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Öğe Adjuvant radiotherapy for Stage I seminoma: A Single-institutional experience(Wolters Kluwer Medknow Publications, 2019) Kanyilmaz, Gul; Saricanbaz, Irem; Bora, Huseyin; Karahacioglu, Eray; Erkal, Eda YirmibesogluObjectives: There is no consensus regarding the management of Stage 1 seminomas following inguinal orchiectomy. In this study, we evaluated the treatment results and treatment-related toxicity for patients with Stage 1 seminomas treated with adjuvant radiotherapy (RT) at a single institution. Methods: Sixty-five patients who underwent adjuvant RT following orchiectomy for Stage 1 seminomas between January 1996 and December 2007 were retrospectively reviewed. The age, tumor location, histopathological type, stage, tumor size, RT field, and radiation dose were recorded for all patients. Results: The patients' ages ranged from 17 to 61 years (median, 37 years). Sixty-three patients (97%) were diagnosed with classical seminoma and the remaining two patients (3%) had spermatocytic seminoma. After orchiectomy, 37 patients (57%) received para-aortic RT and 28 patients (43%) received dog-leg field RT. RT was applied with 1.8u2 Gy/day fractionation and the median RT dose was 26 Gy (range, 20u38). Follow-up ranged from 0.3 to 18 years (median, 9.5 years). Local control had been achieved in all patients and all of them were alive with no evidence of disease. Fifty-one patients (77%) had at least 5 years of follow-up and 27 patients (41%) had at least 10 years of follow-up. Overall survival at 10 years was 100%. Conclusion: Although retrospective in nature, this single-institutional study provides useful information about the outcomes and toxicities associated with adjuvant RT in patients with Stage 1 seminomas reporting excellent disease control and survival rates at the expense of acceptable toxicity.Öğe Assessment of Quality of Life Following Radiotherapy in Patients with Rectum Cancer(Springer, 2022) Yavuz, Berrin Benli; Aktan, Meryem; Kanyilmaz, Gul; Demir, Lutfi SaltukPurpose The aim of the present study is to investigate the effects of radiotherapy (RT) on quality of life (QoL) and influencing factors. Methods Data of 106 patients who completely filled out the three questionnaires were evaluated in this prospective study. Quality of life was evaluated with cancer-specific QLQ-C30 and colorectal cancer module QLQ-CR29 created by European Organization for Research and Treatment of Cancer (EORTC). All statistical analyses were done with SPSS version 22 software. A p level of < 0.05 was accepted as statistically significant. Results Median age was 61 (27-86). Of the patients, 77 (72.6%) were male and 29 (27.4%) were female. When QLQ-C30 questionnaires were evaluated, it was observed that physical, role, cognitive, and emotional function scores were impaired following RT, however returned to pre-RT levels on control. According to the results of QLQ-CR29 questionnaire, after RT, impairment was observed in urination frequency, urinary incontinence, stool frequency, dysuria, fecal incontinence, embarrassment, and sexual interest in male scales; however, they returned to pre-RT values on control. When evaluated with regard to age, financial difficulty, global health score, mucus in stool, dysuria, dyspareunia, and abdominal pain were observed to be poorer in the young; urination frequency and urinary incontinence were observed to be poorer in the elderly. Conclusion Although both functional and symptom scales were shown to impair, most of them were detected to be temporal and patients could well tolerate radiotherapy. Additional assessment is required for evaluating the late effects of treatments on QoL.