Wos Açık Erişimli Yayınlar

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Author: search.filters.author.Yavas, Cagdas

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    Prognostic Significance of Serum Human Epididymis Protein 4 Level in Patients with Locally Advanced Non-Small Cell Lung Cancer who Underwent Definitive Chemo-Radiotherapy
    (2022) Yavas, Guler; Birgi, Sumerya Duru; Unlu, Ali; Yavas, Cagdas; Duzova, Mursel; Akyurek, Serap
    We aimed to investigate the prognostic significance of serum human epididymis protein 4 (HE4) level in patients with locally advanced non-small cell lung cancer (LA-NSCLC) who underwent definitive chemo-radiotherapy (CRT). A hundred seventeen patients with the diagnosis of LA-NSCLC were enrolled. The serum concentrations of HE4 were measured at the beginning of CRT, at the end of CRT, and 3 months after the completion of CRT. The median follow-up period was 21.7 months (range, 5.4-39.8 months). The mean serum HE4 levels prior to CRT, at the end of the CRT, and 3rd month after the completion of CRT were 159.2, 130.2, and 127.5, respectively (p= 0.023). The median progression free survival (PFS) was 15.4 months. One, and two-year PFS rates were 58.1%, and 22.2%, respectively. One, and two-year expected survival rates were 81.2%, and 62%, respectively. In multivariate analysis, stage (p= 0.002), HE4 levels after 3 months of CRT (p= 0.037) were predictive of OS. Stage IIIC patients had 10.2 times likely to death when compared to stage IIIA patients (95%CI: 2.3-45.7; p= 0.037). The increase of 1 HE4 levels after 3 months of CRT increased the mortality rate 1.002 (95%CI: 1.000-1.0004; p= 0.037). In multivariate analysis stage was predictive of PFS. When compared to stage IIIA patients, stage IIIC patients have 2.5 times risk for progression (95% CI: 1.2-5.2; p= 0.014). Our findings suggested that serum HE4 may be an important prognostic biomarker for LA-NSCLC patients. This issue warrants further prospective studies with more patient populations.
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    Role of Consolidative Thoracic Radiotherapy for Extensive-stage Small Cell Lung Cancer: Trod Thoracic Oncology Study Group 08-006 Multi-institutional Study
    (2022) Yavas, Guler; Kirakli, Esra Korkmaz; Dagdelen, Meltem; Topkan, Erkan; Saynak, Mert; Dincbas, Fazilet Oner; OzdemIr, Yurday; Yavas, Cagdas; Birgi, Sumerya Duru; Akyurek, Serap
    OBJECTIVE We aimed to evaluate the role of consolidative thoracic radiotherapy (TRT) in patients with extensive-stage small cell lung cancer (ES-SCLC). METHODS The clinical data for 151 patients with the diagnosis of ES-SCLC treated with consolidative TRT from six different hospitals from Turkey analyzed. RESULTS The median age of the patients was 61 years (range 36-83 years). The median dose of radiotherapy (RT) was 45 Gy (range: 30-66 Gy) applied in median 25 fractions (range 10-34 fractions). For 151 assessable patients, the median survival time (MST) was 14 months (range: 12.6-15.3). The patients who has complete response and partial response had 16 months, and 14 months of MST. In multivariate analyses prophylactic cranial irradiation (PCI) (p=0.011), female gender (p=0.017), and comorbidity (p=0.006) were found as significant parameters associated with survival. The MSTs were 12 months in patients without comorbidity, and 16 months for the patients with at least one comorbid disease. The patients who received PCI had improved MSTs when compared the ones without PCI (16 months vs. 12 months). There was a trend towards improved overall survival times in patients who received EQD2 >= 47 Gy RT doses (p=0.08). CONCLUSION Female gender, use of PCI, and unavailability of comorbid disease were associated with improved survival in ES-SLCL patients. There was a trend towards overall survival times in patients who received >= 47 Gy EQD2 doses; however, we believe that this statistical insignificance was related to our limited patient numbers.
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    Cardiac angiosarcoma treated with 1.5 Tesla MR-guided adaptive stereotactic body radiotherapy-Case report and review of the literature
    (2022) Noyan, Asli; Yavas, Guler; Arslan, Gungor; Yavas, Cagdas; Onal, Cem; 0000-0002-2742-9021; 36027835; D-5195-2014
    Introduction: Cardiac angiosarcoma is a very rare disease. As a result of their nonspecific presentation symptoms, and the lack of consensus in treatment, caution should be taken in both diagnosis and treatment. The role of radiotherapy (RT) is debatable due to the continuous movement of the heart, which makes it difficult to safely deliver high radiation doses to the target volume.Presentation of case: The case of a 16-year-old boy with cardiac angiosarcoma that recurred one year after surgery and was treated with chemotherapy is presented. The patient received high field 1.5-Tesla (magnetic resonance) MR-Linac treatment in 5 fractions with a dosage of 25 Gy to the tumor bed and 30 Gy to the recurrent nodules using the simultaneous integrated boost technique. The patient tolerated the treatment well and had stable disease two months later. Discussion: MR-guided radiotherapy, particularly in the case of cardiac malignancies, allows for direct tumor visualization with high soft tissue image resolution capacity. Furthermore, modern RT techniques allow for the full therapeutic window to be used by achieving superior dose distributions, allowing for dose escalation stra-tegies with tolerable toxicity rates.Conclusion: Magnetic resonance guided RT allows direct visualization of the target during treatment delivery, allowing for higher-dose administration with less damage to healthy tissue near the tumor. This treatment strategy is a viable option in selected patients with cardiac angiosarcoma.
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    The utility of 1.5 tesla MR-guided adaptive stereotactic body radiotherapy for recurrent ovarian tumor - Case reports and review of the literature
    (2022) Yavas, Guler; Kuscu, Ulku Esra; Ayhan, Ali; Yavas, Cagdas; Onal, Cem; 36261943
    Introduction: Although epithelioid ovarian cancer (EOC) is a radiosensitive tumor and radiotherapy (RT) played a significant role in adjuvant treatment management in the past, the role of RT has evolved with the advent of platinum-based chemotherapy regimens. Nonetheless, modern RT techniques may be useful in certain patients particularly those with recurrent disease.Presentation of case: After surgery and chemotherapy, two patients, aged 57 and 70, presented with recurrent lesions in the parailiac region. The recurrent lesions were treated with high field 1.5-Tesla MR-Linac treatment in 5 fractions at a dose of 30 Gy. The patients tolerated the treatment well and were disease free after 12 and 20 months of magnetic resonance guided radiotherapy (MRgRT), respectively.Discussion: MRgRT is a novel and rapidly evolving technology that allows for the highly precise treatment of even mobile targets through direct visualization of the tumor. The majority of patients with EOC frequently present with abdominal-pelvic recurrences. It has been demonstrated that EOC requires high radiation doses for curative treatment. MR-Linac enables monitoring of organ motion during treatment, which is necessary for delivering higher doses to target volumes while sparing surrounding organs.Conclusion: To reduce radiation doses to nearby normal tissues, MRgRT allows for the delivery of hypofractio-nated RT with tight safety margins. Regardless of initial resistance or gradual development of intolerance to standard chemotherapy regimens, the role of RT in patients with persistent or recurrent EOC should be reconsidered.
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    Comment on Hunt et al, "Feasibility of magnetic resonance guided radiotherapy for the treatment of bladder cancer"
    (2021) Yavas, Guler; Yavas, Cagdas; Arslan, Gungor; Onal, Cem; 33912694
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