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Öğe A comparison of quality of life and acute toxicity in patients applied with Tomo-helical IMRT and conformal radiotherapy for breast cancer(Springer Heidelberg, 2020) Erdis, Eda; Yucel, Birsen; Bahar, SeherAim To compare quality of life and radiation toxicity in patients applied with Tomo-helical intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) as adjuvant radiotherapy because of breast cancer. Material and method The study included a total of 403 patients. Fifty-eight percent of patients were treated with 3D-CRT, and 42% of patients were treated with Tomo-helical IMRT. Radiation toxicity was evaluated according to the Radiation Therapy Oncology Group (RTOG) toxicity criteria. Quality of life was evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 Quality of life scale version 3-Turkish and the EORTC QLQ-BR23 questionnaires. These questionnaires were completed by all patients at 4 different time points: the start of RT (T-1); the end of RT (T-2); 1 month after completion of RT (T-3); and 6 months after completion of RT (T-4). Statistical data were analysed using the Chi-square and MANOVA tests. Results Radiotherapy-related skin, upper gastro-intestinal system, white blood count and neutrophil toxicity were observed to be higher in the patients treated with 3D-CRT (p < 0.001). No difference was determined between the radiotherapy techniques according to the EORTC-C30 (p > 0.050). In the patients treated with Tomo-helical IMRT, the scores of breast symptoms (p = 0.014), sexual function (p = 0.003) and sexual pleasure (p = 0.020) in the sub-dimension scales of the EORTC-BR23 were found to be better compared with those of patients treated with 3D-CRT. Conclusion The findings of RT toxicity and quality of life appear to be superior in patients applied with Tomo-helical IMRT compared with patients treated with 3D-CRT.Öğe Acute Toxicities and Advers Events of Chemoradiotherapy in Young and Older Adults(Kare Publ, 2024) Erdis, Eda; Yilmaz, Mukaddes; Ucar, Mahmut; Yucel, BirsenOBJECTIVE To evaluate, according to age, the acute toxicity and adverse events, such as interruption or cessation of chemoradiotherapy (CRT) and weight loss, in cancer patients. METHODS A total of 813 patients, 67% aged <65 years and 33% aged >= 65 years, were analyzed retrospectively. Toxicities were graded according to the acute radiation morbidity measurement criteria of the Radiation Therapy Oncology Group. RESULTS For all patients, 5% of the younger and 12% of the elderly patients (p<0.001) ended CRT, 1% of the younger and 4% of the elderly patients died during treatment (p=0.007). There were differences between the groups treated for brain cancer in terms of performance status (p=0.010), cessation (p=0.001), interruption (p=0.026), and death during treatment (p=0.043). For head and neck cancer, the results showed differences in comorbidity (p<0.001), performance status (p=0.017), and death during CRT (p=0.021). In the thoracic area, differences were found in comorbidity (p=0.015), CRT interruption (p=0.014), grade 1-2 skin toxicity (p=0.025), pharynx/esophagus (p=0.002), upper gastrointestinal tract (p=0.036), and hematocrit (p=0.032). For the abdominal area, differences were observed in comorbidity (p<0.001) and grade 1-2 platelet toxicity (p=0.029). For the pelvis, differences were seen in comorbidity (p<0.001), performance status (p=0.045), and CRT interruption (p=0.032). CONCLUSION Cessation, interruption, and death during CRT were observed more frequently in elderly patients.Öğe AFTER THE SIXTH YEAR SCALP METASTASIS ISOLATED CASE OF BREAST CANCER DIAGNOSIS(Aves, 2012) Erdis, Eda; Kilickap, Saadettin; Akkas, Ebru Atasever; Yucel, BirsenBreast cancer metastasizing tumors of the skin is one of the most. Breast cancer, skin metastases may be the first sign of extranodal invasion (1). Often, the direct invasion of the anterior chest wall and / or local infiltration presenting as skin metastasis, although rarely seen in an area outside of the chest wall. Scalp involvement is very rare in breast cancer (2,3). We report a case of metastasis of breast cancer in a patient in the scalp are isolated.