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Vegan beslenme pek çok kişinin ifade ettiği “sadece et yemeyen bireylerin beslenme şekli” anlayışı ile açıklanabilecek bir durum değildir. Bu görüş veganlık olgusunun altında yatan sosyal gerçekliği açıklamada çok yetersiz kalmaktadır. Buradan hareketle gerçekleştirilen bu çalışma vegan bireylerin vegan olmaya iten motivasyonları araştırmaktır. Araştırma yöntemi olarak nitel araştırma, araştırma tasarımı olarak ise fenomenolojik yaklaşım benimsenmiştir. Araştırma verileri İstanbul Anadolu yakasında yer alan bir vegan restorana gelen 19 düzenli müşteriden, yarı yapılandırılmış yüz yüze mülakat tekniği ile elde edilmiştir. Katılımcıların vegan olma motivasyonları; etik, bilişsel/sosyal, sağlık ve ekolojik motivasyonlar olarak ortaya çıkmıştır. Gerçekleşme sıklığına göre incelendiğinde en baskın faktörlerin etik ve bilişsel/sosyal nedenler olduğu söylenebilir. Bilişsel/sosyal motivasyon olarak adlandırılan faktörün alanyazındaki önceki çalışmalardan farklı olarak baskın bir motivasyon kaynağı olduğu görülmektedir. Bu motivasyonun, yazılı ve görsel kaynaklar ve sosyal çevre aracılığıyla “veganlık nedir ve neden vegan olmalıyım?” gibi sorulara yanıt aramada önemli bir yönlendirici olduğu anlaşılmaktadır. Sonuç olarak ister sadece vegan tüketicilere isterse de farklı tüketicilere bir arada hizmet versin, yiyecek ve içecek işletmelerinin yukarıda sayılan faktörleri dikkate alması hizmet etkileşiminin başarısı için faydalı olacaktır, Vegan diet is not a situation that can be explained by solely the understanding of "the diet of individuals who do not eat meat" as expressed by many people. This view is quite insufficient in explaining the social reality underlying the phenomenon of veganism. Accordingly, this study is to investigate the motivations of vegan individuals to be vegan. Qualitative research has been adopted as a research method and a phenomenological approach as a research design. The research data were obtained from 19 regular customers who came to a vegan restaurant on the Anatolian side of Istanbul, using a semi-structured face-to-face interview technique. Participants' motivations to be vegan have been emerged as ethical, cognitive/social, health and ecological motivations. When analyzed according to the frequency of occurrence, it can be said that the most dominant factors are ethical and cognitive & social reasons. It is understood that the factor called cognitive & social motivation is a dominant source of motivation, unlike previous studies in the literature. It is understood that this motivation provides influential guiding in seeking answers to questions such as "What is veganism and why should I be vegan? through written and visual sources and the social relationships. As a result, whether they serve only vegan consumers or more diversified, food and beverage businesses should take vegan consumer motives into account to achieve the successful service interaction.

Aim: To evaluate the prognostic value of the lymph node ratio (LNR) and other clinicopathological factors in patients with stage IIIC endometrial cancer. Methods: Factors affecting overall survival (OS) and progression-free survival (PFS) were assessed in 397 patients with stage IIIC endometrial cancer treated with postoperative radiotherapy. Patients undergoing the removal of at least ten lymph nodes were included in the study. Results: The 5-year OS and PFS rates were 58% and 52%, respectively, with a median follow-up time of 35.7 months. The LNR cutoff value was 9.6%. In the multivariate analysis, advanced age (≥60 years), grade III tumor, presence of cervical stromal invasion, higher LNR and lack of adjuvant chemotherapy were independent predictors for worse OS and PFS. Conclusion: The LNR is an independent predictor for OS and PFS in patients with stage IIIC endometrial cancer treated with postoperative radiotherapy.

Bu çalışmanın amacı pazarlama karması elemanlarından hareketle tüketicilerin coğrafi işaretli ürünlere yönelik algılarını ve tutumlarını ölçmektir. Bu amaçla, Mersin’de yaşayan tüketicilerin tantuni, cezerye ve kerebiç ürünlerinden algıladığı pazarlama karması algısı (ürün, fiyat, tutundurma) ve bu ürünlere yönelik davranışsal tüketim niyetleri araştırılmıştır. Araştırma, betimleyici amaçla nicel araştırma yöntemi ve tarama modelinde tasarlanmıştır. Veriler anketler aracılığıyla ve bırak-topla temas tekniği ile toplanmıştır. COVİD-19 pandemisi nedeniyle kolayda örnekleme tekniği ile veriler toplanmış ve 317 anket toplanmıştır. Sapan analizi sonucunda 42 anket veri havuzundan çıkarılmış ve analizler 275 geçerli anket üzerinden gerçekleştirilmiştir. Bulgulardan hareketle, yerli halkın oybirliğiyle üç ürünü de şehrin imajı açısından önemli bulduğu anlaşılmaktadır. Tantuni ve cezerye ürünlerine yönelik hem pazarlama performansı algısının hem de davranışsal tüketim eğiliminin yüksek olduğu görülmektedir. Buna karşın kerebiç tatlısı ile ilgili algı ve tutumlar diğer iki ürüne göre istatistiksel olarak anlamlı şekilde düşüktür. Bu noktada olumsuz düşünce ve tutumların kerebiçin fiyat ve tanıtım eksikliğinden kaynaklandığı görülmektedir. Araştırma, alanyazına ve uygulayıcılara yönelik çıktılar ve öneriler ile sonlandırılmıştır.

Bu araştırmanın amacı; çocuklu ailelerin alakart restoran seçimlerinde önem verdikleri kriterleri ve bu kriterlerden hareketle algıladıkları hizmet kalitesini önem-performans bakış açısıyla araştırmaktır. İlişkisel tarama modeliyle tasarlanan araştırmada online anket yoluyla 359 ebeveynden veri toplanmıştır. İstatistiksel analiz olarak betimleyici istatistikler, fark testleri ve önem-performans analizi (ÖPA) gerçekleştirilmiştir. Elde edilen bulgular, çocuklu ailelerin restoran seçim kriterlerinin tümünü önemli bulmakla beraber en az öneme sahip boyutun çocuk dostu hizmetler olduğunu göstermektedir. ÖPA bulgularına göre, müşterilerin yüksek önem verdiği ancak performans olarak zayıf bulduğu çocuk dostu hizmetler; emzirme ve alt değiştirme odası ve mama sandalyesi/çocuk masası hizmetlerinin niteliğidir. Ek olarak restoranların çocuklu aileleri mutlu etmek için yoğunlaşması gereken diğer hizmetler; alınan hizmetin ödenen paraya değmesi, restoranın temiz ve hijyenik olması, profesyonel hizmet sunumu ve çalışanların genel iletişim becerileri şeklindedir.

