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Öğe An ambiguous phenomenon of radiation and drugs: Recall reactions(Karger, 2007) Caloglu, Murat; Yurut-Caloglu, Vuslat; Cosar-Alas, Rusen; Saynak, Mert; Karagol, Hakan; Uzal, CemThe term 'radiation recall' describes an acute inflammatory reaction in previously irradiated areas after the administration of certain inciting systemic agents. It was first described in 1959 by D'Angio that dermatitis is related to the application of actinomycin D on the skin. Though this reaction occurs frequently on the skin, it may also be seen in the oral mucosa, the larynx, esophagus, small intestine, lungs, muscle tissue, and brain. Most drugs associated with recall reactions are cytotoxics, however, several other drugs may also elicit the phenomenon. Although this phenomenon is well known, its etiology is not understood. Radiation recall reactions are generally associated with megavoltage radiotherapy. The time interval between the completion of radiotherapy and the recall reaction ranges from days to years. The recall reaction occurs on average 8 days (3 days to 2 months) after the application of the promoting agent. Although no standard treatment exists, some authors suggest discontinuation of the inciting drug and the use of corticosteroids or nonsteroidal anti-inflammatory agents.Öğe Analysis of early and last effects concomittant chemoradiotherapy of 24 patients with locally advanced cervical carcinoma (lacc)(Oxford Univ Press, 2004) Tokatli, Fusun; Uygun, Kazim; Ibis, Kamuran; Bayir, Gulden; Denizli, Bengu; Uzal, Cem[Abstract Not Available]Öğe THE APPLICATION OF CRANIAL PROPHYLACTIC RADIOTHERAPY IN CHILDREN WITH ALL HAS AN EFFECT ON NEUROCOGNITIVE FUNCTION(Wiley-Liss, 2009) Gorker, Isyk; Orhaner, Betuel Biner; Caloglu, Vuslat Yueruet; Aygolu, Fuesun; Uzal, Cem; Caloglu, Murat; Uyanik, Vesile[Abstract Not Available]Öğe The Better Performance Status, the Better Outcome: Laryngeal Carcinoma Treated with Definitive Radiotherapy(B C Decker Inc, 2008) Yurut-Caloglu, Vuslat; Caloglu, Murat; Turan, Fatma Nesrin; Ibis, Kamuran; Karagol, Hakan; Kocak, Zafer; Uzal, CemPurpose: To evaluate the prognostic factors affecting locoregional control (LRC) and overall survival (OS) of patients with laryngeal carcinoma who were not candidates for surgical treatment due to tumour or host factors but were treated with definitive radiotherapy (RT). Patients and Methods: Sixty-three consecutive patients, treated with definitive RT between 1999 and 2005, were retrospectively analyzed. All patients had histologically proven squamous cell carcinomas of the larynx. The median age was 62 years (range 43-83 years). Follow-up ranged from 22 days to 68 months (median 32 months). Results: The LRC rates at 2 and 5 years were 70% and 48%. The 2- and 5-year OS rates were 65% and 40%. No statistically significant relationship was found between World Health Organization performance status score (WHO PS) and age (p = .21), tumour site (p = .42), overall stage (p = .11), T stage (p = .19), and N stage (p = .69). Multivariate analyses showed that a WHO PS score >= 2 (p < .0001) and RT treatment time >= 50 days (p = .0172) significantly decreased LRC. Moreover, a WHO PS score >= 2 (p < .0001), RT treatment time >= 50 days (p = .0138), and RT dose < 66 Gy (p = .04) were significantly negative prognostic factors on OS. Conclusion: Definitive RT, in patients with early- and more advanced-stage squamous cell carcinoma of the larynx, is an important treatment option. It is clear that patients with good pretreatment PS would get better results from definitive RT.