Öğe Brain metastases from prostate cancer: A single-center experience(Aves, 2019) Kanyilmaz, Gul; Aktan, Meryem; Yavuz, Berrin Benli; Koc, MehmetObjective: Metastases from prostate cancer to the brain are very unusual and very few case series have been reported in the literature. Present study was performed to assess the proportion of brain metastasis from prostate cancer among other brain metastasis in men, to evaluate the distribution, pattern and magnetic resonance imaging (MRI) appearance of these metastatic lesions, and prognosis of brain metastasis in patients with prostate cancer. Material and methods: Between January 2010 and November 2016, 339 males who had received radiotherapy at our department were retrospectively reviewed. After the first evaluation of patients data, we reviewed only the patients with brain metastases from prostate cancer. We evaluated MRI characteristics of metastatic brain lesions and characteristics of the patients, tumor and treatment modalities. Results: Ten of 339 patients (2.9%) had brain metastases from prostate cancer. Sixty percent of the patients had pure intraparenchymal metastasis, 20% of the patients had pure extensive dural metastasis and 20% of them had both. Seventy-five percent of the patients with intraparenchymal metastasis had multiple metastatic lesions. The median prostate specific antigen (PSA) level was 49.40 ng/mL and the Gleason score was >= 7 in all patients. Sixty percent of the patients had distant metastasis at the time of the diagnosis of prostate cancer. Median survival time in patients with brain metastasis was 4.5 months. Conclusion: Lesions of brain metastasis from prostate cancer had a large variety of imaging presentation and it is very difficult to distinguish them from the other brain metastasis originating from other types of cancer. Presence of a disseminated disease, high PSA level and high Gleason score can be useful parameters for the prediction of brain metastasis from prostate cancer.Öğe Breast Cancer Among Patients Below Age 40: Clinicopathological Features and Survival Results(Akad Doktorlar Yayinevi, 2020) Yavuz, Berrin Benli; Aktan, Meryem; Kanyilmaz, GulAmong young women breast cancer exhibits quite a heterogenous, quite agressive and complex biology. The purpose of this study is to describe clinicopathological features that affect survival ratio among breast cancer women below age-40. 803 patients having received adjuvant radiotherapy were retrospectively analyzed. Patients were categorized under two groups: age <= 40 and age > 40. Treatments and clinicopathological features were analyzed. 19.4% (156) of 803 patients were below age 40. In patient group below age 40, more neoadjuvant chemotherapy (NAC) was administered compared to the patient group above age 40 (p= 0.007) and it was detected that there were higher incidences of stage 3 disease (p= 0.011), more advanced nodal disease (N2-3) (p= 0.046) and more metastasis (p< 0.001). In conducted multivariate analysis for all age groups presence of N2-3 disease (p= 0.011) and in below age-40 group being grad 3 (p= 0.025) was found to affect overall survival (OS) negatively. In disease free survival (DFS)-focused analysis; for all age groups, receiving NAC (p= 0.001), presence of N2-3 disease (p= 0.002) and being below age 40 were found to have a negative effect; in below age-40 group presence of NAC (p= 0.013) and perineural invasion (p= 0.035); in above age-40 group receiving NAC (p= 0.023) and presence of N2-3 disease (p= 0.035) had a negative effect. Being below age 40 is an independent prognostic factor for DFS. It is suggested to conduct further studies on specific tumor biology to analyze the same group with respect to the characteristics of more aggressive tumors.Öğe Comparison of Prognostic Factors in Glioblastoma Patients with Short- and Long-term Survival(Kare Publ, 2023) Yavuz, Berrin Benli; Kanyilmaz, Gul; Aktan, MeryemOBJECTIVE Glioblastoma (GBM) is the most aggressive primary brain tumor. Despite all treatments, very few have long-term survival. This retrospective study aimed to investigate the clinicopathological features, treatment modalities, and factors affecting survival in GBM patients with short-and long-term survival. METHODS Data from 217 GBM patients who received radiotherapy (RT) between 2010 and 2021 were analyzed. The patients were divided into two groups: short (<6 months) and long (>2 years) living groups. Treatment, patient, and tumor characteristics were evaluated. RESULTS While 37 (17.1%) of 217 patients included in the group lived <6 months, 49 (22.6%) were in the group that lived longer than 2 years. In the long-living group, being under 65 years of age, having better performance, performing total excision, applying conventional RT, and receiving adjuvant chemotherapy (CT) detected more frequently. The regression test showed that young age, good performance, and receiving conventional RT and adjuvant chemotherapy (CT) were independently associated with survival. CONCLUSION It was observed that patients who lived longer were frequently young and well-performing ones who underwent wide excision and received conventional RT and adjuvant CT. By estimating the pre-treatment survival, treatment and support plans can be made accordingly.