Objective: In this study the relevant factors that effects the treatment outcomes of patients like hormone receptor and c-erbB-2 was established.Methods: The overall and disease-free survival rates were evaluated in 640 breast cancer patients. The mean follow-up was 59,1 months. Overall and disease-free survival rates found by Kaplan-Meier method at SPSS version 16.0. Log-Rank test evaluated the prognostic factors impact.Results: In ER (+) and (-) patients 5 year overall survival rates was 85,7%, 71,2% (p<0,001), disease free survival rates was 79,9%, 63,7% (p<0,001) respectively; in PR (+) and (-) patients 5 year overall survival rates was 85,6%, 71,6% (p<0,001), disease free survival rates was 79,6%, 64,3% (p<0,001) respectively. ER and PR positivity were significantly increased overall and disease-free survival. In c-erbB-2 over-expression 5 year overall survival rates was 76,4%, 85,3% (p= 0,002), disease free survival rates was 69,7%, 79,1% (p=0,012) according to (-) patients. The worst prognosis had shown in ER (-), PR (-), c-erbB-2 (+) patients.Conclusion: ER, PR and c-erbB-2 levels have great importance in breast cancer and must be well considered in patients follow-up.

OBJECTIVESAdult intracranial ependymomas constitute 2-5% of all intracranial tumors. The aim of this study was to evaluate postoperative results and prognostic factors.METHODSTwenty-one patients over the age of 18 who received radiotherapy in our department between 1996 and 2009 were retrospectively evaluated.RESULTSThe median progression-free survival time was 110 months. Two-, five- and 10-year progression-free survival rates were 80%, 66% and 66%, respectively. The median overall survival time was 124 months. Two-, five- and 10-year overall survival rates were 92%, 73% and 73%, respectively. The negative prognostic factors affecting progression and overall survival were >15 cm(3) tumor volume and removal of the mass with subtotal resection and biopsy.CONCLUSIONAs a result of our study, the prognostic significance of surgical extension and tumor volume were shown in adult ependymoma patients. However, our results should be verified by studies with large numbers of patients.

This study was conducted to find out the frequency of complementary and alternative medicine (CAM) use that could lead to troubles in patient health and in applied standard therapy protocols when used improperly, which method is used, the reasons for use and from which resources the information about this topic were obtained. A questionnaire consisting of 28 questions was applied to 195 patients with cancer diagnosis by a face-to-face interview. The obtained data were assessed with SPSS 11.5 program. Out of 195 cancer patients, 100 (51.3%) were using CAM and 48.7% (n=95) were not. The most commonly used agent was nettle (72%). This was followed by herbal teas (21%), grape molasses (20%) and black seed (20%). The frequency of CAM use was found higher in those under age 50, in literate people, in those working during the diagnosis stage and having disease at the later stage. While CAM was commonly recommended by friends and relatives of the patients (73%), this ratio was only 5% for health professionals. While 51.3% of all patients were gathering information about CAM, 75% of those actually using CAM gathered information about it. Whilst information was gathered mostly from the relatives of patients and tamperers (47%), it can be gathered from physicians only with a ratio of 10%. Cancer patients use CAM and they gather information mainly from unreliable sources rather than physicians. Although the primary information source should be physicians, the ratio for this was very low (10%). We suggest that physicians should spend more time in gathering correct information and sharing them with their patients for a better guidance.

Introduction: Male breast cancer is accounting less than 1% of all breast cancer cases. Evaluation of charactheristics, treatment response and possible prognostic factors of irradiated (RT) male patients with breast cancer was aimed.Materials and methods: Twelve adult male with breast cancer patients records, treated between 1999 and 2006 were evaluated retrospectively. Disease free survival (DFS) was performed from end of RT.Results: Mean age of patients were 59. Application complaint was painless mass under the areola in all of them. Pathological diagnosis were done after excisional biopsy in the nine patients, after mastectomy in the three of them. In the seven patients lesion was localised in the left breast. Radical modified mastectomy was performed to the eight patients, simple mastectomy to the four of all and axillary dissection were added to the two of these. ER was positive in the nine patients, PR was positive in the eight patients. Two of all had a family history. Median dose of postoperative adjuvant RT was 56 Gy. Median followup was 6.4 years. Median DFS was 4,12 years. DFS rate for 2 years was 6%. DFS rate for 5 years was 65%. During follow-up, local recurrens was evaluated in the one patient and distant metastasis in the four patients.Discussion: Although none of the prognostic factors mentioned in the literature presented significant, unfavorable effects of the positivity of lymph node and performing simple mastectomy was observed on disease free survival.