Öğe Bilateral choroidal metastases as an initial manifestation of small-cell carcinoma of the lung(Turkish Assoc Tuberculosis & Thorax, 2006) Kocak, Zafer; Tabakoglu, Erhan; Benian, Omer; Bayir, Gulden; Unlu, Ercument; Uzal, CemThe occurence of clinically symptomatic intraocular metastases as an initial manifestation of primary neoplasm is rare event. The recognition of metastatic ocular tumors is important since they indicate a poor prognosis. Prompt diagnosis and treatment can significantly improve the quality of life for these patients. We report the case of a 48-year-old man presenting with a two-week history of left sided intraocular pain with blurring of vision and headache, which are the first signs of small-cell lung carcinoma.Öğe Bir olgu nedeniyle radyasyon hatırlatma dermatiti(2004) Tokatlı, Füsun; Uygun, Kazım; Tunçbilek, Nermin; Bayır, Gülden; İbiş, Kamuran; Uzal, CemRadyasyon hatırlatma dermatiti (RHD), daha önce radyoterapi yapılmış alanda kemoterapötik bir ajanın verilmesiyle oluşan doku reaksiyonu olarak tanımlanmaktadır. Literatürde sıklıkla taksanlara bağlı RHD bildirilmiştir. Bu sunumda, metastatik meme kanseri nedeniyle kemik metastazlarına yönelik radyoterapisinin tamamlanmasından kısa süre sonra paklitaksel alan hastada gelişen RHD bildirilmektedir.Öğe Breast Cancer Radiotherapy-induced Cardiotoxicity(Kare Publ, 2022) Nurlu, Dilek; Cosar, Rusen; Parlar, Sule; Uzal, CemIn the multimodality treatment of breast cancer, adjuvant radiotherapy (RT) has an important role in achieving local control and increasing survival. Cardiac toxicity due to breast RT, especially left-sided breast RT, is rare but clearly recognizable. As overall survival rates are steadily increasing, long-term toxicities also become increasingly important in terms of late cardiac events, possibly caused by RT. Even small doses for the heart are thought to increase the risk of cardiac toxicity. Advanced radiation techniques such as intensity-modulated radiation therapy, volumetric-modulated arc RT, deep inspiration breath-hold techniques, and prone positioning for pendular breast can eliminate the heart from the primary beams. In addition to mean heart dose, breast cancer RT planning should also include constraints for cardiac subvolumes. Especially for patients who have pre-existing such as cardiovascular disease, diabetes mellitus, dyslipidemia, arterial hypertension, lifestyle factor (tobacco smoking, alcohol, physical inactivity, and poor nutrition), and physicians have to be careful about cardiotoxicity. Radiation oncologists and cardiology specialists should provide closely cooperating regular and long-term followup. This will provide the improvement of patient outcomes.Öğe Colonic metastasis from carcinoma of the breast that mimicks a primary intestinal cancer(Yonsei Univ Coll Medicine, 2006) Uygun, Kazim; Kocak, Zafer; Altaner, Semsi; Cicin, Irfan; Tokatli, Fusun; Uzal, CemAlthough the lung, liver, or bones are the most common location for distant metastases; in breast cancer patients, metastases to the intestinal tract are very rarely recognized in the clinic. We will present an unusual case of colonic metastasis from a carcinoma of the breast that mimics a primary intestinal cancer, along with a through review of English language medical literature. Despite the fact that isolated gastrointestinal (GI) metastases are very rare and much less common than benign disease processes or second primaries of the intestinal tract in patients with a history of breast cancer, metastatic disease should be given consideration whenever a patient experiences GI symptoms.Öğe Comparison of Protective Effects of L-Carnitine and Amifostine on Radiation-induced Toxicity to Growing Bone: Histopathology and Scintigraphy Findings(Asian Pacific Organization Cancer Prevention, 2010) Yurut-Caloglu, Vuslat; Durmus-Altun, Gulay; Caloglu, Murat; Usta, Ufuk; Saynak, Mert; Uzal, Cem; Cosar-Alas, RusenPurpose: The aim of the present study was to evaluate the radioprotective efficacy of L-carnitine (LC) in growing bones in comparison to amifostine. Materials and Methods: Sixty two-week-old Wistar albino rats were randomly assigned to six equal groups: Group 1, control (CONT); Group 2, irradiation alone (RT); Group 3, amifostine plus irradiation (AMI+RT); Group 4, L-carnitine plus irradiation (LC+RT); Group 5, amifostine alone (AMI); Group 6, L-carnitine alone (LC). The rats in the AMI+RT, LC+RT and RT groups were irradiated individually with a single dose of 20 Gy to the left femur. LC (300mg/kg) and amifostine (200mg/kg) were applied 30 min before irradiation. The animals were scanned for bone area, mineral content and bone mineral density (BMD) by DEXA and the 99mTc methylene diphosphonate uptake ratio (MUR) was calculated by bone scintigraphy. Histopathological analysis of bone and cartilage was also carried out after euthanasia. Results: Pretreatment with LC or amifostine reduced the radiation-induced damage in growing bone (p=0.007 and p=0.04 respectively) and in the epiphysial cartilage (p=0.002 and p=0.015 respectively). The protective effect of LC was similar to that of amifostine on both growing bone and on the epiphysial cartilage. The mean left-femur BMD values were significantly higher in the LC+RT (p=0.02) and AMI+RT (p=0.01) groups than in the RT group. but did not differ with the two protective agents. Pretreatment with AMI (p=0.002) and LC (p=0.01) improved the MUR. Conclusions: L-carnitine is equally as effective as amifostine at protecting growing bone against single dose irradiation damage.Öğe The effect of ion chamber volume on intensity-modulated radiotherapy small field dosimetry(Elsevier, 2022) Parlar, Sule; Uzal, CemThe use of appropriate equipment during the measurements required for a treatment planning system (TPS) directly affects the quality of treatment. The present study investigates the effect of small field output factors (OF) obtained with ion chambers of different volumes on intensity-modulated radiotherapy (IMRT) treatment plans. Three different beam models (BM65, BM13, BM04) were created at TPS using small fields OFs measured by ion chambers with three different volumes, i.e. 0.65, 0.13 and 0.04 cc respectively. IMRT plans with the same features were designed for these models. The difference between the calculated and measured doses at dose distributions for each IMRT plan was investigated using point-dose measurement and gamma index method. The OF values obtained with a 0.65 cc ion chamber were significantly different, especially in small fields. The greatest difference in point-dose measurements made in IMRT plans was observed in the plans produced in the BM65 beam model. There was no significant difference in gamma passing rate (GPR) values in 2D array measurements. Inaccurate OF values obtained during small-field measurements is one of the important parameters that affect dosimetric accuracy. Therefore, using different dosimetric methods in quality assurance during TPS commissioning may allow to detect measurement errors, especially in small-field measurements.Öğe The effect of low molecular weight heparin on survival in patients with cancer(Kare Publ, 2006) Saynak, Mert; Yurut-Caloglu, Vuslat; Bayir, Gulden; Caloglu, Murat; Uzal, CemThe association between cancer and venous thromboembolism (VTE) is well established. Of all new venous tromboembolism, approximately 20% are associated with active malignancy. In these cases, the pathogenic mechanisms of thrombosis involve a complex interaction between tumour cells, the haemostatic system, and charateristics of the patient. Anticoagulants are the mainstay therapy for the prevention and treatment of acute VTE. The natural history of VTE is more agressive and anticoagulant treatment failure is more frequent in cancer patients than in patients without cancer. Recently, the results of new prospective randomized clinical trials to evaluate the effect of low-molecular-weight heparin on cancer survival have become available. The results suggest a benefit from treatment, particularly in patients with nonadvanced disease. However, these results are not conclusive and require further research.