatic breast carcinoma (MBC). The medical records of 227 patients with MBC at initial presentation between April 1999 and January 2013 were retrospectively evaluated. The median age at diagnosis was 50 years (range, 27-83 years). Thirty-nine patients (17%) had no LRT. Among patients who had LRT, 2 (1%) had locoregional radiotherapy (RT) alone, 54 (29%) had surgery alone [mastectomy, n = 50; breast conserving surgery (BCS), n = 4] and 132 (70%) had surgery (mastectomy, n = 119; BCS, n = 13) followed by locoregional RT. The median follow-up time was 35 months (range, 4-149 months). Five-year OS and PFS rates were 44% and 20%, respectively. In both univariate and multivariate analysis LRT per se did not affect OS and PFS rates. However, the 5-year OS and PFS rates were significantly higher in patients treated with locoregional RT than the ones who were not. The corresponding rates were 56% vs. 24% for OS and 27% vs. 7% for PFS (p < 0.001). Median survival was 67 months and 37 months, respectively. Our study showed that patients with MBC who received postoperative locoregional RT may have a survival advantage compared with patients who were only treated by surgery. A phase III trial testing the role of adjuvant locoregional RT may help to distinguish patients who will benefit from adjuvant RT.
Physical Review Letters, 2009
A self-corrugated Cu3N-Cu(110) molecular network shows the potential to overcome the element depe... more A self-corrugated Cu3N-Cu(110) molecular network shows the potential to overcome the element dependence barrier as demonstrated by epitaxial growth of atomic nanowires (˜1nm in width) among various 3d, 4d, and 5d elements. Scanning tunneling microscopy shows that all of the investigated atomic nanowires share an identical structure, featuring uniform width, height, orientation and the same minimum separation distance. Ab initio
Fuel and Energy Abstracts, 2000
We assessed therapeutic outcomes of reirradiation with robotic stereotactic radiotherapy (SBRT) f... more We assessed therapeutic outcomes of reirradiation with robotic stereotactic radiotherapy (SBRT) for locally recurrent nasopharyngeal carcinoma (LRNPC) patients and compared those results with three-dimensional conformal radiotherapy (CRT) with or without brachytherapy (BRT). Treatment outcomes were evaluated retrospectively in 51 LRNPC patients receiving either robotic SBRT (24 patients) or CRT with or without BRT (27 patients) in our department. CRT was delivered with a 6-MV linear accelerator, and a median total reirradiation dose of 57 Gy in 2 Gy/day was given. Robotic SBRT was delivered with CyberKnife (Accuray, Sunnyvale, CA). Patients in the SBRT arm received 30 Gy over 5 consecutive days. We calculated actuarial local control and cancer-specific survival rates for the comparison of treatment outcomes in SBRT and CRT arms. The Common Terminology Criteria for Adverse Events v3.0 was used for toxicity evaluation. The median follow-up was 24 months for all patients. Two-year actuarial local control rates were 82% and 80% for SBRT and CRT arms, respectively (p = 0.6). Two-year cancer-specific survival rates were 64% and 47% for the SBRT and CRT arms, respectively (p = 0.4). Serious late toxicities (Grade 3 and above) were observed in 21% of patients in the SBRT arm, whereas 48% of patients had serious toxicity in the CRT arm (p = 0.04). Fatal complications occurred in three patients (12.5%) of the SBRT arm, and four patients (14.8%) of the CRT arm (p = 0.8). T stage at recurrence was the only independent predictor for local control and survival. Our robotic SBRT protocol seems to be feasible and less toxic in terms of late effects compared with CRT arm for the reirradiation of LRNPC patients.
