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Papers by nina tuncel

International journal of radiology & radiation therapy, May 11, 2021

Turkiye Klinikleri Radiation Oncology - Special Topics, 2017

Nucleation and Atmospheric Aerosols, 2018

The C-arm fluoroscopy X-ray systems have been used for a variety of radio-diagnostic imaging and ... more The C-arm fluoroscopy X-ray systems have been used for a variety of radio-diagnostic imaging and minimally invasive surgical operating procedures. In the operating theater room, these unites help t...

International Journal of Radiation Oncology Biology Physics, Oct 1, 2003

This study examines the change of applicator geometry and its effect on rectal/rectum (R) and bla... more This study examines the change of applicator geometry and its effect on rectal/rectum (R) and bladder (B) doses, and obtained radiobiological equivalent doses (RED), between each high dose rate (HDR) brachytherapy (BT) fraction in cervical carcinoma patients. BT using a tandem (T) and two ovoids (O) is included, and any discrepancies in applicator positions among the fractions were calculated. Whether the change of applicator position had an effect on the calculated R and B doses was analysed. Furthermore, the relationship between the size of tumour, the magnitude of displacement and the change in R and B doses was also investigated. Lastly, the changes in R and B RED were noted. The average magnitude of displacement was between 2.0 mm and 16.9 mm, showing time trend. There was no relationship between tumour size and the magnitude of discrepancy of Left O, Right O, T, R, B, and neither change in R and B doses (p>0.05). The mean differences of R and B doses were between 49-78 cGy, and 70-84 cGy, respectively. The magnitude of discrepancy and changes in doses showed no correlation (p>0.05). There were no significant differences in REDs for bladder (p = 0.8) and rectum (p = 0.2). In conclusion, there were significant differences in the applicator positions R and B and R and B doses among the fractions, which confirm the necessity of treatment planning in each HDR BT fraction. However, the total calculated R and B REDs did not show a remarkable difference.

Medical Physics, Jun 1, 2013

ABSTRACT Purpose: To investigate the organ doses of patients undergoing to General Electric (GE) ... more ABSTRACT Purpose: To investigate the organ doses of patients undergoing to General Electric (GE) Light Speed RT computed tomography (CT) device by the measurement and calculation method. Methods: The head, thorax and pelvis regions of Rando phantom scanned with 120kV, 200 mA, and 2.5 mm thickness for helical and axial mode. TLD pairs were used for dose measurements in specified 10 organ locations. Each exam was repeated and the TL counts averaged for organs. TL count conversion to dose was done for each scanning parameters using CTDI dose measurement on CT phantom. On the other hand, for calculation of organ doses at the same scanning process IMPACT software was utilized by using CTDI‐air (100 mAs) that measured by ion chambers in small and large window widths. CTDI‐air (100 mAs) in small and large window widths was 26.43 mGy and 21.17 mGy respectively. The organ doses that obtained from software and those from TLD measurements were compared. Results: In each examination the organ doses were tailored as the in‐field and out‐field radiation. The in‐field organ dose differences between TLD measurements and Impact software calculation by entering CTDI‐air (100 mAs): In helical and axial head exam the dose differences for eye, brain and thyroid were 2.8, 1 and 13.3, and 8.2, −8.3 and 9.6 mGy respectively, in helical and axial chest exam the dose differences for heart, lung, liver and kidney 2.7, 15.3 1.1 and 7.3 and, 9.1, 6.5, 0.3 and 5.2 mGy respectively, in helical and axial pelvic exam the dose differences for bladder, prostate, uterus and testis −3.6, −5.1, 1.9 and −21.7, and −3, −3.2, 1.8 and −15.5 mGy respectively. Conclusion: The availability of this program for organ dose calculations by measuring the CTDI‐air value of the CT device that used in the radiotherapy would be considered valuable.