Öğe The Effects of Micronuclei with Whole Chromosome on Biological Dose Estimation(Tubitak Scientific & Technological Research Council Turkey, 2008) Pala, Funda S.; Alkaya, Fadime; Tabakcioglu, Kiymet; Tokatli, Fuesun; Uzal, Cem; Parlar, Sule; Alguenes, CetinThe total micronucleus (MN) assay has been used for purposes of biological dosimetry for many years. The variable spontaneous incidence of micronuclei in peripheral blood lymphocytes affects the sensitivity of biological dose estimations at low doses. It has been suggested that this problem could be solved by using the micronuclei-centromere assay. In this study. Co-60 gamma ray dose response curves for micronuclei (MN) and micronuclei without centromeres (MNC-) in the range of 0-5.0 Gy were established using a pancentromeric FISH probe on cultured binucleate lymphocytes from 2 donors. There were no significant inter-donor differences in the dose responses for either MN or MNC-. The relative proportions of MN that contained centromeres (MNC+) decreased with radiation dose, which is in line with the proposition that radiation predominately causes chromosomal breakage rather than whole chromosome loss. The a coefficients of MNC- curves decreased to 62% of the values for total MN whilst the beta coefficients were unchanged. MN and MNC+ frequencies of 60 control smoker and 40 non-smoker donors were also compared. No effect of smoking was observed. However the MNC+ spontaneous frequencies showed an age and gender effect with the highest frequencies in older women.Öğe Evaluation of morphine effect on tumour angiogenesis in mouse breast tumour model, EATC(Humana Press Inc, 2011) Ustun, Funda; Durmus-Altun, Gulay; Altaner, Semsi; Tuncbilek, Nermin; Uzal, Cem; Berkarda, SakirBreast cancer is the leading cause of death among women, and morphine is used to relieve the pain of patients with cancer. The data on the effects of morphine on tumour growth and angiogenesis are contradictory. We determined in mouse breast cancer model whether analgesic doses of morphine would affect tumour angiogenesis, and then the correlation between microvessel density (MVD), Doppler sonography (DS) and Tc-99m-Tetrofosmin (TF) uptake. Ehrlich ascites tumour cell xenografts, Pgp-negative tumour were divided into two groups: (a) Morphine sulphate [0.714 mg/kg/day (equivalent to 50 mg per day for a 70 kg human)], (b) no-morphine. For the determination of angiogenesis in mice tumour tissue, TF scintigraphy, microvessel density and DS were done. MVD was significantly different between groups (49.4 +/- 1.8 vs. 41.8 +/- 1.9, morphine and no-morphine groups, respectively, P < 0.001). A strong correlation was found between late uptakes of mass at scintigraphy and degree of angiogenesis in histopathologic examination (r = 0.52, P < 0.01). There was statistically significant inverse correlation between degree of angiogenesis in histopathologic examination and washout ratio of TF (r = 0.40, P < 0.05). The higher values for angiogenesis are related to higher TF reuptake. There was no statistically significant correlation between DS and TF. A strong correlation was found between MVD and grade of DS (r = 0.51, P < 0.01). Our preclinical mice study indicates that morphine at clinically relevant doses stimulates angiogenesis, and angiogenesis triggered of morphine is demonstrated with MVD and DS, but not TF. However, uptake and washout of TF are compared with immunohistochemically assessed morphine-stimulated angiogenesis in tumour tissue.