Factors that are effective in surgery preferences of patients diagnosed with breast cancer who are admitted to radiation oncology clinics

OBJECTIVE In this study, the factors affecting the choice of treatment were investigated in patients diagnosed with breast cancer who were treated with breast-conserving surgery or mastectomy. METHODS Factors that may be effective in surgical choice were aimed to be determined by retrospectively examining patient files regarding age, pathological type, diameter and lateralization of the tumor, number of lymph nodes in the axilla, estrogen and progesterone receptor (ER and PR), c-erbB-2 status, the place of residence, center of operation and distribution of patients according to years. The relationships among the data in this study were examined using statistical methods. RESULTS The mean age of the patients was 52.06±11.91 (age range: 28–86). Tumor lateralization was the right side in 44.4% of the patients and the left side in 55.6% of the patients. There were significantly more modified radical mastectomy (MRM) surgeries in the cases with left-sided lateralization and more breastconserving surgeries (BCS) in the patients with right-sided lateralization (p=0.001). Significantly more BCSs were found to be performed when the tumor diameter was less than 2.5 cm, and more MRMs were performed as the nodal stage increased (p=0.000, p<0.001). The patients with positive PR receptors were treated with BCS significantly more frequently (p=0.005). The presence of radiotherapy facilities increased the frequency of BCSs, and the MRM rates were higher in the patients living in rural areas. CONCLUSION We found that the patients with good prognostic characteristics known for breast cancer were more frequently treated with BCSs, whereas the patients with poor prognostic characteristics were more frequently treated with MRMs. We also found that being younger, living in a city, having right-sided lateralization and radiotherapy facilities increased the choice of BCS

Chemoradiotherapy for elderly patients with rectal cancer: A single‑institution study

Introduction: The incidence of cancer, particularly rectal cancer (RC), in older adults is gradually increasing. The aim of the present study was to evaluate radiotherapy (RT) and chemoradiotherapy (CRT) results, clinicopathological features, and survival factors in older patients with RC. Methods: We evaluated patients aged ≥65 years with RC treated at a radiation oncology clinic. The demographic, clinical, and histopathological data of the patients were obtained by reviewing their medical records. The toxicity criteria of the Radiation Therapy Oncology Group were applied. Results: Among 401 patients with RC, 183 (45.6%) were older adults (65–92 years). Furthermore, 122 (66.7%) patients had clinically stage 3 and above RC, and 183 and 91 patients received RT and neoadjuvant CRT, respectively. Surgical treatment was performed for 116 (63.4%) patients, 41 (34.4%) and 76 (65.6%) of whom underwent postoperative CRT and preoperative RT, respectively. Grade 3 or higher toxicity was observed in 22 (18.9%) patients during CRT. RT was performed in 64 patients(35%) at a 1–15‑day interval. The mean follow‑up duration was 34.7 (range, 1.4–149.0) months. The 2‑ and 5‑year overall survival (OS) rates were 71.4 and 37.4%, respectively, and the 2‑ and 5‑year disease‑free survival (DFS) rates were 65.7 and 35.3%, respectively. OS was 49.4 and 34.9 months for patients aged 65–74 and ≥75 years, respectively. Survival was shorter in patients with the advanced geriatric disease (p = 0.013). In the multivariate analysis, factors affecting overall and DFS were age, distance from the tumor to the anal canal, and metastasis (p < 0.05). Conclusion: The results of this study suggested that the selection of treatment modalities for older patients with RC should be based on performance status and not age. RT and CRT were safe treatment modalities for older patients with RC, particularly for those who could not undergo surger