Journal of Magnetism and Magnetic Materials, 2003
Frequency and temperature dependence of magnetic properties of BEDT-TTF intercalated molecular ma... more Frequency and temperature dependence of magnetic properties of BEDT-TTF intercalated molecular magnet MnPS3 have been studied by electron paramagnetic resonance (EPR) technique at X-, K-,and Q-bands. A very strong and relatively narrower (than expected 400–500G from overlapped six hyperfine transitions of paramagnetic Mn2+ ion) single EPR peak in X-band spectra has been observed at all the temperature range, implying collective
Nephron, 2003
Purpose: In this study, we examined the changes of tissue contents of trace elements and iron aft... more Purpose: In this study, we examined the changes of tissue contents of trace elements and iron after total body irradiation (TBI) and their possible impact on late toxicities. Material and Methods: 20 female Wistar rats were randomly assigned to two groups – either radiation (n = 10) or control (n = 10). Rats in the radiation group received TBI of
International Journal of Radiation Oncology Biology Physics, 1999
Purpose: A comparison of American Joint Committee on Cancer (AJCC) 1988 and 1997 nasopharyngeal c... more Purpose: A comparison of American Joint Committee on Cancer (AJCC) 1988 and 1997 nasopharyngeal carcinoma (NPC) classifications was made in terms of patient distribution and efficacy in predicting prognosis.Methods and Materials: Between 1993–1997, 90 patients (64 M, 26 F) with non-metastatic NPC were treated. The mean age was 42.02 (range: 9–82) years old. Histopathological diagnosis was WHO 2 and 3
Annals of Vascular Surgery, 2005
Klippel-Trénaunay-Weber syndrome (KTWS) is characterized by combined vascular malformations of ca... more Klippel-Trénaunay-Weber syndrome (KTWS) is characterized by combined vascular malformations of capillary, venous, and lymphatic types usually observed during infancy or childhood. In this report, we describe two KTWS patients treated with radiotherapy after long-term conservative treatment or multiple surgical interventions. The first patient, a 15-year-old female, presented with vascular masses located on the right upper extremity. She was treated conservatively for 14 years, and amputation was offered at the age of 14 due to cardiac failure. A course of radiotherapy to a total dose of 40 Gy with conventional daily fractionation was administered as an alternative to the mutilating surgery, and prominent improvement both subjectively and objectively was detected 1 year after radiotherapy. The second patient, a 40-year-old male, suffered from huge vascular masses of both the trunk and lower extremities. Despite multiple surgical interventions and conservative treatment, disease progressed and neurological symptoms occurred due to compression of vertebral structures. He was administered a course of 30 Gy radiotherapy with 1.5 Gy daily fractions to the lower thoracic region and whole abdominal cavity. Six months after radiotherapy, subjective relief described by the patient but without any objective response was detected. Though considered as a benign disease, KTWS can cause life-threatening complications. The response of one of our patients is a hopeful finding for considering radiotherapy as an alternative treatment modality for these patients.
Asian Pacific journal of cancer prevention : APJCP, 2014
Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerl... more Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/ radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assess the outcomes of our patients with stage IB endometrioid endometrial cancer. Sixty two patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvant chemotherapy was not given to any of the patients. Median age was 62 (range, 42-95). Ninety percent of the patients had grade 1-2 disease. Thirteen patients (21%) received intra ...
Radiotherapy and Oncology, 1999
Background and purpose: The description of giant pituitary adenoma is not clear yet. In this stud... more Background and purpose: The description of giant pituitary adenoma is not clear yet. In this study we tried to identify which adenomas can be de®ned as giant pituitary adenomas when tumor control and progression free survival (PFS) are taken as end points and we also tried to evaluate prognostic factors other than tumor size.
Medical Oncology, 2007
The thyroid gland is frequently affected by radiotherapy applied for the treatment of head and ne... more The thyroid gland is frequently affected by radiotherapy applied for the treatment of head and neck tumors. Hypothyroidism is observed as a late side effect of radiotherapy, especially seen in the patients who have surgery in the treatment procedure. We evaluated the radiation-induced hypothyroidism for a selected type of head and neck cancer- nasopharyngeal cancer (NPC)-which does not include surgery involving the thyroid gland in the treatment. We observed 12 patients (14%) who developed hypothyroidism, two of which were subclinical hypothyroidism. The patients with hypothyroidism were statistically significantly younger than the euthyroid patients, but there were no statistically significant differences among the two groups in disease stages, radiotherapy neck doses, and gender. We recommend life-long TSH screening after RT to the neck owing to the incidence of RTinduced hypothyroidism and the importance of early thyroid hormone replacement therapy in patients becoming hypothyroid for maintaining optimal quality of life.
