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Öğe Adjuvant Radiotherapy Approach in Stage I High Risk and High-intermediate Risk Endometrioid-type Uterine Cancers TROD 04-005 Gynecological Tumors Subgroup Survey Study(Kare Publ, 2021) Guzeloz, Zeliha; EyIler, Ferhat; Ozsaran, ZeynepOBJECTIVE Evaluation of adjuvant therapy approach in Stage I, high and high-intermediate risk endometrioid-type uterine cancers with a survey. METHODS Our survey, which was designed as the Turkish Society of Radiation Oncology-Gynecological Tumors Subgroup Study asked adjuvant therapy preference (ATP) according to different scenarios. RESULTS A total of 122 people participated in the survey. Myometrial invasion and grade were chosen the most frequently evaluated prognostic factor. In patients with Stage 1A-B, Grade 1-2, lymphovascular invasion (LVI) (+) as determined by the staging surgery (SS), the ATP was 68% for vaginal brachytherapy (VB). In 48 (40%) participants who did not recommend SS for the patient without SS, the recommendations were external radiotherapy (ERT)+VB in 33%. In Stage 1A, Grade 3, LVI (-) patients who had undergone SS, the ATP was 63% for VB. For LVI (+) patients in the same group, the ATP was 43% for ERT+VB. In 39 (32.5%) participants who did not recommend SS for the patient without SS, the recommendations were ERT+VB in 43%. In Stage 1B, Grade 3, LVI (-) patients who had undergone SS, ATP was 45% for ERT+VB. For the LVI (+) positive patients, the ATP was 71% for ERT+VB. In 31 (26%) participants who did not recommend SS, for the patient without SS, the recommendations were ERT+VB in 55%. CONCLUSION Our survey showed that ATP of participants was similar to current guidelines. They preferred adjuvant therapy as a multi-modality treatment instead of single-modality in the presence of prognostic factors, such as not performing SS or LVI.Öğe Adjuvant radiotherapy for uterine carcinosarcoma: A retrospective assessment of treatment outcomes(Wolters Kluwer Medknow Publications, 2019) Yilmaz, Ugur; Alanyali, Senem; Aras, Arif Bulent; Ozsaran, ZeynepObjectives: the objective of the study is to understand the impact of adjuvant radiotherapy (RT) and prognostic factors for patients diagnosed with uterine carcinosarcoma.Materials and Methods: the records of 31 patients receiving adjuvant RT between the dates of September 2003-January 2013 in our clinic were evaluated retrospectively. Surgery was performed in 27 (87%) patients as staging laparotomy, for 4 patients as total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pelvic external beam radiotherapy (EBRT) was 4500-5040 cGy in 25-28 fractions. in addition, 23 patients received brachytherapy following EBRT, 12 patients received adjuvant, and 1 patient received neoadjuvant chemotherapy (CT).Results: the median age was 63 (between 30 and 78). the stage distribution of the patients was as follows: Stage I, 20 (64%); Stage II, 7 (23%), and Stage III, 4 (13%) patients. Five-year locoregional control (LRC) rate was 100%, disease-free survival (DFS) and overall survival (OS) rates were 65.5% and 66.2%, respectively. Stage I or II patients have a tendency for better 5-year OS and DFS rates than Stage III patients (73.1% vs. 42.9% and 72.7% vs. 42.9%; P = 0.065 and 0.051). Regarding lymph node dissection was performed or not, 5-year OS (64.7% vs. 75.0%) was not statistically different between groups (P = 0.77). Five-year OS and DFS rates were 69.2% and 61.5% for patients receiving CT (adjuvant or neoadjuvant) versus 63.7% and 68.8% for patients not receiving CT; P = 0.63 and P = 0.89, respectively. Based on the analysis of peritoneal washings, 5-year OS was 0% for patients with malignant or suspicious cytology whereas 89% for patients with benign cytology (P = 0.000). A negative correlation was observed between mitotic count of sarcomatous component and DFS time (rs = -0.812 and P = 0.05).Conclusions: Surgery and adjuvant RT seem beneficial for excellent LRC rate. However, survival rates are low due to distant metastases. Thus, there is a great need for better systemic therapies.