Öğe Cutaneous Metastases of the Synchronous Primary Endometrial and Bilateral Ovarian Cancer: An Infrequent Presentation and Literature Review(Hindawi Ltd, 2016) Kanyilmaz, Gul; Aktan, Meryem; Koc, Mehmet; Findik, SiddikaThere are limited data about the cutaneous metastases of gynecological malignancies in the literature. Based on this limited number of studies, cutaneous metastases from gynecological malignancies are uncommon occurrences. Cutaneous metastases from the synchronous endometrioid carcinoma of the uterine corpus and bilateral ovaries arising from endometriosis are extremely rare. Herein, we report a 51-year-old woman with FIGO Stage 1A Grade 1 endometrial endometrioid-type adenocarcinoma and synchronous bilateral Stage 1B ovarian endometrioid-type adenocarcinoma who presented 34 months following total abdominal hysterectomy and bilateral salpingo-oophorectomy with skin metastases. After the patient underwent an excisional biopsy, we applied a palliative radiotherapy. The patient received the combination therapy with cisplatin and doxorubicin after the completion of radiotherapy but the disease evolution was rapidly fatal and the patient died 4 months after her admission to our department due to widely disseminated disease.Öğe Cutaneous Vasculitis after Radiotherapy(Aves, 2019) Temiz, Selami Aykut; Ozer, Ilkay; Kanyilmaz, Gul; Ataseven, Arzu; Oltulu, PembeCutaneous vasculitis is a large heterogeneous group of diseases, where blood vessels are targeted by immunological and inflammatory reactions, which are the primary causes of this condition. Infections, medications, systemic collagenosis, chronic diseases, and malignancies are the secondary factors that cause cutaneous vasculitis. Hemangiomas are the most common primary benign tumors of the spinal cordand are rarely symptomatic. The most commonly manifestedsymptom is pain, but in rare cases, cutaneous vasculitis may lead to paraparesis and paralysis. Radiotherapy (RT) is a safe and effective treatment for symptomatic spinal cord hemangiomas. A 44-year-old male patient was admitted to our dermatology polyclinic with a complaint of a bilateral rash on both legs that had lasted for 1 week. The medical history of the patient included no disease other than a sacral hemangioma with symptomatic pain, for which the patient had been treated with 4500 cGy curative radiotherapy 1 month previously. In our case, it was thought that cutaneous vasculitis was caused by the radiotherapy without any other triggering factor. A skin biopsy was taken to arrive at a definite diagnosis, and in the histopathological examination, abundant amounts of extra-red blood cells and lymphocytes were observed, along with endothelial profiling in superficial vessels; all of which are findings consistent with vasculitis. The patient was diagnosed with cutaneous vasculitis, both clinically and histopathologically. To the best of our knowledge, radiotherapy as a cause of vasculitis has been the subject of very few studies in the literature to date. In this regard, the present report describes a case of cutaneous vasculitis as a possible immune-related side effect of RT.Öğe Erythema Multiforme Associated With Phenytoin and Cranial RadiationTherapy (EMPACT) Syndrome Associated With Cranial Radiotherapy and Levetiracetam: A Case Report(Cureus Inc, 2022) Yilmaz, Tugba; Yavuz, Berrin B.; Kanyilmaz, Gul; Aktan, Meryem; Temiz, Selami A.Cranial radiotherapy (RT) is an irradiated way to treat patients with brain malignancies. Seizure is the most common symptom. Due to the frequency of seizure risk, cranial RT is usually received concomitant with previously initiated antiepileptic drugs (AED). This combination can lead to erythema multiforme (EM) like serious skin reactions starting from the irradiated port site and spreading to whole cutaneous surfaces and mucosal membranes. This clinical entity is named after as an acronym of components which are Erythema Multiforme associated with Phenytoin And Cranial RadiationTherapy as EMPACT syndrome. Most cases of EMPACT syndrome are reported