Radiotherapy and Oncology, 2004
Nephron Experimental Nephrology, 2003
In this study, we examined the changes of tissue contents of trace elements and iron after total ... more In this study, we examined the changes of tissue contents of trace elements and iron after total body irradiation (TBI) and their possible impact on late toxicities. 20 female Wistar rats were randomly assigned to two groups - either radiation (n = 10) or control (n = 10). Rats in the radiation group received TBI of 5 Gy in a single fraction. Rats were sacrificed and tissue samples of heart, lung and kidney were taken 8 weeks after radiation. Tissue levels of zinc, copper, magnesium, manganese and iron analysis were performed with an atomic absorption spectrophotometer and suprapure grade standard solutions. One kidney of each animal was taken for electron microscopic analysis. Blood samples were collected from all animals and the blood chemistry related to kidney function was studied. The kidney levels of Fe and Cu significantly increased 8 weeks after irradiation (p < 0.05). The Cu/Zn ratio did not reach statistical significance in any tissue, however in kidney, there was a tendency to rise (p = 0.08). Myocardium and lung content of trace elements and iron did not show any significant change 8 weeks after irradiation. Electron microscopic analysis showed significant injury in glomerular endothelial cells, renal tubules and thickening of basement membrane. Blood chemistry showed a significant rise in serum creatinine (p = 0.008) and calcium (p = 0.01) in the TBI group. Serum creatinine levels were 0.73 and 0.84 mg/dl, and serum calcium levels were 10.1 and 11.3 mg/dl in control and TBI groups, respectively. A sublethal dose of TBI causes deposition of Cu and Fe within the kidney after TBI. Deposition of these elements may have some additional role on the toxicity caused by direct radiation on the kidney.
The Breast Journal, 2008
n Abstract: We retrospectively assessed the predictive factors for brain metastasis in high-risk ... more n Abstract: We retrospectively assessed the predictive factors for brain metastasis in high-risk breast cancer patients receiving radiotherapy after mastectomy. Between January 1994 and 2002, the medical charts of nonmetastatic breast cancer patients receiving post-mastectomy radiotherapy were evaluated. The clinical and pathologic features of patients who developed brain metastasis as the first site metastatic disease were compared with nonmetastatic patients treated at the same time period. All eligible patients in this study were treated with postoperative radiotherapy ± chemotherapy. Age, stage, percent positive lymph node involvement, number of lymph node metastasis, primary tumor size, grade, surgical margin status, estrogen receptor status, and perinodal fat tissue invasion were analyzed as predictive factors for brain metastasis. Statistical analyses were performed by using Log-rank test and Cox's regression analysis. Median follow-uptime was 61 months. In this period, 32 out of 957 patients (3.3%) developed brain metastasis. In univariate analysis percent positive axillary lymph node involvement (p < 0.001), primary tumor size (p < 0.001), number of lymph node metastasis (p = 0.01), and American Joint Committee on Cancer 2002 stage (p < 0.001) were found to be predictive for brain metastasis. Multivariate analysis revealed that only the primary tumor size and percent positive lymph node involvement were significant predictive factors for the development of brain metastasis. The primary tumor size and percent positive lymph node involvement increases the risk of brain metastasis in patients with nonmetastatic breast cancer receiving postoperative radiotherapy and chemotherapy. n
Supportive Care in Cancer, 2010
In this prospective study, the efficacy and safety of radiotherapy combined with zoledronic acid ... more In this prospective study, the efficacy and safety of radiotherapy combined with zoledronic acid was evaluated. Breast cancer patients with painful bone metastases were randomized to either high- or reduced-dose radiotherapy. All patients received zoledronic acid (4 mg) every 28 days from the beginning of radiotherapy. Analgesic and pain scores in addition to visual analog score (VAS) for treatment satisfaction and whole-body bone scintigraphy were evaluated. No significant differences could be found in analgesic or pain scores and bone scintigraphy results between the groups. Our results suggest that reduced-dose radiotherapy produces similar response rates and response durations when used concomitantly with zoledronic acid.