Regarding service failures restaurants are one of the most experienced one in the tourism and hospitality businesses. High level of service interaction and presence of other consumers in a groups of different size make the failures more complicate. Customers whose service expectation is not meet inform other group members through their negative emotions and may lead to a similar change in the emotions of others. Therefore, dealing with service failure requires more inclusive perspective. In this context, the main purpose of this research is to understand the relationship between service failure and dissatisfaction from group service interaction. To that end, it examines i) the effect of the negative behavioral reactions and emotional contagion on the perceived service failure and service dissatisfaction and ii) the mediator role of service failure on the effect of the negative emotional responses and emotional contagion on dissatisfaction. To collect data scenario-based experiment was applied. Data obtained through both online and face to face survey. Based on 1437 scenario based questionnaire structural equation modeling analysis was performed. Results show that the dominant factor effecting their service failure perception is the feeling of disappointment rather than anger in group failures. Emotional contagion is also effective on service failure perception. Neither negative emotions nor contagion has direct effect on dissatisfaction. Perceived service failure consisting the dimensions of service quality, has a mediating role between emotional states and feeling of satisfaction. That is, consumers’ dissatisfaction feelings occur if they support their emotional reactions with their cognitive assessments of service quality.

Background To assess the predictive value of 18F-fluorodeoxyglucose positron-emission tomography (FDG–PET/CT) in detecting mediastinal lymph node metastasis with histopathologic verification in breast cancer (BC) patients. Materials and methods Between February 2012 and October 2019, 37 BC patients who underwent histopathological verification for FDG-PET positive mediastinal lymph nodes were retrospectively analyzed. Nine patients (24%) were screened before beginning treatment, while 27 (76%) were screened at the time of disease progression, an average of 39 months after completion of initial treatment. Results The histopathologic diagnosis revealed lymph node metastasis from BC in 15 patients (40%) and benign disease in 22 patients (60%). The standardized uptake value (SUVmax) of mediastinal lymph nodes was significantly higher in patients with lymph node metastasis compared to those with benign histology (9.0 ± 3.5 vs. 5.9 ± 2.4; P = 0.007). The cut-off value of SUVmax after the ROC curve analysis for pathological lymph node metastasis was 6.4. Two of the 15 patients with mediastinal SUVmax ≤ 6.4 and 13 of the 22 patients with SUVmax > 6.4 had lymph node metastasis. Age and pathological findings were prognostic factors for overall survival in univariate analysis. The treatment decision was changed in 19 patients (51%) after mediastinoscopic evaluation of the entire cohort. Conclusions This is the first study to support the need for pathologic confirmation of a positive PET/CT result following evaluation of mediastinal lymph nodes for staging BC, either at initial diagnosis or at the time of progression. Treatment decisions were consequently altered for nearly half of the patients., Highlights • Αpproximately 25–30% of breast cancer cases involve distant metastasis. • Τhe 5-year survival rate for breast cancer patients with distant metastasis is 25%. • Histopathologic evaluation of suspected mediastinal lymph nodes is essential. • Using only FDG-PET/CT to assess mediastinal lymph nodes may produce a false positive. • Half of all treatment decisions were revised following mediastinoscopic evaluation.

Restoran işletmeleri için hijyen her zaman için önemli konulardan birisi olmuştur. Bununla birlikte son 6 aydır dünya genelinde yaşanan Koronavirüs (Covid-19) salgını nedeniyle çok daha önemli bir konu haline gelmiştir. Hizmet kalitesinin önemli faktörlerinden birisi olan hijyen konusu gerek şikayet yönetimi gerekse dışarıda yeme davranışları konusunda turizm alanyazınında sıklıkla ele alınan bir konudur. Çoğunlukla hizmetin tüm unsurlarıyla birlikte ele alınan bu konu, bu araştırma kapsamında tek başına ele alınmıştır. Tripadvisor.com internet sitesinde yer alan Mersin’deki alakart restoranlara yönelik çevrimiçi hijyen şikayetleri üzerinden veri toplanmıştır. Ocak 2013 – Haziran 2020 arasında, Tripadvisor.com’da Mersin’de bulunan 22 Alakart restorana yönelik yapılan 1600 olumlu ve olumsuz yorum içerisinden, hijyen sorununu işaret eden 106 kişiden 141 yorum elde edilmiştir. Veriler, nitel araştırma yöntemlerinden betimsel analiz tekniği ile analiz edilmiştir. Elde edilen bulgular, hijyene yönelik müşteri şikayetlerinin mikrobiyolojik hijyen ve ortak kullanım alanlarına yönelik hijyen boyutlarında yoğunlaştığını göstermektedir. En sık karşılaşılan şikâyet unsurları; “taze olmayan ürün kullanımı”, “kirli mekân”, “kirli eşyalar”, “kirli lavabo ve tuvalet” ve “servis ekipmanlarının kirliliği” şeklindedir. Ek olarak sunum ve personelden kaynaklı hijyen sorunları da ciddiye alınacak derecede yüksektir. Bu bulgular alanyazındaki önceki araştırma bulgularıyla benzeşmekle beraber, alakart restoranlar örnekleminde mikrobiyolojik hijyen yani gıda hazırlama sürecine yönelik hijyene dair sorunların daha baskın olduğu sonucunu ortaya koymaktadır. Araştırma sonuçları restoran yöneticilerinin hijyeni, hizmet sürecinin tüm aşamaları için mutlak bir zorunluluk olarak görmeleri gerektiğini de ortaya koymaktadır.