with phenytoin in the literature, but there are no reported cases with levetiracetam to the best of our knowledge in the literature. Here, we report a 62-year-old male with glioblastoma, presented with severe conjunctivitis, extensive bleeding erosions in his oral mucosa and erythematous macular eruptions on the right temporoparietal port region of the scalp, and EM-like generalized lesions involved neck, chest, back, and arms following the end of his cranial RT. He was diagnosed with EMPACT syndrome, related to using levetiracetam concomitant with cranial RT. Early diagnosis is crucial for the complete response of treatment. Physicians should be alert to possible skin and mucosal reactions of patients under levetiracetam treatment, especially co-existing use of cranial RT.Öğe Factors affecting pathological response and survival following neoadjuvant chemoradiotherapy in rectal cancer patients(Wolters Kluwer Medknow Publications, 2021) Aktan, Meryem; Yavuz, Berrin Benli; Kanyilmaz, Gul; Oltulu, PembeBackground: Despite all advanced treatment methods for rectal cancer, not all patients can provide an adequate response, and hence, possible prognostic factors must be evaluated. The aim of this study was to evaluate the relationship between systemic inflammatory markers and pathological response, overall survival (OS) and disease-free survival (DFS) in patients treated with neoadjuvant chemoradiotherapy (nCRT). Methods: We evaluated data of 117 patients for the period 2010 to 2017. Serum measurements of albumin, hemoglobin, C-reactive protein, modified Glasgow prognostic score (mGPS), and white cell counts were obtained. Rodel scoring system was used to determine pathologic tumor regression. Results: Overall, 77% of the patients were in the good response group according to the radiological images. A total of 48% of patients were categorized as a good pathologic response. Pathologic response to treatment was associated with a mGPS of 0 (P = 0.001), normal platelet lymphocyte ratio (PLR) (P = 0.003), TNM stage (P = 0.03), pathologic T stage (P = 0.001), radiologic response to nCRT (P = 0.04), tumor differentiation (P = 0.001), lymphovascular invasion (LVI) (P = 0.001) and perineural invasion (P = 0.02). LVI (P = 0.04), albumin level (P = 0.05), C-reactive protein (P = 0.01), neutrophil platelet score (NPS) (P = <0.001) and mGPS (P = 0.01) had a statistically significant effect on OS. Operation type (P = 0.03), tumor differentiation (P = 0.01), depth of invasion (P = 0.03), NPS (P < 0.01), mGPS (P = 0.01), PLR (P = 0.004), neutrophil-lymphocyte ratio (P = 0.01) and LVI (P = 0.05) were statistically significant on DFS. Conclusions: There was an association between systemic inflammatory markers and pathologic response and also, between OS and DFS. This study can be preliminary data for prospective controlled studies.Öğe Factors affecting survival in glioblastoma patients below and above 65 years of age: A retrospective observational study(Wolters Kluwer Medknow Publications, 2021) Yavuz, Berrin B.; Kanyilmaz, Gul; Aktan, MeryemBackground: The purpose of this study is to identify the differences with respect to survival and prognostic factors in a comparison between radiotherapy-receiving glioblastoma (GBM) patients above and below 65 years of age. Methods: The results of 157 patients with GBM were analyzed retrospectively. Patients were divided into two groups as those below and above 65 years of age. A comparison was drawn with respect to each group's demographic characteristics, treatment methods, and findings. Results: Out of a total of 157 patients, 53 patients (33.8%) were above 65 years of age. Karnofsky performance status (KPS) was weaker among older patients (P = 0.002). On the other hand, with respect to radiotherapy dose, among older patient group, greater hypofractionation and whole-brain radiotherapy was applied (P = 0.003) compared with younger patients. The survival rates for 1, 2, and 5 years among patients aged <65 years were 63%, 30%, and 3%, respectively, and in patients aged >= 65 years were 43%, 13%, and 0%, respectively. In univariate analyses, a comparison between patients below and above 65 years of age revealed that values higher than 80 KPS (P = 0.002), applying total excision (P < 0.001), receiving concurrent chemotherapy (P = 0.004), receiving conventional radiotherapy (P < 0.001), and adjuvant chemotherapy (P < 0.001) were effective factors on overall survival rates. Conclusion: In the patient group above 65 years of age, the patient should be attentively selected before opting for a specific treatment, age alone should not be the sole determinant factor. Rather, by considering the KPS scores, potential aggressive treatment options should also be applied.