Yazar "Temelli, Oztun" seçeneğine göre listele
Listeleniyor 1 - 18 / 18
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Can diffusion weighted magnetic resonance imaging (DW-MRI) be an alternative to 18f-FDG PET/CT (18f fluorodeoxyglucose positron emission tomography) in nasopharyngeal cancers?(Scientific Publishers India, 2017) Yildirim, Ismail Okan; Ekici, Kemal; Dogan, Metin; Temelli, Oztun; Kekilli, Ersoy; Saglik, Semih; Erbay, FatihObjective: This study aimed to evaluate correlations, if any, between the ADC (Apparent Diffusion Coefficient) measurements in MRI (Magnetic Resonance Imaging) and SUV max (Standardized Uptake Value) in F-18-FDG PET/CT in patients with nasopharyngeal cancers and to investigate whether DW-MRI (Diffusion Weighted MRI) can be an alternative to F-18-FDG PET/CT in the evaluation of the response to treatment and prognosis in those patients. Methods: This study was performed between January 2015 and February 2016 at Inonu University Medical Faculty, Department of Radiology on 22 patients who were diagnosed with nasopharyngeal cancer by histopathological evaluation at Department of Pathology of the same faculty. Diffusion weighted images were obtained using 1.5 T MRI in all patients. F-18-FDG PET/CT images were obtained approximately 1-2 weeks after the diffusion-weighted images. Results: Two groups were created according to the histological subtypes as keratinized (n: 8) and non-keratinized (n: 14) among the 22 cases with a definitive histopathological diagnosis of nasopharyngeal cancer. No statistical difference was found between the groups in terms of SUVmax, SUVmean and ADC mean values (p> 0.05). ADC mean values measured in patients with nasopharyngeal cancer were statistically significantly and negatively correlated with SUV max (r=-0.619, p< 0.001) and SUV mean values (r=-0.677, p< 0.001). Conclusion: Even though there are anatomic and patient-related limitations of the DW-MRI in nasopharyngeal cancers, we suggest that it may be a complementary and alternative method of F-18-FDG PET/CT in the evaluation of treatment response and prognosis detection in nasopharyngeal cancers.Öğe Combinatorial effect of zoledronic acid and irradiation on the prevention of DMBA-induced precancerogenic changes in the mammary tissues of rats(Wolters Kluwer Medknow Publications, 2016) Gurocak, Simay; Karabulut, Aysun Bay; Tuzcu, Mehmet; Sahin, Nurhah; Temelli, Oztun; Ince, Volkan; Sahin, KazimBackground: At present, the rates of breast cancer are continuously increasing, with over a million new cases being diagnosed worldwide each year. Hence, the development of new breast cancer chemopreventive drugs with acceptable efficacy and toxicity that are suitable for use for a protracted period of time is urgently needed. The present study investigated the potential preventive effects of zoledronic acid [ZOL] and radiotherapy [RT], both alone and in combination, on precancerogenic changes on the breast tissues of females. Materials and Methods: Wistar rats were treated with 7,12-dimethylbenz [a] anthracene [DMBA] at the acute phase. Fifty female rats were divided into seven groups: Control group [I]; ZOL, group [II]; RT, group [III]; DMBA, group [IV]; DMBA + RT, group [V]; DMBA + ZOL, group [VI]; and DMBA + ZOL + RT, group [VII]. Results: The treatment of DMBA-exposed rats with ZOL and RT, both alone and in combination, successfully upregulates the transcriptional levels of Bax, caspase-3, caspase-9, p21, and BRCA 1 in mammary tissues, which may account for the elevated apoptotic activities observed and the eventual inhibition of tumor growth. The administration of RT and ZOL both alone and in combination was found to be effective for inhibiting the DMBA-induced precancerogenic changes on breast tissues and modulating the expression of apoptosis-associated proteins in the acute phase. Conclusions: The combination of RT and ZOL was more effective than either agent alone. Our results suggest that the administration of ZOL and irradiation in combination can offer maximal protection against DMBA-induced mammary precancerogenic changes.