The aim of the study is to investigate the correlation between the intensity of prostate-specific membrane antigen (PSMA) uptake in primary tumor and clinico-pathological characteristics of non-metastatic prostate cancer patients treated with definitive radiotherapy (RT). Using the clinical data of 201 prostate cancer patients who were referred for 68 Ga-PSMA-positron emission tomography (PET/CT) for staging and RT planning, we analyzed the correlations among intermediate- or high-risk disease based on Gleason score (GS), prostate-specific antigen (PSA) level, D’Amico risk group classification, and maximum standardized uptake (SUVmax) of primary tumor. Primary tumor was visualized via 68 Ga-PSMA-PET/CT scan in 192 patients (95.5%). The median SUVmax of primary tumor and metastatic lymph node were 13.2 (range 3.3–83.7) and 11.4 (range 3.6–64.5), respectively. A significant moderate correlation was observed between PSA level and median tumor SUVmax as measured by 68 Ga-PSMA-PET/CT (Spearman = 0.425; p 10 ng/mL, GS > 7, D’Amico high-risk group classification, and pelvic lymph node metastasis had significantly higher tracer uptake in primary tumor than their counterparts. The median SUVmax of primary tumor was highest in patients with GS 9. The primary tumor detection rates of 68 Ga-PSMA-PET/CT were 83%, 92%, and 99% for patients with serum PSA ≤ 5.0 ng/mL (14 patients, 7%), PSA 5.1–10.0 ng/mL (45 patients, 22%), and PSA > 10 ng/mL (142 patients, 71%), respectively. We demonstrated a correlation between prostate tumor characteristics and PSMA tracer uptake. Patients with serum PSA > 10 ng/mL, GS > 7, D’Amico high-risk group classification, and pelvic lymph node metastasis had significantly higher SUV than their counterparts. In addition, the primary tumor detection rate was higher in patients with serum PSA > 10 ng/mL and GS > 7.

Background: To analyze the outcomes of breast cancer liver metastasis (BCLM) treated with stereotactic body radiotherapy (SBRT) and systemic treatment. Materials and methods: The treatment outcomes of 33 patients with oligometastasis ( Results: Median age and follow-up time were 45 years (range 24 - 77 years) and 13.6 months (range 1.9 - 59.4 months), respectively. Among 33 patients, 25 (76%) had solitary LM while 7 patients (21%) had two lesions and 1 patient (3%) had three lesions. Estrogen receptor (ER) and progesterone receptor (PR) were positive in 26 patients (79%) and 19 patients (58%), respectively. All patients had mastectomy for primary disease, and 29 patients (88%) received postoperative adjuvant chemotherapy and radiotherapy, while 4 patients (12%) had adjuvant chemotherapy only. Most of the patients [29 patients (88%)] developed LM during the follow-up of initial treatment, while only 4 patients (12%) had LM at the time of first diagnosis. 22 patients (67%) had another organ metastasis besides LM [lung 2 (6%), bone 13 (39%) and multiple 7 (21%)], only LM was observed in 11 patients (33%). At last visit, 21 patients (64%) had disease recurrence, median 8.0 months (range 0.7 - 30.6 months) after completion of liver SBRT. Only 2 patients (6%) had local recurrences and 19 patients (58%) had distant disease recurrence. Median OS and PFS were 35 months [95% confidence interval (CI) 9.9 - 60.1 months]) and 10.4 months (95% CI; 8.1 - 12.6 months), respectively. The 1- and 2-year LC and OS rates were 90% and 60%, respectively. In uni- and multivariate analysis, no significant prognostic factors, including disease extension, size of metastasis, number of liver metastasis and timing of liver metastasis, hormonal status affecting survival and local control were found. No patients experienced Grade 4 or 5 toxicity; furthermore, only two patients experienced rib fracture 6-8 months after completion of treatment, and one patient had a duodenal ulcer. Conclusion: This study is the first to evaluate the feasibility of SBRT to BCLM patients in a larger patient cohort. Our findings support that the liver SBRT is a feasible and safe method for BCLM with excellent LC and acceptable toxicities. Keywords: Breast cancer, Liver metastasis, Radiotherapy, Stereotactic body radiotherapy, Survival Citation Format: Ozan Cem Guler, Berna Akkus Yıldırım, Ozgur Ozyilkan, Cem Onal. Treatment outcomes of breast cancer liver metastasis treated with stereotactic body radiotherapy [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-12-30.

This is a significant study that shows that definitive chemo-radiotherapy is an effective treatment option for cervical esophageal squamous cell carcinoma. We are curious, though, whether local control has any effect on survival.

Purpose To evaluate the potential benefit of curative radiotherapy (RT) to the primary tumor in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone. Materials and methods The clinical parameters of 106 mCRPC patients treated with abiraterone were retrospectively evaluated. Patients were either oligometastatic (= 50% of the baseline obtained 3 weeks after abiraterone therapy was the only significant prognostic factor for better OS and progression-free survival (PFS). Patients treated with primary RT to the prostate had significantly less progression under abiraterone and a longer abiraterone period than those treated without local prostate RT. Conclusions Local prostate RT significantly improved OS and local control in mCRPC patients treated with abiraterone. The patients treated with primary RT had significantly less progression under abiraterone and a longer abiraterone period than those treated without local prostate RT.

PURPOSE/OBJECTIVE(S) The utility of metabolic positron-emission tomography (PET) parameters in patients with cervical cancer who had complete metabolic response (CMR) after chemoradiotherapy (ChRT) is unclear. We investigated the importance of metabolic parameters measured with 18F-FDG-PET/CT for predicting progression-free survival (PFS) and overall survival (OS). MATERIALS/METHODS The clinical data of 152 patients with biopsy-proven cervical cancer treated with definitive ChRT at our institution between November 2006 and August 2012 were retrospectively evaluated. The clinical data and PET parameters including standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of 122 patients having CMR in post-treatment 18F-FDG-PET/CT delivered a median of 3.9 months after ChRT completion were analyzed. The PET parameters were measured for primary tumors (p) and metastatic lymph nodes (ln) separately. RESULTS With a median follow-up of 8.4 years, 55 patients (45%) presented with disease a median of 19.7 months after ChRT. The cut-off values determined with receiver operating curve analysis for survival were 15.8, 48.7 cm³, 552.3, 8.7, 7.0 cm³, and 24.6 and for disease recurrence were 19.9, 49.8 cm³, 597.4, 9.1, 7.3 cm³, and 25.2 for SUVp, MTVp, TLGp, SUVln, MTVln, and TLGln, respectively. All metabolic PET parameters were significant prognostic factors for OS and PFS in univariate analysis. FIGO stage was predictive of both OS and PFS, while pelvic and/or para-aortic lymph node metastasis were predictive of OS only. In multivariate analysis, FIGO stage ≥IIB [HR = 2.53 (95% CI, 1.02-7.34), P = 0.04], MTVp ≥49.8 cm³ [HR = 4.13 (95% CI, 2.51-6.78), P < 0.001] and TLGp ≥597.4 [HR = 2.21 (95% CI, 1.06-4.61), P = 0.03] were predictive of worse OS. Advanced stage [HR = 4.11 (95% CI, 0.98-7.22) P = 0.05], presence of lymph node metastasis [HR = 1.48 (1.09-2.39), P = 0.04], higher TLGp [HR = 2.31 (95% CI, 1.14-4.68), P = 0.02] and larger MTVln [HR = 2.24 (1.05-4.74), P = 0.04] were significant factors for poor PFS rates. CONCLUSION Advanced stage and higher TLGp values were significant predictors for poor survival and higher progression rates. Additional prognostic factors for worse OS were larger MTVp and lymph node metastasis and for disease progression, MTVln. We also found that most disease recurrences presented as distant metastasis, which suggests a need for effective systemic treatment. AUTHOR DISCLOSURE C. Onal: None. O. Guler: None. M. Reyhan: None. A. Yapar: None.

