Mustafa Adli

The effects of oral Ginkgo biloba supplementation on radiation-induced oxidative injury in the lens of rat.

Background: The aim of this study was to evaluate the antioxidant role of Ginkgo biloba (GB) against radiation-induced cataract in the rat lens after total cranial irradiation with a single 5 Gray (Gy) dose of gamma irradiation. Materials and Methods: Twenty-four Sprague-Dawley rats were used for the experiment. The rats were randomly divided into three equal groups. Group 1 did not receive GB or irradiation (control group) but received 1-ml saline orally plus sham-irradiation. Group 2 received total cranium 5 Gy of gamma irradiation as a single dose (IR group) plus 1-ml saline orally. Group 3 received total cranium irradiation plus 40 mg/kg/day GBE (IR plus GBE group). Biochemical parameters measured in murine lenses were carried out using spectrophotometric techniques. Results: Lens total (enzymatic plus non-enzymatic) superoxide scavenger activity (TSSA), non-enzymatic superoxide scavenger activity (NSSA), glutathione reductase (GRD), and glutathione-S- transferase (GST) activities significantly increased in the IR plus GBE groups when compared with the IR group. However, TSSA, GRD and GST activities were significantly lower in the IR group when compared with the control group. Lens xanthine oxidase (XO) activity in the IR group significantly increased compared to that of both the control and IR plus GBE groups. Conclusion: GBE has clear antioxidant properties and is likely to be a valuable drug for protection against gamma-irradiation and/or be used as an antioxidant against oxidative stress.

FDG PET-CT in cervical cancer: relationship between primary tumor FDG uptake and metastatic potential.

ObjectiveWe retrospectively evaluated the relationships between primary tumor 18F-fluorodeoxyglucose (FDG) uptake measured as the maximum standardized uptake value (SUVmax) and local extension, and nodal or distant metastasis in patients with cervical cancer on pretreatment FDG positron emission tomography–computed tomography (PET-CT). MethodsForty-three patients (mean age, 55.14 years; range, 34–90 years) with cervical cancer who underwent FDG PET-CT scans for staging before the initiation of treatment were included in the study. Primary tumor SUVmax was calculated; clinical tumor stages, presence of local extension, sites of lymph node and distant organ metastases were recorded. The patients were divided into low and high SUV groups by using the median primary tumor SUVmax. The low SUV group consisted of 21 patients with SUVmax less than 13.5, the high SUV group consisted of 22 patients with SUVmax ≥13.5. Their data were compared statistically. ResultsThe average SUVmax was 9.6±2.6 and 19.9±4.9 in the low and high SUV groups, respectively. In the low SUV group, six patients (29%) had a local extension, eight (38%) had pelvic and/or para-aortic lymph node metastasis, and one had distant organ metastasis (4.7%). In the high SUV group, 10 patients (45%) had a local extension, 16 (73%) had pelvic and/or para-aortic lymph node metastasis, and two (9%) had distant organ metastases. There was a significant difference in the lymph node metastasis rate between the two groups (P<0.05), but differences in local extension and distant organ metastasis were not statistically significant (P>0.05). In addition, there was a moderate correlation between SUVmax and clinical tumor stages (r=0.40, P=0.0075). ConclusionHigher primary tumor FDG uptake predicts higher nodal metastatic potential in cervical cancer patients. Patients with higher SUVmax in cervical tumor may need a close follow-up because of their higher metastatic potential.

Zinc administration modulates radiation-induced oxidative injury in lens of rat

Background: The aim of this study was to evaluate the antioxidant role of zinc (Zn) against radiation-induced cataract in the rat lens after total cranial irradiation with a single 5 Gray (Gy) dose of gamma irradiation. Materials and Methods: Twenty-one Sprague-Dawley rats were used for the experiment. The control group did not receive Zn or irradiation but received 1-ml saline orally plus sham-irradiation. The irradiation (IR) group received 5 Gy gamma irradiation to the total cranium as a single dose plus 0.1 ml physiological saline intraperitoneally. The IR plus Zn group received irradiation to total cranium plus 10 mg/kg/day Zn intraperitoneally. Biochemical parameters measured in rat lenses were carried out using spectrophotometric techniques. Results: Lens total (enzymatic plus non-enzymatic) superoxide scavenger activity (TSSA), glutathione reductase (GRD), and glutathione-S-transferase (GST) activities significantly increased in the IR plus Zn groups when compared with the IR group. However, TSSA, GRD and GST activities were significantly lower in the IR group when compared with the control group. Lens non-enzymatic superoxide scavenger activity (NSSA) in the IR plus Zn group was significantly increased compared to that of the IR group. Lens xanthine oxidase (XO) activity in the IR group significantly increased compared to that of both the control and IR plus Zn groups. Conclusion: Zn has clear antioxidant properties and prevented oxidative stress by scavenging free radicals generated by ionizing radiation in rat lenses.