Ejc Supplements, Sep 1, 2003

Journal of Applied Clinical Medical Physics, 2021

PurposeThe aim of the study is to present a new planning approach to provide better planning targ... more PurposeThe aim of the study is to present a new planning approach to provide better planning target volume (PTV) coverage and reduce bladder and rectum dose with hybrid Tomo‐Helical (TH)/Tomo‐Direct (TD) radiotherapy (RT) for localized prostate cancer (LPC).MethodsTwenty‐five LPC patients were included in this retrospective study. TH plans, TD plans, and hybrid TH/TD plans were created. Lateral beams were used for the hybrid TD plan and the prescribed dose was 70 Gy in 28 fractions (hybrid plans were combined 45 Gy/ 18 fxs for TH and 25 Gy/10 fxs for TD). Doses of PTV (D2%, D98%, D50%, homogeneity index (HI), conformity index (CI), coverage) and organs at risk (OARs) (V50%, V35%, V25%, V5%, and V95%) were analyzed. The Wilcoxon signed‐rank test was used to analyze the difference in dosimetric parameters. p‐Value < 0.05 was considered statistically significant.ResultsTH plans showed better CI, and target coverage (p < 0.01) than TD and hybrid plans in all patient plan evaluatio...

AIP Conference Proceedings, 2018

The C-arm fluoroscopy X-ray systems have been used for a variety of radio-diagnostic imaging and ... more The C-arm fluoroscopy X-ray systems have been used for a variety of radio-diagnostic imaging and minimally invasive surgical operating procedures. In the operating theater room, these unites help t...

Radiotherapy and Oncology, 1996

Radiotherapy and Oncology, 2004

ABSTRACT Purpose: To explore whether in-house dosimetry protocol and optimization techniques are ... more ABSTRACT Purpose: To explore whether in-house dosimetry protocol and optimization techniques are valid to obtain homogenous dose distribution in intended target volume in vaginal cuff brachytherapy using ovoids, as well as how often optimization is needed and whether there is a contribution of optimization. Methods: Catheter oriented dose points (dps) normalization was performed. In addition, the vaginal apex dose point (Vk) dose and rectum (Rg) and bladder (Bl) doses according to ICRU-38 were calculated. Although dose prescription was made to dps, optimization as time and position was made considering Vk, Rg and Bl doses. Furthermore, for this particular study, another dose point called Vk’ dose was calculated prospectively. Target dose homogeneity, the relations of both prescribed dose -Vk and Vk’, and the necessity of optimization frequency and its relation with ovoid diameter were investigated.Results: 109 fractions of 33 patients, using ovoid diameters 1.5, 2 and 2.5cm, were evaluated. The obtained dose variation in the target was within +5%. Optimization was required in 92 out of 109 (83%) fractions. Vk was around the upper and Vk&#39; around to the lower limit of the target dose. There were significant relations between the ovoid diameter and rectal doses (correlation coefficient: 0.32 and p&lt; 0.001) and Vc (correlation coefficient: 0.16 and p:0.08). No association was seen between the ovoid diameter and Vc&#39; (correlation coefficient: 0.07 and p:0.46), minimum dps (correlation coefficient:- 0.01 and p:0.88) and maximum dps (correlation coefficient:- 0.01 and p:0.32). Although ovoid diameter had significant effect on Rg (p:0.002), Vc (p:0.01) and Vc&#39; (p:0.03), no effect was observed on minimum dps (p: 0.68) and maximum dps (p: 0.52). Conclusion: Catheter oriented dose points normalization provides adequate homogenous dose distribution in the target volume, requiring time-position optimization in vaginal cuff brachytherapy using ovoids. Rg should be considered seriously in ovoids where the diameter is &gt; 2.5 cm.

Radiotherapy and Oncology, 2004

ABSTRACT Aim: The validity of different dose prescription points for level III axillary lymph nod... more ABSTRACT Aim: The validity of different dose prescription points for level III axillary lymph nodes in patients with breast carcinoma receiving supraclaviculary-axillary irradiation as part of their treatment was examined. Methods: The material of this study was dosimetric data of 20 patients whom target includes supraclaviculary – axillary (SA) lymph nodes irradiated via anterior field with 150 gantry angle. Two dimensional radiotherapy planning procedure was carried out, isodose distribution for SA were obtained on computerize tomography (CT) slice that taken central plane of SA field in treatment position. In-house technique requires identification of level III axillary lymph nodes from CT and dose calculation in concordance with this location. For this particular study, additional dose calculation was made according to standard and study techniques which are based on dose prescription points located in half of patient thickness in central axis and off-central axis respectively. Results: Depth of axillary lymph nodes was not matched with half of the antero-posterior thickness in both central axis and off - central axis for any patients; mean depth of axillary lymph nodes from the skin was 4.53 cm despite mean half of the patient thickness in central axis was 8.7cm. There was no relation between level III axillary lymph node dose and neither patient thickness in central axis nor patient thickness in off-central axis on central plane. Conclusion: Dose specification according to patient thickness is inappropriate. Axillary lymph nodes receive approximately 7% less than prescribed dose as a result introducing a small posterior complementary boost field is limited 1-2 fraction.