Öğe Comparison of The International Federation of Gynecology and Obstetrics (FIGO) 2018 and 2009 Staging Systems for Operated Cervical Carcinoma(Kare Publ, 2021) Sert, Fatma; Balci, Beril; Alanyali, Senem; Ozsaran, ZeynepOBJECTIVE The purpose of the study was to compare FIGO 2009 and 2018 uterine cervical carcinoma staging systems in terms of patient distribution and efficacy in predicting treatment outcome in patients treated with surgery and adjuvant radiotherapy (RT)+/-concomitant chemotherapy (CT). METHODS The records of 184 uterine cervical cancer patients treated with post-operative RT/RCT from 2007 to 2017 were retrospectively reviewed. Surgical procedure was in the form of Wertheim surgery in 96 patients (52%) and pelvic lymph node dissection was performed in 32 patients (17.5%). One hundred and sixty-six patients (87.5%) received both external RT and intracavitary brachytherapy, and 23 (12.5%) patients were treated only with external RT. RESULTS The median follow-up time was 61.5 months (range, 8-132 moths). One hundred and fifty-one (82%) patients were alive, and 144 (94%) of these were free of disease at the time of this analysis. The median time for locoregional failure and distant metastasis were 25 months (range, 8-88 months) and 38 months (range, 12-118 months). Stage migration was recorded in 130 patients (70.7%) in our series when the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system was used. The most remarkable stage migration was detected for Stage I patients. A total of 119 (64.6%) patients with Stage I showed stage migration. Five-year locoregional control, disease-free survival, disease-specific survival, and overall survival rates were 91%, 88%, 91%, and 83%, respectively. CONCLUSION The updated FIGO staging system for invasive cervical cancer incorporates imaging and pathological findings. Our results suggest us that the major improvement of 2018 staging system for uterine cervical carcinoma is that it produced better discrimination in terms of survival outcome in patients with lymph node metastases both pelvic and para-aortic.Öğe Dosimetric Comparison of Volumetric and Intensity-modulated Radiotherapy Techniques in Cervical Cancer Patients with Paraaortic Lymph Node Metastasis(Kare Publ, 2024) Enet, Irem Alemdar; Eren, Hakan; Olacak, Nezahat; Ozsaran, ZeynepOBJECTIVE To compare the dosimetric criteria of intensity-modulated radiotherapy (IMRT) and volumetric modulated radiotherapy (VMAT) plans with simultaneous integrated boost (SIB) technique in cervical cancer patients with para-aortic lymph node (PALN) metastases. METHODS SIB-IMRT and SIB-VMAT plans of 10 patients were retrospectively analyzed. The elective volume received 45 Gy(PTV45) in 25 fractions of 1.8 Gy, while the integrated boost volume (lymph nodes) simultaneously received 55 Gy (PTV55). Using the same dose constraints in optimization, IMRT plans consisted of 9 fields, while VMAT plans were performed with 2 full arcs. Volume and dose parameters were determined across the planning target volume, bladder, bowel, femoral heads, kidneys, liver, rectum, sigmoid, and spinal cord. Conformity and homogeneity indices were calculated, the Monitor Unit (MU) was analyzed, and the Wilcoxon-signed rank test was applied for statistical analysis (p <= 0.05). RESULTS Both techniques were found to be effective for treatment, but there was a significant difference in favor of SIB-VMAT in terms of target volume reaching the predicted dose and protection of critical organs (OAR) (p=0.028). For PTV55, MU and right-left kidney; V-20,V-30- V-20, V-30, liver; D-ort , liver values were significantly different (p=0.005, p=0.005, p=0.005, p=0.02, p=0.005, p=0.007, p=0.03, respectively). In SIB-IMRT, a significant difference was observed for CI value close to 1 (p=0.02). CONCLUSION The SIB-VMAT technique showed lower MU, kidney, and liver values, and SIB-IMRT showed better CI values. Other parameters indicated that the two planning techniques were nearly equivalent. These findings indicate the different efficacies of treatment techniques in radiotherapy planning for cervical cancer patients who were diagnosed with PALN metastases.