American Hospital Anderson Radiation Treatment Center

İstanbul, Turkey

American Hospital Anderson Radiation Treatment Center

İstanbul, Turkey
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Bolukbasi Y.,Koç University | Bolukbasi Y.,American Hospital Anderson Radiation Treatment Center | Bolukbasi Y.,University of Texas M. D. Anderson Cancer Center | Saglam Y.,American Hospital Anderson Radiation Treatment Center | And 6 more authors.
Turk Onkoloji Dergisi | Year: 2017

OBJECTIVE The aim of the present study was to determine if volumetric modulated arc therapy (VMAT) provided superior dose distribution than intensity-modulated radiotherapy (step-and-shoot; ssIMRT) based on target volume coverage and organs at risk (OARs) doses in postoperative radiotherapy for pancreatic cancer patients. METHODS New 4-dimensional computed tomography plans for 10 pancreatic cancer patients were created. The ssIMRT plans had 6 coplanar fields (330-0-30-60-90°) and VMAT plans were generated with 2 268-92° arcs. RESULTS VMAT plans revealed better overall sparing of right kidney (volume receiving 15% of prescribed dose [V15]: 28.3% vs 46.9%, p=0.012; V20: 16.1% vs 27.6%, p=0.007; V25: 8.6% vs 15.2%, p=0.005; mean dose 1549 centigray [cGy] vs 1987 cGy, p=0.005). VMAT delivered similar isodose distribution (planning target volume [PTV] mean dose: 5164 vs 5183 cGy, PTV max: 5526 cGy vs 5505 cGy; p=0.541) with significantly fewer monitor units (MU) (MU: 468 vs 527; p=0.032) in comparison with ssIMRT. VMAT was also found to be superior for V30 intestinal dose, but mean dose was similar (1963 cGy vs 2032 cGy; p=0.05). CONCLUSION VMAT provided more effective protection for bilateral kidneys and small intestine with better OAR doses, as well as for liver, with reduced high-dose volumes in this cohort. This could be investigated as more tolerable concurrent radiochemotherapy treatment with better OAR preservation. © 2017, Turkish Society for Radiation Oncology.


Falay O.,Koç University | Ozturk E.,Koç University | Bolukbas Y.,Koç University | Bolukbas Y.,American Hospital Anderson Radiation Treatment Center | And 10 more authors.
Leukemia and Lymphoma | Year: 2016

Bleomycin is an antineoplastic agent causing fatal pulmonary toxicity. Early diagnosis of bleomycin-induced pneumonitis is crucial to prevent irreversible damage. Pulmonary function tests are unreliable for identifying risk of bleomycin toxicity. Fluorodeoxyglucose PET/CT scanning can reveal inflammation secondary to pneumonitis but is not sufficiently specific for diagnosis. We retrospectively analyzed scans from 77 patients with Hodgkin lymphoma (median age 41 years, mean bleomycin dose 134 mg) to evaluate bleomycin-induced pneumonitis. We identified 13 patients with abnormal lung uptake of fluorodeoxyglucose. Tracer activity was predominantly diffuse, bilateral, in the lower lobes and subpleural areas. Interim scanning during treatment revealed pneumonitis in eight of 13 patients (asymptomatic in six). One asymptomatic patient died of bleomycin toxicity. For remaining 12 patients, bleomycin was discontinued and methylprednisolone given, all showed resolution of the pneumonitis. These findings suggest that routine interim or end-of-treatment FDG-PET/CT scanning could be beneficial for alerting clinicians to asymptomatic bleomycin-induced toxicity. © 2016 Informa UK Limited, trading as Taylor & Francis Group

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