International Journal of Radiation Oncology*Biology*Physics, 2009

was 26 Gy and 33 Gy for single and 3 fractionated treatment, respectively. Patients are trained t... more was 26 Gy and 33 Gy for single and 3 fractionated treatment, respectively. Patients are trained to reduce their respiratory volume using as control a computerized spirometer (Elekta ABC) in order to minimize the ITV. SBRT was delivered by a 6 MV Elekta Synergy and dynamic mMLC by multiple arcs. Cone Beam CT was acquired before each treatment for corrections of setup and isocenter position. Results: With median follow-up of 15.8 months (3-84), 51% of treated patients are still alive (19% NED). One hundred fifty lesions were evaluable for local control, defined as no tumor re-growth in the treated site. The LC rate was 94% and 91% at 1 and 2 years, respectively. Kaplan Meier OS was 90% and 79% at 1 and 2 years, respectively. Median OS was 14 months. No statistically significant differences of OS were observed between NSCLC and colorectal patients. Out of 16 lesions recurred in the treated site, 8 were retreated by SBRT without severe toxicity. Toxicity for all treated patients was mild (CTCAE v.4). Conclusions: In our experience, patients presenting lung confined oligometastases treated by SBRT can reach high rates (over 90%) of local control without significant toxicity. The OS rates shows that this category of patients can be cured by SBRT in selected cases, or inducted in a chronic state of their disease. No significant differences were evaluated between different types of primary tumors.

onkoloji.dergisi.org

... FATMA ATAMAN, NİNA TUNÇEL, AYŞE NUR DEMİRAL, ELİF TEKELİ, ADEM ÜNAL KIZILDAĞ, VİLDAN ŞİMŞİR, ... more ... FATMA ATAMAN, NİNA TUNÇEL, AYŞE NUR DEMİRAL, ELİF TEKELİ, ADEM ÜNAL KIZILDAĞ, VİLDAN ŞİMŞİR, AYSUN TOY, MUSA ALTUN. ... edilen V25 değerleri (25 Gy ve üstünde doz alan hacim yüzdesi) karşılaştırıldığında istatistiksel anlamlı fark bulunmadı (sağ ve sol ...

