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ATASOY, BESTE MELEK

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BESTE MELEK

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    Baş-Boyun Kanserli Hastalarda Radyoterapiyle İlişkili Erken ve Geç Etkilerin Yönetimi
    (Türkiye Klinikleri, 2022-01-01) ATASOY, BESTE MELEK; GÜL D., ÜÇÜNCÜ KEFELİ A., ATASOY B. M.
    Radyoterapi baş-boyun kanserlerinin tedavisinde ana modalitelerden biridir. Gelişen teknoloji tümöre yüksek doz uygulamayı sağlarken risk altındaki organları daha iyi korumaya yardımcı olur. Buna rağmen bu bölgenin kompleks anatomisi birden fazla hedef dışı organın fonksiyonel olarak etkilenmesine ve hastanın hayat kalitesinin bozulmasına neden olabilmektedir. Kaçınılmaz olan erken ve geç yan etkilerin sıklık ve şiddetinin azaltılabilmesi iyi bir tedavi planlamasıyla başlar; bir dizi erken müdahale ve iyi bir takiple devam eder. Tedaviye bağlı yan etkilerin yönetimi en az hastalık kontrolü kadar önemlidir. Bu makalede baş-boyun kanserlerinde radyoterapiye bağlı başlıca erken ve geç yan etkilerin yönetimi güncel literatür ışığında incelenmiştir. Anahtar Kelimeler: Baş-boyun kanserleri; radyoterapi; yan etkiler
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    Sağlıkta yapay zekânın etik yönü
    (Türkiye Klinikleri, 2022-01-01) ATASOY, BESTE MELEK; SERT, GÜRKAN; ATASOY B. M., ÜÇÜNCÜ KEFELİ A., SERT G.
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    PublicationOpen Access
    Effects of resveratrol against scattered radiation-induced testicular damage in rats
    (WALTER DE GRUYTER GMBH, 2021-09-06) ATASOY, BESTE MELEK; Sener, Tarik Emre; Atasoy, Beste Melek; Cevik, Ozge; Kaya, Ozlem Tugce Cilingir; Cetinel, Sule; Degerli, Ayse Dagli; Sener, Goksel
    Objectives: To investigate the possible protective effects of resveratrol against oxidative testicular damage due to scattered radiation during pelvic ionizing radiation exposure in rats. Methods: Rats were divided into 5 groups; control, radiation, and radiation + resveratrol therapy in early and late periods. Under anesthesia, 20 Gy ionizing radiation was applied to prostatic region. Resveratrol was administered (10 mg/kg/day) orally before ionizing radiation exposure. Animals were decapitated at the end of 1st and 10th weeks. Biochemical markers of oxidative stress; caspase-3 and sirtuin-1 protein expressions; testosterone levels were evaluated, histological examinations were performed. Results: Significant increases in malondialdehyde, 8-hydroxy-deoxyguanosine levels, myeloperoxidase, and caspase-3 activities were observed after ionizing radiation exposure, also superoxide dismutase and glutathione activities were significantly decreased. Radiotherapy increased caspase-3 and decreased sirtuin-1 protein expressions. Resveratrol treatment significantly reversed these parameters and also reversed the decrease in testosterone levels back to control levels in late period. Conclusion: Resveratrol showed antioxidant and sirtuin-activating properties against oxidative damage caused by scattered radiation to testis and provided hormonal protection. These results suggest that resveratrol may be an alternative protective agent on testicular tissues against the effects of scattered pelvic radiation.
