Albendazole-induced bicytopenia: case report CASE REPORT

A AB BS ST TR RA AC CT T Echinococcosis is a parasitic disease which occurs due to cyst hydatid Echinococcus granulosus and occurs in the liver in 55-70% of cases. Cyst hydatid treatment can be performed in three ways: primary surgery, medical and PAIR (Puncture Aspiration Injection Reaspiration) treatment. Medical treatment can be applied with PAIR in order to decrease post-surgery recurrence and facilitate the treatment in repeating cases. The most commonly used agent in medical treatment is albendazole. The most common albendazole-induced side effect is elevated levels of liver enzymes. It rarely causes bone marrow toxic consequences. We present herein a case with albendazole-induced leukopenia and thrombocytopenia, which to our knowledge has never been reported in the literature. K Ke ey y w wo or rd ds s: : Albendazole, cyst hydatid, leukopenia, thrombocytopenia Ö ÖZ ZE ET T A Al lb be en nd da az zo ol lu un n i in nd dü ük kl le ed di i¤ ¤i i b bi is si it to op pe en ni i: : v va ak ka a s su un nu um mu u Kist hidatik echinococcus granulosusa ba¤l› oluflan ve %55-70 karaci¤erde görülen paraziter bir hastal›kt›r. Kist hidatik tedavisi primer cerrahi olmak üzere, medikal ve PAIR (perkütan aspirasyon injeksiyon reaspirasyon) tedavisi olmak üzere üç flekilde verilebilir. Nüks eden olgularda, cerrahi sonras› rekurrensi azaltmak ve ifllemi kolaylaflt›rmak için PAIR ile birlikte medikal tedavi verilebilir. Medikal tedavide en s›k tercih edilen ajan albendazoldur. Albendazol kullan›m›na ba¤l› en s›k görülen yan etki karaci¤er fonksiyon testi yüksekli¤idir. Kemik ili¤i supresyonuna nadiren neden olur. Bu makalede albendazol kullan›m›na ba¤l› lökopeni ve trombositopeni geliflen bir vakay› literatürde daha önce görülmemesi nedeniyle sunduk. A An na ah ht ta ar r k ke el li im me el le er r: : Albendazol, kist hidatik, lökopeni, trombositopen

Diagnostic delay in rare diseases

OBJECTIVE Post-operative radiotherapy (PORT) in non-small cell lung cancer (NSCLC), especially after complete resection, has long been an unresolved dilemma and debated among therapeutic disciplines. We aimed to evaluate the effects of different radiotherapy volumes and techniques on local-regional recurrence patterns and PORT results in patients with NSCLC. METHODS The results of 389 patients who underwent surgery and received PORT at 11 centers were analyzed retrospectively. The surgical margin was positive or closes in 100 (26%) patients. The PORT dose was a median of 50 Gy (36-60 Gy). Intensity-modulated RT methods were used in 68 (17.5%) patients. RESULTS The first recurrence of the patients who developed relapse, local recurrence was found in 77 (19.8%) patients, distant recurrence was found in 95 (24%) patients, and both recurrences was found in 30 (8%) patients. The median time to locoregional relapse was 14 months (1.84-59.7 months). Local-regional recurrence was not significantly higher in patients with positive surgical margins than in negative pa-tients (39% vs. 29%, p=0.1), but the dose administered to these patients was also higher. Mediastinal recurrence occurred in 28 (19%) patients who did not receive radiotherapy to the mediastinum; 25 of these recurrences (89%) were just near or outside the field. Cardiac events became 7% in all groups and did not change according to chosen mediastinal radiotherapy volume. CONCLUSION A clear description of the PORT volumes according to the localization of the primary tumor and the involved lymph nodes would be beneficial in terms of establishing the recurrence/toxicity balance better

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

Role of Consolidative Thoracic Radiotherapy for Extensive-stage Small Cell Lung Cancer: Trod Thoracic Oncology Study Group 08-006 Multi-institutional Study

OBJECTIV

Risk factors of radiation pneumonitis in patients with NSCLC treated with concomitant chemoradiotherapy--Are we underestimating diabetes?--Turkish oncology group (TOG)/Lung cancer study group

Introduction To evaluate the clinical and dosimetric parameters that increase the risk of radiation pneumonitis (RP) in locally advanced non-small cell lung cancer (NSCLC) patients treated with concomitant chemoradiotherapy of nationwide multicentric data analysis. Methods All data of 268 patients who underwent definitive chemoradiotherapy were retrospectively collected from eight institutes participating in this study. Patient, tumor and treatment-related factors and dosimetric parameters were analyzed for grade >= 2 RP. The toxicity scoring system of The Radiation Therapy Oncology Group used for grading the severity of pneumonitis. A relationship with the risk of RP with potential predictive factors were evaluated by univariate and multivariate analyses. A recursive partition analysis (RPA) was applied to stratify patients according to the risk of developing RP. Results There were 90 (33.6%) patients who had grade >= 2 RP. The median time to pneumonitis after treatment was 4 months (range:1-6 months). In univariate analysis, diabetes mellitus (DM), use of cisplatin/etoposide, total and daily radiotherapy (RT) fraction dose, the planning target volume (PTV) size, mean lung dose, V5, V10 and RT technique were associated with the development of pneumonitis. In multivariate analysis, only DM (P = 0.008) was found to be independent risk factors for RP. According to RPA, the risk of developing RP was highest in patients with DM. Conclusions In our study, besides the known dosimetric factors, DM was found to be the most important risk factor causing RP development in multivariate analysis and RPA. The risk is tripled compared to patients without DM