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

Intensity-modulated radiation therapy (IMRT) with couch rotation in right unilateral breast cancer

Background: In this study, intensity-modulated radiation therapy plans were made with and without couch rotation in patients with right unilateral breast cancer, and a dosimetry analysis was carried out to compare the radiation doses received by target and normal tissues. Materials and Methods: The radiotherapy planning tomography sets of 10 patients who underwent right unilateral mastectomies were retrospectively selected. Target volumes and normal at-risk organs were recontoured, two radiotherapy plans were created for each patient, and these plans were compared by dosimetry analyses. Results: Doses in the target volume (D2%, D98, D50, HI, VRI, and T -PTV-V95) were similar between the plans. In terms of organs at-risk doses, the maximum doses in the contralateral breast were similar between the plans, while the differences in all other organs at-risk dose parameters between the plans were statistically significant. All dosimetry parameters of the heart were significantly lower in the plans with couch rotation. Ipsilateral lung doses were higher in the plans with couch rotation. Contralateral lung and mean breast doses were significantly lower in the plans with couch rotation. Conclusion: In this study, organs at-risk doses were reduced, especially for the heart and the contralateral breast, in patients who were subjected to postmastectomy radiotherapy with right thoracic wall and regional nodal irradiation without compromising radiotherapy dose coverage for the target volumes by rotating the treatment couch by 270°

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

The effects of coenzyme Q10 (CoQ10) on Ionizing radiation- induced pancreatic β-cell injury

Objective: This study investigated the antioxidant effect of coenzyme Q10 on ionizing radiation induced oxidative damage in pancreatic & beta;-cells. Methods: Twenty-four male rats were assigned to 4 groups. Group 1 constituted the control group, Group 2 only received a single i.p. dose of coenzyme Q10, Groups 3 and 4 received a total of 4 Gy external x-ray radiation to the abdomen in a single fraction. Group 4 also received a single dose of 200 mg/kg coenzyme Q10 i.p. 30 minutes prior to x-ray irradiation. Results:The x-ray radiation group showed decreased & beta;-cell positivity in the islets of Langerhans compared to the control group on immunohistochemical analysis. In contrast, an increase in & beta;-cells exhibiting insulin positivity was observed in group 4 (ionizing radiation + coenzyme Q10) compared to the irradiation group. Terminal deoxynucleotidyl transferase dUTP nick end labeling assay indicated a rise in the number of apoptotic cells in the x-ray radiation group compared to the control and coenzyme Q10-only groups (Group 2). Meanwhile, we observed a decrease in the number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive apoptotic cells in the islets of Langerhans in the ionizing radiation + coenzyme Q10 treatment group (Group 4) relative to the irradiation group. Conclusion: This study shows that coenzyme Q10 reduces apoptosis in the rat pancreas exposed to abdominal ionizing radiation

Factors affecting mortality at home and hospital in oncology patients and the effect of age

Objective: Several factors assessing cancer mortality and impacting the choice of place of death for terminally ill patients have been previously documented. We examined the relationships between several oncological factors, including age, on cancer mortality and the choice of place of death. Material and Methods: All patient data were collected retrospectively from hospital computer records and medical chart reviews. A total of 2,183 patients admitted to our hospital over 6 years (September 2013-December 2019) were included. Results: A total of 2,183 patients were analyzed, of which 58.5% (n=1,277) of patients died. More deaths occurred in the hospital than at home (n=1,032 vs. n=245). The mean age of patients who died at home was more than those who died in the hospital (mean ages: 68.4±12.5 vs. 63.5±12.5; median ages: 69, range 24-100 vs. 63, range 19-97). The hospital mortality rate of patients <65 years old was statistically higher than patients ≥65 years old. Conclusion: We found that a second primary cancer, metastasis, diagnosis from the primary mass, certain cancer diagnoses (such as lungs, stomach, and brain cancers), locally advanced and metastatic stage cancers, certain histological types, late diagnosis (the first application to branches such as chest diseases, emergency, neurosurgery) negatively affected mortality. In addition, we determined that metastatic, locally advanced stage. and patients aged <65 years of age died more frequently in the hospital

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

Circadian clock on ionizing radiation-induced testicular injury

Objective: This research focuses on the interaction between the circadian clock and the damage caused to testicular tissue by x-ray ionizing radiation. By examining the links between circadian rhythms and radiation -induced testicular damage, a deeper understanding of the underlying mechanisms may emerge, potentially leading to new strategies to mitigate or prevent such damage and its subsequent consequences. Methods: Twenty-four Sprague-Dawley rats were divided into 3 groups. Rats in group 1 (control group) did not undergo any procedures. Rats in group 2 (day) received 6 Gy total body external x-ray radiation in a single fraction between the hours 05:00 and 06:00. Rats in group 3 (night) received 6 Gy total body external x-ray radiation in a single fraction between the hours 19:00 and 20:00. Results: The day group was compared with the control group, and a decrease in spermatogenetic cells and edematous areas was observed. In addition, there was vacuolar accumulation in the cytoplasm of spermatids in the germinal epithelium and necrotic Leydig cells in the intertubular spaces. In the night group, we observed that the changes observed in group 2 were significantly restored. In terminal deoxynucleotide transferase dUTP nick end labeling and 8-hyd roxy-2'-de oxygu anosi ne immunohistochemical analyses, we observed significantly increased immunopositivity in group 2 compared to the control group and group 3. Conclusion: In conclusion, it reveals that the circadian clock protects against testicular damage caused by x-ray ionizing radiation. By regulating DNA repair processes, antioxidant defense mechanisms, and other important pathways, the circadian clock appears to increase the resistance of testicular tissues to radiation stress

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