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Öğe Acute radiation-aloe vera induced dermatitis in a malignant eccrine tumor of left gluteal region: A case report(2006) Topkan E.; Gülbaş H.A 67 year-old female with the diagnosis of malignant eccrine tumor of left gluteal region was treated with radiation therapy. Concurrent with radiation therapy, a topical aloe vera cream was applied to prevent acute skin toxicity of radiation therapy. On the third day of treatment she presented with lesions mimicking a grade 3 acute radiation-induced dermatitis limited to the radiation portal. Radiation therapy and aloe vera cream was discontinued urgently and topical prednisolone was applied. Patch test for aloe vera was negative. One week later all lesions disappeared and remaining course of radiation therapy was continued without further skin toxicity. The evidence for early skin reaction in this case is suggestive of radiation-aloe vera induced dermatitis.Öğe The levels of urine calcium and deoxypyridinoline in patients with metastatic bone disease treated with palliative radiotherapy(2004) Topkan E.; Özyi?it G.; Gülbaş H.; Karao?lu A.We prospectively evaluated the predictability of urine calcium and deoxypyridinoline (DPD), the two bone resorption markers, in the assessment of objective response to palliative radiation therapy (RT) for metastatic bone disease. Nineteen patients with radiographic evidence of metastatic bone disease due to breast or lung primaries, and suffering from persisting pain despite analgesic treatment were enrolled in this prospective study. There were 7 female and 12 male with a median age of 58 years (range 43 to 84 years). Urine samples for the measurement of urinary calcium and DPD levels were taken at the beginning of RT, sixth week, and twelfth week following RT. All patients received a total dose of 30 Gy in 3 Gy daily fraction doses 5 days a week for 10 days. Mean urine calcium and DPD levels before RT for whole patients were 17.53 ± 3.60 g/dl/?mol creatinine, and 100.12 ± 70.39 pmol/?mol creatinine. Fourteen patients (Group I) were alive with no evidence of progression of metastatic bone disease. Urine calcium and DPD levels were found to show a significant and progressive decrease after RT in Group I patients (p<0.001 for urine calcium and p=p<0.001 for urine DPD). Clinical and radiological evaluation revealed further bone dissemination of malignancy in five patients (Group II). Urine DPD and calcium concentrations were found to increase significantly in Group II patients (p=0.006 for urine calcium and p=0.009 for urine DPD). Our preliminary results demonstrated that both urine calcium and DPD may serve as valuable objective tools for assessing response to palliative RT of metastatic bone disease, and may serve as early predictors of disease progression.Öğe Radiotherapy in management of Peyronie's disease(2004) Topkan E.; Gürkaynak M.Peyronie's disease, although benign with its pathological characteristics, is an important health problem due to its painfull disease course and adverse effects on patients' sexual life. Various treatment modalities has been proposed for its treatment but some of them needs invazive procuderes while others have severe systemic side effects. At this point of view, radiation therapy with its negligable side effects and well proven effectivity, serves as a good treatment choice. In the present study, trials about radiation treatment of Peyronie's disease has been summarized.Öğe Utility of octreoide as second line treatment in concurrent chemoradiation induced diarrhea: Preliminary results in 20 patients(2004) Topkan E.; Selek U.To evaluate efficacy of octreotide in treatment of chemo-radiation induced diarrhea refractory to loperamide treatment. Our study consists of 20 intractable diarrhea patients that was resistant to loperamide, out of 33 rectum adenocarcinoma patients (T3-4NXM0) treated at Department of Radiation Oncology, Inonu University, between September 2002 and January 2003. All patients were treated with conventional radiotherapy (50.4 Gy, 1.8 Gy/fraction) with high-energy photons and concurrent 500mg/m_/week i.v. bolus 5FU. Twenty-four patients were recorded having Grade 3 or Grade 4 gastrointestinal toxicity during chemoradiation, according to National Cancer Institute Common Toxicity Criteria (NCI-CTC). Four patients who required parenteral support due to severe cramping, incontinence, gross bloody diarrhea were not included in the trial. Diarrhea failed to improve in 20 patients after 48 hours of per oral loperamide (4 mg tid) administration on outpatient basis. Twenty patients were assigned to receive octreotide (150 mg tid, Sandostatin, Novartis Pharma AG, Basel, Switzerland)) subcutaneously for 5 consecutive days. Complete resolution of diarrhea was considered therapeutic response, whereas partial or no response in 5 days of octreotide application was documented as failure. Diarrhea, recorded as NCI-CTC Grade 3 & 4, was largely experienced in the first two weekly cycles of 5FU administration concurrent with radiotherapy (80%). Subcutaneous octreotide application for 5 days resolved diarrhea completely in 17 patients out of 20 cases (85%) without any side effects (1-3 days, 15 patients-75%; 4-5 days, 2 patients-10%). Mean response period was 2.5 days. No side effects related with octreotide application was observed. Three irresponsive patients (15%) following 5 days of octreotide treatment were recorded as failure and were hospitalized to receive additional antidiarrheal agents, antibiotics, and parenteral fluid-electrolyte support; 2 cases recovered at 7th and 1 case recovered at 8th day. Daily subcutaneous octreotide application (150 mg tid) for five days seems to be an effective, tolerable second-line treatment for concurrent chemoradiation induced diarrhea refractory to loperamide.