Turkiye Klinikleri Journal of Medical Sciences, 2019

Prostat kanseri radyoterapisinde dinamik yoğunluk ayarlı radyoterapi (D-IMRT) ve hacimsel yoğunlu... more Prostat kanseri radyoterapisinde dinamik yoğunluk ayarlı radyoterapi (D-IMRT) ve hacimsel yoğunluk ayarlı ark tedavisi (VMAT) tekniklerinin, hasta tedavi planları ile dozimetrik olarak karşılaştırılmasıdır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Yüksek riskli 10 prostat kanseri hastası için, CMS Monaco Tedavi Planlama Sistemi (TPS) kullanılarak 6MV enerjide X ışını üreten Linak tabanlı 9-alan D-IMRT ve çift ark VMAT teknikleri ile planlar tasarlandı. İki planlama tekniği; planlanmış hedef hacim (PTV) 46, PTV 56, PTV 74 yapılarındaki doz sarımı ve homojenite indeksi (HI) ile konformite indeksi (CI) değerleri bakımından karşılaştırıldı. Kritik organlarda, rektum için V50, V60, V65, V70 (doz volümleri) değerleri mesane için V65, V70 değerleri, femur başları için ise V40 değerleri incelendi. Her iki teknik ile elde edilen planların tedavi süreleri, segment sayıları ve monitör ünite (MU) değerleri karşılaştırıldı. Ayrıca, hastaların aldığı integral doz olarak V37 değerlendirildi. Elde edilen tüm veriler Wilcoxon işaretli sıra testi uygulanarak, istatistiksel olarak karşılaştırıldı. B Bu ul lg gu ul la ar r: : D-IMRT ve VMAT teknikleri ile hedef hacimler için, birbirlerine yakın doz sarımları elde edilmiştir. PTV 74 için hesaplanan HI ve CI değerleri her iki teknikte benzer bulunmuştur. Her iki planlama tekniği ile tüm kritik organlar, doz sınırlamalarının altında tutulabilmiştir. Genel olarak, risk altındaki organ dozları bakımından her iki teknik ile birbirlerine yakın sonuçlar elde edilmiştir. Ancak; rektum için V70 değerleri bakımından her iki teknik arasında anlamlı bir fark bulunmuştur. İntegral doz açısından da her iki teknik arasında anlamlı fark bulunmuştur. VMAT tekniği ile oluşturulan planlardan elde edilen segment ve MU sayıları, D-IMRT tekniği ile oluşturulan planlara göre fazla olmasına rağmen tedavi süresinin daha kısa olduğu gözlenmiştir. S So on nu uç ç: : Prostat kanseri radyoterapisinde kullanılan 9-alan D-IMRT tekniği ve VMAT teknikleri tedavi planlama sistemi üzerinden karşılaştırıldığında, hem PTV sarımları hem de kritik organ korumaları açısından benzer dozimetrik sonuçlar elde edilmiştir. Sadece tedavi süresi açısından, VMAT tekniğinin D-IMRT tekniğine belirgin bir üstünlüğü gözlenmiştir. A An na ah ht ta ar r K Ke el li im me el le er r: : Prostat kanseri; D-IMRT; VMAT A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study is to compare dosimetric values of dynamic intensity modulated radiation therapy (dIMRT) and volumetric modulated arc therapy (VMAT) treatment techniques in the treatment of prostate cancer radiotherapy. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Treatment plans were designed for 10 high-risk prostate cancer patient with Linac based 9-fields D-IMRT and double arc VMAT techniques using CMS Monaco Treatment Planning System (TPS). Two planning techniques; were compared to homogeneity index (HI) and conformity index (CI) values as well as the dose coverage of planning target volume (PTV) structures. Critical organs were assessed V50, V60, V65, V70 for the rectum, V65, V70 for the bladder and V40 for the femoral heads. The treatment time, segment number and monitor unit (MU) values of the plans obtained with the two techniques were compared. V37 was also evaluated as integral dose of the patients. All obtained data were statistically evaluated by Wilcoxon signed rank test. R Re es su ul lt ts s: : With the D-IMRT and VMAT techniques, similar dose coverage were obtained for target volumes. HI and CI values calculated for PTV 74 were found to be the similar in both techniques. With both planning techniques, all critical organs could be kept below the dose limits. In general, in terms of organs at risk doses, close results were obtained from both techniques. However, there was a significant difference between the two techniques in terms of V70 values for rectum. A significant difference was also found between the two techniques in terms of integral dose. Although the segment and MU numbers obtained from the plans generated by the VMAT technique were higher than the plans generated by the D-IMRT technique, the treatment time was found shorter. C Co on nc cl lu us si io on n: : Similar dosimetric results were obtained from 9-fields D-IMRT and VMAT techniques used in the treatment of prostate cancer radiotherapy in terms of PTV dose coverage and critical organ protection. The VMAT technique has an advantage over the D-IMRT technique only in terms of treatment time.

Background: It was aimed to evaluate the differences and relationship between the anthropometric ... more Background: It was aimed to evaluate the differences and relationship between the anthropometric characteristics of the patients who received radiotherapy in our clinic after breast-conserving surgery due to breast cancer. Methods: A total of 40 patients underwent whole breast and lymph node irradiation after breast-conserving surgery were evaluated according to dosimetric parameters and ​anthropometric variables such as weight, mid-sternum thickness, Haller index, central lung distance (CLD) and breast volume.Results: In internal mammary node (IMN) irradiated patients, lung doses (V5, V10, V20, V30, minimum dose (Dmin) and maximum dose (Dmax)) and contralateral breast doses (Dmax and V5) were significantly higher than the patients not received IMN irradiation. Also, breast size shown to be an important factor; when small and large breast sized patients were compared, ipsilateral lung V10, V20, and V30 values and the Dmin of heart were higher in patients with large breast volume. Th...