Radiotherapy and Oncology, 2005
IMRT can effectively spare organs at risk (OAR) that are, for example, placed in a concavity of t... more IMRT can effectively spare organs at risk (OAR) that are, for example, placed in a concavity of the PTV. It can, however, only spare OAR when there is a minimal separation of OAR and PTV. Maximum dose to OAR that are in immediate contact with the PTV cannot be reduced. IMRT alone is therefore not the solution in cases with small bowel located deep in the douglas pouch adjacent to the seminal vesicles. Dislocation of the small bowel using a laparoscopic omentum plastic enabled radiotherapy to full dose without an increased normal tissue complication probability. Like other uncontaminated laparoscopic surgical interventions morbidity and mortality for this procedure should be very low with a total risk of complications like infection or bleeding well below 1% [1]. Time for hospitalisation is short and specific tumor therapy can be started without a relevant delay.
![Research paper thumbnail of Comment on: “HIV infection and invasive cervical cancers, treatment with radiation therapy: toxicity and outcome” [Radiother Oncol 2005;74:31–35, Shrivastava et al.]](https://attachments.academia-assets.com/44881401/thumbnails/1.jpg)
](Radiotherapy and Oncology, 2005
Radiotherapy and Oncology, 2001
Poslcrs conformation ratio. Results: 28 pts obtained an objective response two months after treat... more Poslcrs conformation ratio. Results: 28 pts obtained an objective response two months after treatment. for an overall response rate of 80%. 20 pts achieved complete clinical responses. After a mean follow-up of 18 months crude survival is 85%. 26 pts (74%) are alive without evidence of disease, 3 pts are alive with tumour and 5 pts have died of tumour. 10% of the pts developed G3-4 haematological toxicity. No renal, neurological gastrointestinal or genitourinary Gill-IV toxicity was detected. There was no toxicity-related death. Conclusions: haematological toxicity after concomitant chemotherapy with CDDP and EBRT-PDRBT in cervical cancers is low to moderate, with no increase in gastrointestinal or urinary toxicity. Concurrent PTX-and CDDPbased chemo-radiation is an effective and feasible option with an excellent compliance for the primary treatment of cervical carcinoma. DFS was 74% for a median follow up of 18 months. PBRBT was technically feasible and gave no additional toxicity to this schedule.
International Journal of Gynecological Cancer, 2008
Yildiz F, Atahan IL, Ö zyar E, Karcaaltıncaba M, Cengiz M, Ozyigit G, Aydın A, Usubü tü n A, Ayha... more Yildiz F, Atahan IL, Ö zyar E, Karcaaltıncaba M, Cengiz M, Ozyigit G, Aydın A, Usubü tü n A, Ayhan A. Radiotherapy in congenital vulvar lymphangioma circumscriptum. Int J Gynecol Cancer 2008;18:556-559.
Radiotherapy and Oncology, 2004
Background and purposeThe objective of this study is to analyze the mode of recurrence patterns a... more Background and purposeThe objective of this study is to analyze the mode of recurrence patterns and survival of our 96 non-metastatic stage IVA and IVB nasopharyngeal carcinoma (NPC) patients.
British Journal of Dermatology, 2000
The Breast, 2014
In this study, we tried to evaluate the efficacy of locoregional treatment (LRT) in patients with... more In this study, we tried to evaluate the efficacy of locoregional treatment (LRT) in patients with metastatic breast carcinoma (MBC). The medical records of 227 patients with MBC at initial presentation between April 1999 and January 2013 were retrospectively evaluated. The median age at diagnosis was 50 years (range, 27-83 years). Thirty-nine patients (17%) had no LRT. Among patients who had LRT, 2 (1%) had locoregional radiotherapy (RT) alone, 54 (29%) had surgery alone [mastectomy, n = 50; breast conserving surgery (BCS), n = 4] and 132 (70%) had surgery (mastectomy, n = 119; BCS, n = 13) followed by locoregional RT. The median follow-up time was 35 months (range, 4-149 months). Five-year OS and PFS rates were 44% and 20%, respectively. In both univariate and multivariate analysis LRT per se did not affect OS and PFS rates. However, the 5-year OS and PFS rates were significantly higher in patients treated with locoregional RT than the ones who were not. The corresponding rates were 56% vs. 24% for OS and 27% vs. 7% for PFS (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Median survival was 67 months and 37 months, respectively. Our study showed that patients with MBC who received postoperative locoregional RT may have a survival advantage compared with patients who were only treated by surgery. A phase III trial testing the role of adjuvant locoregional RT may help to distinguish patients who will benefit from adjuvant RT.
