Mustafa Kandaz

Adjuvant radiotherapy in stage 1 seminoma: Evaluation of prognostic factors and results of survival

PURPOSE The purpose of this study was to evaluate the prognostic factors affecting overall survival (OS), cause-specific survival (CSS), progression-free survival (PFS), and survival among patients undergoing adjuvant radiotherapy (RT) for stage-1 seminoma. MATERIALS AND METHODS Between August 1997 and May 2013, 68 patients diagnosed with stage-1 seminoma were retrospectively evaluated. The median age was 39 (24-74) years. All patients received adjuvant RT after inguinal orchiectomy. Fifty-eight (85.3%) patients received paraaortic RT; 10 (14.7%) received dog-leg field RT. The median RT dose was 23.4 (23.4-30.6) Gy. RESULTS The median follow-up period was 77.5 (6.7-198.5) months. During the follow-up period, two patients developed distant metastasis, and none developed local recurrence. Two patients died from seminoma, and three died for other reasons. The 5, 10, and 15-year OS rates were 94.7%, 89.6%, and 89.6%, respectively. The 5, 10, and 15-year CSS rates were 98.5%, 96%, and 96%, respectively. The 5, 10, and 15-year PFS rate was 96.1%. The univariate analysis showed that only histological subtype was significant for OS. The 10-year survival rate was 100% among patients with seminoma histology, 90.8% among patients with a classic seminoma histology, and 50% among patients with an anaplastic seminoma histology (P < 0.001). A multivariate analysis showed that the anaplastic seminoma was a negative prognostic indicator for OS (P = 0.042). CONCLUSION Adjuvant RT resulted in excellent long-term survival and local control in patients with stage-1 seminoma after orchiectomy. During a short follow-up, secondary malignancy (SM) and late cardiovascular morbidity were not observed. Despite those results, concern of SM and late cardiovascular morbidity remains.

Radiotherapy in the management of classic Kaposi's sarcoma: A single institution experience from Northeast Turkey

Kaposi sarcoma is a rare adult neoplasm and there has been no certain consensus on standard treatment, either local or systemic. Radiotherapy is an effective, suitable treatment modality. Between 1996 and 2016, patients who were diagnosed with Kaposi sarcoma and referred to our clinic for radiotherapy were included in this retrospective study. Ninety‐two patients were examined in total and it was diagnosed that all the patients had non‐HIV associated Kaposis sarcoma. There were 36 (39%) females and 56 (61%) males and female to male ratio was 2/3. Median age at presentation was 72 (30–93) years. Sixty‐eight patients (77%) were treated with 8 Gy (1 fraction), 15 patients (16%) were treated with 20 Gy (2 Gy/fraction), four patients (4%) were treated 25 Gy (2.5 Gy/fraction), and five patients (6%) were treated 30 Gy (3 Gy/fraction). The median follow‐up time was 72 (5–192) months. The complete response at 5 years was 91.6% with >20 Gy and 89.6% with 8 Gy. Radiotherapy is an effective, suitable treatment modality of Classic Kaposi sarcoma and usually, radiotherapy is well tolerated with minimal side effects.

Survival and prognostic factors in limited stage small cell lung cancer: A retrospective study from northeast Turkey.

AIM OF THE STUDY The purposes of this retrospective study were to identify survival rates for limited stage small cell lung cancer (LD-SCLC) and analyze treatment outcomes and influencing factors on survival. MATERIALS AND METHODS We conducted data from patients diagnosed with LD.SCLC between January 1998 and December 2012 at our institution. Dermographic information, treatment modalities, pretreatment clinical asessment, were recorded. Most of the patients. (88.4%) were treated with curative intent. The survival probabilties were asessed by Kaplan.Meier analysis. Cox regression was used to assess prognostic factors on overall survival and disease.free survival. RESULTS A total of 129 patients were examined as a LD-SCLC. The median age was 60 (range; 31-86). Median follow-up time was 9.4 (SE ± 20.5) months and the median overall survival was 13.9 months [95% cumulative incidence (CI): 10.1-17.6]. On multivariate analysis, concurrent chemotherapy [HZ: 2.7 (95% CI: (1.0-7.2)] (P = 0.037) and doses of radiation therapy (<50, ≥50) [HZ: 1.4 (95% CI: (1.0-2.2)] (P = 0.046) were statistically significant on overall survival. With regard to multivariate anlaysis age (<60, ≥60) [HZ: 2.2 (95% CI: (0.6-3.7)] (P = 0.011), doses of radiation therapy (<50, ≥50) [HZ: 2.7 (95% CI: (1.0-7.2)] (P = 0.046), precense of surgery [HZ: 15.3 (95% CI: (1.5-152)] (P = 0.020), prophilactic cranial radiation therapy (PCI) [HZ: 2.3 (95% CI: (1.1-4.5)] (P = 0.014), and presence of concurrent chemoradiotherapy [HZ: 3.0 (95% CI: (1.3-6.8)] (P = 0.008) were important variable affecting disease-free survival. CONCLUSION For LD-SCLC patients concurrent chemoradiation therapy and 50. Gy and over doses radiation therapy provided improvement on overall and disease.free survival.

