Yazar "Kucucuk, Seden" seçeneğine göre listele

Listeleniyor 1 - 4 / 4
  • Küçük Resim Yok
    Öğe
    The Effect of Positional Movement of a Semiflexible Applicator on Dose Distrubutions in Low Dose Rate Brachytherapy for Cervical Carcinoma
    (Ortadogu Ad Pres & Publ Co, 2010) Kucucuk, Seden; Kemikler, Gonul; Okutan, Murat; Aslay, Isik; Disci, Rian; Alas, Rusen Cosar; Tore, Gokhan
    Objective: Current study aims to detect the movements of a semiflexible applicator (TORE's applicator) in the first 24 hours and to analyze its effect on the calculated point A, bladder and rectum doses in low dose rate brachytherapy (LDR-BT) applications. Material and Methods: Eighty films were evaluated on 18 cervical carcinoma patients (20 applications) who were treated with curative radiotherapy. The comparison of the reference points and doses at critical organs were performed by using a reference axis which was fixed to bony landmarks in the pelvis. To evaluate the movement of the applicator, distance of the upper point and lower point of the tandem to the reference axis were measured. Additionally, the angular deviation of the applicator was tested. Results: The movements of the upper point and lower point of the tandem in x, y, z axes were 5.30 +/- 6.33 mm, 2.80 +/- 2.24 mm, 6.65 +/- 8.33 mm and 3.45 +/- 4.32 mm, 3.75 +/- 3.59 mm, 3.05 +/- 3.08 mm, respectively. The mean differences were 3.30 +/- 2.99 degrees in alpha-angle and 5.65 +/- 4.76 degrees in beta-angle. The mean percent dose changes in point A, bladder and rectum were 1.5 +/- 1.2%, 3.7 +/- 3.1%, 4.4 +/- 4.0%, respectively. Conclusion: Our study demonstrates that there are some movements of the applicator during LDR-BT, however these movements do not result in significant dose changes in target volumes and critical organs. Therefore, positional correction is not required. In conclusion, CT-compatible TORE's applicator that allows an advantage for CT-based 3D planning is useful and safe for brachytherapy.
  • Küçük Resim Yok
    Öğe
    Evaluation of prognostic factors and comparison of systemic treatment modalities in patients with recurrent or metastatic endometrial carcinoma
    (Humana Press Inc, 2006) Karagol, Hakan; Saip, Pinar; Uygun, Kazim; Kucucuk, Seden; Aydiner, Adnan; Topuz, Erkan
    Background: Prognostic factors related to survival in patients with inoperable metastatic or recurrent endometrial carcinoma (MREC) have remained unclear due to lack of clinical trials.The management of these patients is also controversial.This study was performed to compare the efficacy and toxicity profiles of two different systemic therapies (chemotherapy vs hormonal therapy) given for the treatment of patients with MREC and to identify the impact of various prognostic factors on the survival. Methods: Between 1992 and 2004, 44 patients with MREC were admitted to our oncology department. Four cases were excluded from this retrospective study because of lack of data in their charts. Age, presence of other systemic diseases (such as diabetes mellitus, hypertension), histological type, tumor grade, staae, disease-free interval, site of recurrence or metastasis, systemic treatment modality, overall response to treatment, and duration of time to progression were evaluated as prognostic factors. Cox regression analysis was per-formed for identification of independent prognostic factors and differences between patients characteristics of two treatment groups were calculated by the chi-square or t test. Results: The median follow-up was 18 mo (range 3-113). The overall response rates for chemotherapy and hormonal therapy group were 42% and 41 %, respectively (p > 0.05). The median time to progression was 4 mo for the chemotherapy group and 5 mo for the hormonal therapy group (p > 0.05). The median survival after metastasis or recurrence was I I mo for the chemotherapy group and 16 mo for the hormonal therapy group (p > 0.05). In the group of chemotherapy, grade 3-4 hematologic and northematologic toxicities were seen in eight and two, patients, respectively. No grade 3-4 toxicities were noted in patients treated with hormonal C therapy. In multivariate analysis, only time to progression (p = 0.001) and grade (p = 0.04) were the independent prognostic factors on survival after metastasis or recurrence. Conclusion: Histological differentiation and duration of time to progression are predictive factors for survival after metastasis or recurrence in the whole group. The efficacy of two different groups of treatment in these patients appears to be similar. But the chemotherapy may have some disadvantageous in terms of toxicity. This study supports a future randomized prospective trial of hormonal therapy vs chemotherapy in patients with MREC.