Physical Review Letters, 2009
A self-corrugated Cu3N-Cu(110) molecular network shows the potential to overcome the element depe... more A self-corrugated Cu3N-Cu(110) molecular network shows the potential to overcome the element dependence barrier as demonstrated by epitaxial growth of atomic nanowires (˜1nm in width) among various 3d, 4d, and 5d elements. Scanning tunneling microscopy shows that all of the investigated atomic nanowires share an identical structure, featuring uniform width, height, orientation and the same minimum separation distance. Ab initio
Fuel and Energy Abstracts, 2000
We assessed therapeutic outcomes of reirradiation with robotic stereotactic radiotherapy (SBRT) f... more We assessed therapeutic outcomes of reirradiation with robotic stereotactic radiotherapy (SBRT) for locally recurrent nasopharyngeal carcinoma (LRNPC) patients and compared those results with three-dimensional conformal radiotherapy (CRT) with or without brachytherapy (BRT). Treatment outcomes were evaluated retrospectively in 51 LRNPC patients receiving either robotic SBRT (24 patients) or CRT with or without BRT (27 patients) in our department. CRT was delivered with a 6-MV linear accelerator, and a median total reirradiation dose of 57 Gy in 2 Gy/day was given. Robotic SBRT was delivered with CyberKnife (Accuray, Sunnyvale, CA). Patients in the SBRT arm received 30 Gy over 5 consecutive days. We calculated actuarial local control and cancer-specific survival rates for the comparison of treatment outcomes in SBRT and CRT arms. The Common Terminology Criteria for Adverse Events v3.0 was used for toxicity evaluation. The median follow-up was 24 months for all patients. Two-year actuarial local control rates were 82% and 80% for SBRT and CRT arms, respectively (p = 0.6). Two-year cancer-specific survival rates were 64% and 47% for the SBRT and CRT arms, respectively (p = 0.4). Serious late toxicities (Grade 3 and above) were observed in 21% of patients in the SBRT arm, whereas 48% of patients had serious toxicity in the CRT arm (p = 0.04). Fatal complications occurred in three patients (12.5%) of the SBRT arm, and four patients (14.8%) of the CRT arm (p = 0.8). T stage at recurrence was the only independent predictor for local control and survival. Our robotic SBRT protocol seems to be feasible and less toxic in terms of late effects compared with CRT arm for the reirradiation of LRNPC patients.
Journal of Magnetism and Magnetic Materials, 2003
Frequency and temperature dependence of magnetic properties of BEDT-TTF intercalated molecular ma... more Frequency and temperature dependence of magnetic properties of BEDT-TTF intercalated molecular magnet MnPS3 have been studied by electron paramagnetic resonance (EPR) technique at X-, K-,and Q-bands. A very strong and relatively narrower (than expected 400–500G from overlapped six hyperfine transitions of paramagnetic Mn2+ ion) single EPR peak in X-band spectra has been observed at all the temperature range, implying collective
Nephron, 2003
Purpose: In this study, we examined the changes of tissue contents of trace elements and iron aft... more Purpose: In this study, we examined the changes of tissue contents of trace elements and iron after total body irradiation (TBI) and their possible impact on late toxicities. Material and Methods: 20 female Wistar rats were randomly assigned to two groups – either radiation (n = 10) or control (n = 10). Rats in the radiation group received TBI of
International Journal of Radiation Oncology Biology Physics, 1999
Purpose: A comparison of American Joint Committee on Cancer (AJCC) 1988 and 1997 nasopharyngeal c... more Purpose: A comparison of American Joint Committee on Cancer (AJCC) 1988 and 1997 nasopharyngeal carcinoma (NPC) classifications was made in terms of patient distribution and efficacy in predicting prognosis.Methods and Materials: Between 1993–1997, 90 patients (64 M, 26 F) with non-metastatic NPC were treated. The mean age was 42.02 (range: 9–82) years old. Histopathological diagnosis was WHO 2 and 3