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    Prognostic factors in progressive high-grade glial tumors treated with systemic approach: A single center experience
    (SAGE PUBLICATIONS LTD, 2021) ATASOY, BESTE MELEK; Alan, Ozkan; Telli, Tugba Akin; Tuylu, Tugba Basoglu; Arikan, Rukiye; Demircan, Nazim Can; Ercelep, Ozlem; Kaya, Serap; Babacan, Nalan Akgul; Atasoy, Beste M.; Bozkurt, Suheyla; Bayri, Yasar; Gul, Dilek; Ekinci, Gazanfer; Ziyal, Ibrahim; Dane, Faysal; Yumuk, P. Fulden
    Purpose Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor, and the prognosis is generally extremely poor. In this retrospective study, we analyzed the outcome of systemic treatment in recurrent high-grade glioma patients and the impact of prognostic factors on survivals. Methods Data from 114 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 were retrospectively analyzed. Eastern Cooperative Oncology Group (ECOG) performance status, age, gender, histology, type of surgical resection, side effects after systemic treatment (deep vein thrombosis, hypertension, proteinuria), IDH1 and alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation status were investigated as prognostic factors for progression-free survival and overall survival. Results At the time of diagnosis, the median age was 48 (17-77) and 68% of the patients were male. Most common pathologic subtype was glioblastoma multiforme (68%). Median follow-up duration was 9.1 months (1-68 months). Median progression-free survival and overall survival were 6.2 months and 8 months, respectively. In multivariate analysis, ECOG PS, deep venous thrombosis and the presence of ATRX and IDH1 mutation were found to be independent prognostic factors for progression-free survival (p < 0.05) and, ECOG PS, the presence of ATRX and IDH1 mutation for overall survival (p < 0.05). Conclusion Our study is real life data and the median progression-free survival and overall survival rates are similar to the literature. We have found ECOG PS, presence of ATRX and IDH1 mutation to be independent prognostic factors for both progression-free survival and overall survival.
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    The role of radiotherapy in intracranial hemangiopericytoma: TROD CNS group study 07-008
    (2022-05-01) ATASOY, BESTE MELEK; Kaydihan N., Guney Y., Yazici G., Erpolat P., Kamer S., Atasoy B. M., Aslan D., ATALAR B., Demircioglu F., Dincbas F. O., et al.
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    PublicationOpen Access
    Long-term outcomes of gamma-knife radiosurgery for intracanalicular vestibular schwannomas
    (2022-01-01) PINAR, ERTUĞRUL; BAYRİ, YAŞAR; BAYRAKLI, FATİH; SAKAR, MUSTAFA; ATASOY, BESTE MELEK; Sakar M., Pınar E., Bayri Y., Bayraklı F., Atasoy B. M., Ziyal M. İ.
    GİRİŞ ve AMAÇ: Kanal içi vestibüler schwannomalar, tüm vestibüler schwannomalar içerisinde küçük bir yüzdeye sahiptir. Kanal içi vestibüler schwannomalarda işitmenin korunması, hasta yönetiminin temel amaçlarındandır. Bu çalışmanın amacı, kanal içi vestibüler schwannomalarda Gamma-Knife radyocerrahinin (GKR) tümör kontrolü ve işitmenin korunması üzerine etkisinin incelenemesidir.YÖNTEM ve GEREÇLER: Bu geriye dönük çalışmada, Gamma-Knife Radyocerrahi Merkezi’mizde Ocak 2010–Ocak 2020 arasında kanal içi vestibüler schwannoma tanısı ile stereotaksik radyocerrahi almış, klinik, odyometrik ve radyolojik takibi bulunan hastalar değerlendirildi. Tümör kontrolü manyetik rezonans görüntüleme yönteminde tümör boyutlarının ölçülmesi ile takip edildi. İşitme seviyeleri Gardner-Robertson (GR) işitme sınıflaması yöntemine göre değerlendirildi.BULGULAR: Ortalama 48.23 aylık takipte, çalışmaya dahil edilen toplam 45 hastadan 44’ünde tümör kontrolü sağlandığı görüldü (%97.7). Tümör büyümesi görülen bir hastada ise, ek bir tedavi uygulanması gerekmedi. Ek tedavi gerekliliğine göre değerlendirildiğinde tüm hastalarda tümör kontrolü sağlandı (%100). Tedavi öncesi fonksiyonel işitmesi olan (GR derece I ve II) toplam 29 hastadan, ortalama 70.42 aylık takip sonrasında, toplam 13 hastada fonksiyonel işitme korundu (%44.8). GR derecesinde kayıp, ameliyat öncesinde yüksek GR derecesine sahip olmak ile korelasyon gösterdi (Rs=0.459, p=0.002). Tedavi dozu işitme kaybı ile korelasyona sahipti ve daha yüksek doz alan hastalar daha kötü sonuçlara sahipti (Rs=0.459, p=0.002).TARTIŞMA ve SONUÇ: Kanal içi vestibüler schwannomalarda GKR uzun dönemli takiplerde mükemmel tümör kontrolü sağlamaktadır. Beş yılın üzerindeki takip sürelerinde fonksiyonel işitmenin korunma oranı azalabilir. Kanal içi vestibüler schwannomalarda GKR sonrası işitmenin seyrini ortaya koyabilmek için uzun takip süreli daha fazla çalışma gerekmektedir.Anahtar Kelimeler:Gamma-knife radyocerrahi, işitmenin korunması; kanal içi; tümör kontrolü; vestibüler schwannoma.