In this study we compared postoperative early vs sandwich chemoradiotherapy in operated stage IIA-IIIC gastric cancer patients in terms of effectiveness and outcome.The data of 201 gastric cancer patients treated in the same center between December 2006 and June 2017 were retrospectively evaluated. One hundred forty nine patients who were eligible for the study criteria were divided into two groups according to the postoperative treatment modality. The first group included 85 patients who were given chemoradiotherapy simultaneously (ETG) and the second group icluded 64 patients who received sandwich (chemotherapy-chemoradiotherapy-chemotherapy) (STG) treatment. Overall survival (OS) and disease-free survival (DFS) were evaluated as primary endpoints.The median follow-up time for all patient groups was 26.7 months (1.3 -136.5 months). Adjuvant chemotherapy and radiotherapy were initiated concurrently in patients receiving concomitant therapy. Half of the planned chemotherapy, then chemoradiotherapy and then the remaining chemotherapy treatments were given to the sandwich treatment group. A total of 50.4 Gy radiotherapy was given to the concurrent chemoradiotherapy group and a total of 45 Gy radiotherapy to the group receiving the sandwich treatment.. OS was 30.6 months (23.7-37.5) in all groups, 30.4 months (23.7-35.0) in concurrent therapy (ETG) and 35.6 months (26.3-45) in sandwich therapy (STG) (p=0.73). DFS was 26.6 months (21.3-32.0) in all groups and 24.5 months (18.1-31.0) in the group receiving ETG, 32.5 months (22.2-42.8) in STG. (p=0.46). The most common grade 3 and above toxicities were; acute upper gastrointestinal toxicity (19.1% in ETG vs. 9.0% in STG, p=0.01) and hematological toxicity (31.8% in ETG vs. 13.9% in STG; p=0.002). Early cessation of treatment was similar in both groups. In multivariate analysis, female gender (p=0.01), stage III disease, grade III disease were seen as negative predictive factors for overall survival. In DFS multivariate analysis, there was no difference between the groups in terms of gender, T stage, N stage, and AJCC stage.In this study, superiority of sandwich treatment over concurrent treatment was observed in patients with operated stage IIB-IIIC gastric cancer, but the difference was not statistically significant. If this study is performed in larger patient series, the difference of sandwich treatment may become meaningful.

This study aims to explore the positive psychological effects of culinary experiences during the COVID-19 lockdown days. Qualitative research methods adopted to provide a deeper understanding. Data was collected through a structured online survey from 30 participants in Turkey. This occurred between April 10th and June 3rd, 2020 when the strict confinement measures were applied. Content analysis was deductively applied according to the Stebbins’s Theory of Casual vs. Serious Leisure which classifies the well-being according to characteristics of leisure experiences. The results revealed that at the first stage people went into the kitchen with the motivation of pure happiness and relaxation indicating hedonic well-being. However, people who intended to spend time with culinary activities with the expectations of pure happiness left the kitchen with eudaimonic outcomes by gaining special skills and knowledge, self-actualization and self-enrichment. When these outcomes are evaluated based on the Stebbins’s theoretical framework, culinary activities have both casual and serious leisure experience characteristics in terms of psychological well-being. It is understood that culinary activities have versatile leisure characteristics. Thanks to the culinary activities, people do not only obtain pure happiness and relaxation but can draw wider inferences about their life by realizing their own potential during the psychologically challenging COVID-19 lockdown days.

Ovarian cancer is the fifth leading cause of cancer related death in women. Platin-based doublet regimens plus bevacizumab is standard treatment in relapse. Due to formal regulation of Turkish Ministry of Health, adjuvant bevacizumab has not been reimbursed and clinicians can use bevacizumab at a dose of 7.5 mg/kg/3wk in platin-resistant and sensitive relapse settings. The primary aim of this study was to evaluate 7.5 mg/kg/3wk bevacizumab dosing in platin-resistant and sensitive relapse ovarian cancer and compare these findings with the current literature.A total of 106 patients with relapsed ovarian cancer and treated with bevacizumab (bevacizumab is not reimbursed as a part of adjuvant treatment in Turkey) on their first relapse were included.At a median follow-up of 32.1 months (5.3-110.8), 56 (52.8%) patients died. Progression-free survival (PFS) and overall survival (OS) were estimated at 18.8 months (14.4-23.3) vs 29.7 months (24.3-35.1) of the whole group overall survival. We observed that 78.4% of patients treated with primary surgery without neoadjuvant treatment and 59 (57.8%) out of the 102 patients with debulking surgery relapsed. A significant number of patients (81%) treated with primary surgery without neoadjuvant treatment and 59 (76.6 %) had secondary debulking surgery at relapse. In relapse, 38 patients were treated with single agent liposomal doxorubicin (LPD) plus bevacizumab. On the other hand, 68 patients were treated with carboplatin and LPD plus bevacizumab. Multivariate analysis failed to show any clinicopathological characteristics with significant effect on PFS. However, cytoreductive surgery at relapse showed significant effect on OS. Bevacizumab-related toxicities were detected in 23 (21.7%) patients; hypertension, pulmonary embolism, perforation, and other toxicities (nephrotic syndrome in 2, osteonecrosis in 2, cerebrovascular and cardiac ischemia in 3 patients) were seen in 12 (11.3%), 3 (2.8%), 1 (0.9%) and 7 (6.6%) patients, respectively.In conclusion, our findings showed that 7.5 mg/kg/3week dosing of bevacizumab in relapsed ovarian cancer could have similar effectiveness compared to standard 15 mg/kg/3week dosing. Increase of OS and PFS in patients treated with primary and secondary debulking surgery with no-visible disease was more pronounced. No new safety information was observed but lower rate of grade 3 or above hypertension with similar rate of severe vascular and intestinal complications were detected.