  • Küçük Resim Yok
    Öğe
    Factors affecting the prognosis of breast cancer patients with brain metastases
    (Churchill Livingstone, 2008) Saip, Pinar; Cicin, Irfan; Eralp, Yesim; Kucucuk, Seden; Tuzlali, Sitki; Karagol, Hakan; Aslay, Isik
    The aim of this retrospective analysis was to investigate the factors affecting the prognosis of brain metastases in breast cancer patients to identify subgroups which might benefit from prophylactic treatments in future. Seventy-three early and 13 advanced stage patients with known Erb-2 status were included. In 14% of the early stage patients, the first recurrence site was isolated brain metastasis. None of the anthracycline resistant patients had brain metastases as their first recurrence site. The median interval between diagnosis and brain metastasis was 41.5 months (95% CI, 35.79-47.20) in early stage patients. The median interval between the first extracerebral metastases to the brain metastases was 15.5 months (95% CI, 12.24-18.76) in all patients. High histologic and nuclear grade, large tumor, anthracycline resistance were the factors which significantly affected the early appearance of brain metastases but only advanced age (>= 55 years, P = .035) correlated with isolated brain metastasis. Progression with isolated brain metastases was significantly higher in responsive ErbB-2 positive population (P = .036) and none of other pathological factors was associated with isolated brain metastasis in advanced stage. The median survival after brain metastasis in patients with brain metastasis as first recurrence was longer than the patients with brain metastasis after other organ metastasis (13 months vs 2 months P = .003). The median survival following brain metastases in complete responsive patients was higher than the others (24 months vs 6 months, P = .002). Therefore, response to systemic treatment was more determinative in the development of isolated brain metastases than clinical and pathologic features. ErbB-2 should be emphasized in prophylactic treatment strategies. Prophylactic cranial radiotherapy may be an effective treatment option for metastatic patients with complete responsive disease and with controlled ErbB-2 positive disease. (C) 2008 Elsevier Ltd. All rights reserved.
  • Küçük Resim Yok
    Öğe
    Identification of patients who may benefit from the prophylactic cranial radiotherapy among breast cancer patients with brain metastasis
    (Springer, 2009) Saip, Pinar; Cicin, Irfan; Eralp, Yesim; Karagol, Hakan; Kucucuk, Seden; Alas, Rusen Cosar; Yavuz, Ekrem
    Background To identify the candidates for prophylactic cranial radiotherapy (PCI) among the patients with early and advanced-stage breast cancer. Methods The demographic, pathologic and clinical features and survival results of 182 brain metastatic breast cancer patients treated with cranial radiotherapy were examined. Results Early stage patients who progressed with isolated brain metastasis had longer survival (13 months vs. 4 months P = 0.006). Lobular/mixed type histology (P = 0.033), high nuclear (P = 0.046) and high histological grade (P = 0.034) were the prognostic factors for isolated brain metastases. The most significant factor for the time to brain metastasis was the number of involved of lymph nodes (P = 0.004). In 60% of 148 patients with metastatic breast cancer, a progression with isolated brain metastasis was developed while the systemic disease was under control. Isolated brain metastasis progression was related to the presence of the hepatic metastasis at the first relapse (P = 0.001) and with ErbB-2 overexpression (P = 0.034). The time to the brain metastasis from the first extracerabral metastasis was associated with the high nuclear grade (P = 0.040) and with chemoresistance (P = 0.037). The median survival time after the brain metastases in chemosensitive patients was longer than in chemoresistant patients (8 months vs. 3 months P = 0.044). In chemoresistant patients (P = 0.0028) and/or in triple negative patients (P = 0.05) the development of the brain metastasis was early and the survival after brain metastasis was short. Discussions Since there is a tendency to early brain metastasis in early stage patients with high-grade, lobular/mixed type histology tumors and with a high number of involved lymph nodes, the value of PCI can be explored in these patients by a well designed prospective trial. Advanced stage chemosensitive patients with ErbB-2 over-expression and/or with hepatic metastasis at their first relapse may be candidates for PCI. There is no place for PCI in chemoresistant and triple-negative breast cancer patients.