COVID-19 vaccine immunity in oncology patients

BACKGROUND: To investigate the effect of vaccine types applied in our country against 2019 coronavirus disease on the formation of protective antibodies in oncology patients. MATERIALS AND METHODS: The data of 81 cancer patients who received at least one dose of vaccine for COVID-19 and radiotherapy were analyzed retrospectively. At any time after the vaccination, blood samples were taken and the antibody titers against the vaccine were measured. RESULTS: There were 28 (34.6 %) patients who received two doses of vaccine and 48 patients (59.3 %) who received 3 doses of vaccine (Sinovac only), while 26 patients (32.1 %) were given both vaccines. The mean time for antibody measurement was 62 days after the last vaccination. IgG levels were significantly higher in patients who received Biontech vaccine than in those who received Sinovac (r = 0.525; p < 0.001). While chemotherapy was the factor that decreased the mean IgM level (p = 0.044), advanced disease (stages 3 and 4) was a significant factor that increased the mean IgG level (p = 0.047). A statistically significant negative correlation was found between IgM antibody level and WBC count after first vaccination (r = ‒0.251; p = 0.024). For every WBC count unit increase in the first vaccination period, there was a 1.333-fold increase in the risk of IgM negativity. CONCLUSION: The Biontech vaccine produced higher antibody levels in advanced oncology patients. While the application of radiotherapy in cancer patients was not found to be an effective factor in the vaccination status, it was determined that the application of chemotherapy significantly reduced IgM levels (Tab. 5, Ref. 28). Text in PDF www.elis.skRecep Tayyip Erdogan University ; Coordination Unit for Projects of Scientific Researc

Comparison of DNA isolation methods from mammalian sperm cells and development of a new protocol

Sperm DNA tightly packed with protamines makes the DNA isolation procedure from sperm cells long and laborious. Cell lysis is also a challenging step because of the disulfide bonds-rich membranes of the sperm cells. In this study we aimed to evaluate potential rapid DNA isolation protocols to isolate DNA from mammalian sperm cells, and develop an easy, rapid, and cost-effective protocol for sperm DNA isolation which can be used in molecular biology and diagnostics. Sperm samples were collected from seven adult rats. Our developed protocol included Proteinase K and small amount of β-mercaptoethanol (βME) for cell lysis. A modified salting-out technique was then employed to collect DNA. Alternative protocols involving InstaGene matrix and cell sonication techniques were also applied to achieve DNA isolation. Concentration of the DNA yield was measured, and the degradation of DNA was checked using agarose gel electrophoresis. The intactness of the DNA yield was assessed and validated using polymerase chain reaction (PCR) and capillary gel electrophoresis techniques. The lysis of the cells and high-quality DNA yield have only been achieved using our developed optimized protocol. To confirm the quality of DNA for assays, PCR product was synthesized for rat actin β (RActβ) gene and then analyzed using capillary gel electrophoresis. A strong peak at right m/z value for the amplicon was obtained. We described an improved protocol over the previous methods suggesting the use of combined commercial kits and long incubation times

Mucinous Cystadenocarcinoma of the Breast with Estrogen Receptor Expression: A Case Report and Review of the Literature

Primary mucinous cystadenocarcinoma (MCA) of the breast was first described by Koenig and Tavassoli in 1998. To our knowledge, only 9 cases of MCA of the breast have been reported. The optimal treatment of MCA could not be defined yet. This article aims to increase the knowledge about this rare variant of breast cancer and to review the literature

The protective effects of red ginseng and amifostine against renal damage caused by ionizing radiation