Purpose: we aimed to retrospectively investigate the prognostic worth of pretreatment advanced lung cancer inflammation index (ALI) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients treated with concurrent chemoradiotherapy (C-CRT). Patients and methods: A total of 164 LA-NPC patients treated with cisplatinum-based definitive C-CRT were included in this retrospective cohort analysis. The convenience of ideal pre-C-CRT ALI cut-offs affecting survival results was searched by employing the receiver operating characteristic (ROC) curve analyses. The primary endpoint was the link between the ALI groups and overall survival (OS), while cancer-specific survival (CSS), locoregional progression-free survival [LR(PFS)], distant metastasis-free survival (DMFS), and PFS comprised the secondary endpoints. Results: the ROC curve analyses distinguished a rounded ALI cut-off score of 24.2 that arranged the patients into two cohorts [ALI ≥ 24.2 (N = 94) versus, NA

Background: we retrospectively compared the incidence of isolated elective nodal failure (IENF) and toxicity rates and survival outcomes after elective nodal irradiation (ENI) versus involved-field RT (IFRT) by employing the propensity score matching (PSM) methodology in stage IIIB/C inoperable non-small-cell lung cancer (NSCLC) patients treated with definitive concurrent chemoradiotherapy (C-CRT). Methods: our PSM examination included 1048 stage IIIB/C NSCLC patients treated with C-CRT from January 2007 to December 2016: a total dose of 66 Gy (2 Gy/fraction) radiotherapy and 1-3 cycles of platinum-based doublet chemotherapy concurrently. The primary and secondary endpoints were the IENF and toxicity rates and survival outcomes after ENI versus IFRT, respectively. Propensity scores were calculated for each group to adjust for confounding variables and facilitate well-balanced comparability by creating 1: 1 matched study groups. Results: the median follow-up was 26.4 months for the whole study accomplice. The PSM analysis unveiled 1: 1 matched 646 patients for the ENI (N = 323) and IFRT (N = 323) cohorts. Intergroup comparisons discovered that the 5-year isolated ENF incidence rates (3.4% versus 4.3%; P=0.52) and median overall survival (25.2 versus 24.6 months; P=0.69), locoregional progression-free survival (15.3 versus 15.1 months; P=0.52), and progression-free survival (11.7 versus 11.2 months; P=0.57) durations were similar between the ENI and IFRT cohorts, separately. However, acute grade 3-4 leukopenia (P=0.0012), grade 3 nausea-vomiting (P=0.006), esophagitis (P=0.003), pneumonitis (P=0.002), late grade 3-4 esophageal toxicity (P=0.038), and the need for hospitalization (P, NA

Purpose/objective(s) Few studies have investigated the feasibility of MDT in metastatic castration-resistant prostate cancer (CRPC) patients with heterogeneous patient populations with different treatment strategies and various imaging modalities other than gallium prostate-specific membrane antigen-positron emission tomography (68Ga-PSMA-PET/CT) for detecting oligoprogressive lesions. We assessed the outcomes of stereotactic body radiotherapy (SBRT) to treat oligoprogressive castration-resistant prostate cancer (CRPC) patients with ≤5 lesions using 68Ga-PSMA-PET/CT. Materials/methods The clinical data of 67 CRPC patients with 133 lesions treated with 68Ga-PSMA-PET/CT-based SBRT were retrospectively analyzed. All of the patients had oligoprogressive disease during androgen-deprivation therapy (ADT). The inclusion criteria were as follows: a histologic diagnosis of PC on primary tumor biopsy, less than or equal to 5 bone and/or lymph node metastases detected with 68Ga-PSMA-PET/CT during ADT, being castration-resistant according to the European Association of Urology guidelines, a controlled primary tumor, SBRT fraction doses of at least 6 Gy per fraction and a biologically effective dose (BED) of at least 90 Gy using α⁄β of 3 Gy. The prognostic factors for overall- (OS) and progression-free survival (PFS) and the predictive factors for switching to next-line systemic treatment (NEST) and NEST-free survival (NEST-FS) were analyzed. Results With a median follow-up of 17.5 months, the 2-year overall survival (OS) and PFS rates were 86.9% and 34.4%, respectively. Most of the patients had GS 9 or 10 tumors and locally advanced disease. The most frequent oligoprogressive site was bone only (64.2%), and more than half of the patients (53.7%) had a single metastasis. The median number of metastases was 1 (range, 1-5). In the case of bone metastasis, the most adopted methods were single-dose 16 Gy and 18 Gy, and the most adopted prescription for nodal metastasis was 30-35 Gy delivered in 5 fractions. The PSA response after SBRT was observed in 49 patients (73.1%). Progression was observed in 37 patients (55.2%) at a median of 11.0 months following SBRT. Forty-five patients (67.2%) remained on ADT after SBRT, and 22 patients (32.8%) had a NEST change at a median of 16.4 months after MDT. Patients with a NEST change had higher post-SBRT PSA values and fewer PSA nadirs after MDT than their counterparts. In multivariate analysis, higher pre-SBRT PSA values were the only significant predictor for worse OS and NEST-FS, and no significant factor was found for PFS. No serious acute or late toxicities were observed. Conclusion This study demonstrated the feasibility of MDT using SBRT to treat oligoprogressive lesions by 68Ga-PSMA-PET/CT in CRPC patients is efficient and well-tolerated, prolonging the effectiveness of ADT by delaying NEST.

