Browsing by Author "Igdem, Sefik"

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Evaluation of Nutritional Status and Anxiety Levels in Patients Applying to the Radiation Oncology Outpatient Clinic during the COVID-19 Pandemic: Turkish Society for Radiation Oncology Group Study (TROD 12:02)
(2022) Caloglu, Vuslat Yurut; Akmansu, Muge; Yalman, Deniz; Gul, Sule Karabulut; Kocak, Zafer; Alicikus, Zumre Arican; Serarslan, Alparslan; Akyurek, Serap; Mustafayev, Teuta Zoto; Demiroz, Candan; Oksuz, Didem Colpan; Kanyilmaz, Gul; Altinok, Pelin; Saglam, Esra Kaytan; Balkanay, Ayben Yentek; Akboru, Halil; Keven, Emine; Yildirim, Berna; Onal, Cem; Igdem, Sefik; Ozkan, Emre; Ozdener, Fatih; Caloglu, Murat; 35792709
Cancer patients often face malnutrition, which negatively affects their response to cancer treatment. This study aims to analyze the effects of the COVID-19 pandemic on nutritional status and anxiety in cancer patients with different types and stages of cancer. This is a cross-sectional cohort study that includes 1,252 patients with varying cancer types from 17 radiation oncology centers. The nutritional risk scores (NRS-2002) and coronavirus anxiety scale (CAS) scores of all patients were measured. NRS-2002 >= 3 and CAS >= 5 were accepted as values at risk. Of all patients, 15.3% had NRS-2002 >= 3. Breast cancer was the most prevalent cancer type (24.5%) with the lowest risk of nutrition (4.9%, p < 0.001). Nutritional risk was significantly higher in patients with gastrointestinal cancer, head and neck cancer, and lung cancer (p < 0.005) and in patients with stage IV disease (p < 0.001). High anxiety levels (CAS >= 5) were significantly related to voluntary avoidance and clinical postponement of hospital visits due to the pandemic (p < 0.001), while clinical postponement was particularly frequent among patients with NRS-2002 < 3 (p = 0.0021). Fear and anxiety in cancer patients with COVID-19 cause hesitations in visiting hospitals, leading to disrupted primary and nutritional treatments. Thus, nutritional monitoring and treatment monitoring of cancer patients are crucial during and after radiotherapy.
Oligometastatic Bone Disease in Castration-Sensitive Prostate Cancer Patients Treated With Stereotactic Body Radiotherapy Using Ga-68-PSMA PET/CT TROD 09-004 Study
(2021) Onal, Cem; Ozyigit, Gokhan; Akgun, Zuleyha; Atalar, Banu; Igdem, Sefik; Oymak, Ezgi; Agaoglu, Fulya; Selek, Ugur; Guler, Ozan Cem; Hurmuz, Pervin; 33661210
Purpose To evaluate the outcomes of metastasis-directed treatment (MDT) using stereotactic body radiotherapy (SBRT) for bone-only oligometastasis (OM) detected with gallium prostate-specific membrane antigen (Ga-68-PSMA) PET/CT in castration-sensitive prostate cancer (PC) patients. Methods In this multi-institutional study, clinical data of 74 PC patients with 153 bone lesions who were undergoing MDT were retrospectively evaluated. Twenty-seven patients (36.5%) had synchronous, and 47 (63.5%) had metachronous OM. All patients had PC with 5 metastases or fewer detected by Ga-68-PSMA PET/CT and treated using SBRT with a median dose of 20 Gy. The prognostic factors for PC-specific survival (PCSS) and progression-free survival (PFS) were analyzed. Results The median follow-up was 27.3 months. Patients with synchronous OM were older and received higher rates of androgen deprivation therapy after SBRT compared with patients with metachronous OM. The 2-year PCSS and PFS rates were 92.0% and 72.0%, respectively. A prostate-specific antigen (PSA) decline was observed in 56 patients (75.7%), and 48 (64.9%) had a PSA response defined as at least 25% decrease of PSA after MDT. The 2-year local control rate per lesion was 95.4%. In multivariate analysis, single OM and PSA response after MDT were significant predictors for better PCSS and PFS. In-field recurrence was observed in 4 patients (6.5%) with 10 lesions at a median of 13.1 months after MDT completion. No serious late toxicity was observed. Conclusions We demonstrated that SBRT is an efficient and well-tolerated treatment option for PC patients with 5 bone-only oligometastases or fewer detected with Ga-68-PSMA PET/CT.