Öğe Comparsion of Tomotherapy,Volumetric Arc Therapy and Three-Dimensional Conformal Radiotherapy Planning Techniques with Dosimetric Parameters in Pediatric Craniospinal Radiotherapy(Akad Doktorlar Yayinevi, 2023) Pepele, Eda Kaya; Dirican, Bahar; Temelli, OztunIn present study, the comparison results of craniospinal radiotherapy plans using three different planning techniques including helical tomotherapy (HT), volumetric arc therapy (VMAT) and three-dimensional conformal radiotherapy (3D-CRT) were evaluated in pediatric patients diagnosed with medulloblastoma depending on dosimetric parameters. Ten pediatric patients with medulloblastoma were planned with 3 techniques. Standard-risk medulloblastoma treatment doses of 23.4 Gy in the craniospinal region and 54 Gy in the posterior fossa region were used. When comparing treatment plans, doses of PTV, V95%, maximum PTV dose, homogeneity index (HI) conformity index (CI) criteria were taken into account. When the dosimetric results of PTV are examined; It has been seen that all plans meet the desired criteria, but the target volume coverage of tomotherapy is superior in do-simetric results compared to VMAT and 3D-CRT due to its ability to irradiate at once without field intersection (p< 0.003). It was found that the HI results of the tomotherapy plans and the CI results of the VMAT plans were closer to the criteria expected from the ideal plan. Target max dose were reduced with for tomotherapy and vmat compared to 3DCRT. When all treatment modalities are compared, it can be said that modern radio-therapy techniques may be preferred in Medulloblastoma radiotherapy because they have sufficient target volume coverage, good dose homogeneity and low maximum doses.Öğe Dosimetric Comparison of Adjuvant Pelvic Radiotherapy for Endometrial Cancer using Intensity-Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (VMAT) and Helical Tomotherapy (HT)(Kare Publ, 2019) Temelli, Oztun; Demirtas, Mehmet; Sisecioglu, Mahmut Serdar; Pepele, Eda KayaObjectives:The purpose of the present study is to compare dosimetrically IMRT, VMAT, HT techniques in endometrium cancer adjuvant radiotherapy practice. Methods: The 10 patients to whom we had applied Pelvic RT due to endometrium cancer previously were selected retrospectively. All patients had received TAH+BSO+BPLND. Three different plans were made for the patients as IMRT, VMAT, and HT. Results: The rectum V40 was found to be 53%, 54%, 45% (p=0.002), respectively; and the bladder V45 was 27%, 26%, 20% (p=0.002), respectively. Bowel V40 was found to be 15%,17%,12%, respectively (p=<0.001). Total monitor unit (MU) and beam-on times were found superior at VMAT (<0.001). Bone marrow V40 was found to be 27%, 26%, 33%, respectively (p<0.001). Conclusion: It was found that the three techniques were suitable in terms of planning criteria and OARs. HI and CI were found to be superior at HT. In risky organs, in rectum, bowel and bladder, HT was found to be superior than the others; in terms of bone marrow, IMRT was found to be superior; and in terms of bone, VMAT was found to be superior. VMAT has the advantage of having short treatment time and low MU.Öğe Dosimetric comparison of helical tomotherapy and hybrid (3DCRT-VMAT) technique for locally advanced non-small cell lung cancer(Cambridge Univ Press, 2021) Temelli, Oztun; Demirtas, Mehmet; Ugurlu, Berat TugrulAim: The purpose of the present study is to compare hybrid [three-dimensional conformal radiation therapy-volumetric-modulated arc therapy (3DCRT-VMAT)] and helical tomotherapy (HT) techniques in terms of both planning target volume (PTV) and organs at risk (OARs) in the plans we made in locally advanced non-small cell lung cancer (NSCLC) patients Material and methods: Radiotherapy was planned for 15 locally advanced NSCLC patients with 2 different techniques. Large tumours with positive mediastinal lymph nodes were preferred. The prescription dose was determined as 60 Gy at 30 fractions. Results: Mean PTV volume was 602 center dot 5 cc (range: 265-1461). Mean total lung volume was 4264 cc (range: 1885-6803). Homogeneity index, D-mean, D-max, D-2 and V-105 were found to be lower in HT, V-100, total monitor units (MU) and total beam on time were found to be lower in the hybrid plan. Total lung D-mean was found to be 17 Gy in both techniques. V-10 value was 42 center dot 85 in the hybrid plan and 48 center dot 67 in HT (p = 0 center dot 037). Heart D-mean was 14 center dot 5 Gy in the hybrid plan and 18 center dot 7 in HT (p < 0 center dot 001), and V-30 values were 18 center dot 1 and 22 center dot 9, respectively (p = 0 center dot 009). Conclusion: Suitable dose coverage and OAR doses can be provided with both techniques. Especially the opposite lung, heart and oesophagus doses can be kept lower with the hybrid plan, and lower MU and shorter beam on time can be provided.