Background/aim To compare simultaneous-integrated boost (SIB) versus sequential-boost (SB) delivered in the context of whole-breast irradiation (WBI) via volumetric-modulated arc therapy (VMAT) and helical-tomotherapy (HT). Materials and methods Planning target-volume (PTV) dosimetric parameters and organs at risk (OAR) were analyzed for SB plan (50 Gy plus 16 Gy boost) and SIB plan (50.4 Gy WBI and 64.4 Gy tumor bed boost) in VMAT and HT techniques. Results Conformity and homogeneity for target-volume doses were better in HT plans compared to VMAT plans. There were no significant differences in ipsilateral lung doses between VMAT and HT plans for SB/SIB techniques, except for a significantly higher lung V5 value with VMAT-SB, and lung V13 value with HT-SIB technique. HT provided a statistically significant decrease in contralateral lung mean V5. Conclusion The SIB technique showed better target-volume dose distribution in both HT and VMAT plans, and better sparing heart in HT compared to the SB technique.

BACKGROUND: To compare the efficacies of standard dose-(SDRT) and escalated dose radiotherapy (EDRT) in newly diagnosed glioblastoma (GBM) with concurrent and adjuvant temozolomide (TMZ). MATERIALS AND METHODS: Outcomes of 126 newly diagnosed GBM patients who received SDRT (60 Gy, 30 fractions) or EDRT (70 Gy, 30 fractions) with concurrent plus adjuvant TMZ were retrospectively analyzed. Both groups received concurrent TMZ (75 mg/m2) during the course of RT and at least one course of adjuvant TMZ (150–200 mg/m2), thereafter. Overall survival (OS) and local progression free survival (LPFS) constituted the primary and secondary endpoints, respectively. RESULTS: At median 14.2 months follow-up, 26 (20.6%) patients were alive. Median LPFS and OS were 9.2 [95% confidence interval (CI); 8.4–10.0] and 15.4 months (95% CI; 12.1–18.8), respectively, for the entire cohort. Although the median OS was numerically superior in the EDRT this difference could not reach statistical significance (22.0 vs. 14.9 months; P = 0.45), Likewise, LPFS was also (9.9 vs. 8.9 months; P = 0.89) not different between the two treatment groups. In multivariate analysis, better recursive partitioning analysis class (3–4 vs. 5; P = 0.044) and extensive surgery (gross total resection vs. subtotal resection/biopsy only; P= 0.021) were identified to associate significantly with superior OS times, irrespective of the RT protocol. CONCLUSIONS: Although the current median OS of 22 months of the EDRT group is promising, no statistically significant survival advantage for EDRT was observed even in the presence of TMZ. Randomized studies with larger population sizes and available genetic markers are warranted to conclude more reliably on the fate of EDRT plus TMZ.

AIM To evaluate the clinical characteristics and treatment outcomes of non-small cell lung cancer (NSCLC) patients with brain metastasis, who were treated by whole brain radiotherapy with a conventional boost at a single institution. MATERIAL AND METHODS A total of 296 patients diagnosed with NSCLC with brain metastasis and referred to our clinic for radiotherapy between 2000 and 2017 were included in this retrospective study. RESULTS The median age was 60.8 ± 12.1 years, with a range of 21-85 years. The estimated median survival time for all patients was 7.81 ± 0.66 months (95% CI: 6.52-9.11). The one-year survival, two-year survival and three-year survival rates were 18.8%, 5.8% and 2.9%, respectively. The median survival of patients with solitary brain metastasis who received 45 Gy radiotherapy was 14.70 ± 2.80 months (95% CI: 9.20-20.20). These patients had 6 and 12 months survival rates of 65.4% and 42.6%, respectively. The median survival time of patients with solitary brain metastasis who received > 45 Gy radiotherapywas 13.86 ± 2.56 months (95% CI: 8.08-18.02). These patients had 6 and 12 months survival rates of 66.2% and 27.2%, respectively. There was no significant difference between the two groups (p=0.321). The median survival duration of patients under 65 years was 9.65 ± 1.02 months. The median survival time of patients aged 65 years and overwas 5.15 ± 0.51 months. There was a statistically significant difference in the median survival rates between the groups (p < 0.001). CONCLUSION Patients with solitary metastasis or single metastases tolerated whole brain radiotherapy with a conventional boost. Although the overall survival rates were numerically better in the high dose RT group, the difference was not statistically significant. Prospective studies with a larger sample size are needed to consolidate our results.

WOS: 000461481000002, PubMed: 30887753, Objective: To analyze the outcomes of sequential or sandwich chemotherapy (ChT) and radiotherapy (RT) in patients with node-positive endometrial cancer (EC). Methods: Data from 4 centers were collected retrospectively for 179 patients with stage IIIC EC treated with postoperative RT and ChT (paclitaxel and carboplatin). Patients were either treated with 6 cycles of ChT followed by RT (sequential arm; 96 patients) or with 3 cycles of ChT, RT, and an additional 3 cycles of ChT (sandwich arm; 83 patients). Prognostic factors affecting overall survival (OS) and progression-free survival (PFS) were analyzed. Results: The 5-year OS and PFS rates were 64% and 59%, respectively, with a median followup of 41 months (range, 5-167 months). The 5-year OS rates were significantly higher in the sandwich than sequential arms (74% vs. 56%; p=0.03) and the difference for 5-year PFS rates was nearly significant (65% vs. 54%; p=0.05). In univariate analysis, treatment strategy, age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology, rate of myometrial invasion, and grade were prognostic factors for OS and PFS. In multivariate analysis, non-endometrioid histology, advanced FIGO stage, and adjuvant sequential ChT and RT were negative predictors for OS, whereas only non-endometrioid histology was a prognostic factor for PFS. Conclusion: Postoperative adjuvant ChT and RT for stage IIIC EC patients, either given sequentially or sandwiched, offers excellent clinical efficacy and acceptably low toxicity. Our data support the superiority of the sandwich regimen compared to the sequential strategy in stage IIIC EC patients for OS.