This study aimed to elucidate the effects of amifostine (ethyol) (AM), a synthetic radioprotector, and red ginseng (RG), a natural radioprotective agent, against the toxic effect of ionizing radiation (IR) on kidney tissues through changes in biochemical and histopathological parameters in addition to contributions to the use of amifostine and RG in clinical studies. Five groups were established: Group I (control, receiving only saline by gavage), Group II (IR only), and Group III (IR+AM, 200 mg/kg intraperitoneally (i.p.). Group IV (IR + RG, 200 mg/kg orally once a day for 4 weeks), and Group V (IR+RG+AM, 200 mg/kg orally once/day for 4 weeks before IR and 200 mg/kg AM administered (i.p.) 30 min before IR). All groups, except for the control group, were subject to 6-Gy whole-body IR in a single fraction. 24 h after irradiation, all animals were sacrificed under anesthesia. IR enhanced MDA, 8-OHdG, and caspase-3 expression while decreasing renal tissue GSH levels (p < .05). Significant numbers of necrotic tubules together with diffuse vacuolization in proximal and distal tubule epithelial cells were also observed. The examination also revealed substantial brush boundary loss in proximal tubules as well as relatively unusual glomerular structures. While GSH levels significantly increased in the AM, RG, and AM+RG groups, a decrease in KHDS, MDA, 8-OHdG, and caspase-3 expression was observed, compared to the group subject to IR only (p < .05). Therefore, reactive oxygen species-scavenging antioxidants may represent a promising treatment for avoiding kidney damage in patients receiving radiation

Positron emission tomography-computed tomography use during the COVID-19 pandemic outbreak

Sir, The severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), which first appeared in Hubei/China, has spread worldwide quite rapidly since December 2019.[1] In the current scenario, it is difficult to predict when and how long the pandemic will continue. Patients with cancer are also more susceptible to infection and more likely to have serious events due to the immunosuppressive condition. However, it seems as though patients of oncology were not included in the management strategies during this pandemic; they must be remembered and be able to continue their treatments

Akciğer Kanseri Tanılı Hastalarda Koagülasyon Test Değerlerinin Tanı Anındaki Evreyle İlişkisi

INTRODUCTION: In this study, the effects of changes in coagulation tests on survival and distant organ metastasis in lung cancer patients were investigated. METHODS: We retrospectively evaluated the data of patients who were diagnosed with primary lung cancer by our radiation oncology clinic. The relationship between age, sex, histopathological diagnosis, metastasis status and coagulation test values and lifespan were analyzed. RESULTS: A total of 342 patients were included in the study. 18,4% of the patients had small cell lung cancer (SCLC), and 81,6% had non-small cell lung cancer (NSCLC). Adenocarcinoma (45.0%) was the most common histopathological subtype in patients with NSCLC. When distant organ metastasis rates were handled for all patients, while there weren’t distant organ metastasis in 44.4% of patients, distant organ metastasis was found out in 55.6% of the patients. 65.1% of patients with SCLC and 53.4% of patients with SCLC were in advanced stages with distant organ metastasis. 18.4% of the patients had brain metastasis, and 81.6% had no brain metastasis. There was no statistically significant effect of APTT, PT, INR, % PT which are among the coagulation tests, and fibrinogen values on brain metastasis status and survival (p> 0.05). However, in patients with brain metastases, increase in the ratio close to statistical significance the INR and% PT values was found (p = 0.068, p = 0.059, respectively) when compared to the non-men. DISCUSSION AND CONCLUSION: In the case of lung cancer, an increase in the frequency of brain metastasis may be associated with the hypothesis that prolongation of the coagulation test and deterioration of the blood-brain barrier, but there is a need for extensive studies with more patients.GİRİŞ ve AMAÇ: Bu çalışmada akciğer kanserli hastalarda koagulasyon testlerindeki değişikliklerin sağkalım ve uzak organ metastazı üzerine etkisi araştırıldı. YÖNTEM ve GEREÇLER: Çalışmamız, hastanemiz radyasyon onkolojisi kliniğine başvuran primer akciğer kanseri tanısı almış hastaların verileri retrospektif değerlendirilerek yapıldı. Ya?, cinsiyet, histopatolojik tanı, metastaz durumu ile koagulasyon test değerleri ve yaşam süresi arasında ilişki analiz edildi. BULGULAR: Çalışmaya toplam 342 hasta dahil edildi. Hastaların %18.4’ü küçük hücreli akciğer kanseri (KHAK) iken %81.6 küçük hücreli dışı akciğer kanseri (KHAK) tanısına sahipti. KHDAK’li hastalarda en sık görülen histopatolojik alt tip Adenokarsinom (%45.0) idi. Tüm hastalar için uzak organ metastaz oranlarına bakıldığında hastaların %44.4’ünde uzak organ metastazı yokken, %55.6’sında uzak organ metastazı vardı. KHAK’li hastaların %65.1’i, KHDAK’lı hastaların ise %53.4’ü uzak organ metastazı olan ileri evre olgulardı. Hastaların %18.4’ünde beyin metastazı varken, %81.6’sında ise beyin metastazı yoktu. Koagulasyon testlerinden APTT, PT, INR, %PT ve fibrinojen değerlerinin beyin metastazı durumu ve sağkalım üzerine istatistiksel anlamlı etkisi saptanmadı (p>0.05). Ancak beyin metastazı olanlarda, olmayanlarla karşılaştırıldığında INR ve %PT değerlerinde istatiksel olarak anlamlılığa yakın oranda artış tespit edildi (sırasıyla p=0.068, p=0.059). TARTIŞMA ve SONUÇ: Akciğer kanseri olgularında koagulasyon testlerindeki uzama ile kan beyin bariyerinin de bozulduğu hipotezi ile ilişkili olarak beyin metastazı sıklığında artış oluşabilir ancak daha fazla hasta sayısının olduğu geniş kapsamlı çalışmalara ihtiyaç vardır

