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    Is helical tomotherapy-based intensity-modulated radiotherapy feasible and effective in bilateral synchronous breast cancer? A two-center experience
    (Imprimatur Publications, 2016) Ekici, Kemal; Gokce, Tumay; Karadogan, Ilker; Eraslan, Aysun Fatma; Akcay, Cimen; Temelli, Oztun; Pepele, Eda Kaya
    Purpose: This study describes the early clinical results and dosimetric parameters of intensity-modulated radiation therapy (IMRT) using a tomotherapy device in patients with primary bilateral synchronous breast cancer (PSBBC). Methods: Fourteen patients with bilateral breast cancer were treated with tomotherapy between January 2011 and October 2014. The treatment planning objectives were to cover 95% of the planning target volume using a 95% isodose, with a minimum dose of 90% and a maximum dose of 107%. The organs at risk (OAR), such as the lungs, heart, esophagus and spinal cord, were contoured. Acute toxicity was recorded during and after radiation therapy. Results: The advantages included better treatment conformity with lower dosages to minimize the risk to susceptible organs, such as the lungs, heart and spinal cord. There was improved coverage of the planning target volume, including the regional nodes, without any field junction problems. The median homogeneity index was 0.13 and the median conformity index 1.32. The median V20, V15, V10 and V5 for the total lungs were 18.5, 23.3, 24.2 and 60%, respectively. Skin acute toxicity was grade 1 in 72% and grade 2 in 14% of the patients. Esophageal acute toxicity was grade 1 in 43% of the patients. Conclusion: Tomotherapy delivers treatment that is well-tolerated, with high homogeneity and coverage indexes and the capability to reduce the irradiation dose received by the lungs and heart in PSBBC patients. This technique is therefore feasible and safe for the treatment of bilateral breast cancer.
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    PATTERNS OF CARE FOR LUNG CANCER IN RADIATION ONCOLOGY DEPARTMENTS OF TURKEY
    (Elsevier Science Inc, 2008) Demiral, Ayse Nur; Alicikus, Zuemre Arican; Ugur, Vahide Isil; Karadogan, Ilker; Yoeney, Adnan; Andrieu, Meltem Nalca; Yalman, Deniz
    Purpose: To determine the patterns of care for lung cancer in Turkish radiation oncology centers. Methods and Materials: Questionnaire forms from 21 of 24 (87.5%) centers that responded were evaluated. Results: The most frequent histology was non-small cell lung cancer (NSCLC) (81%). The most common postoperative radiotherapy (RT) indications were close/(+) surgical margins (95%) and presence of pN2 disease (91%). The most common indications for postoperative chemotherapy (CHT) were >= IB disease (19%) and the presence of pN2 disease (19%). In Stage IIIA potentially resectable NSCLC, the most frequent treatment approach was neoadjuvant concomitant chemoradiotherapy (CHRT) (57%). In Stage IIIA unresectable and Stage IIIB disease, the most frequent approach was definitive concomitant CHRT (91%). In limited SCLC, the most common treatment approach was concomitant CHRT with cisplatin+etoposide for cycles 1-3, completion of CHT to cycles 4-6, and finally prophylactic cranial irradiation in patients with complete response (71%). Six cycles of cisplatin + etoposide CHT and palliative thoracic RT, when required, was the most commonly used treatment (81%) in extensive SCLC. Sixty-two percent of centers did not have endobronchial brachytherapy (EBB) facilities. Conclusion: There is great variation in diagnostic testing, treatment strategies, indications for postoperative RT and CHT, RT features, and EBB availability for LC cases. To establish standards, national guidelines should be prepared using a multidisciplinary approach. (c) 2008 Elsevier Inc.