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Objective: Lung cancer is the most common cancer worldwide and is among the leading causes of cancer death. The aim of this study is to examine the survival of patients who received radiotherapy for the brain metastases, whose primary is non-small cell lung cancer, and also determine the factors that are like to affect the survival and to examine the results of radiotherapy in these patients as well. Materials and Methods: This study included 99 patients with primary non-small cell lung cancer. All patients with brain metastases received radiotherapy. The patients were grouped and compared according to the number of brain metastases, whether surgery was performed for brain metastasis, gender, pathology and stage of the primary focus, visceral organ involvement, and ECOG performance status after brain metastasis developed. Results: The change in survival rate according to the number of brain metastases at the time of diagnosis was found statistically significant (p

Amaç: Bu çalışmanın amacı, invaziv meme kanserli hastalara uygulanan adjuvan radyoterapinin sağkalıma etkisini araştırmak ve hastaların prognostik faktörleri ile sağkalım arasındaki ilişkiyi belirlemektir. Giriş: Yaşları 35-55 yaş arası olan kadınlarda meme kanseri en sık ölüm nedenidir. Meme kanserlerinde cerrahi, kemoradyoterapi, radyoterapi, hormon tedavisi ve immünoterapi uygulanan tedavi yöntemleridir.Gereç ve Yöntemler: Mayıs 2016-Mart 2019 tarihleri arasında Adana Şehir Eğitim ve Araştırma Hastanesi Radyasyon Onkolojisi polikliniğine başvuran ve invaziv meme kanseri nedeniyle adjuvan radyoterapi alan, yaşları 39-68 arasında olan 120 hasta, retrospektif olarak çalışmamıza dahil edildi.Bulgular: Lenfovasküler invazyon, insan epidermal büyüme faktörü reseptör 2 pozitifliği, tümör ve lenf nodu durumu ile genel sağkalım arasında istatistiksel olarak anlamlı bulgular elde edildi. Fakat menapoz durumu, uygulanan cerrahi yöntem, histopatolojik tümör tipi, ekstrakapsüler invazyon varlığı, östrojen ve progesteron hormon reseptörleri ile genel sağkalım arasında istatistiksel olarak anlamlı bir bulguya ulaşılamadı. Östrojen ve progesteron reseptörlerinin pozitif olması prognoz açısından olumlu bulunurken, Her2 pozitif olması prognoz açısından olumsuz bulunmuştur.Tartışma: Çalışmaya dahil edilen hasta sayısının yetersiz olmasından dolayı, istatistiki olarak anlamsız sonuçlar elde ettiğimizi düşünmemize rağmen bu sonuçların genel sağkalım üzerindeki etkilerini gösterdik. Modern görüntüleme yöntemleriyle erken teşhis, meme kanserinde genel sağkalımı artırsa da, uygun hastalar için uygun tedavilerin seçimi çok önemlidir.Sonuç: İstatistiksel olarak yeterince belirleyemesek de, literatürdeki önceki çalışmalar ve bu çalışmada ki gözlemlerimiz ışığında adjuvan radyoterapinin sağkalımı olumlu etkilediği sonucuna vardık. Objective: The aim of this study is to investigate the effect of adjuvant radiotherapy applied on patients with invasive breast cancer on survival and to determine the relationship between prognostic factors and survival in patients.Introduction: Breast cancer is the most common cause of death in women between the ages of 35-55. Surgery, chemoradiotherapy, radiotherapy, hormone therapy and immunotherapy are treatment modalities applied in breast cancers.Materials and Methods: Our retrospective study included 120 patients ranging between 39 and 68 years who were admitted to Adana City Education and Research Hospital Radiation Oncology outpatient clinic between May 2016 and March 2019 and who received adjuvant radiotherapy due to invasive breast cancer.Results: Statistically significant findings were obtained between lymphovasculer invasion, human epidermal growth factor receptor 2 positivity, tumor and lymph node status and overall survival. But, no statistically significant findings could be attained between menapause status, surgical method applied, histopathological type of tumor, presence of extracapsular invasion, estrogen and progesterone hormone receptors and overall survival. While estrogen and progesterone receptors were found to be positive in terms of prognosis, Her2 positive was found to be negative in terms of prognosis.Discussion: Statistically insignificant results are thought to arise from insufficient number of patients incorporated in the study, however, their effect on overall survival was exhibited. Although early diagnosis with modern imaging methods increases overall survival in breast cancer, the selection of appropriate treatments for suitable patients is crucial.Conclusion: Even though we could not specify enough statistically, we concluded that adjuvant radiotherapy positively affected survival in the light of previous studies in the literature and our observations during present study.