Öğe An institutional experience: quality assurance of a treatment planning system on electron beam(Kare Publ, 2013) Yaray, Kadir; Ozguven, Yildiray; Alkaya, Fadime; Yucel, Birsen; Soyuer, SerdarOBJECTIVES This study aims to application of the IAEA TRS-430 QA procedures of Eclipse (TM) v7.5 TPS for electron energies. In addition, the trends of the deviations found in the conducted tests have been determined. METHODS The calculations of TPS and measurements irradiations of the treatment device have been compared. As a result, the local dose deviation values and their confidence limit values have been obtained. RESULTS All confidence limit values were detected that it was increased depending on expanding depth. But each confidence limit values were found to show different change depending on expanding field size. Results of CT based inhomogeneity corrections and complex surface shapes tests were found outside tolerances, especially delta 3. CONCLUSION The QA of our clinic's TPS has been done and it has been found that there aren't drawbacks in its use in treatment. Only the errors found in our study for the parameters used in treatment planning has to be considered.Öğe Assessing anxiety levels and empathic tendency in blood and platelet donors(PERGAMON-ELSEVIER SCIENCE LTD, 2013) Kilic, Suar Caki; Dogan, Erdogan; Sevimligul, Gulgun; Yucel, Birsen; Bolat, Fatih; Kavakci, Onder; Sencan, MehmetIn spite of a constantly-increasing requirement for blood transfusion in the world, blood donation does not exhibit an increase at the same rate. In Turkey with a population of 74 million, only 15 per 10,000 people donate blood regularly and rate of voluntary blood donation is very low compared to developed countries. The aim of this study is to determine empathic level of donors and anxiety levels of blood and platelet donors and also to enable comfort and motivation of donors by taking precautions for reducing their anxieties. This prospective and descriptive study was conducted with 100 voluntary donors (50 blood donors, 50 platelet donors) who admitted to Blood Centre of Cumhuriyet University Hospital between 15 March 2012 and 30 April 2012. Average age of these donors was 27 (19-48) years. The mean scores of donors from Empathic Tendency Scale (ETS), State Anxiety Invertory (SAI) and Trait Anxiety Inventory (TAI) were 70 (49-83), 40 (33-45) and 34 (30-44), respectively. ETS score of those donating blood/platelet for the first time was low, >1 is higher in those who donated previously. SAI and TAI scores of blood donors were higher than those of platelet donors (p < 0.001) and TAI score was higher in those who donate for the first time (p < 0.007) compared to previously donated precipitants. In conclusion, this study underscores that the request of the donor to help others is the most important factor for donation. People frequently donate blood to unfamiliar people and recurring blood donations increase the level of empathy. Donation made during the continuous disclosure is an important factor for being a donor. (C) 2013 Elsevier Ltd. All rights reserved.Öğe Assessment of the life quality in head and neck cancer patients.(AMER SOC CLINICAL ONCOLOGY, 2012) Akkas, Ebru Atasever; Yucel, Birsen; Kilickap, Saadettin; Okur, Yillar; Kacan, Turgut; Eren, Mehmet Fuat; Babacan, Nalan Akgul…Öğe Association of higher proliferation of Ki67 with unfavorable prognostic factors and shorter survival in breast cancer(AMER SOC CLINICAL ONCOLOGY, 2012) Kilickap, Saadettin; Kaya, Yalcin; Yucel, Birsen; Tuncer, Ersin; Elagoz, Sahande…Öğe A Case of Multifocal Skin Metastases from Lung Cancer Presenting with Vasculitic-type Cutaneous Nodule(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2015) Babacan, Nalan Akgul; Kilickap, Saadettin; Sene, Saner; Kacan, Turgut; Yucel, Birsen; Eren, Mehmet Fuat; Cihan, SenerAlthough cutaneous metastasis