Öğe The Influence of Hormone Therapy on the Development of Pulmonary Fibrosis after Radiotherapy in Patients with Breast Cancer(Akad Doktorlar Yayinevi, 2022) Yavuz, Berrin Benli; Poyraz, Necdet; Kanyilmaz, Gul; Aktan, Meryem; Tuncez, Ismail H.; Koc, MehmetThe aim of the present study is to investigate the effects of hormone therapy on pulmonary fibrosis in patients who received curative conformal radiotherapy for breast cancer. Data of 469 patients were evaluated. Computerized tomography images were evaluated by a radiologist as blindly. The influence of hormone therapy (tamoxifen and aromatase inhibitors), age, menopause, radiotherapy fields, ipsilateral lung volume receiving 5 Gy (V5), ipsilateral lung volume receiving 20 Gy (V20), ipsilateral mean lung dose (MLD) and the effects of taxane group of chemotherapy on pulmonary fibrosis were investigated. The mean age was 51 (range 27-83) years. As hormone therapy, 159 patients (33.9%) used tamoxifen and 253 patients (53.9%) used aromatase inhibitors. A significant relationship was found between both 6th month lung fibrosis and 2nd year lung fibrosis, and V5, V20, MLD, regional lymphatic irradiation and hormone therapy use. More grade 2 fibrosis was detected in the patients who received tamoxifen compared to the patients who received aromatase inhibitors and the control group (p< 0.001). No association was found between menopausal status, age, and taxane group chemotherapy and lung fibrosis development. In multivariate analysis, V5, MLD, and using hormone therapy were shown to be independent predictors of the risk of developing fibrosis at both 6 months and 2 years. Use of tamoxifen increases early and late lung fibrosis more than aromatase inhibitors in patients who receive radiotherapy for breast cancer. However, V5, V20, MLD and regional lymph node irradiation also contribute to the prevalence of fibrosis.Öğe Late PET/CT Findings of COVID-19 Pneumonia With 2 Different Radiopharmaceuticals in a Patient PSMA Avidity Higher Than FDGs(Lippincott Williams & Wilkins, 2021) Sahin, Ozlem; Kaya, Bugra; Aydin, Zeynep; Karaagac, Mustafa; Kanyilmaz, GulWe present the Ga-68-PSMA and F-18-FDG PET/CT findings comparatively of a 67-year-old prostate cancer and malignant melanoma patient who had COVID-19 pneumonia 3 months ago. In Ga-68-PSMA PET/CT, ground-glass opacities showing markedly increased PSMA uptake were observed in the patient's lungs. It was learned that the patient had COVID-19 pneumonia 3 months ago and was treated in the intensive care unit for 13 days. In F-18-FDG PET/CT, FDG uptake was minimal in the same areas. In the midterm period after COVID-19 pneumonia, lung PSMA uptake is more intense than FDG, which may help better understand the disease's healing phase.Öğe Outcomes of reirradiation in the treatment of patients with multiple brain metastases of solid tumors: a retrospective analysis(Ame Publ Co, 2015) Aktan, Meryem; Koc, Mehmet; Kanyilmaz, Gul; Tezcan, YilmazBackground: Patients with multiple brain metastases are often treated with whole brain radiation therapy (WBRT). Second course of WBRT is an important treatment option for patients with clinical or radiological intracranial disease progression. This study examines the outcomes in patients with multiple brain metastases who underwent reirradiation. Methods: We examined the medical records of 34 patients with multiple brain metastases who were treated WBRT. The median dose for the first course of WBRT was 30 Gy (range, 25-30 Gy) and for the second course 25 Gy (range, 20-30 Gy). Statistical analyses were performed with using Cox regression analyses, log-rank test and Kaplan-Meier method. Results: The median Karnofsky performance status (KPS) was 80 (range, 50-100) before reirradiation. Patients with KPS of >70 had a median survival of 11.4 months, compared to 2.2 months with KPS of <= 70 (P=0.012) and patients who have severe symptoms at the time of reirradiation with median survival 2.2 months while those with mild symptoms had a median of 4.8 months survival (P=0.08). The median overall survival for all patients after diagnosis of metastases was 24.7 months, after the re-irradiation WBRT (re-WBRT) it was 5.3 months (95% CI, 4.08-6.62) and from the diagnosis of primary tumor was 27.1 months (95% CI, 17.75-37.04). Conclusions: In select patients who have good performance status and who do not have severe symptoms might benefit from re-WBRT and re-WBRT seems to be associated with minimal toxicity in patients treated with lower palliation doses.