PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Long-term outcomes of cervical cancer patients with complete metabolic response after definitive chemoradiotherapy(2021) Onal, Cem; Guler, Ozan Cem; Reyhan, Mehmet; Yapar, Ali Fuat; 0000-0002-2742-9021; 34378362; D-5195-2014Objective: We investigated the importance of metabolic parameters measured with F-18-fluorodeoxyglucose positron-emission tomography integrated with computed tomography (FDG-PET/CT) for predicting progression-free survival (PFS) and overall survival (OS) in cervical cancer with complete metabolic response (CMR) after chemoradiotherapy (ChRT). Methods: The clinical data and PET parameters including standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of 122 patients having CMR in post-treatment F-18-FDG-PET/CT delivered a median of 3.9 months after ChRT completion were analyzed. Results: With a median follow-up of 8.4 years, 55 patients (45%) presented with disease a median of 19.7 months after ChRT. For SUVp, MTVp, TLGp, SUVln, MTVln, and TLGp, the cut-off values for OS determined by receiver operating curve analysis were 15.8, 48.7 cm(3), 552.3, 8.7, 7.0 cm(3), respectively. All metabolic PET parameters were significant prognostic factors for OS and PFS in univariate analysis. International Federation of Gynecology and Obstetrics (FIGO) stage was predictive of both OS and PFS, while pelvic and/or para-aortic lymph node metastasis were predictive of OS only. In multivariate analysis, FIGO stage >= IIB, MTVp >= 49.8 cm(3), and TLGp >= 597.4 were predictive of worse OS. Advanced stage, presence of lymph node metastasis, higher TLGp, and larger MTVln were significant factors for poor PFS rates. Conclusion: We found that advanced stage and higher TLGp values were significant predictors for poor survival and higher progression rates. Volumetric PET parameters could be used to predict treatment outcomes in patients with CMR after definitive ChRT.Item 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-5195-2014Purpose 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.Item Outcome of loco-regional radiotherapy in metastatic castration-resistant prostate cancer patients treated with abiraterone acetate(2019) Yildirim, Berna Akkus; Onal, Cem; Kose, Fatih; Oymak, Ezgi; Sedef, Ali Murat; Besen, Ali Ayberk; Aksoy, Sercan; Guler, Ozan Cem; Sumbul, Ahmet Taner; Mualloglu, Sadik; Mertsoylu, Huseyin; Ozyigit, Gokhan; 30701292Purpose To evaluate the potential benefit of curative radiotherapy (RT) to the primary tumor in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone. Materials and methods The clinical parameters of 106 mCRPC patients treated with abiraterone were retrospectively evaluated. Patients were either oligometastatic (<= 5 metastases) at diagnosis or became oligometastatic after the systemic treatment was analyzed. Local RT to the primary tumor and pelvic lymphatics was delivered in 44 patients (41%), and 62 patients (59%) did not have RT to the primary tumor. After propensity match analysis, a total of 92 patients were analyzed. Resultsn Median follow-up time was 14.2 months (range: 2.3-54.9 months). Median overall survival (OS) was higher in patients treated with local RT to the primary tumor than in those treated without local RT with borderline significance (24.1 vs. 21.4 months; p=0.08). Local RT to the prostate and pelvic lymphatics significantly diminished the local recurrence rate (16 patients, 31% vs. 2 patients, 5%; p=0.003). In multivariate analysis, the prostate specific antigen (PSA) response >= 50% of the baseline obtained 3 weeks after abiraterone therapy was the only significant prognostic factor for better OS and progression-free survival (PFS). Patients treated with primary RT to the prostate had significantly less progression under abiraterone and a longer abiraterone period than those treated without local prostate RT. Conclusions Local prostate RT significantly improved OS and local control in mCRPC patients treated with abiraterone. The patients treated with primary RT had significantly less progression under abiraterone and a longer abiraterone period than those treated without local prostate RT.