occurs usually at the terminal stage of the disease, it may be rarely concurrent with the diagnosis and may also present as the first sign of the illness. A 55-year-old male patient presented with vasculitic-type cutaneous nodular lesions and a necrotic distal phalangeal lesion developed over the last month. He was a tradesman and smoked 40 packets year. On physical examination, he was found to have multiple cutaneous lesions on the skin of the face, limbs, neck, scalp, dorsal side, ingers, subungual side, right leg, and feet. A skin lesion punch biopsy was performed and squamous cell carcinoma metastasis was detected. He was diagnosed as having squamous cell lung cancer with bronchoscopic biopsy. Although it is very rare, cutaneous metastases that is concurrent with the diagnosis of lung cancer may be the first sign of the disease. In patients with suspicious skin lesions, the patient's age, smoking history, and other symptoms should be evaluated and a biopsy should be performed.Öğe Chemotherapy-Induced Spontaneous Orgasms in a Patient with Breast Cancer(HARVEY WHITNEY BOOKS CO, 2012) Kilickap, Saadettin; Kesikli, S. Altug; Erdis, Eda; Yucel, Birsen…Öğe Comparison of Clinicopathological Features and Survival Outcomes Associated with HER2-Zero and HER2-Low Breast Cancers: A retrospective, Observational Study(Akad Doktorlar Yayinevi, 2024) Ucar, Mahmut; Yilmaz, Mukaddes; Erdis, Eda; Yucel, BirsenDespite being classified as HER2-negative, HER2-zero and HER2-low subtypes are considered distinct entities due to their varying clinicopathological features and survival outcomes. This study was designed to evaluate the sociodemographic, clinical, survival and prognostic differences between HER2-zero and HER2-low patients who were evaluated as HER2 negative. This retrospective singlecenter study included patients with HER2-negative non-metastatic breast cancer between 2003 and 2022. Patients were analyzed in two groups as HER2-zero and HER2-low. Of 680 patients, 484 (71%) were included in the HER2-zero group and 196 (29%) in the HER2-low group. Statistically significant differences were found between the groups in terms of histopathologic subtyping (p< 0.001), ER (p< 0.001) and PR status (p= 0.005), and presence of lymphovascular invasion (p= 0.023). When survival results were analyzed according to HER2 status, overall survival and disease-free survival were not statistically different for all patients. This result was also supported in luminal A, luminal B and triple negative patients (p>0.050). HER-2 status was not observed as a factor affecting OS and DFS in univariant and multivariant analyses (p> 0.050). There were no clinically and pathologically significant differences between HER2-low and HER2-zero, except that HER2-low patients had more ER and PR positivity, more luminal subgroups and more lymphovascular invasion. When evaluated together with histopathologic subgroups, no survival difference was detected between both groups. HER2 status could not be determined as a prognostic factor.Öğe Comparison of Invasive Ductolobular Carcinoma and Lobular Carcinoma: An Observational Study(MDPI, 2025) Ucar, Mahmut; Yilmaz, Mukaddes; Erdis, Eda; Yucel, BirsenBackground and Objectives: Mixed ductolobular carcinomas (mDLCs) are tumors that contain both ductal and lobular components. The clinicopathological characteristics and impacts on survival of the two components, which have distinct biological behaviors, are still not clearly understood. This study aimed to compare the clinicopathological characteristics, recurrence/metastasis patterns, and survival outcomes of mDLC and invasive lobular carcinoma (ILC), as well as to investigate the prognostic significance of both histopathologies. Materials and Methods: The outcomes of 132 patients who were followed and treated between 2010 and 2021 were analyzed. Patients were examined in two groups, ILC and mDLC. Chi-square tests were performed to compare the baseline clinicopathological characteristics and treatments. Survival rates were