Browsing by Author "Duransoy, A"
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Item Prognostic Factors in Metastatic Brain Tumors: Study of 62 PatientsDuransoy, YK; Selçuki, M; Gökçe, T; Duransoy, ABackground: Brain metastases are the major cause of morbidity and mortality in patients with cancer. Variety of clinical and autopsy studies showed that brain metastases develop at 15%-45% of all cancer patients during the course of the disease and 1/2-2/3 of them were symptomatic. Average life expectancy of cancer patients with untreated metastatic brain tumors are approximately 1-2 months. Methods: We investigated the prognostic factors of removal of metastatic brain tumors in patients who admitted to neurosurgery department. Eighteen of 80 patients in the program excluded for various reasons and this study was completed with the remaining 62 cases. Results: Our study showed that neurological and general status, the extension of surgical resection, presence of the extra-cranial metastases at diagnosis and localization of the primary focus affect the prognosis. Conclusion: In the planning of treatment of patients with metastatic brain tumors, colleagues have to keep in mind level of neurological and general status, the extension of surgical resection, presence of the extra-cranial metastases at diagnosis and localization of the primary focus affect the prognosis. Surgical resection is beneficial for improving neurological status and survival of patients in brain metastases. Local control is essential and can be achieved with one of the adjunct therapies following the surgery.Item Osteoporosis in women with breast cancer and its effect on quality of life: a pilot studyTuran, Y; Kocaaga, Z; Karakoyun-Celik, O; Gurgan, A; Duransoy, APurpose: The primary aim of this study, was to evaluate the risk of osteoporosis (OP) in patients who had received adjuvant chemotherapy for breast cancer The secondary aim was to investigate the effect of OP on the quality of life of these patients. Patients and methods: Twenty-six patients with breast cancer and 21 health); controls were recruited into the study All breast cancer patients were treated with 6 cycles of adjuvant chemotherapy. Bone mineral density (BMD) was measured by Dual-energy X-ray absorptiometry (DXA). Short Form-36 (SF-36) questionnaire was used to assess the quality of life. Results: The mean lumbar area BMD value significantly lower inpatients with breast cancer than in healthy controls (p=0.017). There were no significant differences in the femoral area BMD measurements between the groups. OP was more pronounced after 24 months of the last chemotherapy course than in the first 12 months (p=0.04). The most affected domain of the SF-36 in patients with breast cancer was the physical role. Conclusion: Adjuvant chemotherapy increases the risk of accelerated bone loss in the lumbar spine. OP should be investigated during follow-up in order to improve the quality of life of the surviving breast cancer patients.Item Prognostic factors in definitive radiotherapy of uterine cervical cancerYalman, D; Aras, AB; Özkök, S; Duransoy, A; Çelik, ÖK; Özsaran, Z; Haydaroglu, APurpose: To determine the prognostic factors related to local control and survival in 257 patients with uterine cervical cancer treated with definitive radiotherapy (RT). Materials and Methods: The medical records of 257 patients treated with definitive RT from January 1987 to December 1998 were reviewed retrospectively. Pretreatment and treatment parameters were analyzed to determine their prognostic value on local control and survival. Survival analyses were performed using the Kaplan-Meier method. The log-rank test was used for univariate analyses and the Cox regression model was used for multivariate analyses. Results: Median age was 55 (range 25-82). Squamous cell carcinoma was the most common histologic type (89.1%). The distribution per FIGO Stage was IIA: 13.2%; IIB: 54.9%; IIIA: 3.9%; IIIB: 19.8%; IVA: 8.2%. Ninety-eight patients (38.1%) were treated with external RT alone; 134 (52.1%) received both external RT and intracavitary brachytherapy; 21 (8.2%) received external RT and chemotherapy and four (1.6%) received external RT, intracavitary brachytherapy and chemotherapy. Median follow-up duration was 50 months (range 24-155 months). The failure rate was 51.8% with 26.5% of patients having only local failure, 16.7% only distant failure and 8.6% both local and distant failure. Five-year local progression-free, disease-free and overall survival rates were 58.1%, 44% and 63.7%, respectively. In univariate analysis the prognostic factors identified for local progression-free survival were histology (p = 0.008), FIGO stage (p < 0.001), initial hemoglobin (Hgb) level (p = 0.001), total radiation dose (p = 0.039), use of brachytherapy (p = 0.001) and of chemotherapy (p = 0.037) and enlarged paraaortic nodes (p = 0.016). In multivariate analysis the prognostic factors were FIGO stage (p = 0.014), initial Hgb level (p = 0.040), and use of brachytherapy (p = 0.013). The prognostic factors identified for disease-free survival were histology (p = 0.011), FIGO stage (p < 0.001), initial Hgb level (p < 0.001), use of brachytherapy (p = 0.001) and of chemotherapy (p = 0.014) in univariate analysis; and FIGO stage (p < 0.001), initial Hgb level (p = 0.017), total tumor dose (p = 0.034), use of brachytherapy (p = 0.006) and of chemotherapy (p = 0.021) in multivariate analysis. Factors influencing overall survival were FIGO stage (p < 0.001), initial Hgb level (p = 0.006), overall treatment time (p = 0.028), total tumor dose (p = 0.007), use of brachytherapy (p < 0.001), enlarged paraaortic (p < 0.001) and pelvic nodes (p = 0.004) in univariate analysis; and FIGO stage (p < 0.001), overall treatment time (p = 0.031), enlarged paraaortic (p = 0.007) and pelvic lymph nodes (p = 0.043) in multivariate analysis. Conclusion: Definitive RT is an effective treatment for patients with uterine cervical cancer. There are many prognostic factors influencing treatment outcome. Brachytherapy and chemotherapy must be added in appropriate patients to improve the outcome. Future prospective trials should be undertaken to confirm the validity of these factors and to individualize the treatment strategy for every patient.Item Bone mineral density in women with breast cancerCelik, OK; Turan, Y; Kocaaga, Z; Gürgan, A; Duransoy, AItem OSTEOPOROSIS IN WOMEN WITH BREAST CANCER AND ITS EFFECT ON QUALITY OF LIFE: A PILOT STUDYTuran, Y; Kocaaga, Z; Karakoyun-Celik, O; Gurgan, A; Duransoy, A