International journal of radiology & radiation therapy, May 11, 2021

Turkiye Klinikleri Radiation Oncology - Special Topics, 2017

Nucleation and Atmospheric Aerosols, 2018

The C-arm fluoroscopy X-ray systems have been used for a variety of radio-diagnostic imaging and ... more The C-arm fluoroscopy X-ray systems have been used for a variety of radio-diagnostic imaging and minimally invasive surgical operating procedures. In the operating theater room, these unites help t...

International Journal of Radiation Oncology Biology Physics, Oct 1, 2003

This study examines the change of applicator geometry and its effect on rectal/rectum (R) and bla... more This study examines the change of applicator geometry and its effect on rectal/rectum (R) and bladder (B) doses, and obtained radiobiological equivalent doses (RED), between each high dose rate (HDR) brachytherapy (BT) fraction in cervical carcinoma patients. BT using a tandem (T) and two ovoids (O) is included, and any discrepancies in applicator positions among the fractions were calculated. Whether the change of applicator position had an effect on the calculated R and B doses was analysed. Furthermore, the relationship between the size of tumour, the magnitude of displacement and the change in R and B doses was also investigated. Lastly, the changes in R and B RED were noted. The average magnitude of displacement was between 2.0 mm and 16.9 mm, showing time trend. There was no relationship between tumour size and the magnitude of discrepancy of Left O, Right O, T, R, B, and neither change in R and B doses (p&gt;0.05). The mean differences of R and B doses were between 49-78 cGy, and 70-84 cGy, respectively. The magnitude of discrepancy and changes in doses showed no correlation (p&gt;0.05). There were no significant differences in REDs for bladder (p = 0.8) and rectum (p = 0.2). In conclusion, there were significant differences in the applicator positions R and B and R and B doses among the fractions, which confirm the necessity of treatment planning in each HDR BT fraction. However, the total calculated R and B REDs did not show a remarkable difference.

Medical Physics, Jun 1, 2013

ABSTRACT Purpose: To investigate the organ doses of patients undergoing to General Electric (GE) ... more ABSTRACT Purpose: To investigate the organ doses of patients undergoing to General Electric (GE) Light Speed RT computed tomography (CT) device by the measurement and calculation method. Methods: The head, thorax and pelvis regions of Rando phantom scanned with 120kV, 200 mA, and 2.5 mm thickness for helical and axial mode. TLD pairs were used for dose measurements in specified 10 organ locations. Each exam was repeated and the TL counts averaged for organs. TL count conversion to dose was done for each scanning parameters using CTDI dose measurement on CT phantom. On the other hand, for calculation of organ doses at the same scanning process IMPACT software was utilized by using CTDI‐air (100 mAs) that measured by ion chambers in small and large window widths. CTDI‐air (100 mAs) in small and large window widths was 26.43 mGy and 21.17 mGy respectively. The organ doses that obtained from software and those from TLD measurements were compared. Results: In each examination the organ doses were tailored as the in‐field and out‐field radiation. The in‐field organ dose differences between TLD measurements and Impact software calculation by entering CTDI‐air (100 mAs): In helical and axial head exam the dose differences for eye, brain and thyroid were 2.8, 1 and 13.3, and 8.2, −8.3 and 9.6 mGy respectively, in helical and axial chest exam the dose differences for heart, lung, liver and kidney 2.7, 15.3 1.1 and 7.3 and, 9.1, 6.5, 0.3 and 5.2 mGy respectively, in helical and axial pelvic exam the dose differences for bladder, prostate, uterus and testis −3.6, −5.1, 1.9 and −21.7, and −3, −3.2, 1.8 and −15.5 mGy respectively. Conclusion: The availability of this program for organ dose calculations by measuring the CTDI‐air value of the CT device that used in the radiotherapy would be considered valuable.