Öğe Prognostic importance of expression of mini-chromosome maintenance proteins (MCMs) in patients with nasopharyngeal cancer treated with curative radiotherapy(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2022) Kanyilmaz, Gul; Oltulu, Pembe; Yavuz, Berrin Benli; Aktan, MeryemObjective: The prognostic importance of minichromosome maintenance complex expression in nasopharyngeal cancer is still unknown. We aimed to find whether minichromosome maintenance complex 2-7 expression may potentially be used to predict the prognosis of nasopharyngeal cancer patients treated with definitive radiotherapy. Methods: Between April 2007 and July 2020, patients with nasopharyngeal cancer treated with radiotherapy were identified. Immunohistochemical analysis was performed on formalin-fixed paraffin-embedded tissues of cases. A single pathologist analyzed the histologic specimens of all patients. Results: Totally, 67 patients were included. The median followup was 75.3 months. Higher tumor (T) stage was correlated with minichromosome maintenance complex 2 overexpression. Minichromosome maintenance complex s expression was also associated with histopathologic subgroups. According to univariate analysis, AJCC stage, histopathological subgroups, tumor response after treatment, minichromosome maintenance complex 2, 3, 5, 6 and 7 expression were the prognostic factors that predict overall survival. According to multivariate analysis minichromosome maintenance complex 7 expression was the only prognostic marker for bothprogression-free survival and overall survival. Conclusion: The overexpression of minichromosome maintenance complex 2, 3, 5, 6 and 7 indicated bad prognosis. Minichromosome maintenance complex 7 was an independent prognostic factor for survival outcomes in nasopharyngeal cancer and may be a potential therapeutic target for treatment. (c) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).Öğe Prognostic Importance of Ki-67 in Breast Cancer and Its Relationship with Other Prognostic Factors(Aves, 2019) Kanyilmaz, Gul; Yavuz, Berrin Benli; Aktan, Meryem; Karaagac, Mustafa; Uyar, Mehmet; Findik, SiddikaObjective: The clinical feature of breast cancer is very heterogeneous because of the variable prognostic factors impact its behaviour. The aim of study is to find the prognostic importance of Ki-67 and to analyse the correlation between Ki-67 index and the other conventional prognostic factors in breast cancer patients. Materials and Methods: Between 2010 and 2017, patients with invasive ductal carcinoma who received radiotherapy after surgery were included in study. A single pathologist re-defined of all cases retrospectively. Ki-67 were established three categories based on Ki-67 levels: low (<10%), intermediate (10-25%) and high (>25%). Results: A total of 258 patients were included. 46 of 258 (18%) patients were in low, 82 of 258 (32%) patients were in intermediate and 130 of 258 (50%) patients were in high Ki-67 group. There were no correlations between menopausal status, age, and Ki-67 level. Low-pT stages tended to have low Ki-67 expression (p=0.07). Low-pN stages correlated with low Ki-67 values (p=0.007). Patients with ECE (+) were prone to have higher Ki-67 values (p=0.02). The significant correlation was seen between Ki-67 and tumour grading (p=<0.0001). Patients with LVI (+) had higher Ki-67 expression (p=0.007). Luminal A tumours were correlated with low Ki-67 group (p=<0.0001). Ki-67 values had significant effect on DFS (p=0.03) but not OS (p=0.09). Conclusion: This study showed that high Ki-67 expression is associated with higher pT-stage, higher pN-stage, higher grade, ER/PR negativity, HER2/neu positivity, ECE and LVI positivity. The prognostic impact of Ki-67 was only demonstrated for DFS.