Treatment outcomes of metastasis-directed treatment using(68)Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002)
(2020) Hurmuz, Pervin; Onal, Cem; Ozyigit, Gokhan; Igdem, Sefik; Atalar, Banu; Sayan, Haluk; Akgun, Zuleyha; Kurt, Meral; Ozkok, Hale Basak; Selek, Ugur; Oymak, Ezgi; Tilki, Burak; Guler, Ozan Cem; Mustafayev, Teuto Zoto; Saricanbaz, Irem; Rzazade, Rashad; Akyol, Fadil; 0000-0001-6908-3412; 0000-0002-2742-9021; 32617620; AAC-5654-2020; D-5195-2014
Purpose The aim of this study was to evaluate the outcomes of(68)Ga prostate-specific membrane antigen (Ga-68-PSMA) positron-emission tomography (PET)/CT-based metastasis-directed treatment (MDT) for oligometastatic prostate cancer (PC). Methods In this multi-institutional study, clinical data of 176 PC patients with 353 lesions receiving MDT between 2014 and 2019 were retrospectively evaluated. All patients had biopsy proven PC with <= 5 metastases detected with(68)Ga-PSMA-PET/CT. MDT was delivered with conventional fractionation or stereotactic body radiotherapy (SBRT) techniques. CTCAE v4.0 was used for acute and RTOG/EORTC Late Radiation Morbidity Scoring Schema was used for late toxicity evaluation. Results At the time of MDT, 59 patients (33.5%) had synchronous and 117 patients (66.5%) had metachronous metastases. Median number of metastases was one and the MDT technique was SBRT in 73.3% patients. The 2-year overall survival (OS) and progression-free survival (PFS) rates were 87.6% and 63.1%, respectively. With a median follow-up of 22.9 months, 9 patients had local recurrence at the irradiated site. The 2-year local control rate at the treated oligometastatic site per patient was 93.2%. In multivariate analysis, an increased number of oligometastases and untreated primary PC were negative predictors for OS; advanced clinical tumor stage, untreated primary PC, BED3 value of <= 108Gy, and MDT with conventional fractionation were negative predictors for PFS. No patient experienced grade >= 3 acute toxicity, but one patient had a late grade 3 toxicity of compression fracture after spinal SBRT. Conclusion Ga-68-PSMA-PET/CT-based MDT is an efficient and safe treatment for oligometastatic PC patients. Proper patient selection might improve treatment outcomes.
Treatment outcomes of prostate cancer patients with Gleason score 8-10 treated with definitive radiotherapy
(2019) Ozyigit, Gokhan; Onal, Cem; Igdem, Sefik; Alicikus, Zumre Arican; Iribas, Ayca; Akin, Mustafa; Yalman, Deniz; Cetin, Ilknur; Aksu, Melek Gamze; Atalar, Banu; Dincbas, Fazilet; Hurmuz, Pervin; Guler, Ozan Cem; Aydin, Barbaros; Sert, Fatma; Yildirim, Cumhur; Gorken, Ilknur Birkay; Agaoglu, Fulya Yaman; Korcum, Aylin Fidan; Yüce, Deniz; Ozkok, Serdar; Darendeliler, Emin; Akyol, Fadil; 31143994
Purpose To validate the clinical outcomes and prognostic factors in prostate cancer (PCa) patients with Gleason score (GS) 8-10 disease treated with external beam radiotherapy (EBRT)+ androgen deprivation therapy (ADT) in the modern era. Methods Institutional databases of biopsy proven 641 patients with GS 8-10 PCa treated between 2000 and 2015 were collected from 11 institutions. In this multi-institutional Turkish Radiation Oncology Group study, a standard database sheet was sent to each institution for patient enrollment. The inclusion criteria were, T1-T3N0M0 disease according to AJCC (American Joint Committee on Cancer) 2010 Staging System, no prior diagnosis of malignancy, at least 70Gy total irradiation dose to prostate +/- seminal vesicles delivered with either three-dimensional conformal RT or intensity-modulated RT and patients receiving ADT. Results The median follow-up time was 5.9 years (range 0.4-18.2 years); 5-year overall survival (OS), biochemical relapse-free survival (BRFS) and distant metastases-free survival (DMFS) rates were 88%, 78%, and 79%, respectively. Higher RT doses (>= 78Gy) and longer ADT duration (>= 2 years) were significant predictors for improved DMFS, whereas advanced stage was a negative prognosticator for DMFS in patients with GS 9-10. Conclusions Our results validated the fact that oncologic outcomes after radical EBRT significantly differ in men with GS 8 versus those with GS 9-10 prostate cancer. We found that EBRT dose was important predictive factor regardless of ADT period. Patients receiving 'non-optimal treatment' (RT doses <78Gy and ADT period <2 years) had the worst treatment outcomes.