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  • Küçük Resim Yok
    Öğe
    Radiotherapy in the management of Kaposi's sarcoma: Comparison of 8 Gy versus 6 Gy
    (NATL MED ASSOC, 2006) Yıldız, Ferah; Genç, Mine; Akyürek, Serap; Cengiz, Mustafa; Özyar, Enis; Selek, Uğur; Atahan, I. Lale
    Objective: To evaluate prospectively the efficacy of a single fraction of high-dose radiotherapy in patients with Kaposi's sarcoma. Patients: Between 1994 and 2004, 47 patients with Kaposi's sarcoma were treated at Hacettepe University, Department of Radiation Oncology. Thirteen (28%) patients received chemotherapy before radiotherapy and were referred due to recurrent or progressive disease or intolerance to chemotherapy. All lesions were treated locally with a 2-3-cm safety margin with 4-6-MeV electron beams. Radiotherapy consisted of a single fraction of 8 Gy in the first four years and 6 Gy thereafter. Results: The male:female ratio was 4:1. The median age was 61 years (range 18-87). Eight out of 47 patients (17%) had an underlying immunocompromised state, and one had a previous diagnosis of Hodgkin's disease. Of 203 fields treated, 51 and 152 fields were treated with 8 Gy and 6 Gy, respectively. Overall response rates (RR) at 12 months for 8- and 6 Gy were 93% and 86%, which were not statistically different. However, the difference between complete RRs at 12 months (93% and 60% for 8 Gy and 6 Gy respectively) was significant (p < 0.0001). Progression-free survival and reirradiation rates were not significantly different. Side effects were tolerable in all but three patients with grade 2-3 fibrosis and edema. Conclusion: Radiotherapy is an effective mode of treatment for Koposi's sarcoma, and a single dose of 8 Gy is more effective in terms of complete RR compared to 6 Gy, though overall response and progression-free survival rates were similar.
  • Küçük Resim
    Öğe
    Radyoterapi sonrası beyin hasarı ve tedavi yaklaşımları
    (2006) Genç, Mine; Ergun, Ufuk; Selek, Uğur
    Radyasyona bağlı nörotoksisite nadir ama ciddi bir komplikasyondur. Esas hedef hücreler endotel ve glial hücreler olmakla birlikte günümüzde radyasyona bağlı nörotoksisitenin santral sinir sistemi içindeki parankimal ve vasküler endotelyal hücreler arasındaki kompleks dinamik etkileşimlerden kaynaklandığı düşünülmektedir. Görüntüleme tekniklerindeki gelişmelere rağmen radyasyon nekrozunun tanısı hala zor olup, kesin tanı histopatolojik incelemeyi gerektirir. Hastaların bir kısmı radyasyon nekrozunun cerrahi rezeksiyonundan yararlanır. Kortikosteroidler hem profilaksi hem de tedavide kullanılır. Radyasyona bağlı nörotoksisitenin önlenmesi ve tedavisinde etkili olabilecek büyüme faktörleri, kök hücreler gibi birçok ajan üzerinde araştırmalar devam etmektedir.