Öğe Dosimetric Evaluation of Deep Inspiration Breath-Hold Technique for Breast Cancer Radiotherapy: A Single-Center Experience(Kare Publ, 2020) Temelli, Oztun; Demirtas, Mehmet; Ugurlu, Berat Tugrul; Pepele, Eda Kaya; Yaprak, Bahaddin; Gulbas, Hulya; Eraslan, Fatma AysunOBJECTIVE To retrospectively evaluate the absorbed doses of organs at risk, such as lungs and the heart of the patients who underwent radiotherapy (RT) using the voluntary deep inspiration breath-hold (vDIBH) technique, and to compare the results with the literature. METHODS In this study, 102 patients who underwent adjuvant RT for the treatment of breast cancer in our clinic between November 2018 and December 2019 were included. A breast and/or chest wall, and/or lymph node RT of 50 Gy in 25 fractions was planned for all patients, and an additional boost of 10 Gy in five fractions was planned for patients requiring an RT boost. The treatment plans included 3DCRT, Field in Field (FIF), IMRT and VMAT approaches. RESULTS In the group undergoing supraclavicular fossa RT, the mean V20Gy was found to be 24.8%, compared to 16% in the group not undergoing supraclavicular fossa RT (p<0.01). In the group undergoing mammaria interna RT, the mean heart dose was 3.1 Gy, compared to 2.1 Gy in the group not undergoing mammaria interna RT (p=0.04). CONCLUSION Respiratory motion control techniques can reduce uncertainties in the target related to respiratory motion. The irradiated volume doses of the ipsilateral lung, heart reduce.Öğe Effect of different doses of radiation on morphogical, mechanical and chemical properties of primary and permanent teeth-an in vitro study(Bmc, 2020) Duruk, Gulsum; Acar, Burcin; Temelli, OztunBackground Radiotherapy, applied to the head and neck region, can cause radiation side effects such as reduction of saliva and radiation caries. The aim of this study was to perform an in vitro assessment of the effects of radiation therapy on the morphological, mechanical, and chemical properties of primary and permanent teeth. Methods One hundred four extracted human teeth (52 impacted wisdom teeth, 52 primary molar teeth) were used. The teeth were divided into two parts in the mesiodistal direction. Of the 98 teeth, the vestibular sections were used for the vickers analysis and lingual sections were used for the Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES) analysis. The teeth in the experimental group were fixed to wax models. Each model had an equal number of teeth (n = 7). The doses were applied to the teeth for 6 weeks; 5 week days and 2Gy daily. After the radiotherapy was conducted weekly, a wax model was taken from radiation reception. Along with the elemental contents (Na, K, Mg, P, and Ca) of the teeth, enamel and dentin microhardness was evaluated, and SEM analyzes were performed on 6 teeth. Results Radiation caused a decrease in microhardness of enamel and dentin (p < 0.05). In the elemental analysis by ICP-OES, it was observed that there were decreases in all elements after 60Gy compared to the control group (p < 0.05). In the experimental groups, amorphous structures were encountered in SEM images. Conclusions Radiation has negative effects on the teeth structure and additional studies are needed in this regard. This study indicates that radiotherapy patients are at a higher risk for dental caries.Öğe The Effect of Prognostic Factors and Adjuvant Radiotherapy on Survival in Patients with High-Grade Early-Stage Endometrial Cancer: A Retrospective Clinical Study(Int Scientific Information, Inc, 2019) Yilmaz, Ercan; Gurocak, Simay; Melekoglu, Rauf; Koleli, Isil; Faydali, Simge; Temelli, Oztun; Yar, TubaBackground: This retrospective clinical study aimed to investigate the effect of prognostic factors and adjuvant radiotherapy in patients with high-grade early-stage endometrial cancer on overall survival (OS) and disease-free survival (DES). Material/Methods: The medical records of patients diagnosed with high-grade, early stage (I or II) endometrial adenocarcinoma who had received adjuvant radiotherapy after surgery were reviewed. Results: Seventy-nine patients included 39 patients (49.4%) with stage II endometrial cancer, 25 patients (31.6%) with histologic grade 3 tumors, and 