Primer Spinal Glioblastoma Multiforme: Bir Vaka Sunumu ve Literatür Derlemesi

Giriş: Primer spinal glioblastoma multiforme yüksek morbidite ve mortalite hızına sahip çok nadir görülen bir hastalıktır. Kesin bir tedavi algoritması yoktur ancak multimodal tedavi rejimleri uygulanmaktadır. Tedavinin amacı kitlenin tama yakın çıkarılması, sonrasında radyoterapi ve kemoterapinin kısa sürede uygulanmasıdır. Metod: 1989'dan itibaren İngilizce yazılmış makaleler, anahtar kelimelerin kullanılması ve derleme makalelerinden referansların ayrıştırılması yoluyla PubMed ve MEDLINE gibi arama motorları taranarak ayrıştırılmıştır. Kullanılan anahtar kelimeler primer, spinal ve glioblastoma multiformedir. Sonuçlar: Alt ekstremitede güçsüzlük ve gayta-üriner inkontinans ile başvuran 4 yaşındaki bir erkek hastada spinal manyetik rezonans görüntülemede (MRI)C2-T8 seviyesinde intramedüller kitle saptandı. Mikrocerrahi metodla kitlesi tama yakın çıkarılan hastada postoperatif dönemde sepsis gelişti. Radyoterapi başlanmasından kısa bir süre sonra klinik durumunda ve nörolojik tablosunda düzelme olan hasta ekstübe edildi. Tedavi sonrası hastanede 3 ay daha izlenmiştir. Literatür bulguları sGBM tedavisinde sekansiyel veya eş zamanlı olarak her üç modalitenin de kullanılabileceğini, kötü prognoza sahip olduğunu, hastaların çoğunluğunun hastalığa bağlı olarak öldüğünü ve semptomların süresinin çok kısa olduğunu göstermektedir. Tartışma: Hastalık nadir görüldüğü için, bu grup hasta popülasyonunda prospektif çalışmalar yapılamamaktadır.Introduction: Primary spinal glioblastoma multiforme is a very rare disease with high morbidity and mortality rates. No definite treatment algorhythm can be constituted, but multimodal treatment regimens have been administered. Aim of the treatment is to excise the mass nearly completely, and then application of radiotherapy and chemotherapy in a short period. Methods: Publications were identified by browsing search engines such as PubMed and MEDLINE for English-language articles since 1989 using a list of keywords; as well as identifying references from review articles. The following keywords were used for searching databases: primary, spinal, glioblastoma multiforme. Results: Intramedullary mass was detected at the levels of C2-T8 in the spinal magnetic resonance imaging (MRI) examination performed in our 4-year old male patient, who applied to us with complaints of weakness in lower extremities and gaita-urine incontinence. Sepsis was developed in postoperative period of the patient, whose mass was gross-totally resected by using microsurgery method. After the patient was started to have radiotherapy, he was extubated with improvements in the clinical state and neurological picture. He has been followed up at the hospital in the three-month monitorization after the treatment. Literature data suggested that all three therapy modalities can be used for sGBM, sequentially or concurrently, it has a poor survival, most of the patients die due to disease and the duration of symptoms are very short. Conclusion: Because the disease is very rare, prospective studies cannot be performed in this patient population

Radiotherapy for benign diseases in Turkey: a patterns of care survey of the Turkish Society for Radiation Oncology (TROD 05-002).

Purpose: We aimed to investigate the patterns of radiotherapy (RT) care in cases of benign diseases in Turkey. Methods: A questionnaire survey was sent to all radiation oncology (RO) departments in Turkey. The number of patients treated for benign disease between 2015 and 2020 was requested. A list of benign conditions was given, and information on the number of patients per disease, single and total doses prescribed, weekly fractions, radiation type, energy, and device was requested. Results: Of the 138 RO departments, 29 (21%) responded. The data received concerned 15 (52%) university, 10 (34%) public, and four (14%) private hospitals. A total of 130,846 patients were treated with RT in these departments. Of these patients, 6346 (4.85%) were treated for benign conditions. The most common benign diseases treated with RT were meningioma (35%), plantar fasciitis (19%), schwannoma (16%), arteriovenous malformation (11%), and pituitary adenoma (7%). Most centers performed RT for paraganglioma, heterotopic ossification, vertebral hemangioma, and Graves’ ophthalmopathy, but none treated arthrosis. Wide variations were observed across the departments. Radiosurgery for intracranial pathologies was performed intensively in four centers. By contrast, RT for plantar fasciitis was predominantly treated in five centers, one of which had more than 1000 patients. Conclusion: The ratio of patients who underwent RT for benign diseases in Turkey among all patients who underwent RT was 4.85%. The common pattern of RT in 72% of patients was radiosurgery for intracranial benign diseases, followed by low-dose RT for plantar fasciitis in 19%