Second Line Palliative Endobronchial Radiotherapy with HDR Ir 192 in Recurrent Lung Carcinoma

Purpose To observe the efficiency of reirradiation with high dose rate intraluminal brachytherapy in symptomatic palliation of recurrent endobronchial tumors. Materials and Methods Between January 1994 and June 1998, 21 patients diagnosed with recurrent endobronchial tumors following external beam radiotherapy were treated palliatively with high dose rate intraluminal irradiation at Hacettepe University Oncology Institute. A single fraction of 10 Gy was prescribed to the specified area in 9 patients and 15 Gy to 12. Results Endobronchial treatment improved the performance and reduced symptomatology in 17 (81%) patients. Ten dyspneic patients (10/14, 71%) recovered clinically with an accompanying radiological downstaging. The median symptomatic palliation was 45 days (range, 0 - 9 months), and the overall median survival was 5.5 months (range, 4 - 12 months). The palliative intrabronchial brachytherapy was well tolerated, with the exception of in one patient with a fatal hemorrhage, and another with medically salvaged bronchospasm and intrabronchial edema. Conclusion Recurrent patients with a history of previous thoracic external beam irradiation can be effectively palliated with high dose rate endobronchial reirradiation if the symptoms are directly related to the endobronchial tumor

Turkiye'de Endeksli Bonolar Kullanilarak Enflasyon Telafisi Olculmesi

[TR] Enflasyon beklentilerine iliskin dogru bilgi elde etmek tüm iktisadi birimler icin daha saglikli ekonomik kararlarin alinabilmesi acisindan onem tasimaktadir. Uygulamada, enflasyon beklentilerini olcmek amaciyla kullanilan kaynaklar beklenti anketleri ve finansal piyasa verileridir. Bu notta, enflasyon telafisinin anket verilerine alternatif bir enflasyon beklentisi gostergesi olarak kullanimi ustunlukleri ve sakincalarindan bahsedilerek tartisilmaktadir. Buna ek olarak, nominal ve enflasyona endeksli tahvil verileri kullanilarak hesaplanan enflasyon telafilerinin para politikasina iliskin cesitli analizlerde kullanilabilecegi gosterilmistir. [EN] For all economic actors, obtaining accurate information about inflation expectations is crucial in decision making process. In practice, two main sources in the measurement of inflation expectations are expectation surveys and financial market data. In this note, we discuss inflation compensation as an alternative indicator of inflation expectations to expectation surveys along with the advantages and disadvantages of its usage. In addition, we show that inflation compensation, calculated by using nominal and inflation-linked bond data, can be used as a tool in various monetary policy analyses.

Management of Ductal Carcinoma in Situ Patients Receiving Postoperative Radiotherapy After Breast Conserving Surgery: Hacettepe Experience

We retrospectively evaluated our therapetic results in ductal carcinoma in situ (DCIS) patients treated with postoperative radiotherapy following breast-conserving surgery (BCS). Sixty-seven DCIS patients were treated with curative radiotherapy (RT) after BCS, in our department from December 1998 to January 2008. All patients have been treated with 6 MV photon energy on lineer accelerator machine. Radiotherapy treatment fields were opposed tangential to the whole breast. A total dose of median 50 Gy (48-50 Gy) was delivered in five fractions in a week. In twenty patients, boost dose to the tumour region was applied. Fifty patients received systemic hormonotherapy. Median follow-up time was 44 moths (range 12-122 months). Five-year OS, DFS and local control rates were found as 96%, 97% and 97%, respectively. There was only one ipsilateral breast recurrence in our study (2%). Two patients died due to other causes except disease (3%). Grade III dermatitis was seen in only one patient (2%), and there was no serious acute side effects in 41 patients (63%). There was no late side effect in our patients. Sixty-two patients were alive without evidence of tumour recurrence, with their intact breast and with good cosmesis. Our survival rates and side effects were in consistent with literature, and RT is an effective option for DCIS patients following BCS.WoSScopu

TCMB Faiz Kararlarinin Piyasa Faizleri Ve Hisse Senedi Piyasalari Uzerine Etkisi

Para politikasinin mali piyasalara etkisi parasal aktarim mekanizmasinin ilk adimidir. Politika faizinin varlik fiyatlari uzerine etkisi tahmin edilirken karsilasilan onemli sorunlardan biri politika faizleri ve varlik fiyatlari arasindaki eszamanli etkilesimdir. Bu calismada, para politikasinin Turkiye’deki hisse senedi fiyatlari ve piyasa faizleri uzerindeki etkisi, eszamanlilik sorununa etkili bir cozum olan Rigobon ve Sack (2004) tarafindan onerilen degisen oynakliga dayali genellestirilmis beklemler yontemi (GMM) ile tahmin edilmistir. Bulgular daha once de vaka calismasi ile elde edilen sonuclar ile uyumludur. Politika faizlerindeki artislar, hisse senedi fiyatlarini dusurmekte, daha uzun vadeli faizleri ise vadeye gore asamali olarak azalan bir olcude artirmaktadir.