To identify the outcomes of prognostic factors of solitary plasmacytoma mainly treated with local radiotherapy (RT). The data were collected from 80 patients with solitary plasmacytoma (SP). Forty patients (50.0%) received radiotherapy (RT) alone while 38 of them (47.5%) were treated with surgery (S) and RT. The median radiation dose was 46 Gy (range 30–64). The median follow up was 2.41 years (range 0.33–12.33). Ten‐year overall survival (OS) and local relapse‐free survival (LRFS) were 73% and 94%, respectively. The median progression‐free survival (PFS) and multiple myeloma‐free survival (MMFS) were 3.5 years and 4.8 years, respectively. On multivariate analyses, the favorable factors were radiotherapy dose of ≥50 Gy and RT + S for PFS and younger age for MMFS. For the patients with medullary plasmacytoma, the favorable factor was younger age for MMFS. RT at ≥50 Gy and RT + S may be favorable prognostic factors on PFS. Younger patients, especially with head‐neck lesion and without pre‐RT macroscopic tumor, seem to have the best outcome when treated with RT ± S. Progression to MM remains as the main problem especially for older patients. Am. J. Hematol., 2008. © 2008 Wiley‐Liss, Inc.

The aim of the study was to evaluate the toxicity and efficacy of 62 patients with locally advanced nasopharyngeal carcinoma (NPC) (stage III, IVA, IVB) treated by three different modalities. Cisplatin was given weekly 35 mg/m(2)/day or every 3 weeks 100 mg/m(2)/day during radiotherapy (RT) in all patients. Patients were classified into following three groups: The patients in the group 1 (n = 23) were treated only with concurrent chemoradiotherapy (CCRT). In the group 2 (n = 15), before the CCRT, neoadjuvant chemotherapy, consisting of intravenous cisplatin and docetaxel on day 1, every 3 weeks treatment cycles was administered. In the group 3 (n = 24), adjuvant chemotherapy, consisting of cisplatin on day 1 and 5-flourouracil on day 1 to 5 every 3 weeks was used after CCRT. Three arms were treated with the same RT technique and dose. There was no difference for age, sex, and stage among the groups. Radiotherapy was administered in planned dose for all patients. A total of 82% patients completed planned chemotherapy concurrent with RT. The treatment related adverse effects were mild or moderate in intensity. There was no statistical difference between the groups regarding the treatment responses. Complete response rate of RT was 73.9%, 86.7%, and 87.5%, respectively. Median progression free survival (PFS) and overall survival (OS) were 13, 12, 9 months and 22, 20, 15 months for groups 1, 2, 3, respectively. No difference was observed in median OS and PFS among three groups. In our study, the efficacy and toxicity of neoadjuvant and/or adjuvant chemotherapy with CCRT and CCRT alone were found similar.

Background: Preoperative radiotherapy (RT) is an increasingly popular form of adjunct therapy for rectal cancer; however, little is known about its effects on matrix metalloproteinase (MMP) expression in colonic anastomotic healing. Methods: Wistar rats were irradiated to a total dose of 25 or 40 Gy. Four days after the end of RT, an end-to-end colorectal anastomosis was performed. Animals were sacrificed at 1, 3, and 7 days after the anastomosis. A control group was studied similarly, but was not irradiated. Results: No significant differences were found in peritonitis rate and anastomotic complications. The average bursting pressure and breaking strength were only reduced significantly in the rats irradiated with 40 Gy. However, the concentration and the content of hydroxyproline in anastomotic tissues were unchanged. In irradiated rats, MMP-2 and MMP-9 were significantly increased at 40 Gy, but not at 25 Gy. On the other hand, 25-Gy irradiation induced a smaller increase in the level of the tissue inhibitors of metalloproteinase-1 compared with the controls. Conclusion: Anastomotic strength is adversely affected by high-dose fractionated preoperative RT. In contrast, preoperative RT at 25 Gy in five fractions over 5 days is safe with regard to the maintenance of wound strength in colorectal anastomosis. Copyright (c) 2007 S. Karger AG, Basel.