Purpose To assess the survival outcomes and prognostic factors of young (≤45 years) Stage IIIB nonsmall cell lung cancer (NSCLC) patients treated with definitive concurrent chemoradiotherapy (C-CRT). Materials and Methods Medical records of 145 Stage IIIB NSCLC patients (≤45 years) who received 60-66 Gy thoracic radiotherapy and concurrent 1-3 cycles of cisplatin-based doublet chemotherapy were retrospectively evaluated. The primary endpoint was overall survival (OS), while locoregional progression-free survival (LRPFS), progression-free survival (PFS), and evaluation of potential prognostic factors constituted the secondary endpoints. Results At median 21.6 months (range: 7.3-62.5) of follow-up, the median and 4-year survival estimates were 24.8 months and 24.2% for OS, 15.7 months and 18.9%, for LRPFS and 12.0 months and 11.2% for PFS, respectively. On univariate analyses, among all factors, the smaller tumor size (≤7.0 cm; P = 0.03), lower T-stage (T1-T2; P = 0.02), lower N-stage (N2; P = 0.01), absence of anemia before C-CRT (hemoglobin [Hb] ≥12 g/dL; P < 0.001), and lower/no pretreatment weight loss (WL ≤5%; P < 0.001) were found to be associated significantly with longer median OS durations, which also retained their independent significance on multivariate analyses, except for tumor size category. Conclusions The encouraging median 24.8 months OS duration observed here in young NSCLC patients accords well with the results of recent landmark locally advanced NSCLC series without age stratification. Other than the well-established T and N stages, extra exhibit of superior OS in patients with initial Hb ≥12 g/dL and ≤5% WL levels suggests a noteworthy prognostic role for these two latter variables in the stratification of such patients.

Background To assess the outcomes of breast cancer liver metastasis (BCLM) treated with stereotactic body radiotherapy (SBRT) and systemic treatment. Materials and methods Patients with oligometastasis at the time of liver metastasis (LM) or who became oligometastatic (≤5 metastases) after systemic treatment were assessed. Twenty-nine liver metastatic lesions were treated with a total of 54 Gy delivered in 3 fractions. The local control (LC), overall survival (OS), and progression-free survival (PFS) rates were calculated using Kaplan-Meier analyses. Results A total of 22 patients with 29 liver metastatic lesions treated with liver SBRT between April 2013 and September 2017 were retrospectively analyzed. After a median follow-up time of 16.0 months (range 4.4-59.4 months), 18 patients (82%) had disease recurrence, median of 7.4 months (range 1.0-27.9 months) after completion of liver SBRT. The 1- and 2-year OS rates were 85% and 57%, and the 1- and 2-year PFS rates were 38% and 8%, respectively. The 1- and 2-year LC rates were 100% and 88%, respectively. No significant prognostic factors, including disease extension, size of metastasis, number of liver metastasis and timing of liver metastasis, hormonal status affecting OS, PFS and LC were found. No patients experienced Grade 4 or 5 toxicity; furthermore, only one patient experienced rib fracture 6 months after completion of treatment, and one patient had a duodenal ulcer. Conclusion This study is the first to evaluate the feasibility of SBRT to BCLM patients. Liver SBRT is a conservative approach with excellent LC and limited toxicities.

OBJECTIVE: To evaluate the prognostic significance of metabolic parameters derived from fludeoxyglucose (FDG) positron emission tomography (PET)/CT, in cervical cancer patients treated with concurrent chemoradiotherapy. METHODS: We retrospectively reviewed medical records from 129 biopsy-proven non-metastatic cervical cancer patients treated with external radiotherapy and intracavitary brachytherapy at our department. Correlation between metabolic parameters and tumour characteristics was evaluated. Prognostic factors for survival, local control and distant metastasis were analysed. RESULTS: The median follow up for all patients and surviving patients was 30.0 months (range, 3.7–94.7 months) and 50.5 months (range, 14.5–94.7 months), respectively. The 2- and 5-year overall survival (OS) and disease-free survival (DFS) rates were 68 42, 54 and 38%, respectively. The maximum standardized uptake value (SUV(max)), SUV(mean), metabolic tumour volume (MTV) and total lesion glycolysis were significantly higher in patients with larger tumours (>4 cm) and partial regression or progressive disease after definitive treatment compared to patients with smaller tumour (≤4 cm) and post-treatment complete response. On univariate analysis, stage, lymph node metastasis, tumour size >4 cm, SUV(max), MTV, SUV(mean) and total lesion glycolysis were prognostic factors for OS and DFS. On multivariate analysis, only larger tumour and presence of lymph node metastasis were significant prognostic factors for both OS and DFS. Additionally, extensive stage was a significant prognosticator for DFS. CONCLUSION: Although, metabolic parameters derived from FDG-PET/CT had a prognostic significance in univariate analysis, the significance was lost in multivariate analysis where tumour stage, size and lymph node status were the only independent parameters. ADVANCES IN KNOWLEDGE: The clinical benefit of using FDG-PET/CT metabolic parameters to evaluate the high-risk patients among cervical cancer patients and to eventually change patient management still needs further clarification.

We aimed to identify the fatal pulmonary hemorrhage- (FPH-) related risk factors in stage 3B/C squamous-cell lung carcinoma (SqCLC) patients treated with definitive concurrent chemoradiotherapy (C-CRT). Medical records of 505 stage 3B/C SqCLC patients who underwent 66 Gy radiotherapy plus 1-3 cycles of concurrent chemotherapy with available pretreatment thoracic computerized tomography scans were retrospectively analyzed. Primary end-point was the identification of FPH-related risk factors. Examined factors included the basal patient and tumor characteristics with specific emphasis on the tumor cavitation (TC) status, tumor size (TS) and cavitation size (CS), tumor volume and cavitation volume (TV and CV), relative cavitation size (RCS = CS/Ts), and relative cavitation volume (RCV=CV/TV). FPH emerged in 13 (2.6%) patients, with 12 (92.3%) of them being diagnosed 0.14 (37.5% versus 11.1% for RCV 0.14. Diagnosis of >90% FPHs, NA