Introduction: Ductal carcinoma in situ is a non-invasive pathology of breast cancer. Pure ductal carcinoma in situ is extremely rare, although it is often accompanied by invasive breast cancers. Materials and Methods:The study included 27 patients who applied to the Adana City Training and Research Hospital Radiation Oncology outpatient clinic and received adjuvant radiotherapy with a diagnosis of pure ductal carcinoma in situ. Results:The mean age of the patients was 45.33 in the premenopausal period and 59.83 in the postmenopausal period, and a statistically significant result was obtained when the age of both groups was compared (p = 0.001). Age and tumor diameter (38.8%) was assessed statistically significant (p

Amaç: Bu çalışmada, prostat kanserlerinde metastatik kemiğe radyoterapi uygulanan hastalarda sağ kalım üzerine etkili olabileceği düşünülen faktörlerin karşılaştırılması amaçlanmıştır.Gereç ve Yöntemler: Prostat kanserinin kemik metastazı nedeniyle radyoterapi almış olan 92 hasta çalışmaya dahil edilmiştir.Bulgular: Yetmiş yaşından küçük hastalarda %57.1 oranında ölüm gözlenirken, >70 yaş hastalarda bu oran %74 olarak belirlenmiştir. Bu değerlerin karşılaştırılmasında her ne kadar istatistiksel olarak anlamlı fark görülmese de >70 olan hastaların ≤70 hastalara göre ölüm riskinin 2.135 kat daha yüksek olmaeğiliminde olduğu gözlenmiştir (p>0.05). Visseral organ metastazı ile birlikte kemik metastazı olan hastalarla, yalnız kemik metastazı olan hastaların sağ kalımı karşılaştırıldığında istatistiksel olarak anlamlı sonuç bulunmuştur (p, Objective: This study aimed to compare the factors that are thought to affect the survival of patients who received radiotherapy to the metastatic bone in prostate cancers.Material and Methods: The study included 92 patients who received radiotherapy for prostate cancer bone metastasis.Results: While death was observed with a rate of 57.1% in patients aged ≤70 years, this rate was determined as 74% in patients aged >70 years. Although there was no statistically significant difference in comparing these values, it was observed that patients aged >70 years tend to have a 2.135 times higher risk of death compared to patients aged ≤70 years (p>0.05). When the survival of patients with visceral organ metastasis and bone metastasis was compared with those with only bone metastasis, a statistically significant result was observed (p

Glioblastoma multiforme en sık görülen ve en agresif primer beyin tümörüdür. Glioblastoma multiforme'nin prognozu oldukça kötüdür. Bu tümörlerin küratif tedavilerinden sonra bile, intrakraniyal lokal nüks, kraniyal metastaz ve spinal metastazlar ortaya çıkabilir. Kraniyal glioblastoma multiforme olgularının %0.4–%2’sinde spinal metastaz teşhis edilebilir. Bu hastalarda tanıdan spinal metastaza kadar geçen süre 10-13 aydır ve spinal metastaz sonrası ortalama sağkalım süresi 3-4 aydır. Sol frontal lobda glioblastoma multiformeden operasyon öyküsü olan hastamızda sıradışı olarak tanıdan 4 yıl sonra spinal metastaz gelişmiş, hasta palyatif radyoterapiye rağmen tanıdan 53 gün sonra ölmüştür. Bu olguda uzun süre progresyonsuz seyreden supratentoryal yerleşimli primer glioblastoma multiformeden kaynaklanan nadir spinal metastazı vurgulayacağız.