Ejc Supplements, Sep 1, 2003

Journal of Applied Clinical Medical Physics, 2021

PurposeThe aim of the study is to present a new planning approach to provide better planning targ... more PurposeThe aim of the study is to present a new planning approach to provide better planning target volume (PTV) coverage and reduce bladder and rectum dose with hybrid Tomo‐Helical (TH)/Tomo‐Direct (TD) radiotherapy (RT) for localized prostate cancer (LPC).MethodsTwenty‐five LPC patients were included in this retrospective study. TH plans, TD plans, and hybrid TH/TD plans were created. Lateral beams were used for the hybrid TD plan and the prescribed dose was 70 Gy in 28 fractions (hybrid plans were combined 45 Gy/ 18 fxs for TH and 25 Gy/10 fxs for TD). Doses of PTV (D2%, D98%, D50%, homogeneity index (HI), conformity index (CI), coverage) and organs at risk (OARs) (V50%, V35%, V25%, V5%, and V95%) were analyzed. The Wilcoxon signed‐rank test was used to analyze the difference in dosimetric parameters. p‐Value < 0.05 was considered statistically significant.ResultsTH plans showed better CI, and target coverage (p < 0.01) than TD and hybrid plans in all patient plan evaluatio...

AIP Conference Proceedings, 2018

The C-arm fluoroscopy X-ray systems have been used for a variety of radio-diagnostic imaging and ... more The C-arm fluoroscopy X-ray systems have been used for a variety of radio-diagnostic imaging and minimally invasive surgical operating procedures. In the operating theater room, these unites help t...

Radiotherapy and Oncology, 1996

Radiotherapy and Oncology, 2004

ABSTRACT Purpose: To explore whether in-house dosimetry protocol and optimization techniques are ... more ABSTRACT Purpose: To explore whether in-house dosimetry protocol and optimization techniques are valid to obtain homogenous dose distribution in intended target volume in vaginal cuff brachytherapy using ovoids, as well as how often optimization is needed and whether there is a contribution of optimization. Methods: Catheter oriented dose points (dps) normalization was performed. In addition, the vaginal apex dose point (Vk) dose and rectum (Rg) and bladder (Bl) doses according to ICRU-38 were calculated. Although dose prescription was made to dps, optimization as time and position was made considering Vk, Rg and Bl doses. Furthermore, for this particular study, another dose point called Vk’ dose was calculated prospectively. Target dose homogeneity, the relations of both prescribed dose -Vk and Vk’, and the necessity of optimization frequency and its relation with ovoid diameter were investigated.Results: 109 fractions of 33 patients, using ovoid diameters 1.5, 2 and 2.5cm, were evaluated. The obtained dose variation in the target was within +5%. Optimization was required in 92 out of 109 (83%) fractions. Vk was around the upper and Vk&#39; around to the lower limit of the target dose. There were significant relations between the ovoid diameter and rectal doses (correlation coefficient: 0.32 and p&lt; 0.001) and Vc (correlation coefficient: 0.16 and p:0.08). No association was seen between the ovoid diameter and Vc&#39; (correlation coefficient: 0.07 and p:0.46), minimum dps (correlation coefficient:- 0.01 and p:0.88) and maximum dps (correlation coefficient:- 0.01 and p:0.32). Although ovoid diameter had significant effect on Rg (p:0.002), Vc (p:0.01) and Vc&#39; (p:0.03), no effect was observed on minimum dps (p: 0.68) and maximum dps (p: 0.52). Conclusion: Catheter oriented dose points normalization provides adequate homogenous dose distribution in the target volume, requiring time-position optimization in vaginal cuff brachytherapy using ovoids. Rg should be considered seriously in ovoids where the diameter is &gt; 2.5 cm.

Radiotherapy and Oncology, 2004

ABSTRACT Aim: The validity of different dose prescription points for level III axillary lymph nod... more ABSTRACT Aim: The validity of different dose prescription points for level III axillary lymph nodes in patients with breast carcinoma receiving supraclaviculary-axillary irradiation as part of their treatment was examined. Methods: The material of this study was dosimetric data of 20 patients whom target includes supraclaviculary – axillary (SA) lymph nodes irradiated via anterior field with 150 gantry angle. Two dimensional radiotherapy planning procedure was carried out, isodose distribution for SA were obtained on computerize tomography (CT) slice that taken central plane of SA field in treatment position. In-house technique requires identification of level III axillary lymph nodes from CT and dose calculation in concordance with this location. For this particular study, additional dose calculation was made according to standard and study techniques which are based on dose prescription points located in half of patient thickness in central axis and off-central axis respectively. Results: Depth of axillary lymph nodes was not matched with half of the antero-posterior thickness in both central axis and off - central axis for any patients; mean depth of axillary lymph nodes from the skin was 4.53 cm despite mean half of the patient thickness in central axis was 8.7cm. There was no relation between level III axillary lymph node dose and neither patient thickness in central axis nor patient thickness in off-central axis on central plane. Conclusion: Dose specification according to patient thickness is inappropriate. Axillary lymph nodes receive approximately 7% less than prescribed dose as a result introducing a small posterior complementary boost field is limited 1-2 fraction.