Öğe Evaluation of burnout in oncology employees(Oxford Univ Press, 2006) Dubova, Senem; Yildirim, Yasemin K.; Demir, Ozlem; Ozsaran, Zeynep; Yalman, Deniz; Haydaroglu, Ayfer; Uslu, RuchanÖğe Evaluation of burnout syndrome in oncology employees(Humana Press Inc, 2010) Demirci, Senem; Yildirim, Yasemin Kuzeyli; Ozsaran, Zeynep; Uslu, Ruchan; Yalman, Deniz; Aras, Arif B.Burnout is an important occupational problem for health care workers. We aimed to assess the burnout levels among oncology employees and to evaluate the sociodemographic and occupational factors contributing to burnout levels. The Maslach Burnout Inventory, which is designed to measure the three stages of burnout-emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA), was used. The study sample consisted of 90 participants with a median age of 34 (range 23 +/- 56). The mean levels of burnout in EE, DP and PA stages were 23.80 +/- 10.98, 5.21 +/- 4.99, and 36.23 +/- 8.05, respectively, for the entire sample. Among the 90 participants, 42, 20, and 35.6% of the employees had high levels of burnout in the EE, DP, and PA substage, respectively. Sociodemographic and occupational factors associated with higher levels of burnout included age of less than 35, being unmarried, being childless, >40 work hours per week, working on night shifts, and <10 years experience in the medicine/oncology field. Within all oncology clinics, medical oncology employees had the highest levels of burnout. Furthermore, employees who are not pleased with working in oncology field, who would like to change their speciality if they have an opportunity, and whose family and social lives have been negatively affected by their work experienced higher levels of burnout. Burnout syndrome may influence physical and mental health of the employee and affects the quality of health care as well. Therefore, several individual or organizational efforts should be considered for dealing with burnout.Öğe Evaluation of unusual and highly aggressive variant of endometrium cancer: nonendometrioid endometrium carcinoma of the uterus(Wichtig Publishing, 2017) Sert, Fatma; Yilmaz, Ugur; Alanyali, Senem; Aras, Arif; Ozsaran, ZeynepAims: To evaluate the survival and treatment outcomes of patients with nonendometrioid endometrium carcinoma after postoperative radiotherapy. Methods: The records of 94 patients treated with postoperative radiotherapy (RT) between January 2005 and December 2011 were retrospectively reviewed. Postoperative RT was delivered with a dose of 45-50.4 Gy with 1.8 Gy daily fractions and brachytherapy was added to external RT for 62 patients with a dose of 3 x 6 Gy. Median follow-up time was 35 months (range 6-95 months). Results: Median age was 63 years (range 43-83 years) and lymph node metastasis (LNM) was positive in 15 (16.0%) patients. The stage distribution of the patients was as follows: stage I, 58 (61.7%); stage II, 16 (17.0%); stage III, 18 (19.1%); stage IV, 2 (2.2%). Five-year locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) rates were 92.3%, 68.2%, and 78.6%, respectively. In univariable analysis, it was determined that the factors affecting OS rates were stage (p = 0.003), presence of LNM (p = 0.003), and presence of lymphovascular space invasion (LVSI) (p = 0.007); factors affecting DFS rates were stage (p = 0.019), presence of LVSI (p = 0.002), and having LNM (p = 0.049); and the factor affecting LRC rates was tumor size (>5 cm) (p = 0.011). In subgroup analyses, among all stage I patients, the DFS rates were lower for those with histologic grade 3 tumors and more than 1/2 myometrial invasion. Conclusions: Due to its rarity, the prognostic factors and outcomes of nonendometioid endometrium carcinoma are not fully understood. In our analysis, stage, LNM, and presence of LVSI were found to be the most important prognostic factors. In order to tailor the optimal treatment strategy, prospective studies are needed.