47 patients (59.5%) with endometrial cancer showing lymphovascular space invasion (LVSI). There were 45 patients (57.0%) who received external pelvic radiotherapy with an average dose of 46.0 Gy (range, 11.2-50.4 Gy), and 34 patients (43.0%) received vaginal brachytherapy (VBT) with an average dose of 21.5 Gy (range, 10-36 Gy). Multivariate analysis showed that tumor stage (HR, 4.066; 95% CI, 1.227-13.467; p=0.022) and histologic grade (HR, 16.652; 95% CI, 4.430-62.589; p<0.001) were independent predictors for OS. Increased serum CA-125 levels (HR, 1.136; 95% CI, 0.995-1.653; p=0.047) and histologic grade (HR, 3.236; 95% CI, 1.107-15.156; p=0.015) were independent predictors for DES. Adjuvant radiotherapy was not found to be significantly associated with improved OS (HR, 1.259; 95% CI, 0.518-3.058; p=0.612) or DES (HR, 1.056; 95% CI, 0.994-1.123; p=0.078). Conclusions: This retrospective study showed that in high-grade early-stage endometrial cancer treated with postoperative adjuvant radiotherapy, independent predictors for OS were tumor stage and grade. Adjuvant radiotherapy was not associated with improved OS or DES.Öğe The evaluation of depression, anxiety and quality of life in children living with parental cancer: A case-control study(Klinik Psikiyatri Dergisi, 2021) Karayagmurlu, Ali; Naldan, Muhammet Emin; Temelli, Oztun; Coskun, MuratObjective: Parental cancers may have adverse effects on children and adolescents. The majority of studies on this subject have been performed in Western societies, and few have investigated quality of life in children. The purpose of this study was to investigate quality of life, anxiety and depressive symptoms in children living with parental cancer. Method: The case group consisted of 50 children, aged 8-16 years old, with a parent diagnosed with cancer. A group of 50 children, aged and gender matched, with healthy parents was included as the control group. All subjects were administered the Revised Child Anxiety and Depression Scale (RCAD-S) to assess the symptoms of anxiety and depression. Parents completed the Questionnaire for Quality of Life Assessment for Children and Adolescents: Parent Form to determine the child's quality of life. Results: Depression (p=0.011) and anxiety (p=0.011) scores were significantly higher in the case group than in the control group. Among the anxiety disorder symptoms, symptoms of separation anxiety were more common in case group (p=0.032). Compared to the control group, the case group reported a significantly lower quality of life (p=0.045). Discussion: Children of parents with cancer may suffer from anxiety and depression that may reduce their quality of life. Clinicians should collaborate with relevant disciplines and have a family-based, multidimensional view when evaluating patients with cancer who have children. Consulting or refering to child psychiatry may be considered when emotional and/or behavioral problems present in children.Öğe Evaluation of the dose received by ovaries in the treatment of a desmoid tumour presenting in the lower extremity using intensity-modulated radiotherapy tomotherapy(Cambridge Univ Press, 2017) Us, Songul Barlaz; Temelli, OztunBackground Desmoid tumour is a rare neoplasm occurring intra- and extra-abdominally. Method In this study, a lower extremity desmoid tumour located close to the ovaries was irradiated with tomotherapy after surgery in a 16-year-old female patient. 30 fractions defined for delivery of 54 Gy were administered to the patient. Result The planning target volume and organs at risk doses were evaluated and the ovary doses were discussed for fertility. Conclusion The patient tolerated the radiotherapy well. During radiotherapy, only grade 1 skin toxicity occurred.