Annals of Vascular Surgery, 2005
Klippel-Trénaunay-Weber syndrome (KTWS) is characterized by combined vascular malformations of ca... more Klippel-Trénaunay-Weber syndrome (KTWS) is characterized by combined vascular malformations of capillary, venous, and lymphatic types usually observed during infancy or childhood. In this report, we describe two KTWS patients treated with radiotherapy after long-term conservative treatment or multiple surgical interventions. The first patient, a 15-year-old female, presented with vascular masses located on the right upper extremity. She was treated conservatively for 14 years, and amputation was offered at the age of 14 due to cardiac failure. A course of radiotherapy to a total dose of 40 Gy with conventional daily fractionation was administered as an alternative to the mutilating surgery, and prominent improvement both subjectively and objectively was detected 1 year after radiotherapy. The second patient, a 40-year-old male, suffered from huge vascular masses of both the trunk and lower extremities. Despite multiple surgical interventions and conservative treatment, disease progressed and neurological symptoms occurred due to compression of vertebral structures. He was administered a course of 30 Gy radiotherapy with 1.5 Gy daily fractions to the lower thoracic region and whole abdominal cavity. Six months after radiotherapy, subjective relief described by the patient but without any objective response was detected. Though considered as a benign disease, KTWS can cause life-threatening complications. The response of one of our patients is a hopeful finding for considering radiotherapy as an alternative treatment modality for these patients.
Asian Pacific journal of cancer prevention : APJCP, 2014
Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerl... more Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/ radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assess the outcomes of our patients with stage IB endometrioid endometrial cancer. Sixty two patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvant chemotherapy was not given to any of the patients. Median age was 62 (range, 42-95). Ninety percent of the patients had grade 1-2 disease. Thirteen patients (21%) received intra ...
Radiotherapy and Oncology, 1999
Background and purpose: The description of giant pituitary adenoma is not clear yet. In this stud... more Background and purpose: The description of giant pituitary adenoma is not clear yet. In this study we tried to identify which adenomas can be de®ned as giant pituitary adenomas when tumor control and progression free survival (PFS) are taken as end points and we also tried to evaluate prognostic factors other than tumor size.
Medical Oncology, 2007
The thyroid gland is frequently affected by radiotherapy applied for the treatment of head and ne... more The thyroid gland is frequently affected by radiotherapy applied for the treatment of head and neck tumors. Hypothyroidism is observed as a late side effect of radiotherapy, especially seen in the patients who have surgery in the treatment procedure. We evaluated the radiation-induced hypothyroidism for a selected type of head and neck cancer- nasopharyngeal cancer (NPC)-which does not include surgery involving the thyroid gland in the treatment. We observed 12 patients (14%) who developed hypothyroidism, two of which were subclinical hypothyroidism. The patients with hypothyroidism were statistically significantly younger than the euthyroid patients, but there were no statistically significant differences among the two groups in disease stages, radiotherapy neck doses, and gender. We recommend life-long TSH screening after RT to the neck owing to the incidence of RTinduced hypothyroidism and the importance of early thyroid hormone replacement therapy in patients becoming hypothyroid for maintaining optimal quality of life.
