Browsing by Author "Haydaroglu, A"

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    Do we overtreat or undertreat the axillary region in lymph node-positive breast cancer patients?
    Celik, OK; Hoca, S; Bölükbasi, Y; Olacak, N; Haydaroglu, A
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    Evaluation of anxiety level during intracavitary brachytherapy applications in patients with gynecologic malignancy
    Yalman, D; Kamer, S; Ozsaran, Z; Celik, O; Bolukbasi, Y; Bildilk, O; Haydaroglu, A
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    QUALITY-OF-LIFE ASSESSMENT OF APPLIED THERAPY TO BREAST CANCER PATIENTS
    Sert, F; Özsaran, Z; Eser, E; Alanyali, S; Haydaroglu, A; Aras, A
    Objective: Quality-of-Life (QoL) has an important role for breast cancer patients when considering long life expectancy. The main purpose of this study is evaluating the impact of hormonal therapy upon QoL, which is applied after radiotherapy, in the light of realistic data. Materials and Methods: The breast cancer patients treated with adjuvant radiotherapy at Ege University Hospital between January 2007 and December 2009 were evaluated for this trial after obtaining their informed consent FACT-Gv4 and FACT-ESv4 FACT-ES questionnaires were used for QoL evaluations. Obtained surveys were evaluated with the original guide of FACT. Results: A body mass index of over 30 was used as the obesity limit. There was a statistical significance between social well-being score and obesity (p=0.028). Functional well-being scores were statistically better for the patients without co-morbid disease (p=0.018). Endocrine subscale scores were deteriorated during hormonal therapy but they presented some increase in second evaluation but they did not reach basal levels (p=0.000 for all parameters). Conclusion: The diagnosis of breast cancer is affecting QoL independently of the applied treatment. When considering this, post-diagnosis and/or pretreatment physiological support is very important. Methods of treatment and the patient's demographic data are important factors that may affect the QoL. Assessment of QoL has an important role in terms of patient compliance to disease and treatment. For breast cancer patients who have a long life expectancy, multi-institutional QoL researches are needed for presenting the patient's beliefs and adherences to their therapy. We can provide more detailed and clear information with the help of future researches.
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    BREAST CONSERVING SURGERY AND ADJUVANT RADIOTHERAPY FOR DUCTAL CARCINOMA INSITU: EXPERIENCE OF EGE UNIVERSITY
    Bölükbasi, Y; Demirci, S; Özsaran, Z; Iscan, G; Çelik, OK; Haydaroglu, A; Aras, A
    Purpose: To evaluate the treatment results of patients diagnosed with ductal carcinoma in situ (DCIS) treated with breast conserving surgery and adjuvant radiotherapy. Materials and Methods: Between 1991 and 2006, 46 patients were treated in Ege University Faculty of Medicine for DCIS, were analyzed retrospectively. All the patients underwent breast conserving surgery and adjuvant radiotherapy. Fifty Gy was delivered to whole breast through tangential portals. Boost dose was 10 Gy and it was given by photons in 3 (% 10.7) patients and electrons in 25 (% 89.3) patients. Results: Median age was 48 (range: 16- 66). Of the patients, 45.6% (21) were diagnosed by screening mammography, the others were presented with palpable mass (50%), pain (2.2%) and discharge (2.2%). The most common tumor localization was upper outer quadrant (63%). Comedo histopathology was detected in 7 patients (15.2%). After the surgery, cosmetic evaluation was as follows: 36.8% (14) excellent, 44.8% (17) good, 10.5% (4) satisfactory and 7.9% (3) fair. After radiotherapy cosmetic evaluation was performed at least 6 months after the end of treatment. The scores were found to be excellent in 34.2% (13) patients, good in 47.4% (18), satisfactory in 10.5% (4) and fair in 7.9% (3) patients (p= 0.564). Five and ten years disease free survival and local relaps free survival were 95.3%, 92.7% and 88.2%, 90.1%, respectively. Five and ten years overall survival 100% and for distant metastases free survival, these parameters were 100% and 88.3%, respectively. Conclusion: Partial mastectomy and adjuvant radiotherapy in the treatment of DCIS provides low recurrence rates and optimal cosmesis.
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    Evaluation of anxiety levels during intracavitary brachytherapy applications in women with gynecological malignancies
    Kamer, S; Özsaran, Z; Çelik, Ö; Bildik, O; Yalman, D; Bölükbasi, Y; Haydaroglu, A
    Purpose: To evaluate the anxiety levels of women treated for gynecological malignancies using intracavitary brachytherapy. Methods: Anxiety levels prior to and after intracavitary brachytherapy application and factors influencing anxiety levels were evaluated. Women were evaluated for quality of life and psychological status before each brachytherapy application using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0-7 = normal, 8-10 = borderline, 11-21 = abnormal. Women were also questioned about other factors which could affect anxiety levels such as marital status, education level, number of pregnancies and prior surgical history. Results: Between January 2003 and August 2004, 146 women with a median age of 56 years were evaluated (range: 27-80). Eighty-six women had cervix uteri carcinoma and 63 had endometrial carcinoma. Sixty-seven women were premenopausal and 85 women were postmenopausal. The median pregnancy number was three (range = 0-10). Eighty-nine women had at least three children. Sixty-seven women had had previous operations. One hundred and twenty-five women were married and 24 women were unmarried or widowed. Before treatment, the anxiety scores were scored as normal in 49 (32%), borderline in 41 (28%), and abnormal in 59 (40%). Anxiety levels were lower in 69 women during the last application as compared with the pretreatment levels (p = 0.00). Marital status and pregnancy number showed a significant correlation with anxiety scores (p = 0.04). Age, level of education or having had a previous operation showed no significant correlation with anxiety level. Conclusion: These results indicate that intracavitary brachytherapy is associated with anxiety. Women need to be given detailed information before the brachytherapy application to reduce anxiety. Additional studies are needed to determine it.