Prognostic factors in postoperative radiotherapy in salivary gland carcinoma: A single institution experience from Turkey

BACKGROUND We reviewed clinical characteristics, treatment outcomes, local and distant failure and prognostic factors in patients with salivary gland carcinoma treated with surgery and postoperative radiotherapy. MATERIALS AND METHODS We retrospectively reviewed 75 patients with salivary gland cancer. 69 (%92) patients had cancer of the parotid gland, 3 (%4) patients had cancer of the submandibular gland and 3 (%4) patients had cancer of the minor salivary gland. 4 patients underwent postoperative chemoradiotherapy and 71 patients underwent postoperative radiotherapy. Median radiotherapy dose was 60Gy (range, 30Gy to 69Gy). RESULTS Median age was 59.6±17.9 (13-88) and the female/male ratio was 1/1.7. Median follow-up 52 months (2-228 months). The mean overall survival 69.2±8 (95%confidence interval[CI], 53.4-85.1) months. The 1-,3-,5- and 10- year overall survival rates were 79.8%, 53.2%, 37.4% and 22.8% respectively. The mean disease free survival 79.7±10 (95%CI, 60.1-99.3) months. The 1-,3-,5- and 10- year disaese free survival rates were 72.8%, 51.9%, 44.1% and 30.4% respectively. On multivariate analysis, the OS was significantly better for the female sex (hazard ratio[HR]:3,0;95%CI:1.5-5.6;P=0.001), absence of lymph node involvement ([HR]:3,0;95%CI:1.7-5.3;P=0.0001), lower tumor grade ([HR]:25,7;95%CI:3.3-199.3;P=0.002), negativity of the surgical margin ([HR]:2,3;95%CI:1.3-4.2;P=0.005), absence of lymphovasculer invasion ([HR]:2,6;95%CI:1.5-4.6;P=0.001), absence of extracapsuler extension ([HR]:6,5;95%CI:2.2-19.1;P=0.001), absence of perineural invasion ([HR]:4,8;95%CI:2.6-8.7;P=0.0001) and ≤60Gy radiotherapy dose ([HR]:3,1;95%CI:1.7-5.5;P=0.0001). They observed local recurrens in17 (23%) patients and distant metastasis in 33 (44%) patients. CONCLUSIONS Employing existing standards of postoperative radiotherapy is a possible treatment that was found to be effective mainly in patients with salivary gland carcinomas.

Prognostic Factors and Clinical Outcome in Parotid Gland Tumors: a Single Institution Experience from the Eastern Black Sea Region of Turkey.

PURPOSE To review clinical characteristics, treatment outcomes and prognostic factors in patients with parotid gland tumors treated with surgery and postoperative radiotherapy. MATERIALS AND METHODS We retrospectively reviewed 69 patients with parotid gland tumors, with a median follow-up of 52 months (range, 2-228 months). and a median radiotherapy dose of 60Gy (range, 30-69 Gy). RESULTS There were 24 (35%) females and 45 (65%) males, at a ratio of 1/1.9. Median age at presentation was 58.9±17.2 (range 13-88) years. The most common histology was adenoid cystic carcinoma (33%) and mucoepidermoid carcinoma (28%). The mean overall survival (OS) was 65.3±8 (95% confidence interval [CI], 49.6-81.1) months and the median overall survival was 40.0 ± 7 (95% CI, 26.2-53.7) months. The -1, -3, -5 and -10 year OS rates were 78%, 52.4%, 35.3% and 19.6% respectively. The mean disease free survival (DFS) was 79.2±10 (95% CI, 59.3-97.1) months and the median disease free survival was 38±13 (95% CI, 7.05-88.7) months. The -1,-3,-5 and -10 year DFS rates were 71.9%, 50.1%, 43.7% and 30.1% respectively. On univariate analysis, the OS was significantly better with female sex (p<0.005), < 50 age (p<0.021), T stage (p<0.0001), absence of lymph node involvement (p<0.0001), lower tumor grade (p<0.0001), absence of lymphovascular invasion (p<0.002), absence of perineural invasion (p<0.0001), absence of extracapsuler extension (p<0.0001), surgical margin negativity (p<0.006), ≤60 Gy radiotherapy dose (p<0.0001) and absence of distant metastasis (p<0.027). CONCLUSIONS Employing existing standards of postoperative radiotherapy is a possible treatment that was found to be mainly effective in patients with parotid gland carcinomas.