Öğe Prognostic Importance of Ki-67 Labeling Index in Grade II Glial Tumors(Kare Publ, 2018) Kanyilmaz, Gul; Onder, Hatice; Aktan, Meryem; Koc, Mehmet; Bora, Huseyin; Karahacioglu, Eray; Erkal, Haldun SukruOBJECTIVE To date, several methods have been identified for predicting the prognostic subgroups of grade II gliomas; however, these methods have some limitations in predicting survival. So, we aimed to determine the predictive role of Ki-67 labeling, index (LI) on survival. METHODS Between 1995 and 2011, patients with grade II, gliomas were retrospectively analyzed. All patients received radiotherapy (RT). RESULTS This study included 78 patients with median 44 (range, 6-137) months follow-up. Patients aged >= 40 years had a poorer overall survival (OS) than those aged <10 years (p=0.04). Patients with gross total resection/ subtotal resection had a longer OS than those with biopsy/partial resection (p=0.001). If the disease had recurrence or progression during the follow-up period, the patients had a poorer OS (p=0.01). Patients with a Ki-67 LI >= 4% had a poorer OS than those with Ki-67 LI < 4%(p=0.001). The extent of resection, recurrence, or progression, and Ki-67 LI >= 4% were the independent prognostic factors for OS. CONCLUSION In our opinion, Ki-67 LI is an important prognostic factor for grade II gliomas, hut it cannot be used as a diagnostic measure alone. It must be used in combination with the other prognostic factors.Öğe Prognostic importance of PTEN, EGFR, HER-2, and IGF-1R in gastric cancer patients treated with postoperative chemoradiation(Tubitak Scientific & Technological Research Council Turkey, 2019) Benli Yavuz, Berrin; Koc, Mehmet; Kozacioglu, Sumeyye; Kanyilmaz, Gul; Aktan, MeryemBadcground/aim: This study aimed to describe the prognostic importance of epidermal growth factor (EGFR), phosphatase and tensin homolog (PTEN), human EGF receptor-2 (HER-2), and insulin-like growth factor 1 receptor (IGF-1R) in gastric cancer patients treated with postoperative chemoradiation therapy. Materials and methods: Sixty-nine patients treated with adjuvant chemoradiation therapy were retrospectively evaluated. Tumor samples were stained immunohistochemically. Results: All patients were treated with 3D conformal radiation therapy with concomitant and adjuvant chemotherapy. Perineural invasion (PNI) (P = 0.042), prechemoradiation therapy albumin levels below 3.5 mg/dL (P = 0.011), and EGFR positivity (P = 0.008) had negative effects on overall survival (OS). The median OS was 26 months for patients with PNI (+), 34.9 months for those with PNI (-), 19.5 months for those with albumin levels below 3.5 mg/dL, and 33.2 months for those with albumin levels above 3.5 mg/dL. IGF-1R (+) (P= 0.035) and history of cigarette smoking (P= 0.033) were observed to have a statistically significantly negative effect on disease-free survival (DFS). The median DFS was 29.2 months for IGF-1R (+) patients, 37.9 months for those with IGF-1R (-), and 26.3 and 40.59 months for smokers and nonsmokers, respectively. Condusion: IGF-1R and EGFR may be used for patient selection in future prospective studies that evaluate the prognostic importance of these receptors.Öğe Prognostic Value of IDH-1, PTEN and EGFR Expression in High Grade Gliomas(Akad Doktorlar Yayinevi, 2019) Aktan, Meryem; Findik, Sidika; Kanyilmaz, Gul; Yavuz, Berrin Benli; Koc, MehmetGliomas are the most common primary brain tumors in adults. Despite advances in modem diagnostic procedures and therapies, the prognosis is still poor. To improve survival and the knowledge about the biological and clinical presentation of gliomas, more individualised and targeted treatments are needed. The aim of this study was to correlate the immunostaining patterns of isocitrate dehydrogenase-1 (IDH-1), phosphatase and tensin homolog (PTEN) and epidermal growth factor (EGFR) with progression-free survival (PFS) and overall survival (OS) in high grade gliomas patients. We analized 60 high grade gliomas who underwent surgery and standard chemoradiotherapy. Immunohistochemical methods were used to classify the IDH-1 gene mutation presence, staining patterns of PTEN and EGFR in tumor samples of the diagnosis. Median follow-up time was 18.9 months. There was significant relation between IDH-1 mutation and OS. Median OS was 37.9 months for patients with IDH-1 mutation, 12.4 months for patients with no mutation (p< 0.001). Median PFS was 29.8 months for patients with no IDH-1 mutation and 70.4 months for patients with IDH-1 mutation (p= 0.03). There was no significant relation between PTEN and EGFR immunopattern and OS or PFS in univariate analysis. However, there was significant relation between immunoreactivity of PTEN and OS (p= 0.03), immunointensity of PTEN and OS (p= 0.02) in multivariate analysis. In conclusion, the relationship between EGFR mutation and OS and PFS can also be demonstrated by studies with more patients.