In this study, our aim is to evaluate the quality of life, depression and anxiety of the Syrian patients who have brain metastasis and their relatives before starting radiotherapy and to correlate their depression and anxiety after radiotherapy. Brain metastases are frequently considered the last stage in many cancers. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, Beck Depression Inventory, and State-Trait Anxiety Inventory I-II test questionnaires were administered upon the arrival of 51 Syrian immigrant patients with brain metastases and their relatives to a radiotherapy clinic. Beck Depression Inventory, and State-Trait Anxiety Inventory questionnaires II were administered after radiotherapy. Beck Depression Inventory performed before and after radiotherapy in patients and their relatives and Beck Depression Inventory analysis was significant (p

Aim: Pancreatic cancer is a highly lethal malignancy and in locally advanced disease, chemotherapy (CT) or chemoradiotherapy (CRT) are implemented. The aim of this retrospective study was to investigate the general characteristics and survival of our patients receiving CRT. Material and Method: Between the years 2009-2013, 62 pancreatic cancer patients were taken into study who admitted to Van Training and Research Hospital. Eight patients who had whipple operation received radiotherapy (RT) with concurrent CT. Fifty-four patients who were considered to be inoperable underwent CRT. As adjuvant treatment dose, 45 Gy (1,8 Gy/fx/day) radiotherapy was administered to pancreas and regional lymph nodes. In patients who had taken definitive CRT, average 50.4 Gy (1.8 Gy/fx/day) dose was given. Statistical analysis was carried out using SPSS 19 software package; Kaplan-Meier analysis method was used for survival and log-range test for comparisons. Results: Twenty-four patients (38.7%) were female and 38 (61.3%) were male. Eleven patients (17.7%) were at stage IA, 16 (25.8%) were stage IB, 13 (20.9%) were stage IIA, 8 (12.9%) were stage IIB and 14 (22.5%) were staged as stage III. Two-year disease free survival (DFS); time from the date of biopsy until the date of recurrence was approximately 436 days and the median DFS was found to be 362 days. The average overall survival (OS) time; time from the date of biopsy until the date of death were found to be approximately 854 days, the median survival time was found to be 916 days. Survival due to tumor localization (head, body and tail) showed no significant difference statistically (log-range chi-square=0.366;p=0.833). Discussion: According to our single center experience, our data in pancreatic cancer patients were parallel with international data. In preclinical experiments, effective drug therapies for curative modalities are under investigation for pancreatic cancer patients.

Introduction: Non - hepatosplenic Extramedullary Hematopoiesis (NHEMH) is seen as a compensation mechanism in the patients with hematologic dysfunction. Thalassemia is an autosomal recessive hematologic disorder. The tissue involvement is seen very rarely in thalasemia major. Case: A 45 - years old patien t diagnosed with thalassemia major was presented in this case report. The patient had splenectomy after 12 years from diagnosis and he was followed with continuous blood transfusions. Due to the newly emerged chest pain and dyspnea, he was evaluated with c omputed tomography. The operation was done for paraspinal masses caused by NHEMH. But same complaints were seen after 5 years from the operation. Paraspinal and sacral recurrences Mini - r eview Article

Maksiller sinuste miyoepitelyoma, nadir gorulmektedir. Miyoepilelyoma ozellikle tukruk bezlerinde sik olarak karsimiza cikmaktadir. Cok daha az siklikla intraosseoz yapilarda olusmaktadir. Ozellikle kapali kemik yapilarda olusan miyoepitelyoma vakalari, klinik semptomlarini gec vermesi nedeniyle gec tani almaktadir. Bizde bu vaka takdimimizde cok nadir gorulen maksiler sinuse yerlesmis miyoepitelyoma vakasini sunacagiz. 81 yasindaki erkek hastamizda sert damakda sislik, agizda dolgunluk, yemek yiyememe ve bas agrisi sikayetleri olmasi uzerine yapilan tetkikler sonucunda, miyoepitelyoma tanisi konuldu. Hastaya 6000cGy kuratif olarak eksternal RT verildi. RT sonrasi 19 aylik kontrollerinde hastanin kitlesinde kuculme, semptomlarinda azalma saptanmistir. Yapilan takiplerinde RT sonrasi yasam kalitesinde artma olmustur. Anahtar Kelimeler: Myoepitelyoma, radyoterapi

