Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    Local Recurrence Outcomes After Breast Conserving Surgery and Adjuvant Radiotherapy in Ductal Carcinoma in Situ of The Breast And A Comparison With Ecog E5194 Study
    (2018) Akagunduz, Ozlem Ozkaya; Ergen, Arzu; Erpolat, Petek; Gultekin, Melis; Yildirim, Berna Akkus; Parvizi, Murteza; Ikiz, Didem; Oksuz, Didem Colpan; Onal, Cem; Yildiz, Ferah; Ozsaran, Zeynep; https://orcid.org/0000-0001-6661-4185; https://orcid.org/0000-0002-2742-9021; 30121548; V-5717-2017; D-5195-2014
    Purpose: Turkish Radiation Oncology Study Group investigated local recurrence rates and prognostic factors in patients with ductal carcinoma in situ (DCIS) of the breast treated with breast conservative surgery (BCS) followed by radiotherapy (RT) and Eastern Cooperative Oncology Group (ECOG) Study E5194 were compared with the original study. Patients and methods: Totally 252 patients were evaluated retrospectively. Prognostic factors that might influence local control (age, nuclear grade, comedo necrosis, surgical margins, tumor size, hormone receptor status) were compared. The eligibility criteria of ECOG 5194 were stratified into two groups as in the original study and were compared for local control. Results: The median follow-up time was 59 (21-220) months. Local recurrence was observed in 9 patients (3.6%) who had invasive carcinoma (3 patients) and DCIS (6 patients). Ten years local control rates was 91.8% respectively. We found that the risk of ipsilateral breast recurrence was significantly higher in women younger than 50 years old (p = 0.016). In addition, a statistically significant trend was found in patients with tumor larger than 1 cm and HER2 positive tumors (p = 0.051, p = 0.068 respectively). When 12-year results were compared with the ECOG 5194, adjuvant RT produced an absolute difference of 11% in low-intermediate and 20% in high grade in local control. Conclusion: In our study, the 10-year local control rate was 92% and younger than 50 years old was the most important unfavorable prognostic factor for local recurrence. There was provided 20% absolute local control with adjuvant radiotherapy which eligibility criteria of ECOG 5194 high grade group. (C) 2018 Elsevier Ltd. All rights reserved.
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    Treatment outcome and prognostic factors for adult patients with medulloblastoma: The Rare Cancer Network (RCN) experience
    (2018) Atalar, Banu; Ozsahin, Mahmut; Call, Jason; Napieralska, Aleksandra; Kamer, Serra; Villa, Salvador; Erpolat, Petek; Negretti, Laura; Lassen-Ramshad, Yasmin; Onal, Cem; Akyurek, Serap; Ugurluer, Gamze; Baumert, Brigitta G.; Servagi-Vernat, Stephanie; Miller, Robert C.; Ozyar, Enis; Sio, Terence T.; https://orcid.org/0000-0002-2742-9021; 29373196; D-5195-2014
    Background and purpose: The optimal treatment for adults with newly diagnosed medulloblastoma (MB) has not been defined. We report a large series of cases from the Rare Cancer Network. Material and methods: Thirteen institutions enrolled 206 MB patients who underwent postoperative radiotherapy (RT) between 1976 and 2014. Log-rank univariate and Cox-modeled multivariate analyses were used to analyze data collected. Results: Median patient age was 29 years; follow-up was 31 months. All patients had the tumor resected; surgery was complete in 140 (68%) patients. Postoperative RT was given in 202 (98%) patients, and 94% received craniospinal irradiation (CSI) and, usually, a posterior fossa boost. Ninety-eight (48%) patients had chemotherapy, mostly cisplatin and vincristine-based. The 10-year local control, overall survival, and disease-free survival rates were 46%, 51%, and 38%, respectively. In multivariate analyses, Karnofsky Performance Status (KPS) >= 80 and CSI were significant for disease-free and overall survival (P <= .04 for all); receiving chemotherapy and KPS >= 80 correlated with better local-control rates. Conclusions: Patients with high KPS who received CSI had better rates of disease-free and overall survival. Chemotherapy was associated with better local control. These results may serve as a benchmark for future studies designed to improve outcomes for adults with medulloblastoma. (C) 2018 Elsevier B. V. All rights reserved. Radiotherapy and Oncology 127 (2018) 96-102
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    National Multi-Center Observational Retrospective Study to Understand Treatment Patterns and Outcomes for Stage III Non-Small Cell Lung Cancer Patients in Turkey: Turkish Society for Radiation Oncology Study, STONE Trial
    (2022) Onal, Cem; Demiral, Ayse Nur; Atalar, Banu; Yalman, Deniz; Dagoglu, Nergiz; Hurmuz, Pervin; Erpolat, Petek; Akyurek, Serap; Gul, Sute Karabulut; Berber, Tanju; Guler, Ozan Cem; Umay, Cenk; Sert, Fatma; Karahacioglu, Eray; Birgi, Sumerya Duru; Yaprak, Gokhan; Saglam, Esra Kaytan
    This study investigated treatment patterns and outcomes in patients with inoperable stage III non-small cell lung cancer (NSCLC) treated with radiotherapy (RT) in Turkey. We included 492 patients with stage III NSCLC in this multi-center retrospective study. Pa-tient demographics, clinical characteristics, and clinical treatment patterns from the time of the initial diagnosis to disease progression were recorded. Additionally, the prognostic factors predicting overall survival (OS) and progression-free survival (PFS) were analyzed. For the initial treatment, 429 patients (89.2%) received chemotherapy and RT, whereas 53 patients (10.8%) were treated only with RT. The first disease progression occurred in 288 patients (58.4%) at 9.3 months (median) after the initial treatment, and 64.6% re-ceived treatment after first progression. The second disease progression occurred in 30 patients, and 20 patients (66.7%) received treatment. Median OS and PFS were 27.0 months and 13.4 months, respectively. Age (p< 0.001), stage (p= 0.04), poor performance score (PS) (p= 0.03) and RT doses (p= 0.002) were independent predictors for OS and PFS in our multivariate analysis. Additional significant predictors for OS in the multivariate analysis were gender (p= 0.004), treatment period (0.02), and irradiation technique (p= 0.02). Disease progression occurred in nearly 58% of the patients, and one-third of these patients remained untreated during the disease progression. These findings indicate a need for additional treatment options in patients with unresectable stage III NSCLC with high-risk features, namely older age, stage IIIB disease, poor PS, and lower RT doses.