Öğe The histopathological comparison of L-carnitine with amifostine for protective efficacy on radiation-induced acute small intestinal toxicity(Medknow Publications, 2012) Caloglu, Murat; Caloglu, Vuslat Yurut; Yalta, Tulin; Yalcin, Omer; Uzal, CemBackground: The aim of the study was to compare the protective efficacy of l-carnitine (LC) to amifostine on radiation-induced acute small intestine damage. Materials and Methods: Thirty, 4-week-old Wistar albino rats were randomly assigned to four groups - Group 1: control (CONT, n = 6), Group 2: irradiation alone (RT, n = 8), Group 3: amifostine plus irradiation (AMIRT, n = 8), and Group 4: l-Carnitine plus irradiation (LCRT, n = 8). The rats in all groups were irradiated individually with a single dose of 20 Gy to the total abdomen, except those in CONT. LC (300 mg/kg) or amifostine (200 mg/kg) was used 30 min before irradiation. Histopathological analysis of small intestine was carried out after euthanasia. Results: Pretreatment with amifostine reduced the radiation-induced acute degenerative damage (P = 0.009) compared to the RT group. Pretreatment with LC did not obtain any significant difference compared to the RT group. The vascular damage significantly reduced in both of the AMIRT (P = 0.003) and LCRT group (P = 0.029) compared to the RT group. The overall damage score was significantly lower in the AMIRT group than the RT group (P = 0.009). There was not any significant difference between the LCRT and RT group. Conclusions: Amifostine has a marked radioprotective effect against all histopathological changes on small intestinal tissue while LC has limited effects which are mainly on vascular structure.Öğe MARJOLIN'S ULCER IN SCALP: CASE REPORT AND LITERATURE REVIEW(Kare Publ, 2005) Caloglu, Murat; Yurut Caloglu, Vuslat; Cosar Alas, Rusen; Ibis, Kamuran; Altaner, Semsi; Uzal, CemMarjolin's ulcer is a rare skin cancer that originates in areas of chronic wounds and scar tissues. It has more aggressive nature than other primary skin cancers. The exact mechanism of tumor development has not yet been identified. It could be seen on the skin of whole body surface. The most common histopathologic type of this malignancy is squamous cell carcinoma. It could develop in early and late period of time after trauma. Although surgery is still the main treatment, radiotherapy and chemotherapy could be other options in appropriate circumstances. In the present case report we described a patient who had lost her scalp in a work accident 25 years ago and developed skin cancer on scar tissue in late period, with a literature review.Öğe Metastatic giant basal cell carcinoma and radiotherapy(Elsevier Sci Ltd, 2006) Caloglu, Murat; Yurut-Caloglu, Vuslat; Kocak, Zafer; Uzal, Cem[Abstract Not Available]Öğe Nasopharyngeal carcinoma with extensive nodular skin metastases: A case report(Sage Publications Ltd, 2006) Caloglu, Murat; Uygun, Kazim; Altaner, Semsi; Uzal, Cem; Kocak, Zafer; Piskin, SuleymanSkin metastasis from nasopharyngeal carcinoma is a rare clinical finding. The most common form of appearance is a few solitary skin nodules. However, massive and extensive nodular dissemination or diffuse dermal lymphatic infiltration is extremely rare. We here present a case of a 40-year-old man with widespread nodular skin metastases from undifferentiated nasopharyngeal carcinoma.Öğe Oncocytic carcinoma of the parotid gland(Karger, 2006) Caloglu, Murat; Yurut-Caloglu, Vuslat; Altaner, Semsi; Huseyinova, Gulara; Unlu, Ercument; Karagol, Hakan; Uzal, CemBackground: Oncocytic carcinoma is a rare tumor of major salivary glands. Despite being described 5 decades ago, not much is known about these rare tumors. Histochemical or electron microscopic confirmation of the oncocytic nature of the tumor cell is needed for differential diagnosis. The main treatment modality is surgery with or without adjuvant radiotherapy. Malignant oncocytomas have the potential risk of developing distant metastases and demand long term follow-up after therapy. Case Report: A 58-year old man presented with a recurrent mass in the left parotid gland with a prior diagnosis of monomorphic adenoma in the same localization which had been treated by tumor excision in July 2002. Left superficial parotidectomy followed by radiotherapy into tumor bed and upper neck were carried out in September 2004. To date, he has had no evidence of recurrence for 14 months. Conclusion: For an accurate approach in the management of patients, oncocytic adenocarcinoma should be considered in the differential diagnosis of lesions of the parotid gland, most of which are benign.