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Öğe Evaluation of swallowing function with clinical and dosimetric parameters in head and neck cancer patients receiving radio (chemo)therapy(Ijrr-Iranian Journal Radiation Res, 2019) Turkkan, G.; Caloglu, M.; Yurut-Caloglu, V; Karasalihoglu, A. R.; Dogan, M.; Uzal, C.Background: This study aimed to evaluate the relationship between late dysphagia and dosimetric-clinical parameters in patients receiving radiotherapy for head and neck cancer (HNC). Materials and Methods: Twenty-six HNC patients treated with three-dimensional conformal radiotherapy were evaluated. A total dose of 66-70 Gy in 33-35 fractions was administered for curative purposes. Six swallowing organs at risk were contoured for each patient: the superior, middle and inferior pharyngeal constrictor muscles (SPCM, MPCM and IPCM); the cervical oesophagus (CE); the base of tongue (BOT); and the larynx. The mean dose in Gray [Dmean (Gy)], maximum dose in Gray [Dmax(Gy)] and percentages of organ volumes receiving >= 50 Gy, >= 60 Gy and >= 70 Gy [V50 (%), V60 (%) and V70 (%), respectively] were calculated from the dose-volume histograms for each structure. Dysphagia was evaluated using video laryngoscopy, the European Organization for Research and Treatment of Cancer quality of life module for HNC and the Leipzig scale. Results: Dmean, V60 and V70 for the BOT; Dmean and V60 for the SPCM; Dmean, Dmax, V60 and V70 for the IPCM; Dmean, Dmax, V60 and V70 for the larynx; and Dmean, Dmax, V50 and V70 for the CE were correlated with the presence of pharyngeal secretion. Only V50 for the CE was correlated with abnormal glottic closure. Dmean, Dmax, V60 and V70 for the BOT and the SPCM were correlated with liquid swallowing problems. Dmax for the MPCM; Dmean, Dmax, V60 and V70 for the IPCM; and Dmax, V60 and V70 for the CE were correlated with the Leipzig score. Conclusion: The dose-volume parameters of swallowing organs were found to be associated with different rates of late dysphagia in HNC patients receiving radiotherapy. The identification of dosimetric parameters that predict late dysphagia is not adequate yet. Well-designed multi-institutional studies are necessary to clarify the dose-volume constraints.Öğe Investigation of cardiac and pulmonar doses in patients with left sided breast cancer treated by radiotherapy with deep inspiration breath hold technique(Ijrr-Iranian Journal Radiation Res, 2022) Parlar, S.; Var, G.; Cosar, R.; Dogan, M.; Ozguven, Y.; Nurlu, D.; CemUzal, M.Background: Cardiac disease is a documented risk factor in left breast irradiation. In an attempt to reduce cardiac toxicity, different treatment techniques adapted to respiratory cycle phases have been developed. The aim of this study is to investigate the feasibility of the voluntary breath hold technique when irradiating the left breast in selected patients. Material and Methods: The study included 20 patients with left sided breast cancer. For each patient, two computed tomography (CT) scans were acquired, one with the free breathing (FB) technique and one with the voluntary deep inspiration breath hold (DIBH) technique. Treatment plans were created using a field-in-field intensity-modulated radiation therapy technique. A dosimetric comparison was made between the two techniques for the heart, left anterior descending (LAD) coronary artery, ipsilateral lung and contralateral breast. Results: The average of the mean dose of the heart decreased from 7.7 Gy to 5.8 Gy and V-20(Gy) (%) from 12.8% to 8.3% using the DIBH technique (p=0.009, p<0.001). The DIBH technique demonstrated significantly smaller maximum heart distance (2.0 cm vs. 0.9 cm, p < 0.001) and 8.0% reduction in LAD mean dose. Furthermore, D-mean for the ipsilateral lung was reduced from 12.8 Gy to 12.2 Gy and V-20(Gy) (%) from 25.6% to 22.8%. Conclusion: In the treatment plans made using the DIBH technique, a significant reduction in the radiation dose delivered to the heart has been observed. In order to reduce long-term morbidity and mortality risks from cardiovascular disease affecting the survival of patients with left sided breast cancer, irradiation techniques such as the DIBH should be considered, especially for premenopausal patients.