International Journal of Radiation Oncology*Biology*Physics, 2009

was 26 Gy and 33 Gy for single and 3 fractionated treatment, respectively. Patients are trained t... more was 26 Gy and 33 Gy for single and 3 fractionated treatment, respectively. Patients are trained to reduce their respiratory volume using as control a computerized spirometer (Elekta ABC) in order to minimize the ITV. SBRT was delivered by a 6 MV Elekta Synergy and dynamic mMLC by multiple arcs. Cone Beam CT was acquired before each treatment for corrections of setup and isocenter position. Results: With median follow-up of 15.8 months (3-84), 51% of treated patients are still alive (19% NED). One hundred fifty lesions were evaluable for local control, defined as no tumor re-growth in the treated site. The LC rate was 94% and 91% at 1 and 2 years, respectively. Kaplan Meier OS was 90% and 79% at 1 and 2 years, respectively. Median OS was 14 months. No statistically significant differences of OS were observed between NSCLC and colorectal patients. Out of 16 lesions recurred in the treated site, 8 were retreated by SBRT without severe toxicity. Toxicity for all treated patients was mild (CTCAE v.4). Conclusions: In our experience, patients presenting lung confined oligometastases treated by SBRT can reach high rates (over 90%) of local control without significant toxicity. The OS rates shows that this category of patients can be cured by SBRT in selected cases, or inducted in a chronic state of their disease. No significant differences were evaluated between different types of primary tumors.

onkoloji.dergisi.org

... FATMA ATAMAN, NİNA TUNÇEL, AYŞE NUR DEMİRAL, ELİF TEKELİ, ADEM ÜNAL KIZILDAĞ, VİLDAN ŞİMŞİR, ... more ... FATMA ATAMAN, NİNA TUNÇEL, AYŞE NUR DEMİRAL, ELİF TEKELİ, ADEM ÜNAL KIZILDAĞ, VİLDAN ŞİMŞİR, AYSUN TOY, MUSA ALTUN. ... edilen V25 değerleri (25 Gy ve üstünde doz alan hacim yüzdesi) karşılaştırıldığında istatistiksel anlamlı fark bulunmadı (sağ ve sol ...