Dosimetric Comparison Of Three‐Dimensional Conformal Radiotherapy And Intensity‐Modulated Radiotherapy For Left‐Sided Chest Wall And Lymphatic Irradiation

Introduction The aim of this study was to compare five different techniques for chest wall (CW) and lymphatic irradiation in patients with left‐sided breast carcinoma. Methods Three‐dimensional conformal radiotherapy (3DCRT), forward‐planned intensity‐modulated radiotherapy (FP‐IMRT), inverse‐planned IMRT (IP‐IMRT; 7‐ or 9‐field), and hybrid IP‐/FP‐IMRT were compared in 10 patients. Clinical target volume (CTV) included CW and internal mammary (IM), supraclavicular (SC), and axillary nodes. Planning target volumes (PTVs), CTVs, and organs at risks (OARs) doses were analyzed with dose–volume histograms (DVHs). Results No differences could be observed among the techniques for doses received by 95% of the volume (D95%) of lymphatics. However, the FP‐IMRT resulted in a significantly lower D95% dose to the CW‐PTV compared to other techniques (P = 0.002). The 9‐field IP‐IMRT achieved the lowest volumes receiving higher doses (hotspots). Both IP‐IMRT techniques provided similar mean doses (Dmean) for the left lung which were smaller than the other techniques. There was no difference between the techniques for maximum dose (Dmax) of right breast. However, FP‐IMRT resulted in lower Dmean and volume of right breast receiving at least 5 Gy doses compared to other techniques. Conclusion The dose homogeneity in CW‐CTV was better using IMRT techniques compared to 3DCRT. Especially 9‐field IP‐IMRT provided a more homogeneous dose distribution in IM and axillary CTVs. Moreover, the OARs volumes receiving low radiation doses were larger with IP‐IMRT technique, while volumes receiving high radiation doses were larger with FP‐IMRT technique. Hybrid IMRT plans were found to have the advantages of both FP‐ and IP‐IMRT techniques.PubMedWoSScopu

Radiosensitization induced by zinc-doped hydroxyapatite nanoparticles in breast cancer cells

Zinc-doped hydroxyapatite (HA) nanoparticles were synthesized by microwave assisted method and used with ionizing radiation for inhibition of proliferation of breast cancer cells. Zinc-doped HAs were produced in four different compositions in order to determine the best doping rate in terms of physical and biological properties. Nanoparticle characterizations were performed with X-ray diffractometer, Fourier transform infrared spectroscopy, scanning electron microscopy, and inductively coupled plasma-mass spectrometry. Viability of MDA-MB-231(isolated at M D Anderson from a pleural effusion of a patient with invasive ductal carcinoma) cells treated with nano-HA particles and radiation were assessed by MTT assay. Caspase-7 and Poly (ADP-ribose) polymerase protein expressions in samples were examined by the Western blot. X-ray diffraction patterns of our samples were found to be in good correlation with the reference HA peaks. Notably, increasing zinc amount resulted in elevated percentage of beta-tricalcium phosphate, phases. All formulations including pure HA particles were non-cytotoxic in MDA MB 231 cells. On the other hand, low rate Zn-doped HA particles showed significant anti-proliferation effect during irradiation. The combination of irradiation with Zn-doped HA particles also induced apoptosis, demonstrated as cleavage of caspase-7 and PARP proteins. In conclusion, low rate Zn-doped HA enhanced the radiation effect on breast cancer cells

Robotic Stereotactic Radiosurgery In Patients With Nasal Cavity And Paranasal Sinus Tumors

The aim of this retrospective study is to evaluate our therapeutic results in patients with paranasal sinus (PNS) or nasal cavity (NC) malignancies treated with robotic stereotactic radiosurgery (SRS). Between August 2007 and October 2008, 27 patients with PNS or NC tumors were treated in our department using SRS. Median age was 53 years (range, 27-84 years). Eleven patients were female and sixteen were male. Most common histopathology was SCC (44%). The disease involved the maxillary sinus in 15 patients (55%). SRS was applied to 6 patients (22%) for reirradiation, while the others received it as a primary treatment. Seven patients had SRS as a boost dose to external beam radiotherapy. SRS was delivered with cyberknife (Accuray Incorporated, Sunnyvale, CA, USA). The median dose to the tumor was 31 Gy (range, 15-37.5 Gy) in median 5 fractions (range, 3-5 fractions). After a median follow-up of 21.4 months (range, 3-59 months), 76% of the patients were free of local relapse. Three patients showed local progression and 3 developed distant metastases. One- and two-year survival rates for the entire group were 95.2% (SEM = 0.046) and 77.1% (SEM = 0.102), respectively. We observed brain necrosis in 2 patients, visual disorder in 2 patients, bone necrosis in 2 patients and trismus in 1 patient as a SRS related late toxicity. Robotic SRS seems to be a feasible treatment strategy for patients with PNS tumors. Further prospective studies with longer follow up times should be performed.PubMe

Metaplastic Breast Carcinoma: A Heterogeneous Disease

The aim of this study is to evaluate clinicopathologic characteristics and the multi-disciplinary treatment results of metaplastic breast cancer (MBC) patients treated in a single institute. Seventeen female patients with MBC treated in our department between June 2000 and January 2012 were identified and retrospectively evaluated. The median age at diagnosis was 46 years (range, 26-66 years). The median tumor size at diagnosis was 3.5 cm (range 1.5-12 cm). Six (35%) patients underwent breast conservation surgery and 11 (65%) mastectomy. Axillary lymph node metastasis was found in 6 (35%) patients. Twelve (71%) had triple negative tumors. Postoperative RT and systemic adjuvant treatment was given to all patients accordingly to stage and biological characteristics. Median follow-up time was 27 months (range, 12-151 months). At the time of this analysis, 14 (82%) patients were alive with no evidence of disease, and 1 (6%) was alive with disease. The 3-year OS was 91% and 5-year 80%, and DFS rates were 76% and 76%, respectively. Despite the young age of our patients with mostly high grade tumors, larger tumor size and higher rates of lymph node metastasis, the survival outcomes in our study are favorable in comparison with previously reported series.WoSScopu