A dosimetric comparison of different treatment plans of palliative spinal bone irradiation: analysis of dose coverage with respect to ICRU 50 report

BackgroundThis study aimed to analyze three-dimensional (3D) dosimetric data of conventional two-dimensional (2D) palliative spinal bone irradiation using different reference points and treatment plans with respect to the International Commission on Radiation Units and Measurements (ICRU) Report 50.MethodsForty-five simulation CT scans of 39 patients previously treated for thoraco-lumbar spinal bone metastases were used. Three different treatment plans were created: (1) single posterior field plans using the ICRU reference points (ICRUrps); (2) single posterior field plans using the International Bone Metastasis Consensus Working Party reference points (IBMCrps); (3) two opposed anterior-posterior (AP-PA) field plans using the ICRUrps. The intended dose range for planning target volume (PTV) was 90% to 110% of the prescribed dose for AP-PA field plans. Cumulative dose-volume histograms were generated for each plan, and minimum, maximum and mean doses to the PTV, medulla spinalis, esophagus and intestines were analyzed.ResultsThe mean percentages of minimum, maximum and mean PTV doses ± standard deviation were, respectively, 91 ± 1.3%, 108.8 ± 1.3% and 99.7 ± 1.3% in AP-PA field plans; 77.3 ± 2.6%, 122.2 ± 4.3% and 99.8 ± 2.6% in ICRUrp single field plans; and 83.7 ± 3.3%, 133.9 ± 7.1% and 108.8 ± 3.3% in IBMCrp single field plans. Minimum doses of both single field plans were significantly lower (p < 0.001) while maximum doses were significantly higher (p < 0.001) than AP-PA field plans. Minimum, maximum and mean doses were higher in IBMCrp single field plans than in ICRUrp single field plans (p < 0.001). The mean medulla spinalis doses were lower in AP-PA field plans than single posterior field plans (p < 0.001). Maximum doses for medulla spinalis were higher than 120% of the prescribed dose in 22 of 45 (49%) IBMCrp single field plans. Mean esophagus and intestinal doses were higher (p < 0.001) in AP-PA field plans than single field plans, however, less than 95% of the prescribed dose.ConclusionIn palliative spinal bone irradiation, 2D conventional single posterior field radiotherapy did not accomplish the ICRU Report 50 recommendations for PTV dose distribution, while the AP-PA field plans did achieve the intended dose ranges with a homogenous distribution and reasonable doses to the medulla spinalis, esophagus and intestines.

Cyclooxygenase-2 expression is not a marker of poor survival in lung cancer.

OBJECTIVE Cyclooxygenase-2 (COX-2) has been claimed to play role in carcinogenesis and be related to a bad prognosis in tumours. The aim of this study was to investigate the relationship between COX-2 expression and clinical and pathological parameters in early and advanced stage lung cancer patients. MATERIALS AND METHODS A total of 73 patients with lung cancer (27 adenocarcinomas, 33 squamous cell carcinomas, 4 large cell carcinomas and 9 small cell cancer) were analysed retrospectively. COX-2 expression was evaluated by immunohistochemistry in resection materials or lung biopsies. Tumor cells demonstrating more intense staining than smooth muscle and endothelial cells were recorded as COX-2 positive. We investigated the correlation between increased COX-2 expression and histological type of the tumor, the stage of the disease and survival. RESULTS COX-2 expression was observed in 55% of the adenocarcinomas, 45% of the squamous cell carcinomas and 22% of the small cell carcinomas. No correlation was apparent between COX-2 expression and disease stage, histological type and the survival. CONCLUSION The results of this study do not support COX-2 expression as an independent prognostic factor in lung cancer. However, since results of the literature are different, further studies made in larger series are needed.