Radiotherapy and Oncology, 2004
Nephron Experimental Nephrology, 2003
In this study, we examined the changes of tissue contents of trace elements and iron after total ... more In this study, we examined the changes of tissue contents of trace elements and iron after total body irradiation (TBI) and their possible impact on late toxicities. 20 female Wistar rats were randomly assigned to two groups - either radiation (n = 10) or control (n = 10). Rats in the radiation group received TBI of 5 Gy in a single fraction. Rats were sacrificed and tissue samples of heart, lung and kidney were taken 8 weeks after radiation. Tissue levels of zinc, copper, magnesium, manganese and iron analysis were performed with an atomic absorption spectrophotometer and suprapure grade standard solutions. One kidney of each animal was taken for electron microscopic analysis. Blood samples were collected from all animals and the blood chemistry related to kidney function was studied. The kidney levels of Fe and Cu significantly increased 8 weeks after irradiation (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The Cu/Zn ratio did not reach statistical significance in any tissue, however in kidney, there was a tendency to rise (p = 0.08). Myocardium and lung content of trace elements and iron did not show any significant change 8 weeks after irradiation. Electron microscopic analysis showed significant injury in glomerular endothelial cells, renal tubules and thickening of basement membrane. Blood chemistry showed a significant rise in serum creatinine (p = 0.008) and calcium (p = 0.01) in the TBI group. Serum creatinine levels were 0.73 and 0.84 mg/dl, and serum calcium levels were 10.1 and 11.3 mg/dl in control and TBI groups, respectively. A sublethal dose of TBI causes deposition of Cu and Fe within the kidney after TBI. Deposition of these elements may have some additional role on the toxicity caused by direct radiation on the kidney.
The Breast Journal, 2008
n Abstract: We retrospectively assessed the predictive factors for brain metastasis in high-risk ... more n Abstract: We retrospectively assessed the predictive factors for brain metastasis in high-risk breast cancer patients receiving radiotherapy after mastectomy. Between January 1994 and 2002, the medical charts of nonmetastatic breast cancer patients receiving post-mastectomy radiotherapy were evaluated. The clinical and pathologic features of patients who developed brain metastasis as the first site metastatic disease were compared with nonmetastatic patients treated at the same time period. All eligible patients in this study were treated with postoperative radiotherapy ± chemotherapy. Age, stage, percent positive lymph node involvement, number of lymph node metastasis, primary tumor size, grade, surgical margin status, estrogen receptor status, and perinodal fat tissue invasion were analyzed as predictive factors for brain metastasis. Statistical analyses were performed by using Log-rank test and Cox's regression analysis. Median follow-uptime was 61 months. In this period, 32 out of 957 patients (3.3%) developed brain metastasis. In univariate analysis percent positive axillary lymph node involvement (p < 0.001), primary tumor size (p < 0.001), number of lymph node metastasis (p = 0.01), and American Joint Committee on Cancer 2002 stage (p < 0.001) were found to be predictive for brain metastasis. Multivariate analysis revealed that only the primary tumor size and percent positive lymph node involvement were significant predictive factors for the development of brain metastasis. The primary tumor size and percent positive lymph node involvement increases the risk of brain metastasis in patients with nonmetastatic breast cancer receiving postoperative radiotherapy and chemotherapy. n
Supportive Care in Cancer, 2010
In this prospective study, the efficacy and safety of radiotherapy combined with zoledronic acid ... more In this prospective study, the efficacy and safety of radiotherapy combined with zoledronic acid was evaluated. Breast cancer patients with painful bone metastases were randomized to either high- or reduced-dose radiotherapy. All patients received zoledronic acid (4 mg) every 28 days from the beginning of radiotherapy. Analgesic and pain scores in addition to visual analog score (VAS) for treatment satisfaction and whole-body bone scintigraphy were evaluated. No significant differences could be found in analgesic or pain scores and bone scintigraphy results between the groups. Our results suggest that reduced-dose radiotherapy produces similar response rates and response durations when used concomitantly with zoledronic acid.
Radiotherapy and Oncology, 2005
IMRT can effectively spare organs at risk (OAR) that are, for example, placed in a concavity of t... more IMRT can effectively spare organs at risk (OAR) that are, for example, placed in a concavity of the PTV. It can, however, only spare OAR when there is a minimal separation of OAR and PTV. Maximum dose to OAR that are in immediate contact with the PTV cannot be reduced. IMRT alone is therefore not the solution in cases with small bowel located deep in the douglas pouch adjacent to the seminal vesicles. Dislocation of the small bowel using a laparoscopic omentum plastic enabled radiotherapy to full dose without an increased normal tissue complication probability. Like other uncontaminated laparoscopic surgical interventions morbidity and mortality for this procedure should be very low with a total risk of complications like infection or bleeding well below 1% [1]. Time for hospitalisation is short and specific tumor therapy can be started without a relevant delay.
Radiotherapy and Oncology, 2005