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    Prognostic factors in definitive radiotherapy of uterine cervical cancer
    Yalman, D; Aras, AB; Özkök, S; Duransoy, A; Çelik, ÖK; Özsaran, Z; Haydaroglu, A
    Purpose: 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.
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    Radiosensitization of hormone-refractory prostate cancer cells by gossypol treatment
    Akagunduz, O; Karaca, B; Atmaca, H; Uzunoglu, S; Karabulut, B; Sanli, UA; Haydaroglu, A; Uslu, R
    Purpose: Many drugs have been tested to increase the sensitivity of prostate cancer cells to radiotherapy Gossypol, a natural polyphenolic compound extracted from the cotton plant, is one of the agents the efficacy of which has been investigated in the treatment of prostate cancer for this purpose. The main aim of this study was to investigate the best gossypol application with irradiation, when gossypol was applied either sequentially (24 h before and after irradiation) or concurrently in PC-3 hormone-refractory and radioresistant prostate cancer cells. Methods: The XTT viability assay was used to evaluate the cytotoxicity of different concentrations of gossypol in PC-3 cells. Irradiation was applied to PC-3 cells via 6 MV photon linear accelerator and delivered 24 h before, 24 h after radiation or at the same time with gossypol administration. Results: Gossypol caused radiosensitization of PC-3 cells that are known to be radioresistant, with high Bcl-2 levels. Among different applications of gossypol and irradiation (before, after and concurrent) in prostate cancer cells, the best results were observed by the application of gossypol 24 h before irradiation. Conclusion: Our study suggests that gossypol represents a promising novel anticancer treatment for radiosensitization of human hormone-refractory prostate cancer cells.
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    Quality of Life Assessment in Women with Breast Cancer: A Prospective Study Including Hormonal Therapy
    Sert, F; Ozsaran, Z; Eser, E; Alanyali, SD; Haydaroglu, A; Aras, A
    Purpose: Evaluating the effect of hormonal treatment on quality of life (QoL) in breast cancer patients by using the Functional Assessment of Cancer Treatment (FACT) questionnaire is the main purpose of this trial. Methods: Breast cancer patients treated with adjuvant between January 2007 and December 2009 were evaluated. The first survey was done after patients completed their whole adjuvant treatment except for the hormonal therapy and this was as 'basal assessment.' The second survey was done 6 to 12 months after the basal surveys during their routine policlinic controls. The last survey was done within the last 18 to 24 months of the follow-up period. Results: The effect of marital status, number of pregnancies, residence in the village or city, hemoglobin levels, chemotherapy and hormonal therapy for any other reason except for breast cancer on the QoL could not be seen. Endocrine subscale scores were detected to be higher in patients aged >60 years than in younger ones. The other dimension scores were low in the elderly patient group. There was a statistically significant relationship between being >30 years old and improvement in the social well-being score (p=0.028). The functional well-being scores were found to be significantly higher in the patient group that had no comorbid disease (p=0.018). Endocrine subscale scores were statistically worse in patients who had psychiatric disease (p=0.057) but the general QoL data were similar with others. It was shown that all QoL scores for all dimensions had statistically significant changes (p<0.001) in terms of hormonal regimes. Conclusion: The diagnosis of breast cancer was found to be an independent factor that affects social well-being and social life in a negative way. We must give attention to complaints including complaints about sexual life and hormonal status in order to ensure compliance of patients with the required hormonal regimens. By the help of future research, we can improve the prognosis of this disease through increased treatment adherence and belief of patients.
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    A Review for Solitary Plasmacytoma of Bone and Extramedullary Plasmacytoma
    Kilciksiz, S; Karakoyun-Celik, O; Agaoglu, FY; Haydaroglu, A
    Solitary plasmacytoma (SP) is characterized by a mass of neoplastic monoclonal plasma cells in either bone (SBP) or soft tissue without evidence of systemic disease attributing to myeloma. Biopsy confirmation of a monoclonal plasma cell infiltration from a single site is required for diagnosis. The common presentation of SBP is in the axial skeleton, whereas the extramedullary plasmacytoma (EMP) is usually seen in the head and neck. The ratio of SP seen at males to females is 2 : 1 and the median age of patients is 55 years. The incidence rate of SP in black race is approximately 30% higher than the white race. Incidence rate increases exponentially by advancing age. SBP has a significant higher risk for progression tomyeloma, and the choice of treatment is radiotherapy (RT) that is applied with curative intent at min. 4000 cGy. By only RT application, long-term disease-free survival (DFS) is possible for approximately 30% of patients with SBP and 65% of patients with EMP.
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    Clinical and prognostic features of plasmacytomas: A multicenter study of Turkish Oncology Group-Sarcoma Working Party
    Kilciksiz, S; Celik, OK; Pak, Y; Demiral, AN; Pehilvan, M; Orhan, O; Tokatli, F; Agaoglu, F; Zincircioglu, B; Atasoy, BM; Ozseker, N; Yersal, O; Niang, U; Haydaroglu, A
    To identify the outcomes of prognostic factors of solitary plasmacytoma mainly treated with local radiotherapy (FIT). The data were collected from 80 patients with solitary plasmacytoma (SP). Forty patients (50.0%) received radiotherapy (FIT) alone while 38 of them (47.5%) were treated with surgery (S) and FIT. 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.
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    Do conventional radiotherapy fields irradiate the regional lymphatics correctly in patients with breast cancer?
    Haydaroglu, A; Karakoyun-Celik, O; Hoca, S; Bolukbasi, K; Olacak, N
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