subsequently analyzed using the Kaplan-Meier method and compared using the Cox proportional hazards model. Results: In this study, 80 (61%) patients had ILC histopathology, while 52 (39%) had mDLC histopathology. Differences between the groups were observed in median age (p = 0.038), N stage (p = 0.046), estrogen receptor (ER) status (p = 0.005), lymphovascular invasion (p = 0.007), median tumor diameter (p = 0.050), and frequency of distant metastasis (p = 0.029). The treatments, relapse patterns, and metastasis patterns were similar (p > 0.05). No differences in overall survival (OS) and disease-free survival (DFS) were observed. In the multivariate analysis, mDLC histopathology was identified as a poor prognostic factor (HR: 2.95, CI 95%: 1.10-7.88, p = 0.030). Histopathology (ILC vs. mDCL) was not identified as a prognostic factor in the Cox regression analysis for DFS. Conclusion: Although mDLC has poor clinicopathological features (younger age, more advanced N stage, more ER negativity, more lymphovascular invasion, and more frequency of metastases) and appears more aggressive than ILC, these changes do not affect survival in this study. However, mDLC histopathology seems to be associated with poor prognosis for OS.Öğe Comparison of Treatment Outcomes in Patients with Rectal Cancer(Aves, 2019) Erdis, Eda; Yucel, BirsenObjective: The aim of the present study is to evaluate survival results and acute chemoradiotherapy toxicity in patients with rectal cancer who underwent preoperative chemoradiotherapy (CRT), postoperative CRT, and non-operative CRT. Methods: The records of 139 patients with rectal cancer were analyzed retrospectively. Out of these, the data 9 (6%) patients who died during or immediately after treatment and 2 (1%) patients who gave up the treatment were not used in the survival analysis. Results: Postoperative CRT was applied to 57 (44%) patients, preoperative CRT to 47 (37%) patients, and non-operative CRT to 24 (19%) patients. Non-operative CRT group was the oldest patient group (median age: 70). There was a difference between the treatment groups regarding tumor localization (p<0.001), pathological stage (p<0.001), lymphovascular (LVI, p<0.004), and perineural invasion (PNI, p=0.017). A difference was determined between the groups regarding median follow-up and the postoperative CRT group had the longest median follow-up (p<0.001). A difference was also determined between the groups regarding local recurrence and distant metastasis (p=0.467 and p=0.901, respectively). The three-year overall survival and disease-free survival rates were 78% and 78% for the postoperative CRT group, 76% and 73% for the preoperative CRT group, and 48% and 41% for the non-operative CRT group (p<0.001 and p<0.001, respectively). However, the difference between preoperative and postoperative CRT regarding overall survival and disease-free survival was not determined since the non-operative CRT group was included in survival analysis (p=0.184 and p=0.073, respectively). No difference found among the three groups regarding the adverse effects of chemoradiotherapy (p>0.050). Conclusion: While no difference was determined between preoperative and postoperative CRT applications regarding local recurrence and distant metastasis, overall survival and disease-free survival, and adverse effects of treatment, LVI, and PNI determined in earlier pathological stage and lower frequency for the preoperative application. However, overall survival results of patients receiving non-operative CRT were worse as compared to patients receiving operative CRT.