Öğe The interaction between antioxidant status and cervical cancer: a case control study(Wichtig Publ, 2011) Demirci, Senem; Ozsaran, Zeynep; Celik, Handan Ak; Aras, Arif Bulent; Aydin, Hikmet HakanAims and background. To compare the antioxidant status of cervical cancer patients with healthy controls and to assess the antioxidant levels before and after radiotherapy or radiochemotherapy. Methods and study design. Antioxidant levels (glutathione, glutathione peroxidase, superoxide dismutase, and malondialdehyde) were measured in 35 patients with cervical cancer and 35 age-matched healthy controls. Blood samples were collected twice (before and after treatment) from cervical cancer patients and once from healthy control subjects. Results. In the patient group, pre-radiotherapy glutathione and glutathione peroxidase levels were significantly lower (P < 0.01 and P < 0.0001, respectively) than the control group. Pre-radiotherapy levels of superoxide dismutase were significantly higher in cancer patients (P < 0.01). In general, no difference was observed between pre- and post-radiotherapy antioxidant levels in cancer patients. However, when post-radiotherapy glutathione levels were analyzed, patients who did not respond to treatment had significantly higher levels than those who did respond (P < 0.01). Conclusions. Levels of antioxidants significantly differed between the patients with cervical cancer and the controls, and no change in antioxidant levels was observed after treatment. Moreover, further studies evaluating the predictive value of glutathione levels on treatment response are warranted.Öğe Local recurrence outcomes after breast conserving surgery and adjuvant radiotherapy in ductal carcinoma in situ of the breast and a comparison with ECOG E5194 study(Churchill Livingstone, 2018) Akagunduz, Ozlem Ozkaya; Ergen, Arzu; Erpolat, Petek; Gultekin, Melis; Yildirim, Berna Akkus; Parvizi, Murteza; Ikiz, Didem; Oksuz, Didem Colpan; Onal, Cem; Yildiz, Ferah; Ozsaran, ZeynepPurpose: Turkish Radiation Oncology Study Group investigated local recurrence rates and prognostic factors in patients with ductal carcinoma in situ (DCIS) of the breast treated with breast conservative surgery (BCS) followed by radiotherapy (RT) and Eastern Cooperative Oncology Group (ECOG) Study E5194 were compared with the original study. Patients and methods: Totally 252 patients were evaluated retrospectively. Prognostic factors that might influence local control (age, nuclear grade, comedo necrosis, surgical margins, tumor size, hormone receptor status) were compared. The eligibility criteria of ECOG 5194 were stratified into two groups as in the original study and were compared for local control. Results: The median follow-up time was 59 (21-220) months. Local recurrence was observed in 9 patients (3.6%) who had invasive carcinoma (3 patients) and DCIS (6 patients). Ten years local control rates was 91.8% respectively. We found that the risk of ipsilateral breast recurrence was significantly higher in women younger than 50 years old (p = 0.016). In addition, a statistically significant trend was found in patients with tumor larger than 1 cm and HER2 positive tumors (p = 0.051, p = 0.068 respectively). When 12-year results were compared with the ECOG 5194, adjuvant RT produced an absolute difference of 11% in low-intermediate and 20% in high grade in local control. Conclusion: In our study, the 10-year local control rate was 92% and younger than 50 years old was the most important unfavorable prognostic factor for local recurrence. There was provided 20% absolute local control with adjuvant radiotherapy which eligibility criteria of ECOG 5194 high grade group. (C) 2018 Elsevier Ltd. All rights reserved.Öğe Long-Term Follow-Up of Patients with Male Breast Cancer, Single-Center Experience(Kare Publ, 2019) Cakar, Burcu; Sert, Fatma; Gursoy, Pinar; Emekdas, Baris; Ozsaran, Zeynep; Gokmen, Erhan; Haydaroglu, AyferOBJECTIVE Male breast cancer (BC) represents <1% of all BC cases. Our study aimed to define immunohistochemistry (IHC) based surrogate subtype distribution of male BCs, and to define the recurrence pattern and survival among subgroups. METHODS We retrospectively reviewed the medical records of patients with male BC admitted to Ege University School of Medicine, Medical Oncology and Radiation Oncology Clinics between 1998 and 2017. Patient demographics, pathological feature of the primary tumor, adjuvant treatment options, and survival data were analyzed. We defined intrinsic BC subtypes according to estrogen receptor (ER), progesterone receptor (PR), HER-2, and ki-67 status. RESULTS We identified 58 patients with male BC. The median age at diagnosis was 59 years (IQR: 30-78), and median follow-up was 83.7 months. Invasive ductal carcinoma was the