Öğe The impact of the field width on VMAT plan quality and the assessment of half field method(Wiley, 2020) Ugurlu, Berat Tugrul; Temelli, OztunPurpose The goal of this work is to investigate the field width dependence of the volumetric modulated arc therapy (VMAT) plan quality and to propose a half field method to irradiate large volumes effectively with VMAT. Materials and methods We compared four different VMAT methods; namely three full field (3ff), four full field (4ff), three half field (3hf), four half field (4hf). To evaluate the impact of the field width on VMAT plan quality, 12 different size PTVs were created in the virtual phantom and treatment plans generated for each PTV were compared. The effectiveness of our half field method was tested using computed tomography (CT) data of 10 nasopharyngeal carcinoma patients. Results In the virtual phantom study, organs at risk (OAR) mean dose, the maximum point dose, and Homogeneity Index (HI) were found to be field width dependent. Conformation Number (CN) was not significantly affected. In the clinical study, 4hf plans obtained statistically significant dose reduction at brainstem (P < 0.001), right parotid (P = 0.034), oral cavity (P < 0.001), larynx (P = 0.003), cochlea (P = 0.017), lips (P = 0.024), and Body-PTV (P = 0.04) compared to 4ff plans. Conclusion Our results indicate that VMAT plan quality is dependent on the field width. Half field VMAT method, with the help of reduced field width, shows a clear advantage for the irradiation of large size targets compared to traditionally used full field VMAT plans.Öğe 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 KayaPurpose: 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.Öğe Outcomes of radiotherapy in early stage glottic laryngeal carcinoma: a single center experience(Medicine Science, 2016) Ekici, Kemal; Temelli, Oztun; Eraslan, Ayse Fatma; Gurocak, Simay; Kaplan Bozdag, Nihal; Elkiran, Emin Tamer; Kekilli, Ersoy; Kizilay, Ahmet[Abstract Not Acailable]Öğe POSTERIOR REVERSIBLE LEUKOENCEPHALOPATHY SYNDROME DEVELOPING SECONDARY TO SUNITINIB THERAPY IN A PATIENT WITH METASTATIC RENAL CELL CARCINOMA(Carbone Editore, 2018) Kaplan, Nihal Bozdag; Harputluoglu, Hakan; Dikilitas, Mustafa; Elkiran, Emin Tamer; Temelli, OztunPosterior reversible encephalopathy syndrome (PRES) is characterized by vasogenic edema occurring generally in parietal and occipital areas of the brain as a result of different etiologic causes and it is diagnosed by means of clinical and radiologic assessment. Sunitinib is an orally administered tyrosine kinase inhibitor used in the treatment of renal cell carcinoma with its antiangiogenic and antitumor effects. Fatigue, nausea-vomiting, diarrhea, hypertension, cardiotoxicity, hypothyroidism, neutropenia, and skin toxicity are among common side effects associated with sunitinib therapy. The current report presents a female patient with metastatic papillary renal cell cancer who developed posterior reversible encephalopathy syndrome as determined by means of clinical and radiologic assessment at 8 months of sunitinib therapy and who completely recovered with antihypertensive, antiepileptic, and antiedema therapy.Öğe Posterıor reversıble leukoencephalopathy syndrome developıng secondary tosunıtınıb therapy ın a patıent wıth metastatıc renal cell carcınoma(Carbone edıtore, vıa quıntıno sella, 68, palermo, 90139, ıtaly, 2018) Kaplan, Nihal Bozdag; Harputluoglu, Hakan; Dikilitas, Mustafa; Elkiran, Emin Tamer; Temelli, OztunPosterior reversible encephalopathy syndrome (PRES) is characterized by vasogenic edema occurring generally in parietal and occipital areas of the brain as a result of different etiologic causes and it is diagnosed by means of clinical and radiologic assessment. Sunitinib is an orally administered tyrosine kinase inhibitor used in the treatment of renal cell carcinoma with its antiangiogenic and antitumor effects. Fatigue, nausea-vomiting, diarrhea, hypertension, cardiotoxicity, hypothyroidism, neutropenia, and skin toxicity are among common side effects associated with sunitinib therapy. The current report presents a female patient with metastatic papillary renal cell cancer who developed posterior reversible encephalopathy syndrome as determined by means of clinical and radiologic assessment at 8 months of sunitinib therapy and who completely recovered with antihypertensive, antiepileptic, and antiedema therapy.Öğe Prophylactic cranial irradiation in small cell lung cancer: A single-center experience.