Öğe Complete remission after bevacizumab plus temozolomide in a patient with recurrent glioblastoma multiforme(INFORMA HEALTHCARE, 2012) Kilickap, Saadettin; Oztoprak, Ibrahim; Yucel, Birsen…Öğe Concentration modulated skin marker for radiotherapy treatment planning process(ELSEVIER SCI LTD, 2013) Ozguven, Yildiray; Yucel, Birsen; Ozyurek, Betul; Karakus, Gulderen; Ozguven, YucelBackground and purpose: For conformal radiotherapy, it is feasible to achieve high accuracy in contouring the outline of the target volume in treatment planning process. In contouring process, target volume is occasionally defined by means of either surgical clips or skin marker during patient anatomical data acquisition. Treatment planning systems are predicting invalid radiation dose distributions by using surgical clips and skin marker within the patient. Purpose of this study is the production of new skin marker which affects less dose distributions of electron beam. Materials and methods: The influences of lead and commercial markers on dose calculations in a 3D treatment planning systems were investigated in terms of electron beam energy and dose profile depth. Dose deviation with commercial marker was observed to smaller than lead marker. However this dose deviation was still at big value. In order to reduce of this value, barium sulfate suspension and ultrasound gel were mixed with different volumetric ratio. With the purpose of acception the most suitable marker for radiation therapy, obtained new suspensions were investigated in terms of visibility and dose deviation. Results: B:G/1:10 marker was determined to cause optimum visibility and the lowest dose deviation on dose calculations in terms of electron beam energy and dose profile depth. Conclusions: Appropriate marker, mixture of substances such as barium sulfate suspension and ultrasound gel can be produced. This marker is both ease of usage and practical and economical. Each clinic can prepare marker which is peculiar to suspension with different concentration of substance for specific visibility. But, it should be taken into account resultant dose deviation to beam calculation depending on barium sulfate concentration. (C) 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.Öğe Could the neutrophil to lymphocyte ratio be a poor prognostic factor for lung cancers?(AMER SOC CLINICAL ONCOLOGY, 2014) Kacan, Turgut; Babacan, Nalan; Seker, Mehmet Metin; Yucel, Birsen; Behceci, Aykut; Gedikil, Mustafa Asim; Kilickap, Saadettin…Öğe Could the Neutrophil to Lymphocyte Ratio be a Poor Prognostic Factor for Non Small Cell Lung Cancers?(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2014) Kacan, Turgut; Babacan, Nalan Akgul; Seker, Metin; Yucel, Birsen; Bahceci, Aykut; Eren, Ayfer Ay; Eren, Mehmet Fuat; Kilickap, SaadettinBackground: Although many prognostic factors have been identified for lung cancers, new ones are needed to determine the course of the disease. Recently, a high neutrophil to lymphocyte ratio (NLR) prior to surgery or treatment has been shown to be an indicator of prognosis for cancer. The aim of this study was to investigate the value of NLR as a prognostic factor and the correlation between NLR and other probable clinical prognostic factors in non small cell lung cancer patients prior to treatment. Materials and Methods: Data of patients who were diagnosed with non-small cell lung cancer in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristics were recorded. NLR was calculated before the application of any treatment. Results: A total of 299 patients, 270 (90%) males and 29 (10%) females, were included in the study. Age (p<0.001) stage (p<0.001), Eastern Cooperative Oncology Group performance status (p<0.001), weight loss (p<0.001), anemia (p<0.001), histopatology (p<0.001), NLR >= 3 (p=0.048), NLR >= 4 (p=0.025) and NLR >= 5 (p=0.018) were found to be the prognostic factors. Age, anemia, Eastern Cooperative Oncology Group performance status, the stage, NLR (>= 5) were an independent prognostic factors. There was a positive correlation between NLR and the Eastern Cooperative Oncology Group performance status (0.23, p=0.001), the C reactive protein levels (r=0.36, p<0.001). Conclusions: Prior to treatment high NLR was found as an independent poor prognosis factor. Besides, NLR correlated with Eastern Cooperative Oncology Group performance status and the C reactive protein levels.