most common histology (79.3%). Of the patients, 8.6% presented with stage-4 disease. A total of 24 (41.4%) patients had luminal A-like, 28 (48.3%) had luminal B-like, 2 (3.4%) had HER-2 positive, and 4 (6.9%) had triple negative breast cancer (TNBC). Eighteen deaths were observed during follow-up. The overall survival (OS) and disease-free survival (DFS) rates among BC subgroups were not statistically significant. Median OS was 161 months (95% CI 94.7-228.4)in the patient group. DES was statistically related to initial tumor stage. CONCLUSION The disease onset was found at younger age with more locally advanced setting compared to literature. Luminal predominance was demonstrated. Initial stage but not BC subtypes predict the risk of relapse in patients with male BC.Öğe Outcome and predictive factors in uterine carcinosarcoma using postoperative radiotherapy: a Rare Cancer Network study(Pagepress Publ, 2016) Zwahlen, Daniel R.; Schick, Ulrike; Bolukbasi, Yasemin; Thariat, Juliette; Abdah-Bortnyak, Roxolyana; Kuten, Abraham; Igdem, Sefik; Caglar, Hale; Ozsaran, Zeynep; Loessl, Kristina; Belkaaloul, Kaouthar Khanfir; Villette, Sylviane; Vees, HansjorgUterine carcinosarcomas (UCS) are rare tumors. Consensus regarding therapeutic management in non-metastatic disease is lacking. This study reports on outcome and predictive factors when using postoperative radiotherapy. We analyzed a retrospective analysis in 124 women treated between 19872007 in the framework of the Rare-Cancer-Network. Median follow-up was 27 months. Postoperative pelvic EBRT was administered in 105 women (85%) and 92 patients (74%) received exclusive or additional vaginal brachytherapy. Five-year overall survival (OS), disease-free survival (DFS), cancer specific survival (CSS) and locoregional control (LRC) were 51.6% (95% CI 35-73%), 53.7% (39-71%), 58.6% (38-74%) and 48% (38-67%). Multivariate analysis showed that external beam radiation therapy (EBRT) >50Gy was an independent prognostic factor for better OS (P=0.03), CSS (P=0.02) and LRC (P=0.01). Relative risks (RR) for better OS (P=0.02), DFS (P=0.04) and LRC (P=0.01) were significantly associated with younger age (<= 60 years). Higher brachytherapy (BT)-dose (>9Gy) improved DFS (P=0.04) and LRC (P=0.008). We concluded that UCS has high systemic failure rate. Local relapse was reduced by a relative risk factor of over three in all stages of diseases when using higher doses for EBRT and brachytherapy. Postoperative RT was most effective in UCS stage I/II-diseases.Öğe Palliative radiotherapy for the skin metastasis of ovarian cancer: a case report and review of the literature(Humana Press Inc, 2010) Demirci, Senem; Yavas, Fatma; Ozsaran, Zeynep; Ozsaran, Aydin; Dikmen, Yilmaz; Zekioglu, Osman; Karabulut, Bulent; Aras, Arif B.Ovarian cancer which is the most common cause of death among all gynecological malignancies tends to metastasize through peritoneal cavity. Skin metastasis, however, is a very rare clinical entity and related with poor prognosis. We report a 43-year-old patient with recurrent ovarian cancer presented with extensive abdominal skin metastasis approximately 6 years after the initial diagnosis. Patient was treated with radiotherapy with electrons to a total dose of 37.5 Gy given in 2.5 Gy per fraction per day. Skin metastasis showed good response to radiotherapy, and the patient has been alive for 7 months after radiotherapy with no recurrences on abdominal skin. Radiotherapy might be considered as an efficient palliative treatment option for the skin metastasis of ovarian cancer.Öğe Postmastectomy Radiotherapy Decision for Patients without Lymph Node Metastases: Turkish Radiation Oncology Society Breast Cancer Working Group(Kare Publ, 2019) Altinok, Ayse; Gursel, Bilge; Ergen, Sefika Arzu; Alanyall, Senem; Ozsaran, Zeynep; Ay Eren, Ayfer; Metcalfe, Evrim; Akmansu, Muge; Tepetam, Huseyin; Altinok, Pelin; Altmisdortoglu, Ozgur; Serarslan, Alparslan; Bese, NuranOBJECTIVE Recent meta-analysis have not revealed any positive effects of postmastectomy radiotherapy (PMRT) on locoregional recurrence (LRR) or overall survival in axilla-negative patients. However, risk of LRR increases to 15% in the presence of two or more adverse factors for the same