Patients with papillary thyroid carcinoma associated with high stimulated serum calcitonin levels.

Among various substances produced by C-cells, the most important one is calcitonin (CT) that is used for detection, postoperative follow-up and evaluation of individuals at risk of developing medullary thyroid carcinoma (MTC). However, the role of serum CT measurement in the evaluation of thyroid nodules has been widely discussed, and there is still no consensus about the role of CT in the initial evaluation of all thyroid nodules. Two patients with thyroid nodules whose fine-needle aspiration results were compatible with benign cytology besides having mildly elevated basal serum calcitonin levels were reported. Calcitonin responses (peak levels were 313 and 229 pg/mL, respectively) to calcium stimulation test were compatible with the possible diagnosis of MTC. However, the final diagnosis was papillary thyroid carcinoma of the thyroid gland. There are limited numbers of case reports showing such an increased serum calcitonin responses to calcium stimulation test associated with papillary or follicular thyroid carcinoma of the thyroid. We suggest to measure serum CT level once and in case of normal levels, no further CT measurement is necessary. Physicians should keep in mind that thyroid carcinomas other than MTCs may also be associated with high serum CT levels

Neoadjuvant chronomodulated capecitabine with radiotherapy in rectal cancer: a phase II brunch regimen study

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Purpose The aim of this study was to evaluate efficacy and safety of chronomodulated capecitabine administered according to a specific time schedule (Brunch Regimen: Breakfast and Lunch) as a part of neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer. Methods Eighty-five patients with stage II and III rectal cancer were included. Patients received capecitabine (1,650 mg/m2 per day; 60 % dose at 8:00 AM and 40 % dose at 12:00 noon) administered during pelvic radiation (total 50.4 Gy in 28 fractions, 1.8 Gy daily dose between 2:00 p.m. and 4:00 p.m.). After chemoradiotherapy, patients underwent surgery. The primary endpoints were pathological complete response (pCR) rate and toxicity. Results In 17 patients (20 %), total tumor regression was achieved according to Dworak pathological grading system. Grade III diarrhea occurred in nine patients (10.5 %), while only one patient had grade 3 thrombocytopenia. Grade II or III proctitis were seen in nine (10.5 %) subjects, and grade I or II cystitis in six (6.9 %). Only three patients (3.3 %) developed hand and foot syndrome (both grade I–II). There were no grade IV toxicities. Conclusions Brunch Regimen for locally advanced rectal cancer consisting of neoadjuvant chronomodulated capecitabine and concurrent radiation therapy is effective and well tolerated with good safety profile, particularly with regard to the occurrence of hand and foot syndrome, in patients with locally advanced rectal cancer

Treatment outcomes of metastasis-directed treatment using(68)Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002)

Purpose The aim of this study was to evaluate the outcomes of(68)Ga prostate-specific membrane antigen (Ga-68-PSMA) positron-emission tomography (PET)/CT-based metastasis-directed treatment (MDT) for oligometastatic prostate cancer (PC). Methods In this multi-institutional study, clinical data of 176 PC patients with 353 lesions receiving MDT between 2014 and 2019 were retrospectively evaluated. All patients had biopsy proven PC with = 3 acute toxicity, but one patient had a late grade 3 toxicity of compression fracture after spinal SBRT. Conclusion Ga-68-PSMA-PET/CT-based MDT is an efficient and safe treatment for oligometastatic PC patients. Proper patient selection might improve treatment outcomes

Medically inoperable early-stage lung cancer treated with stereotactic ablative radiation therapy (SABR): Multicenter study of Turkish radiation oncology group (TROG)

60th Annual Meeting of the American-Society-for-Radiation-Oncology (ASTRO) -- OCT 21-24, 2018 -- San Antonio, TXWOS: 000447811602068Purpose/Objective(s): To review treatment outcomes for SABR inmedically inoperable early stage lung cancer (NSCLC) patients treated byTurkish Radiation Oncology Group (TROG) member centers.Materials/Methods:Between 2009 and 2017, a total of 386 patients withNSCLC treated with SABR in 12 TROG centers. Patient, disease, andtreatment related prognostic factors were analyzed. Primary endpointswere, overall survival (OS), progression free survival (PFS), local control (LC) and regional control (RC) and radiation-related toxicities.Results:Median follow-up was 15 months. The median age at diagnosis was72 years (43-93) and 79% were men. Median tumor size was 30 mm (5- 78mm). Seventy-two percent of the patients have histologically confirmed diagnosiswhereas 28%of patientswere treated withclinical and radiologicalfindings only without pathological diagnosis. Staging was as follows; T1N0in 215, T2N0 in 166, T3N0 in 2 and T4N0 in 3 patients because of bilaterallytumors. Median SABR dose was 54Gy (30-70Gy), corresponding to a bio-logical equivalent dose (BED) of 112Gy (48- 180Gy) administered in me-dian5 (1-10) fractions.Responseevaluationwas made either with PET/CTorCTin median 3 months after SABR and complete response, partial response,stable disease and progression rates were 48%, 36%, 5.7% and 0.5%,respectively. The cumulative locoregional failure rate was 15%. Amongthese, 23 were local (6%) and 35 regional (9%) failures. Distant failure wasreported in 67 (17%) patients. One to 3 years LC and RC rates were 97%,91% and 93%, 86%, respectively. One and 3 years PFS and OS were 88%,72% and 90%, 65%, respectively. At their last follow up 271 patients (71%) were alive. Prognostic factors associated with LC, RC and OS were sum-marized in table 1. No severe acute side effects were observed. Overall 18patients experienced grade 3 pneumonitis, 11 patients had chest wall painand 1 patient had rib fracture.Conclusion:The results of this retrospective study have shown that SABRis a promising technique with satisfactory LC and OS rates and minimaltoxicity in patients with medically inoperabl NSCLC.American Society for Radiation Oncolog