Öğe Prognostic value of pre-treatment 18F-FDG-PET uptake in small-cell lung cancer(Springer, 2017) Aktan, Meryem; Koc, Mehmet; Kanyilmaz, Gul; Yavuz, Berrin BenliPurpose Small-cell lung cancer (SCLC) is an aggressive disease, despite an initially favorable response to treatment, and its prognosis is still poor. Multiple parameters have been studied as possible prognostic factors, but none of them are reliable enough to change the treatment approach. F-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) is a novel imaging technique for staging of SCLC. The aim of this study was to evaluate the prognostic value of pre-treatment FDG-PET parameters on clinical outcome in limited stage (LS) SCLC patients treated with curative thoracic radiotherapy (RT) and chemotherapy. Clinical records of 46 LS-SCLC patients with pre-treatment FDG-PET imaging were retrospectively reviewed. Patients were treated with definitive RT for a total dose of 50-60 Gy and chemotherapy. The clinical endpoints were progression-free survival (PFS) and overall survival (OS). The median age was 59 (range 30-82) years, and median follow-up time was 23.2 months (range 5-82.8 months). Median OS was 30.9 months for pre-treatment tumor maximum standardized uptake value (SUVmax) < 9.3 and 20.6 months for SUVmax ae9.3 (p = 0.027) and PFS was 55.6 months for SUVmax < 9.3 and 38.6 months for SUVmax ae9.3 (p = 0.16). Median OS was 73 months for pre-treatment lymph node SUVmax < 5.8 and 21 months for ae5.8 (p = 0.01) and PFS was 38.6 months (range 6.8-70.3 months) for SUVmax-LN ae5.8; all patients with SUVmax-LN < 5.8 were alive (p = 0.07). Median survival time was 28.2 months (range 21.7-34.7 months) for patients younger than 65 and 8.7 months (range 5.7-11.8 months) for those ae65 years (p = 0.00). Pre-treatment FDG-PET uptake may be a valuable tool to evaluate prognosis in SCLC patients. Patients with a higher pre-treatment FDG uptake may be considered at increased risk of failure and may benefit from more aggressive treatment approaches.Öğe Pyruvate kinase M2 (PKM-2) expression and prognostic significance in glioblastoma patients(Springer, 2023) Yavuz, Berrin Benli; Kilinc, Fahriye; Kanyilmaz, Gul; Aktan, MeryemPurposePyruvate kinase M2 (PKM2) is a key enzyme that catalyzes the irreversible and final step of glycolysis. It is closely associated with cancer development and progression. The relationship between PKM2 and prognosis in glioblastoma (GB) patients is unknown. The aim of this study was to measure PKM2 expression and evaluate its effect on prognosis in GB patients.MethodsPatients who underwent radiotherapy (RT) for glioblastoma between 2010 and 2021 were evaluated immunohistochemically. A single pathologist evaluated pathology specimens of all patients. The intensity and extent of staining of tumor cells were scored. Patients were categorized as low and high PKM2.ResultsA total of 119 patients were evaluated. While 80.7% of the cases had a low score, 19.3% had a high PKM2 score. It was observed that the group with high PKM2 expression had lower performance, received more hypofractionated RT and received adjuvant chemotherapy (CT) less frequently. Median overall survival (OS) was 15.77 months in the low PKM2 expression group and 6.50 months in the high PKM2 group. In univariate analyses, PKM2 expression, age, performance status, type of surgery, RT scheme, and concurrent and adjuvant CT were prognostic factors in predicting OS. In multivariate analyses, PKM2 expression, type of surgery, RT scheme and receiving adjuvant CT were prognostic factors for OS.ConclusionPKM2 is an independent prognostic factor for survival and is associated with poor prognosis in GBM patients treated with radiotherapy. It may be a potential therapeutic target for anticancer therapy.