(Allied Acad, 2017) Temelli, Oztun; Bozdag, Nihal Kaplan; Eraslan, Fatma Aysun; Gulbas, Hulya; Gurocak, Simay; Dikilitas, MustafaObjective: Small-Cell Lung Cancer (SCLC) constitutes about 15% of all lung cancers. It tends to frequently metastasize to the brain. Prophylactic Cranial Irradiation (PCI) is performed, when the penetration of chemotherapeutic agents to brain is insufficient. The aim of this study was to report our single-center experience with PCI in SCLC cases. Methods: We retrospectively reviewed 28 patients with SCLC diagnosed between March 2007 and November 2016. Cranial Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) was performed from all patients to exclude metastasis before PCI. Radiation Therapy (RT) was conducted using two different instruments: a three-dimensional conformal RT-based Linear Accelerator (LINAC) instrument was used until 2013 and an Intensity-Modulated Radiation Therapy (IMRT) thereafter. All patients were treated with a total of 25-36 Gy with fraction doses of 2-2.5 Gy. Overall survival was estimated in all patients. Results: The mean age was 56 (range: 36 to 72) y. Only one of the patients was female, while the remaining patients were all males. Twenty two patients (78.5%) were in limited stage SCLC, while six patients (21.5%) were in the extensive stage. Seventeen patients died, while 11 of them survived. The mean survival was 35 months, while it was 40 months for limited stage and 17 months for extensive stage (p=0.027). One, two, and five-year OS rates were 81.4%, 58%, and 17%, respectively. Four (14%) patients developed brain metastasis during follow-up. Of these patients, two were treated with Whole Brain RT (WBRT), one with Stereotactic RT (SBRT), and the other with best supportive care. Conclusion: Our study results suggest that PCI is a safe, low-toxicity treatment modality used to prevent brain metastases in SCLC cases.Öğe Small Cell Neuroendocrine Tumor of the Larynx: Two Case Reports(Kare Publ, 2017) Temelli, Oztun; Bozdag, Nihal Kaplan; Akatli, Aysenur; Yaslikaya, Serhat; Dikilitas, MustafaNeuroendocrine tumors of the larynx account for<1% of all laryngeal cancers. Laryngeal small cell carcinomas of the neuroendocrine type (SCNC) account for <0.5% of all laryngeal tumors. We report two cases of 65-and 75-year old men with small cell carcinoma of the supraglottic larynx. The patients were treated with induction chemotherapy (cisplatin-etoposide) and chemoradiotherapy (cisplatin-etoposide). The first patient was alive until 26 months from diagnosis. However, multiple brain metastases developed in the second patient, and he died 16 months after diagnosis. Small cell neuroendocrine carcinomas are very aggressive neoplasms. A combination of platinum-based chemotherapy and radiotherapy is the mainstay of the treatment for SCNC, which is considered to be a systemic disease.Öğe Survival and prognostic factors in patients with brain metastasis: Single center experience(Zerbinis Medical Publ, 2016) Ekici, Kemal; Temelli, Oztun; Dikilitas, Mustafa; Dursun, Ibrahim Halil; Kaplan, Nihal Bozdag; Kekilli, ErsoyPurpose: The purpose of this study was to evaluate the clinical status, prognostic factors and treatment modalities affecting survival in patients with brain metastasis. We aimed to evaluate the whole brain radiation therapy (WBRT) outcomes of patients with brain metastasis in our center. Methods: Clinical data of 315 patients referred to our center between 2004 and 2014 with metastatic brain cancers were collected and analysed for possible relationships between survival time, age, gender, Karnofsky performance status (KPS), recursive partitioning analysis (RPA), primary tumor, number of brain lesions, surgery, radiation therapy scheme, extracranial metastatic status and primary disease control status. Results: The average patient age of onset was 58 years. The primary tumor site was lung (68%), breast (12%), melanoma (4%), colorectal (1.6%), sarcoma (1.3%) and unknown primary disease (4.4%). The rest of the patients had other primary sites. Eighty four (26.6%) patients had single brain metastasis, 71 (22.5%) had 2 or 3 lesions, and 159 (50.4%) patients had more than 3 lesions. Leptomeningeal involvement was seen in combination of paranchymal involvement in 11 (3.5%) patients. Fifty patients had undergone surgical resection. WBRT was delivered to all of the patients. Median overall survival was 6.7 months (95% CI, 5.80-7.74). Median overall survival of patients treated with combination of surgery and WBRT was significantly better compared with those treated with WBRT alone (13.5 vs 5.5 months, p=0.0001). One- and 2- year survival was 17 and 4.7%, respectively. Conclusions: The present study concludes that brain metastasis is common in cancer patients. The best overall survival was obtained by surgery+NBRT in good-condition patients. Treatment should be tailored on an individual basis to all these patients.
