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Biomedical subjects

I L Atahan

Publications and source records attributed to I L Atahan.

32 records · Page 2Linked to original sources

Results of post-operative or exclusive radiotherapy in grade I and grade II cerebellar astrocytoma patients.

43 Patients with the diagnosis of cerebellar astrocytoma were post-operatively treated, between 1 January 1976 and 31 December 1985. Their age ranged between 2 and 51 years with a median of 13. There were 22 males and 21 females. The tumours were reported as grade I in 18, and grade II in 25 patients. The primary surgical intervention was in the form of biopsy in 3, subtotal excision in 24 and macroscopic total excision in 16. All patients were treated with cobalt-60 teletherapy unit, to a total tumour dose of 4500-5500 cGy in 6-7 weeks. The obtained 5 and 10 year actuarial survival rates are 78% and 78%. Our study gives the impression that, age, sex and tumour grade are not determining factors in survival and post-operative radiotherapy improves prognosis in cases treated by subtotal excision while it remains unnecessary in those who had undergone total surgical removal.

Adolescent↗

Radiotherapy in the management of Kasabach-Merritt syndrome: a case report.

A 21-day-old infant with hemangioma was brought to the hospital with enlargement of the hemangioma of the left thigh and purple discoloration around umbilicus. This led to the diagnosis of Kasabach-Merrill syndrome. Initial treatment with corticosteroid failed. The patient underwent radiotherapy that led successfully to improvement of both hemangioma and thrombocytopenia. After 2 years of follow-up, the patient has experienced long-term complications, including atrophy and growth retardation of the irradiated leg.

Adrenal Cortex Hormones↗

Non-Hodgkin's lymphomas of the tonsil: a retrospective analysis of twenty-eight patients with primary tonsillary lymphoma.

AIMS: To analyze the clinical and therapeutic aspects of patients with primary tonsillary non-Hodgkin's lymphoma. METHODS: Twenty-eight patients with primary tonsillary non-Hodgkin's lymphoma who had been followed in the Hacettepe Oncology Institute between 1974 and 1992 were retrospectively analyzed. Fifteen patients were male, 13 were female. Median age was 55 years. RESULTS: Constitutional symptoms were present in 10 patients (35.7%). Stages according to the Ann Arbor classification were I and II in 12 and 16 patients, respectively. According to the Rappaport classification, poorly differentiated lymphocytic was the most common pathologic subgroup (42.9%). Grades according to the Working Formulation were low, intermediate and high in 3, 22 and 3 patients, respectively. Twenty-two patients had received chemotherapy. Cyclophosphamide, vincristine and prednisone (CVP), and cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) were the regimens most commonly employed. Eighteen patients received radiotherapy to Waldeyer's ring and neck. Eight patients achieved remission with chemotherapy plus radio-therapy, 7 patients with chemotherapy alone, and 5 patients with radiotherapy alone. In addition to the 20 patients who achieved complete remission, 3 patients achieved partial remission; the overall response rate was 82.1%. The response rates and survival attained with the combined modality, chemotherapy, or radiotherapy alone were not statistically different (P > 0.05). The median follow-up was 14 months. Overall and disease-free survival at 5 years were 62.6% and 77.6%, respectively. Pathologic grade was the most important prognostic factor influencing overall survival in the Cox multivariate model. CONCLUSIONS: Poorly differentiated lymphocytic lymphomas were the most common pathologic subtype, and pathologic grade was the most important prognostic factor to influence survival in the present study. Although combined modality treatment did not appear to be superior to chemotherapy or radiotherapy alone, a larger number of patients is needed to draw definite conclusions.

Adult↗

Neoadjuvant chemotherapy in locally advanced breast cancer: a preliminary report. Turkish Oncology Study Group.