An urban legend: Malignant transformation caused by radiotherapy in patients with presacral ganglioneuroma. The necessity and first-time administration of radiotherapy. Case report and literature review

Ganglioneuromas (GNs) are well-differentiated, rare benign tumors of neural crest origin and are, for the most part, considered to be the benign equivalent of neuroblastomas. There are very few cases of GN reported to be at presacral location in the literature. The standard form of treatment is the total surgical excision. However, total resection of GN is not always possible depending on the neuron, from which it originates, and its localization. Moreover, adjuvant radiotherapy (RT) or chemotherapy is not recommended even though patients are still symptomatic after subtotal resection. This view is based on the urban legend that it undergoes a malignant transformation although it is a benign tumor. Moreover, there are no data indicating that the GN cases reported in the literature have undergone RT. Therefore, articles about the suspicion that GN may undergo spontaneous or malignant transformation after RT are absolutely controversial. Based on our case, we present here, we believe that we will explain the valid necessity of application of RT that we administered for the first time and that with the clarification of this controversial topic, a significant gap will be closed in the literature

Total Scalp Irradiation: The Comparison of Five Different Plans Using Volumetric Modulated Arc Therapy- Simultaneous Integrated Boost (VMAT-SIB) Technique

The aim of this study was to show that the optimum dosage can be delivered to the target organs at risk (OAR) by radiotherapy, which becomes more complicated because of technical difficulties arising from irregular, convex, and complex geometrical structure of the target, such as scalp irradiation, and because of situations resulting from the necessity of bolus of the lesion and immobilization as well as the proximity to neighboring critical organs using the VMAT-SIB technique. METHODSFive different VMAT-SIB schemes were designed using the Varian Trilogy IX linear accelerator (Varian Medical Systems) for total scalp irradiation and bilateral neck irradiation. These different VMAT scehemes were compared with respect to a dose volume histogram of obtained data, homogeneity, indices, conformity index, OAR, and doses of target volumes.RESULTSThe patient-designed bolus plan 1 with two isocenters was chosen as the most appropriate plan. Plans 2, 3, 4, and 5 were inappropriate plans because the application of the virtual bolus in plan 2 was difficult, plan 3 with one isocenter was unacceptable with respect to the value of conformity index, plan 4 with three isocenters had a matching field, and plan 5 in which different priority values were used had an increase in OAR doses.CONCLUSIONVMAT-SIB can be preferred as an appropriate radiotherapy technique as it can provide optimum and allowable OAR doses in tumors requiring an intensive treatment planning effort