Background: The aim of this study was to investigate the general characteristics of patients with deep vein thrombosis (DVT) and pancreatic cancer as well as evaluate the relationship between mean platelet volume (MPV), DVT and survival. Materials and Methods: Seventy-seven patients with pancreatic cancer, who were admitted to Cukurova University Medical Faculty, Department of Medical Oncology, were enrolled in the study Results: The mean age was 59±20. Forty-nine (63.6%) were men and 28 women (36.4%) . Sixty-eight (88.3%) patients had adenocarcinoma and 9 (11.7%) had a malignant epithelial tumor. Thirty-six (46.7%) had liver metastasis at diagnosis. Twenty-six (33.8%) patients were alive, 20 (26%) were dead and in 31 (40.2%) the status was unknown. Only 14 (18.1%) patients had DVT. In 42 (54.5%) patients MPV values were normal, in 28 (36.4%) patients they were above normal, and in 7 (9.1%) patients they were below normal. There was no statistically significant difference between gender, tumour localization, chemotherapy and survival rates (p:0.56, p:0.11, p:0.21). There was no significant difference between DVT, gender, localisation, histological subtype, the presence of metastasis, stage and if the patient had been treated with chemotherapy (p:0.5, p:0.6, p:0.2, p:0.32, p:0.1, p:0.84). There was also no significant difference between MPV and DVT (p:0.57) but there was a significant difference between liver metastasis and DVT (p:0.02). Age, stage, the presence of metastasis and DVT were prognostic in pancreatic cancer patients. Conclusions: Cases of pancreatic cancer with liver metastasis should be studied more carefully as thrombosis is more common in these patients.

Aim: This study involved 30 patients (16 had gastric, 9 pancreatic and 5 gall bladder cancer) who had received concomitant chemoradiotherapy (CRT). Blood ghrelin and IL-6 values were compared before, in the last week of, and 3 months after CRT. Meanwhile, changes in body weight of patients were also investigated with changes in ghrelin and IL-6 levels before, in the last week of, and after radiotherapy (RT). Methods: Informed consent of the patients and the ethical committee approval from Cukurova University Medical Faculty were taken. Blood ghrelin and IL-6 levels were measured by using the ELISA method. Survival analysis was performed by the Kaplan Maier method, and data were evaluated by using the SPSS 19.0 package. Categorical measurements were calculated as numbers and percentages, whereas numerical data were summarized as mean and standard deviation. Results: The correlation between ghrelin and IL-6 values at the baseline of RT and overall survival rates at the end of the 30-month follow up was analyzed. Accordingly, ghrelin values were also changed in line with changes in patients’ weights (P < 0.001). Patients with ghrelin values above 35 pg/ml before RT had longer survival rates at the end of the 30-month follow up (P = 0.001). Overall survival rates in patients with IL-6 value at or below 3.9 pg/ml before RT were longer than patients with IL-6 value above 3.9 pg/ml (P = 0.021). Conclusion: Therefore, the initiation of ghrelin analogue prophylactically in patients receiving chemoradiotherapy with gastrointestinal system malignancies can both prevent weight loss by increasing appetite and decrease severity of inflammation, thereby increasing survival.

The examination of a twenty-eight-year-old male patient with lower back pain revealed a mass that extended through the spinal canal at the L1-L2 level and exhibited left paravertebral extension which was indistinguishable from the psoas muscle. Neuroblastoma was diagnosed after performing a biopsy. The disease progressed in that same year and in the following years, even after performing surgery, radiotherapy, chemotherapy, and bone marrow transplantation. The course of the disease was resistant to different high-dose chemotherapies and radiotherapy. The patient died four years after diagnosis. Neuroblastoma, a tumor which more frequently appears in children, is seen as an advanced or metastatic disease in adults. Currently there is no standard treatment for neuroblastoma in adults. The treatment protocols applied in children are insufficient for adults. Generally neuroblastoma is characterized as a localized disease, but in adults it is more aggressive.