Reduction of irradiated small bowel volume with Trendelenburg position in gynecologic pelvic radiotherapy

The aim of this study was to assess the effect of Trendelenburg position in comparison to prone position on small bowel volume and treatment dose in gynecologic pelvic external beam radiotherapy using three‐dimensional conformal treatment plans. Eight patients with gynecologic cancers, treated with definitive or postoperative pelvic radiotherapy were investigated. Pelvic computerized tomography (CT) scans for treatment planning were performed in prone and 25 degree Trendelenburg positions for each patient. The dose‐volume histograms of small bowel within the treatment fields were obtained and compared for both positions. The clinical target volume (CTV) and the planning target volume (PTV) were also defined and evaluated in the subjects. Treatment dose was 5040 cGy to PTV with 180 cGy daily fraction doses in both techniques for all patients. The average irradiated small bowel volume was 726 cc for prone position and 458 cc for the Trendelenburg position. The average irradiated small bowel volume reduction in the Trendelenburg position was 38.0% (95% CI 19.5 ± 38%) compared with the prone position. The average small bowel percent dose was 25.4% (1280 cGy) for Trendelenburg position and 39.9% (2010 cGy) for prone position. PTV doses were similar in both techniques. The results of this dosimetric study suggest that gynecologic pelvic radiotherapy in the Trendelenburg position decreases the volume of irradiated small bowel compared to prone position and may decrease treatment related small bowel morbidity. Clinical benefit of this position should be evaluated in further clinical studies.

The Effect of Socio-Economic-Cultural Factors on Breast Cancer

OBJECTIVE Socioeconomic and cultural factors influence breast cancer prognosis. The effect of these factors on breast cancer was evaluated among women who live in Gaziantep and its surroundings. MATERIALS AND METHODS female patients who were admitted to Gaziantep University Oncology Hospital with a diagnosis of breast cancer between October 2006-July 2013 were included in the study. The effects of socio-demographic characteristics on clinical-pathological features were evaluated. RESULTS The mean age of 813 women was 48.8 years. The majority were premenopausal women. Advanced stage disease on diagnosis was detected more in our region. The rate of breast cancer with unfavorable prognostic features was higher among patients who were illiterate, with low economic income and residing in rural areas. CONCLUSION Socioeconomic-cultural factors influence the biology and clinical course of breast cancer among women who live in Gaziantep province.

Influence of ethnicity on survival of breast cancer patients in Turkey.

BACKGROUND Kurdish women with breast cancer have more unfavorable prognostic factors than their Turkish and Arab counterparts. However, the effects of these factors on breast cancer survival among these ethnic groups remain unclear. We therefore investigated the impact of ethnicity on survival in breast cancer patients in Turkey. MATERIALS AND METHODS Ethnicity, age, stage at diagnosis, tumor characteristics, treatments given (surgery, chemotherapy, radiotherapy and hormone therapy), and survival times were recorded. Kaplan- Meier analysis was used to estimate the overall survival times and survival plots. Log-rank test was used to compare the survival curves. RESULTS Of the 723 breast cancer patients included in the study, 496 (68.7%) were Turkish, 189 (26.2%) were Kurdish, 37 (5.1%) were Arabic and 1 was Armenian. Kurdish women with breast cancer had larger tumor sizes and higher rates of hormone receptor negative tumors than Turkish and Arab patients. Mean follow-up time was 118.4 [95% Confidence Interval (CI): 95.4-141.3] months, and it was 129.9 (95% CI: 93.7-166.2), 124.2 (95% CI: 108.4-140.1) and 103.1 (95% CI: 85.9-120.4) months for Turkish, Arabic and Kurdish patients, respectively. CONCLUSIONS Kurdish ethnicity is associated with higher rates of hormone receptor negative and triple-negative tumors and with worse survival. Clinical and epidemiological research is warranted to elucidate reasons underlying overall survival, variations in tumor biology, differences in treatment responsiveness, and effects of social factors among ethnic groups in Turkey.