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

Acute guttate psoriasis associated with streptococcal perianal dermatitis

WOS: 000243200600011PubMed ID: 1716451

Estimating radiation therapy toxicity and tolerability with comprehensive assessment parameters in geriatric cancer patients.

Cancer prevalance and incidence is increasing with aging of populations and age is a critical factor in decision-making for anti-cancer treatment. However it is believed that chronological age is not enough to guide management in elderly cancer patients. Multidisciplinary evaluation and comprehensive geriatric assessment has gained importance regarding the treatment selection especially for definitive anti-cancer therapy recently. We here aimed to analyse the effect of the comprehensive geriatric assessment parameters on radiotherapy toxicity and tolerability in a series of geriatric cancer patients in Turkey

Is there any impact of PET/CT on radiotherapy planning in rectal cancer patients undergoing preoperative IMRT?

Background/aim: To investigate the effect of positron emission tomography-computed tomography (PET/CT)-based contouring on dosimetric parameters in rectal cancer patients undergoing preoperative intensity-modulated radiation therapy (IMRT). Materials and methods: Preoperative radiation therapy plans with conformal radiotherapy (CRT) or IMRT were created and examined according to the CT-and PET/CT-based contouring of 20 rectal cancer patients, retrospectively. Results: The target volumes delineated with PET/CT were significantly larger than the volumes created by CT (P = 0.043). Dose delivered to 98\% of the planning target volume was high in IMRT planning contouring with CT and PET/CT compared with CRT planning, but the difference was not statistically significant (P = 0.056). Percent volumes receiving 105\% of dose and 110\% of dose were low in IMRT planning when compared with CRT (P < 0.0001 and P = 0.044, respectively). The volumes receiving 45 Gy for the small intestine, femur heads, and bladder and the maximum dose received by the bladder were significantly lower in IMRT. Conclusion: We showed that the target volumes created with PET/CT are significantly larger than the target volumes created with CT and that IMRT provides lower radiation exposure to the tumor-free tissues compared to the CRT planning. The dosimetric results primarily favor IMRT planning in rectal cancer patients and consequently present the significant alteration in target volumes

Intensity-Modulated Radiation Therapy Improves the Target Coverage Over 3-D Planning While Meeting Lung Tolerance Doses for All Patients With Malignant Pleural Mesothelioma.

To investigate high conformality on target coverage and the ability on creating strict lung dose limitation of intensity-modulated radiation therapy in malignant pleural mesothelioma

Radical Oncological Surgery and Adjuvan Therapy in Non- Small Cell Lung Cancer Patients over 70 years of Age.

The incidence of lung cancer increases with age. Approximately 50% of non-small cell lung cancer (NSCLC) patients are over 70 years old. Because of the increasing elderly population, treatment approaches in this age group continue to be studied similar to groups of young people

Circulating gelatinases are not prognostic of treatment response and survival in locally advanced rectal cancer patients undergoing preoperative chemoradiotherapy

Purpose: To investigate whether the serum levels of matrix metalloproteinases (MMPs) are predictive on treatment response and survival in locally advanced rectal cancer (LARC) patients undergoing preoperative chemoradiotherapy. Patients and Methods: Serum MMP-2 and MMP-9 was analyzed by enzyme-linked immunosorbent assay and obtained before, midway, and 1-month after the end of preoperative radiotherapy treatment. The prognostic significance of serum MMP-2 and MMP-9 levels and their association with other pathological findings for LARC patients were evaluated. Results: Serum levels of MMP-2 or MMP-9 were found to decrease with increasing clinical stage and negative correlation was statistically significant (P < 0.05). There was no statistically significant difference in tumor response and survival between the low and high MMP-2 and MMP-9 groups. MMP-2 and MMP-9 were not correlated with local-regional recurrence. Conclusions: We propose that serum levels of MMP-2 and MMP-9 are not predictive on treatment response and survival in LARC patients

Intensity-Modulated Radiation Therapy Improves the Target Coverage Over 3-D Planning While Meeting Lung Tolerance Doses for All Patients With Malignant Pleural Mesothelioma

Purpose: To investigate high conformality on target coverage and the ability on creating strict lung dose limitation of intensity-modulated radiation therapy in malignant pleural mesothelioma. Patients and Methods: Twenty-four radiation therapy plannings were evaluated and compared with dosimetric outcomes of conformal radiation therapy and intensity-modulated radiation therapy. Hemithoracal radiation therapy was performed on 12 patients with a fraction of 1.8 Gy to a total dose of 50.4 Gy. All organs at risk were contoured. Radiotherapy plannings were differed according to the technique; conformal radiation therapy was planned with conventionally combined photon-electron fields, and intensity-modulated radiation therapy was planned with 7 to 9 radiation beam angles optimized in inverse planning. Strict dose-volume constraints were applied. Results: Intensity-modulated radiation therapy was statistically superior in target coverage and dose homogeneity (intensity-modulated radiation therapy-planning target volume 95 mean 100\%; 3-dimensional conformal radiation therapy-planning target volume 95 mean 71.29\%, P = .0001; intensity-modulated radiation therapy-planning target volume 105 mean 11.14\%; 3-dimensional conformal radiation therapy-planning target volume 105 mean 35.69\%, P = .001). The dosimetric results of the remaining lung was below the limitations on intensity-modulated radiation therapy planning data (intensity-modulated radiation therapy-lung mean dose mean 7.5 {[}range: 5.6\%-8.5\%]; intensity-modulated radiation therapy-lung V5 mean 55.55\% {[}range: 47\%-59.9\%]; intensity-modulated radiation therapy-lung V20 mean 4.5\% {[}range: 0.5\%-9.5\%]; intensity-modulated radiation therapy-lung V13 mean 13.43\% {[}range: 4.2\%-22.9\%]). Conclusion: With a complex and large target volume of malignant pleural mesothelioma, intensity-modulated radiation therapy has the ability to deliver efficient tumoricidal radiation dose within the safe dose limits of the remaining lung tissue

Clinical Features And Prognostic Factors Of Hodgkin'S Lymphoma: A Single Center Experience

Background: Hodgkin's lymphoma (HL) is a B cell lymphoma characterized by the presence of Reed-Sternberg cells. HL comprises 1% of all cancer cases and 14% of all lymphoma cases. Aims: We designed a retrospective study to investigate the clinical features and prognostic factors of HL patients diagnosed at an experienced oncology centre. Study Design: Retrospective study. Methods: Demographic characteristics, histopathological and clinical features, treatment modalities and response to treatment were obtained from hospital records. Dates of initial diagnosis, remission and relapse, last visit and death were recorded for survival analyses. Results: We analysed data of 391 HL patients (61% male, 39% female; mean age 35.7+/-15.1 years). The most common classical HL histological subtype was nodular sclerosing HL (NSHL) (42.7%). The most common stage was II 50.4%. The most common chemotherapy regimen was doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) (70.6%). Five and 10-year survival rates were 90% and 84%, respectively. Early-stage patients with good prognostic factors had better overall and relapse-free survival rates. The presence of "B" symptoms, albumin level, Eastern Cooperative Oncology Group (ECOG) performance score, and LDH were prognostic factors that affect the survival in both univariate and multivariate analyses. Conclusion: This is the first study that demonstrates the demographic, clinical and prognostic features of HL patients in Turkey, and provides a general picture of the HL patients in our country.WoSScopu