Giriş: Primer spinal glioblastoma multiforme yüksek morbidite ve mortalite hızına sahip çok nadir görülen bir hastalıktır. Kesin bir tedavi algoritması yoktur ancak multimodal tedavi rejimleri uygulanmaktadır. Tedavinin amacı kitlenin tama yakın çıkarılması, sonrasında radyoterapi ve kemoterapinin kısa sürede uygulanmasıdır. Metod: 1989'dan itibaren İngilizce yazılmış makaleler, anahtar kelimelerin kullanılması ve derleme makalelerinden referansların ayrıştırılması yoluyla PubMed ve MEDLINE gibi arama motorları taranarak ayrıştırılmıştır. Kullanılan anahtar kelimeler primer, spinal ve glioblastoma multiformedir. Sonuçlar: Alt ekstremitede güçsüzlük ve gayta-üriner inkontinans ile başvuran 4 yaşındaki bir erkek hastada spinal manyetik rezonans görüntülemede (MRI)C2-T8 seviyesinde intramedüller kitle saptandı. Mikrocerrahi metodla kitlesi tama yakın çıkarılan hastada postoperatif dönemde sepsis gelişti. Radyoterapi başlanmasından kısa bir süre sonra klinik durumunda ve nörolojik tablosunda düzelme olan hasta ekstübe edildi. Tedavi sonrası hastanede 3 ay daha izlenmiştir. Literatür bulguları sGBM tedavisinde sekansiyel veya eş zamanlı olarak her üç modalitenin de kullanılabileceğini, kötü prognoza sahip olduğunu, hastaların çoğunluğunun hastalığa bağlı olarak öldüğünü ve semptomların süresinin çok kısa olduğunu göstermektedir. Tartışma: Hastalık nadir görüldüğü için, bu grup hasta popülasyonunda prospektif çalışmalar yapılamamaktadır. Introduction: Primary spinal glioblastoma multiforme is a very rare disease with high morbidity and mortality rates. No definite treatment algorhythm can be constituted, but multimodal treatment regimens have been administered. Aim of the treatment is to excise the mass nearly completely, and then application of radiotherapy and chemotherapy in a short period. Methods: Publications were identified by browsing search engines such as PubMed and MEDLINE for English-language articles since 1989 using a list of keywords; as well as identifying references from review articles. The following keywords were used for searching databases: primary, spinal, glioblastoma multiforme. Results: Intramedullary mass was detected at the levels of C2-T8 in the spinal magnetic resonance imaging (MRI) examination performed in our 4-year old male patient, who applied to us with complaints of weakness in lower extremities and gaita-urine incontinence. Sepsis was developed in postoperative period of the patient, whose mass was gross-totally resected by using microsurgery method. After the patient was started to have radiotherapy, he was extubated with improvements in the clinical state and neurological picture. He has been followed up at the hospital in the three-month monitorization after the treatment. Literature data suggested that all three therapy modalities can be used for sGBM, sequentially or concurrently, it has a poor survival, most of the patients die due to disease and the duration of symptoms are very short. Conclusion: Because the disease is very rare, prospective studies cannot be performed in this patient population.

Feryal Karaca1, Cigdem Usul Afsar2, Erkut Erkurt1, Hasan Suat Arslantas1, Elif Calis3, Berna Totan Ates3, Emine Bagir3, Melek Ergin3, Semra Paydas2 1Cukurova University Faculty of Medicine, Department of Radiation Oncology, Adana, Turkey 2Cukurova University Faculty of Medicine, Department of Medical Oncology, Adana, Turkey 3Cukurova University Faculty of Medicine, Department of Pathology, Adana, Turkey

e18538 Background: Lung cancer is the leading cause of cancer mortality worldwide. Chemotherapy (CT) is an integral part in the treatment of locally advanced NSCLC (LA-NSCLC) as it improves surviva...

Background: Radiotherapy (RT) is used as an indispensable treatment approach for cancer therapy as an adjuvant or alone for definitive option. For early stage endometrial cancer, RT is applied after operation as an adjuvant. Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a type of lymphoma which is seen rarely and has excellent prognosis with accurate treatment. It is another indication for RT. Developments in the diagnosis and the treatment of PCALCL have improved the disease prognosis and outcomes. Case Presentation: We present a case of a 55-years-old patient who had endometrial cancer and PCALCL, whose 9 years follow-up period was excellent with no recurrences and no metastasis. The outcome was achieved with the combination of surgery and RT. Conclusion: The presented case is important for long follow-up duration with no metastasis and/or no recurrences with single RT usage in both primary cancers. Single RT applications may be considered as an initial treatment option for surgically excised PCALCL with excellent outcome.

Background: Merkel cell carcinoma of skin is seen mostly in elderly Caucasians. Mortality and morbidity is very high. Treatment of these cases is also quite difficult. Recommended treatment is primary total excision, sentinel lymph node dissection after sentinel lymph node sampling and adding radiotherapy or chemotherapy according to stage. Case Presentation: A 35 year old female patient had surgery because of an unhealed wound on the right ear. After giving adjuvant curative radiotherapy the patient had been followed for 18 months. After 18 months of follow up, Merkel cell carcinoma metastasis was detected and para-aortic metastatic mass was resected. The patient is being considered for chemotherapy. Conclusion: Merkel cell carcinoma is an aggressive malignancy observed mostly in elderly Caucasians. Management consists of surgery with adjuvant chemotherapy and/or radiotherapy in accordance with the stage.