Purpose: Torotroapeatlely analyze the prognastik factors on survival in high grate head and neck non hodgkin lymphomas.Materials and Methods: Between 1997 and 2004, 33 patients with highgrade extranodal head-neck NHL were treated. The female to male ratio was 13: 20 and median age was 48 years. The tumor was located in the Waldeyer ring in 29 patients; in 19 of these, it was in the tonsillar region. B symptom(s) and elevated serum LDH levels were present in 14 and 12 patients, respectively. The phenotype was diffuse large cell in 30 patients. A median of 6 cycles of chemotherapy (CHOP for 30 patients and CEOP for 3 patients) was administered to all patients followed by a median 40 Gy involved- field radiotherapy. Survival was analyzed by creating three different risk groups (low, moderate or high risk) including the parameters of bulky tumor (tumor diameter more than 6 cm), age, LDH level, performance status and stage.Results: The mean follow-up was 32.64 months. Overall and disease-free survival, and 2-year survival rates were 75.73 and 74.89 months, and 78% and 67%, respectively. Poor performance status, elevated serum LDH levels or the presence of bulky disease were found to have a negative impact on both overall and disease-free survival. Statistically significant differences were determined according to overall and disease-free survival in favor of the low-moderate risk groups. Poor performance status, elevated serum LDH level and bulky disease were determined to affect survival both alone and together.Conclusion: Bulky tumor is another important prognostic factor with performance status and serum LDH levels in patients with high grade, extranodal head-neck NHL. It is a parameter that should be evaluated during the treatment plan.

Background: Preoperative radiotherapy (RT) is an increasingly popular form of adjunct therapy for rectal cancer; however, little is known about its effects on matrix metalloproteinase (MMP) expression in colonic anastomotic healing. Methods: Wistar rats were irradiated to a total dose of 25 or 40 Gy. Four days after the end of RT, an end-to-end colorectal anastomosis was performed. Animals were sacrificed at 1, 3, and 7 days after the anastomosis. A control group was studied similarly, but was not irradiated. Results: No significant differences were found in peritonitis rate and anastomotic complications. The average bursting pressure and breaking strength were only reduced significantly in the rats irradiated with 40 Gy. However, the concentration and the content of hydroxyproline in anastomotic tissues were unchanged. In irradiated rats, MMP-2 and MMP-9 were significantly increased at 40 Gy, but not at 25 Gy. On the other hand, 25-Gy irradiation induced a smaller increase in the level of the tissue inhibitors of metalloproteinase-1 compared with the controls. Conclusion: Anastomotic strength is adversely affected by high-dose fractionated preoperative RT. In contrast, preoperative RT at 25 Gy in five fractions over 5 days is safe with regard to the maintenance of wound strength in colorectal anastomosis. Copyright (c) 2007 S. Karger AG, Basel.

Amac: Bas-boyun bolgesi yerlesimli, yuksek gradli, ekstranodal, Hodgkin- disi lenfoma (NHL) tanili olgularimizin ozellikleri ve sagkalim uzerinde etkili prognostik faktorlerin retrospektif olarak incelenmesi amaclanmistir. Hasta ve Yontemler: Yuksek gradli, ekstranodal, bas-boyun yerlesimli 33 NHL olgusu 1997-2004 yillari arasinda tedavi edilmistir. Kadin/erkek orani 13/20 ve medyan yas 48’dir. Tumor yerlesimi 19 olguda tonsil olmak uzere 29’unda Waldeyer halkasindadir. B semptom(lari) 14 olguda ve serum LDH yuksekligi 12 olguda mevcuttu. 30 olgu diffuz buyuk hucreli fenotipindeydi. Tum hastalara medyan 6 kur kemoterapi (30 olguda CHOP, 3 olguda CEOP rejimi) sonrasinda medyan 40 Gy tutulmus alan radyoterapisi uygulandi. “Bulky” tumor (6 cm uzerine tumor capi), yas, LDH duzeyi, performans durumu ve evre parametrelerini iceren dusuk, orta ve yuksek olmak uzere 3 ayri risk grubu olusturularak sagkalim analizleri yapilmistir. Bulgular: Ortalama takip suresi 32.64 aydir. Genel ve hastaliksiz sagkalim sureleri sirasiyla 75.73 ve 74.89 ay, 2 yillik sagkalim oranlari sirasiyla %78 ve %67 olarak bulundu. Genel ve hastaliksiz sagkalim acisindan dusuk-orta riskli gruplar lehine istatiksel anlamli fark tespit edildi. Kotu performans durumu, yuksek serum LDH duzeyi veya “bulky” hastalik varliginin hem tek basina hem de bir arada sagkalimi olumsuz etkiledigi tespit edildi. Sonuc: “Bulky” tumor, yuksek gradli, ekstranodal bas-boyun yerlesim- li NHL olgularinda performans durumu ve serum LDH seviyesi yaninda onemli bir diger prognostik faktordur. Tedavi planlamasi yapilirken deger- lendirilmesi gereken bir parametredir. Anahtar Kelimeler: Hodgkin disi lenfoma, bas-boyun tumoru, radyoterapi, kombine tedavi. F ACTORS AFFECTING SURVIVAL IN EXTRANODAL HEAD- NECK LYMPHOMAS: RESULTS FROM A SINGLE CENTRE Purpose: Torotroapeatlely analyze the prognastik factors on survival in high grate head and neck non hodgkin lymphomas. Materials and Methods: Between 1997 and 2004, 33 patients with high- grade extranodal head-neck NHL were treated. The female to male ratio was 13:20 and median age was 48 years. The tumor was located in the Waldeyer ring in 29 patients; in 19 of these, it was in the tonsillar region. B symptom(s) and elevated serum LDH levels were present in 14 and 12 patients, respectively. The phenotype was diffuse large cell in 30 patients. A median of 6 cycles of chemotherapy (CHOP for 30 patients and CEOP for 3 patients) was administered to all patients followed by a median 40 Gy in- volved-field radiotherapy. Survival was analyzed by creating three different risk groups (low, moderate or high risk) including the parameters of bulky tumor (tumor diameter more than 6 cm), age, LDH level, performance status and stage. Results: The mean follow-up was 32.64 months. Overall and disease-free survival, and 2-year survival rates were 75.73 and 74.89 months, and 78% and 67%, respectively. Poor performance status, elevated serum LDH levels or the presence of bulky disease were found to have a negative impact on both overall and disease-free survival. Statistically significant differences were determined according to overall and disease-free survival in favor of the low-moderate risk groups. Poor performance status, elevated serum LDH level and bulky disease were determined to affect survival both alone and together. Conclusion: Bulky tumor is another important prognostic factor with per- formance status and serum LDH levels in patients with high grade, extra- nodal head-neck NHL. It is a parameter that should be evaluated during the treatment plan. Key Words:  Non-Hodgkin  lymphoma,  head-neck  tumor,  radiotherapy, combined treatment.