Öğe Cytoreductive Surgery Followed by Hyperthermic Intraperitoneal Chemotherapy: Morbidity and Mortality Analysis of Our Patients(ORTADOGU AD PRES & PUBL CO, 2012) Karadayi, Kursat; Turan, Mustafa; Karadayi, Sule; Alagozlu, Hakan; Kilickap, Saadettin; Buyukcelik, Abdullah; Sarkis, Cihat; Yucel, Birsen; Boztosun, Abdullah; Cetin, Meral; Yilmaz, Abdulkerim; Yanik, Ali; Sen, MetinObjective: The purpose of this study was to analyze the morbidity and mortality of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) with closed abdomen technique in the treatment of peritoneal surface malignancies. Material and Methods: Twenty-six patients (8 with ovarian cancer, 7 peritoneal mesothelioma, 6 colorectal cancer, 3 uterine sarcoma, 1 peritoneal carcinoma and 1 with gastric cancer) underwent 27 procedures. Peritonectomy was performed with complete removal of all the involved visceral and parietal peritoneum. HIPEC was performed with the closed abdominal technique using preheated (42.5 degrees C) perfusate for 60 minutes. EPIC was continued for postoperative 5 days. Results: All patients underwent resection of the lesions. Total pentonectomy was performed in 12 patients, while subtotal or partial peritonectomy was carried out in 14 according to the spread of carcinomatosis. Completeness of cytoreduction score of our patients was 0 in 18 patients, 1 in 6 patients and 2 in 2 patients. Major morbidity developed in 7 patients (27%). CRS+HIPEC+EPIC yielded acceptable morbidity and mortality rates. Of the 26 patients, 20 (77%) were alive without evidence of disease with a mean follow-up period of 13 6 months. Overall 1 year survival was 60%. Conclusion: Cytoreductive approach combined with intraperitoneal chemotherapy prolongs survival in selected patients with peritoneal carcinomatosis (PC) with acceptable morbidity and mortality.Öğe The diagnostic and prognostic value of UHRF-1 and p53 in gastric cancer.(AMER SOC CLINICAL ONCOLOGY, 2014) Babacan, Nalan Akgul; Egilmez, Reyhan; Yucel, Birsen; Seker, Mehmet Metin; Parlak, Ilknur; Kacan, Turgut; Bahcecl, Aykut; Cihan, Sener; Akincl, Bulent; Kilickap, Saadettin…Öğe Does Diabetes Mellitus Increase Radiotherapy/ Chemoradiotherapy Acute Toxicities?(Kare Publ, 2023) Erdis, Eda; Yucel, BirsenOBJECTIVE The effect of DM on the acute toxicities of RT/CRT was investigated.METHODS 1892 patients were evaluated retrospectively. Acute toxicities were evaluated weekly during Radiotherapy (RT)/Cardiac resynchronization therapy (CRT) and follow ups were performed after 1 and 3 months according to Radiation Therapy Oncology Group criteria. The patients were divided into those without diabetes mellitus (DM) (Group 1, n=1557 82%) and patients with DM (Group 2, n=335 18%).RESULTS There was a difference between the groups in terms of gender (p<0.001), median age (p<0.001), diagnosis (p=0.023), adjuvant (p=0.023), and concurrent (p=0.047) chemotherapy. Grade 3-4 skin (p=0.001), Grade 1-2 lower gis (lower gastrointestinal system [GIS], p<0.001), and Grade 1-2 gus toxicities (GUS, p=0.012) were all observed more in Group 2; the time for which skin toxicity occurred was earlier in Group 2 (p=0.002). Grade 1-2 white blood cells (p=0.027) and Grade 1-2 hemoglobin toxicities (p=0.033) were observed more in Group 1. Hypertension coexisted in 206 patients (61% of the DM group), and blood glucose was not regulated in 256 patients (76%). In DM patients, the toxicity of grade 3-4 skin (p<0.001) and grade 1-2 lower GIS (<0.001) was higher if hypertension coexisted, while grade 1-2 lower GIS (p=0.029) was higher in DM patients whose blood glucose was not regulated.CONCLUSION In this study, it was observed that DM negatively affected acute toxicity of RT/CRT, and having hyper-tension and lack of regulation of blood glucose contributed to this negativity.Öğe Effect of the patient's age on radiotherapy-based adverse effect(AMER SOC CLINICAL ONCOLOGY, 2012) Okur, Yillar; Yucel, Birsen; Akkas, Ebru Atasever; Eren, Mehmet Fuat; Babacan, Nalan Akgul; Kacan, Turgut; Kilickap, Saadettin…
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