AIMS AND BACKGROUND: A pilot study of neoadjuvant chemotherapy with cyclophosphamide-epirubicin-5-fluorouracil (FEC) was performed on 85 patients with locally advanced breast cancer. METHODS AND STUDY DESIGN: Patients received four cycles of neoadjuvant chemotherapy followed by surgery, radiotherapy and a treatment with cyclophosphamide-methotrexate-5-fluorouracil for three cycles. RESULTS: Major clinical response was obtained in 76 (89%) patients. Complete response was documented in 14 (17%) patients at pathologic examination of surgical specimen. Grade 1-2 nausea and vomiting was the most common (77%) side effect. Grade 2-3 alopecia was 66%. Grade 2-3 neutropenia occurred in 16% of patients. None of the patients developed febrile neutropenia. Sinus tachycardia was observed only in one patient. Three patients had a more than 10% decrease in the left ventricular ejection fraction without any clinical signs. Nine patients had progressive or stable disease and 4 did not undergo surgery or receive radiation therapy; thus 13 were excluded from survival analysis. After a median followup of 31 months (range, 15-41), disease-free survival and overall survival were 20 (range, 13-32) and 23 months (range, 17-32). CONCLUSIONS: The FEC combination is safe and effective for a neoadjuvant setting in locally advanced breast cancer. A longer follow-up is necessary for the end point results.

Adult↗

Post-irradiation osteosarcoma of the iliac bone: a case report.

A case of osteosarcoma of the iliac bone developing 12 years after the successful management of childhood rhabdomyosarcoma is presented. The frequency of secondary tumors, mainly bone malignancies, following therapeutic irradiation in the pediatric age-group, and the criteria for the diagnosis of radiation-induced bone sarcoma are discussed.

Abdominal Neoplasms↗

Intracranial ependymomas: treatment results and prognostic factors.

Forty-nine intracranial ependymoma patients were postoperatively irradiated with craniospinal, cranial, or wide local fields. Thirty-two patients received an adjuvant chemotherapy regimen of vincristine and CCNU with or without procarbazine. The 10-year actuarial overall and progression-free survival rates were 57% and 57%, respectively. Age was the only significant prognostic factor in favor of adults (p = 0.01).

Actuarial Analysis↗

Cranial nerve involvement in nasopharyngeal carcinoma: its prognostic role and response to radiotherapy.

Between 1975 and 1989, 23 nasopharyngeal carcinoma patients presenting with cranial nerve involvement (CNI) of one or more nerves at the time of diagnosis were treated and followed-up in our department. All patients were irradiated with curative intent, and total doses of 50 to 70 Gy (median 65 Gy) were delivered to the nasopharynx. Cranial nerves VI, III, V, IV, IX, and XII were the most commonly involved nerves. The total response rate of cranial nerves was 74% in a median follow-up time of 2 years, with the highest rate observed in the third and sixth cranial nerves. All complete responses except two were observed in the first month after radiotherapy.

Adolescent↗

Familial glioma in two siblings.

We report two siblings who had intracranial gliomas, one with glioblastoma multiforme and the other with mixed oligo-astrocytoma. The genetic influences in the development of glioma are discussed.

Adult↗

Plaque radiotherapy in the management of retinoblastoma.

Retinoblastoma is the most common intraocular malignant tumor in childhood and is radiosensitive. We treated five patients with solitary intraocular retinoblastoma using iodine-125 plaque radiotherapy as a primary procedure. Tumor basal diameters ranged from six to 16 mm and thickness ranged from three to 11 mm. The radiation dose delivered to tumor apex ranged from 3500 to 5000 centigrays. All tumors regressed considerably within a follow-up ranging between seven to 12 months. There was no tumor recurrence or any complications related to plaque brachytherapy within this early period. We concluded that plaque radiotherapy is an effective method in local tumor control and allows eye preservation in patients with retinoblastoma.

Brachytherapy↗

Thyroid dysfunction in children receiving neck irradiation for Hodgkin's disease.

Thyroid function was studied in 46 long-term survivors of pediatric Hodgkin's disease with a median follow-up time of 10.5 years. The mean age of the patients at the time of treatment was 8 years. Treatment consisted of radiotherapy alone in seven patients and combined radiation and chemotherapy in 39 patients. The radiotherapy dose to the thyroid gland was less than 2000 cGy in one, 2000-2500 cGy in 15, 2500-3000 cGy in 17, and greater than 3000 cGy in 13 patients. Evaluation consisted of clinical examination and thyroid function tests of total and free triiodothyronine, thyroxin, arid thyroid stimulating hormone levels. Twenty-one of 46 patients (45.6%) showed thyroid function abnormalities, however only nine of them had diffuse or nodular hyperplasia on physical examination. Risk factors of age, chemotherapy schema, total radiation dose, and dose per fraction did not significantly influence the incidence of thyroid dysfunction.

Adolescent↗