Tıp Fakültesi / Faculty of Medicine

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

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2015 - 20192

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Author: search.filters.author.Hurmuz, PervinHas files: Yes

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    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.
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    Three Dimensional Conformal Radiotherapy and Androgen Deprivation Therapy in Patients with Clinically Localized Prostate Cancer; Hacettepe University Experience
    (2015) Ozdemir, Yurday; Akyol, Fadil; Ozyiğit, Gokhan; Hurmuz, Pervin; Onal, Cem; Selek, Ugur; Karabulut, Erdem
    The aim of this study into evaluate the treatment results of three dimensional conformal radiotherapy (3DCRT) and androgen deprivation therapy (ADT) in patients with clinically localized prostate cancer (CLPC). Between June 1998 and December 2011, 577 patients with the diagnosis of CLPC were treated. ADT was started 3 months prior to radiotherapy (RT). 3DCRT was delivered to prostate and the seminal vesicles (SV) to a total dose of 70Gy. Additionally, patients with lymph node (LN) positivity received 50.4Gy RT to pelvic LN's. Median follow up time was 65 months. Five-ten years overall survival (OS), cause specific survival (CSS), PSA relapse-free survival (PSA-RFS) and distant metastasis-free survival (DMFS) rates were 92-74%, 97-91%, 77-55% and 94-88%, respectively. OS was negatively affected from LN positivity (p < 0.001). In the subgroup of patients With GS 8, there was no significant difference between < 1 years and 1 years of ADT in terms of CSS, PSA-RFS and DMFS. OS was better in patients with < 1 years of ADT (p = 0.01). Five year OS (p = 0.02), CSS (p = 0.05), PSA-RFS (p = 0.01) and DMFS (p = 0.07) rates were inferior in the high risk group patients that used ADT 1 year. Acute and late RTOG grade III/IV gastrointestinal system toxicity rates were 1.7% and 5% and acute and chronic RTOG grade III/IV genitourinary system toxicity rates were 1.4% and 5%, respectively. 3DCRT and ADT combination is an effective treatment modality with acceptable toxicities in patients with clinically localized prostate cancer.