Turkiye Klinikleri Journal of Medical Sciences, 2019

Prostat kanseri radyoterapisinde dinamik yoğunluk ayarlı radyoterapi (D-IMRT) ve hacimsel yoğunlu... more Prostat kanseri radyoterapisinde dinamik yoğunluk ayarlı radyoterapi (D-IMRT) ve hacimsel yoğunluk ayarlı ark tedavisi (VMAT) tekniklerinin, hasta tedavi planları ile dozimetrik olarak karşılaştırılmasıdır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Yüksek riskli 10 prostat kanseri hastası için, CMS Monaco Tedavi Planlama Sistemi (TPS) kullanılarak 6MV enerjide X ışını üreten Linak tabanlı 9-alan D-IMRT ve çift ark VMAT teknikleri ile planlar tasarlandı. İki planlama tekniği; planlanmış hedef hacim (PTV) 46, PTV 56, PTV 74 yapılarındaki doz sarımı ve homojenite indeksi (HI) ile konformite indeksi (CI) değerleri bakımından karşılaştırıldı. Kritik organlarda, rektum için V50, V60, V65, V70 (doz volümleri) değerleri mesane için V65, V70 değerleri, femur başları için ise V40 değerleri incelendi. Her iki teknik ile elde edilen planların tedavi süreleri, segment sayıları ve monitör ünite (MU) değerleri karşılaştırıldı. Ayrıca, hastaların aldığı integral doz olarak V37 değerlendirildi. Elde edilen tüm veriler Wilcoxon işaretli sıra testi uygulanarak, istatistiksel olarak karşılaştırıldı. B Bu ul lg gu ul la ar r: : D-IMRT ve VMAT teknikleri ile hedef hacimler için, birbirlerine yakın doz sarımları elde edilmiştir. PTV 74 için hesaplanan HI ve CI değerleri her iki teknikte benzer bulunmuştur. Her iki planlama tekniği ile tüm kritik organlar, doz sınırlamalarının altında tutulabilmiştir. Genel olarak, risk altındaki organ dozları bakımından her iki teknik ile birbirlerine yakın sonuçlar elde edilmiştir. Ancak; rektum için V70 değerleri bakımından her iki teknik arasında anlamlı bir fark bulunmuştur. İntegral doz açısından da her iki teknik arasında anlamlı fark bulunmuştur. VMAT tekniği ile oluşturulan planlardan elde edilen segment ve MU sayıları, D-IMRT tekniği ile oluşturulan planlara göre fazla olmasına rağmen tedavi süresinin daha kısa olduğu gözlenmiştir. S So on nu uç ç: : Prostat kanseri radyoterapisinde kullanılan 9-alan D-IMRT tekniği ve VMAT teknikleri tedavi planlama sistemi üzerinden karşılaştırıldığında, hem PTV sarımları hem de kritik organ korumaları açısından benzer dozimetrik sonuçlar elde edilmiştir. Sadece tedavi süresi açısından, VMAT tekniğinin D-IMRT tekniğine belirgin bir üstünlüğü gözlenmiştir. A An na ah ht ta ar r K Ke el li im me el le er r: : Prostat kanseri; D-IMRT; VMAT A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study is to compare dosimetric values of dynamic intensity modulated radiation therapy (dIMRT) and volumetric modulated arc therapy (VMAT) treatment techniques in the treatment of prostate cancer radiotherapy. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Treatment plans were designed for 10 high-risk prostate cancer patient with Linac based 9-fields D-IMRT and double arc VMAT techniques using CMS Monaco Treatment Planning System (TPS). Two planning techniques; were compared to homogeneity index (HI) and conformity index (CI) values as well as the dose coverage of planning target volume (PTV) structures. Critical organs were assessed V50, V60, V65, V70 for the rectum, V65, V70 for the bladder and V40 for the femoral heads. The treatment time, segment number and monitor unit (MU) values of the plans obtained with the two techniques were compared. V37 was also evaluated as integral dose of the patients. All obtained data were statistically evaluated by Wilcoxon signed rank test. R Re es su ul lt ts s: : With the D-IMRT and VMAT techniques, similar dose coverage were obtained for target volumes. HI and CI values calculated for PTV 74 were found to be the similar in both techniques. With both planning techniques, all critical organs could be kept below the dose limits. In general, in terms of organs at risk doses, close results were obtained from both techniques. However, there was a significant difference between the two techniques in terms of V70 values for rectum. A significant difference was also found between the two techniques in terms of integral dose. Although the segment and MU numbers obtained from the plans generated by the VMAT technique were higher than the plans generated by the D-IMRT technique, the treatment time was found shorter. C Co on nc cl lu us si io on n: : Similar dosimetric results were obtained from 9-fields D-IMRT and VMAT techniques used in the treatment of prostate cancer radiotherapy in terms of PTV dose coverage and critical organ protection. The VMAT technique has an advantage over the D-IMRT technique only in terms of treatment time.

Background: It was aimed to evaluate the differences and relationship between the anthropometric ... more Background: It was aimed to evaluate the differences and relationship between the anthropometric characteristics of the patients who received radiotherapy in our clinic after breast-conserving surgery due to breast cancer. Methods: A total of 40 patients underwent whole breast and lymph node irradiation after breast-conserving surgery were evaluated according to dosimetric parameters and ​anthropometric variables such as weight, mid-sternum thickness, Haller index, central lung distance (CLD) and breast volume.Results: In internal mammary node (IMN) irradiated patients, lung doses (V5, V10, V20, V30, minimum dose (Dmin) and maximum dose (Dmax)) and contralateral breast doses (Dmax and V5) were significantly higher than the patients not received IMN irradiation. Also, breast size shown to be an important factor; when small and large breast sized patients were compared, ipsilateral lung V10, V20, and V30 values and the Dmin of heart were higher in patients with large breast volume. Th...