patient group. In this study, PMRT indications and volume selections of radiation oncologists in Turkey for axilla-negative breast cancer was investigated. METHODS Questionnaires were distributed to members of the breast cancer study group. Data of patients with axillary negative or isolated/micrometastasis and PMRT over 10 years (2006-2016) were collected from 10 participating centers. Clinical and tumor histopathological features and treatment details of 185 patients were analyzed. RESULTS The median age of patients was 48 years. Ratio of early-stage patients was 60% (T1-15%,T2-45%). There were 147 (79%) negative cases, 32 (17%) with micrometastasis, and 6 (3%) with isolated tumor cells. Half of the patients had only their chest walls (CW) irradiated. Peripheral lymphatics were also included in the rest. In Nmic cases, ratio of irradiation of supraclavicular and axillary lymph nodes with CW were statistically significant compared to CW irradiation (72% and 28%, respectively; p=0.015). CONCLUSION Considering the low number of patients treated over 10 years in 10 different centers in Turkey, it can be said that PMRT is often done in node-negative breast cancer. It is difficult to reach a definite conclusion for patients with Nmic, due to lack of data from patients with PMRT. However, the general tendency is to irradiate peripheral lymphatics in Nmic cases if PMRT is to be performed.Öğe Postoperative Vaginal Brachytherapy of a Patient with Endometrial Cancer: Case Presentation(Kare Publ, 2019) Eren, Hakan; Hazeral, Yusuf Ziya; Alanyali, Senem; Ozsaran, ZeynepCase: A 39-year-old woman presented with an abnormal postmenopausal vaginal bleeding, and probe curettage was performed for diagnostic purposes. She was diagnosed with endometrial cancer. She underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, anti pelvic lymph node dissection (TAH+BSO+PPLND). Pathology specimen revealed endometrioid adenocarcinoma sized 2 cm with histologic grade 2. Tumor had halt inner myometrial invasion. Lymphovasculary invasion and lymph node metastases (0/17) were not reported. She was referred to the radiation oncology department tor intracavitary brachytherapy.Öğe Quality of Life Assessment in Women with Breast Cancer: A Prospective Study Including Hormonal Therapy(Korean Breast Cancer Soc, 2013) Sert, Fatma; Ozsaran, Zeynep; Eser, Erhan; Alanyali, Senem Demirci; Haydaroglu, Ayfer; Aras, ArifPurpose: 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.Öğe Radiotherapy can be a Cofactor in the Development and Severity of Lapatinib-Capecitabine-Related Skin Rash(Bilimsel Tip Yayinevi, 2023) Duman, Nilay; Demir, Meryem; On, Sercan; Ozsaran, ZeynepSkin rash induced by concurrent radiotherapy during lapatinib-capecitabine (LC) treatment has been rarely reported. We aim to draw attention to the potential of radiotherapy to act as a cofactor in the development of LC-related skin rash.Herein, we report a case with a drug-related skin rash triggered by radiotherapy during LC treatment.A 31-year-old woman with inflammatory metastatic breast cancer presented with a skin rash during LC treatment combined with radiotherapy. She was started on LC treatment, and palliative whole cranial radiotherapy was applied 3 days later. Three days after the radiotherapy, acneiform lesions started from the scalp and a maculopapular rash developed on the trunk and extremities. LC treatment was interrupted and skin lesions regressed rapidly with topical dermatological care, oral H1-antihistamine, and short-term oral steroid treatment. Although LC treatment was restarted alone in the follow-up, no recurrence was observed.Radiotherapy may be a cofactor in the development and severity of skin toxicity during LC treatment. There is a need to elucidate whether the immunological mechanisms of skin eruptions occurring during concomitant chemoradiotherapy are due to the radiosensitizing effects of biological agents or exacerbation by radiotherapy.