Purpose The aim of this study was to investigate the effects of tangential radiotherapy (RT) on lung clearance in the patients with breast cancer by using 99mTc-DTPA aerosol scintigraphy. Material and methods Thirty-three female patients [non-smoker: 20, ex-smoker: 13] performed surgery and systemic chemotherapy for breast carcinoma [47±13 years] were included in the study. All patients underwent 99mTc-DTPA aerosol scintigraphy prior to RT (preRT), midway through RT (midRT) and after RT (postRT). Total dose was 50 Gy in modified radical mastectomy and 60 Gy in lumpectomy (2 Gy/fraction). Posterior dynamic images of lungs were obtained immediately after the inhalation of 99mTc-DTPA aerosol. Results Pulmonary function tests were normal in three measurements for all cases. In the ex-smokers, there was no significant difference among preRT, midRT and postRT clearance values in both lungs. PreRT lung clearance in non-smoker group did not differ from that in ex-smokers. However, the lung clearance for non-smoker group showed significantly increase following RT. Conclusion In this study, we observed that tangential radiotherapy caused an increase in the lung clearance in the cases of non-smokers even in non-irradiated lung, and that the effect of RT on lung clearance was closely depended on smoking habit before RT.

Turkiye Klinikleri J Med Sci 2004, 24 483 ankreas kanseri insidansı son yıllarda artı göstermekte ve ço u Batı ülkeleri ile Japonya’da kansere ba lı ölümler arasında be inci sırada yer almaktadır. Pankreas adenokarsinomlu hastalarda tek kür olasılı ının cerrahi rezeksiyon oldu u ileri sürülmesine ra men dü ük rezektabilite ve 5 yıllık sa kalım oranları nedeniyle prognozu kötüdür. P ORJ NAL ARA TIRMA / ORIGINAL RESEARCH.

Purpose: In this study our objective was to evaluate the therapeutic significance of concurrent paclitaxel and radiotherapy compared with radiotherapy alone. Patients and methods: Patients with stage III A/B NSCLC were randomly assigned to receive either radiotherapy alone (group 2) or concurrent weekly paclitaxel with radiotherapy (group 1) in GMMA. Radiotherapy was given as a split-course schedule with the total dose of 56 Gy. Paclitaxel, 60 mg/m(2), was administered only to group 1 on the first day of each radiotherapy week. To assess differences between values, P values were calculated with the chi(2) test. A Mann Whitney U-test was used to assess significant differences between the two values. Actuarial survival curves were calculated by the Kaplan-Meier method. Results: There were 25 patients who underwent chemoradiotherapy and 26 who underwent radiotherapy only. Median follow-up was 14 months. The overall response rate was 92% and 70% for groups 1 and 2, respectively (P = 0.003). Median survival was 15.2 months for group 1, and 12.0 months for group 2 (P = 0.027). Conclusion: Based on this response and the toxicity profile, outpatient split-course radiotherapy and weekly paclitaxel seems to be feasible and safe.