Purpose: The aim of this retrospective cohort study was to evaluate the prognostic effect extended temozolamide on survival outcomes of glioblastoma multiforme patients who were underwent surgery/biopsy followed treated with definitive chemo-radiotherapy.Materials and Methods: We retrospectively analyzed the datas of 225 patients with gliablastoma multiforme whom admitted to our clinic All patients were completed concomitant chemoradiotherapy with temozolamide and adjuvant temozolamide therapy at least for six months or more. Patients were divided into two groups as standart and extended temozolamid therapy group as using temozolamide therapy for at least 6 months or more. Results: The median follow-up of the whole patients18 (range 2-125) months, 65 patients (56%) were alive. Extended temozolamide (>6) was associated with longer survival, but was not significantly with survival outcomes in the univariate analysis (49.0 vs 68.33 months;p=0.082). However, progression free survival analysis demonstrated that the patient in extended temozolamide group had paramount extended progression free survival (14 vs 9 months) than other group in standart cycle temozolamide. Conclusion: Our study show that extended temozolamide is well tolerated and leads to a significantly increase in progression free survival and overall survival in newly diagnosed patients with glioblastoma multiforme., Amaç: Retrospektif bu çalışmanın amacı cerrahi/biyopsi ile glioblastoma multiforme tanısı almış, kemoradyoterapi uygulanmış hastalarda uzatılmış temozolamid kullanımının genel ve progresyonsuz sağkalım etkisini araştırmak olarak belirlendi.Gereç ve Yöntem: Kliniğimize başvuran cerrahi/biyopsi ile glioblastoma multiforme tanısı almış 225 hastadan, temozolamid ile birlikte radyoterapi tedavisi uygulandıktan sonra, ≤6 ay ve >6 ay süreyle adjuvan temozolamid kemoterapisi uygulanmış 116 hastatedavi toleransı, genel ve progresyonsuz sağkalımları arasındaki farklar retrospektif olarak incelendi.Bulgular: Hastaların ortalama takip süresi 18 ay (2-125 ay) olarak belirlenirken, 65(%56) hasta halen hayattadır. Uzatılmış temozolamid (>6 ay) olan grupta genel sağkalım daha uzun tespit edilirken istatistiksel bir fark tek değişkenli analizde tespit edilememiştir sırasıyla 49.0 (≤6)vs 68.33 ay(>6). Ancak progresyonsuz sağkalım süresi uzatılmış temozolamid grubunda standart temozolamid alan gruba göre istatistiksel olarak anlamlı oranda uzun saptanmıştır 14 (>6)vs 9 ay(≤6). Gruplar arasında anlamlı bir yan etki farklılığı görülmemiştir.Sonuç: Çalışmamızda glioblastoma multiforme tanısı almış hastalarda uzatılmış temozolamid kullanımı hastaların progresyonsuz sağkalım ve genel sağkalımlarının belirgin oranda artmasına neden olur.

WOS: 000402802300019, PubMed ID: 28339289, Objective: To assess whether delineation courses for radiation oncologists improve interobserver variability in target volume delineation for post-operative gastric cancer radiotherapy planning. Methods: 29 radiation oncologists delineated target volumes in a gastric cancer patient. An experienced radiation oncologist lectured about delineation based on contouring atlas and delineation recommendations. After the course, the radiation oncologists, blinded to the previous delineation, provided delineation for the same patient. Results: The difference between delineated volumes and reference volumes for pre-and post-course clinical target volume (CTV) were 19.8% (-42.4 to 70.6%) and 12.3% (-12.0 to 27.3%) (p = 0.26), respectively. The planning target volume (PTV) differences pre-and post-course according to the reference volume were 20.5% (-40.7 to 93.7%) and 13.1% (-10.6 to 29.5%) (p = 0.30), respectively. The concordance volumes between the pre-and post-course CTVs and PTVs were 467.1 +/- 89.2 vs 597.7 +/- 54.6cm(3) (p < 0.001) and 738.6 +/- 135.1 vs 893.2 +/- 144.6 cm(3) (p < 0.001), respectively. Minimum and maximum observer variations were seen at the cranial part and splenic hilus and at the caudal part of the CTV. The kappa indices compared with the reference contouring at pre- and post-course delineations were 0.68 and 0.82, respectively. Conclusion: The delineation course improved interobserver variability for gastric cancer. However, impact of target volume changes on toxicity and local control should be evaluated for further studies. Advances in knowledge: This study demonstrated that a delineation course based on current recommendations helped physicians delineate smaller and more homogeneous target volumes. Better target volume delineation allows proper target volume irradiation and preventing unnecessary normal tissue irradiation.

Background: We sought to determine the outcomes of adjuvant small pelvic external beam radiotherapy (EBRT) and prognostic factors for survival and disease control. Patients and Methods: We retrospectively evaluated 113 cervical cancer patients treated with postoperative median 50.4-Gy small pelvic EBRT. We treated the surgical bed, bilateral parametria, paravaginal soft tissues, upper third of the vagina, and presacral lymphatics. Results: Median follow-up of all patients and survivors was 58 and 67 months, respectively. The 2- and 5-year overall survival (OS) and disease-free survival rates were 91 and 82%, and 85 and 74%, respectively. The locoregional failure rate was 10%. Age was a significant predictor for OS and distant metastasis-free survival (DMFS) on univariate analysis. The number of dissected lymph nodes being < 30 negatively affected the pelvic recurrence-free survival. The only independent predictor on multivariate analysis was older age for DMFS. Although no severe acute toxicity was observed, late grade ≥ 3 toxicity developed in 8 patients. Conclusion: Small pelvic EBRT produces satisfactory survival and locoregional control with acceptable toxicity, and can be an alternative to whole pelvic EBRT in selected cervical cancer patients.

Purpose: To investigate dosimetric effects of bladder distention on organs at risk (OARs) during treatment of endometrial cancer using 3D image-based planning of postoperative vaginal vault brachytherapy (BRT). Material and methods: Fifteen patients with early-stage endometrial cancer were studied, each undergoing adjuvant BRT of vaginal vault via 3.5 cm diameter cylinder. As treatment, 25 Gy in 5 fractions were delivered to 5 mm depth of the vaginal mucosa. Dose-volume histograms of OARs were generated individually with bladder empty and with bladder inflated by sterile saline (180 ml), to compare doses received. Results: Bladder distention appreciably impacted dosimetry of bladder, sigmoid colon, and small bowel, but dosimetry of rectum was unaffected. With bladder inflated, mean cylinder-to-bowel distance increased significantly (1.69 cm vs. 1.20 cm; p = 0.006). Mean minimum dose to most exposed 2 cc (D 2cc ) volume also rose significantly at bladder (5.40 Gy vs. 4.55 Gy [18.7%]; p < 0.001), as opposed to near-significant reductions in D 2cc at sigmoid colon (15.1%; p = 0.11) and at small bowel (10.5%; p = 0.14). A full bladder had no effect on dose to 50% volume (D 50% ) of bladder or rectum, and declines seen in mean D 50% values of sigmoid colon (22.7%; p = 0.12) and small bowel (19.0%; p = 0.13) again fell short of statistical significance. Conclusions: The combination of a full bladder and an empty rectum may cause significant unwanted increases in BRT dosing of bladder, without significantly impacting sigmoid colon and small bowel exposures. These findings should be validated through further clinical studies. J Contemp Brachytherapy 2014; 6, 4: 371–376 DOI: 10.5114/jcb.2014.47868