Öğe The retrospective analysis of patients with uterine sarcomas: A single-center experience(Wolters Kluwer Medknow Publications, 2016) Terek, Mustafa Cosan; Akman, Levent; Hursitoglu, Behiye Seda; Sanli, Ulus Ali; Ozsaran, Zeynep; Tekindal, Mustafa Agah; Dikmen, Yilmaz; Zekioglu, Osman; Ozsaran, Ahmet AydinBackground: Uterine sarcomas are rare, malignant, gynecological tumors and show diverse histopathological features. Therefore, there is no consensus on risk factors for poor outcome and optimal treatment. The aim of this retrospective analysis is to report the clinical outcome of patients with uterine sarcoma treated at a single center. Materials and Methods: The data was obtained regarding the patient's demographic characteristics, pathological results, treatments given, survival, and complications of all uterine sarcoma patients treated in a single center between the years 2000 and 2012. The 80-month overall survival (OS) was determined with respect to prognostic factors including age, stage of disease, histopathological type, and adjuvant treatment. Results: A total of 57 case records are retrieved for this retrospective analysis. The mean age of the patients is 62.5 +/- 11.2 years. International Federation of Gynecology and Obstetrics (FIGO) stage distribution is stage I: 29; stage II: 13; stage III: 9; stage IV: 6. Fifty-seven patients underwent surgery, 33 received postoperative radiotherapy (PORT), and 32 received chemotherapy. Median follow-up period was 25 months (range 2-85 months). The 80-month OS for the entire group of patients was 36.7%. The significant prognostic factors for survival are age under 50 years, stage of disease, and adjuvant chemotherapy. Conclusion: Although limited by small sample size and retrospective nature, age under 50 years, stage of disease, and adjuvant chemotherapy are significant prognostic factors for survival for uterine sarcomas.Öğe Smoke-free Ege: An attempt for an integrative prevention strategy for tobacco control at a University setting(European Publishing, 2018) Ergin, Isil; Mandiracioglu, Aliye; Durmaz, Seyfi; Karakus, Haydar; Caliskan, Ayhan; Yararbas, Gorkem; Hassoy, Hur; Durusoy, Raika; Gurgun, Alev; Ozsaran, Zeynep; Gor, Muge; Oralalp, Kumral; Basoglu, Ozen; Goksel, Tuncay; Gurgun, Cemil; Budak, NecdetÖğe Treatment results and prognostic factors of patients with vulvar cancer treated with postoperative or definitive radiotherapy(Sage Publications Ltd, 2016) Alanyali, Senem; Duran, Ozge; Ozsaran, Zeynep; Ozsaran, Aydin; Akman, Levent; Solmaz, Ulas; Gokcu, Mehmet; Sanci, Muzaffer; Aras, Arif B.Purpose: Vulvar cancer is a relatively uncommon type of gynecologic cancer. The aim of this study is to analyze the treatment results and prognostic factors of vulvar cancer. Methods: Forty-four vulvar cancer patients treated between 2000 and 2011 at the Department of Radiation Oncology, Ege University Faculty of Medicine, were retrospectively reviewed. External radiotherapy (RT) was applied with 6-18 MV linear accelerators with 1.8 Gy daily fractions with a median total dose of 50.4 Gy (45-59.4 Gy) for postoperative cases and 64.8 Gy (range 54-66 Gy) for definitive cases. Statistical analyses were performed with SPSS 13.0. Results: Among 44 patients with a median age of 68 years (range 28-86), 14 (31.8%) were treated with curative and 30 (68.2%) were treated with postoperative RT or radiochemotherapy (RCT). According to International Federation of Gynecology and Obstetrics staging, 11 (25%) had stage IB, 10 (22.7%) had stage II, 6 (13.6%) had stage IIIA, 5 (11.4%) had stage IIIB, and 12 (27.3%) had stage IVA disease. Within a median of 24 months (range 6-135) of followup, 11 (27.3%) patients had local recurrence, 8 had regional recurrence, 2 had both local and regional recurrence, and 6 had distant metastases. Five-year locoregional, disease-free, and overall survival rates were 45%, 40%, and 54%, respectively. Older age, poor tumor differentiation, positive surgical margin, and lymphovascular space invasion were found to be important prognostic factors for disease-related outcomes. Conclusions: Prognosis of vulvar cancer remains poor even with a multidisciplinary approach. Molecular prognostic factors need to be defined for individualized treatment options to achieve better treatment results.Öğe TREATMENT RESULTS OF STAGE IIIC2 LOCALLY ADVANCED CERVICAL CANCER PATIENTS TREATED WITH RADIOCHEMOTHERAPY(Bmj Publishing Group, 2023) Alanyali, Senem; Odaci, Fethiye; Yildirim, Nuri; Ozsaran, Zeynep[Abstarct Not Available]