Öğe Postmastectomy irradiation in breast in breast cancer patients with T1-2 and 1-3 positive axillary lymph nodes: Is there a role for radiation therapy?(Bmc, 2011) Cosar, Rusen; Uzal, Cem; Tokatli, Fusun; Denizli, Bengu; Saynak, Mert; Turan, Nesrin; Uzunoglu, SernazBackground: We aimed to evaluate retrospectively the correlation of loco-regional relapse (LRR) rate, distant metastasis (DM) rate, disease free survival (DFS) and overall survival (OS) in a group of breast cancer (BC) patients who are at intermediate risk for LRR (T1-2 tumor and 1-3 positive axillary nodes) treated with or without postmastectomy radiotherapy (PMRT) following modified radical mastectomy (MRM). Methods: Ninety patients, with T1-T2 tumor, and 1-3 positive nodes who had undergone MRM received adjuvant systemic therapy with (n = 66) or without (n = 24) PMRT. Patient-related characteristics (age, menopausal status, pathological stage/tumor size, tumor location, histology, estrogen/progesterone receptor status, histological grade, nuclear grade, extracapsular extension, lymphatic, vascular and perineural invasion and ratio of involved nodes/dissected nodes) and treatment-related factors (PMRT, chemotherapy and hormonal therapy) were evaluated in terms of LRR and DM rate. The 5-year Kaplan-Meier DFS and OS rates were analysed. Results: Differences between RT and no-RT groups were statistically significant for all comparisons in favor of RT group except OS: LRR rate (3% vs 17%, p = 0.038), DM rate (12% vs 42%, p = 0.004), 5 year DFS (82.4% vs 52.4%, p = 0.034), 5 year OS (90,2% vs 61,9%, p = 0.087). In multivariate analysis DM and lymphatic invasion were independent poor prognostic factors for OS. Conclusion: PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval.Öğe PROGNOSTIC FACTORS AND TREATMENT RESULTS IN LARYGEAL CARCINOMA: DEPARTMENT OF RADIATION ONCOLOGY OF TRAKYA UNIVERSITY MEDICAL SCHOLL EXPERIENCE(Kare Publ, 2005) Caloglu, Murat; Yurut Caloglu, Vuslat; Uzal, Cem; Karagol, Hakan; Tokatli, Fusun; Uygun, KazimPurpose: To review the Department of Radiation Oncology of Trakya University Medical School experience in the treatment of laryngeal carcinoma and to evaluate the different factors affecting locoregional control. Methods and Material: We reviewed the records of 78 consecutive patients were treated for laryngeal carcinoma between July 1999 and November 2004. There were 74 men and 4 women, with a median age of 58 years (range, 34-80 years). Forty-two patients had T4 lesions, and 20 had T3 lesions; 32 had NO, 15 had N1, 27 had N2, and 2 had Nx disease. Surgery was the primary treatment modality in 34 patients. Twenty-six patients had RT alone, or chemotherapy combined with RT. Eighteen patients applied with locoregional or distant recurrent disease and they were given salvage or palliative treatment. x2 statistics were employed to identify significant factors for LRC. Results: The median follow-up was 18 months (range, 4-54 months). Twelve patients relapsed, of which 9 (26.5 %) locoregional failures among 34 patients of postoperative radiotherapy group. Significant prognostic factors for locoregional recurrence on univariate analysis were performance status, and surgical margin. Nine of 26 (34.6 %) patients relapsed and all of them had locoregional failures in primary radiotherapy group. Significant prognostic factors for these patients were primary tumor site, overall stage, T stage, and N stage. Conclusion: Radiotherapy is effective in the treatment of laryngeal carcinoma. The identification of prognostic factors for locoregional recurrence could help to determine more effective treatment strategies.