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    Prognostic value of modified Glasgow prognostic score in recurrent high-grade glial tumors treated with systemic treatment
    (ELSEVIER, 2020) ATASOY, BESTE MELEK; Alan, Ozkan; Telli, Tugba Akin; Basoglu, Tugba; Arikan, Rukiye; Demircan, Nazim Can; Ercelep, Ozlem; Bozkurt, Suheyla; Atasoy, Beste Melek; Dane, Faysal; Yumuk, Perran Fulden
    Objectives: Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor. We aimed to evaluate the prognostic value of modified Glasgow Prognostic Score (mGPS), which is combination of C-reactive protein (CRP) and albumin, in recurrent high-grade glioma patients treated with systemic treatment. Patients and Methods: Data of 85 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 was retrospectively collected and analyzed. Patients were grouped according to mGPS criteria: mGPS-0: CRP 10 mg/L and albumin 3.5 g/dL or CRP 10 mg/L and albumin > 3.5 g/dL; and mGPS-2: CRP > 10 mg/L and albumin < 3.5 mg/L. We investigated the prognostic role of mGPS groups, mutations and survival outcomes. Results: There were 42 (49.4 %), 25 (29.6 %), and 18 (21 %) patients in mGPS-0, mGPS-1, and mGPS-2 groups, respectively. Median follow-up duration was 10 months (1-70 months). Median OS was 8.1 months. According to mGPS-0,-1 and-2; median OS was 13.8 months, 7.3 months and 3.6 months respectively (p = 0.003). mGPS, ATRX and IDH-1 mutation status, and ECOG PS were found to be independent prognostic factors for OS. Conclusion: In our study, mGPS was found to be an independent prognostic factor in patients with recurrent high-grade gliomas. If validated, mGPS can be used as an objective, easily calculated, cheap, and readily available prognostic model in routine practice.
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    Anxiety and depression level and body appreciation of breast cancer patients who had oncology physician and nurse led education during postoperative radiotherapy
    (2020-10-17) ÖZGEN, ZERRİN; YANARTAŞ, ÖMER; ATASOY, BESTE MELEK; Çankaya G., Özgen Z., Korkmaz A., Yanartaş Ö., Atasoy B. M.
    OP-02 Anxiety and depression level and body appreciation of breast cancer patients who had oncology physician and nurse led education during postoperative radiotherapy Gul Cankaya, Zerrin Ozgen, Ayse Korkmaz, Omer Yanartas, Beste Melek Atasoy Department Of Radiation Oncology Marmara University Pendik Training Hospital Istanbul Turkey INTRODUCTION: In this study, we have investigated effect of education on anxiety and depression levels and body perception of breast cancer patients during postoperative radiotherapy (RT) led by physicians and oncology nurse. MATERIAL-METHODS: Ethical approval was obtained from institutional ethical committee. In this prospective study we have enrolled 50 patients with written consent who were operated and had indication for RT (n = 50). Hospital Anxiety and Depression Scale (HAD-A1 and HAD-D1) and Body Appreciation Scale (BAS-1) were applied to patients after first examination. Then the patients had education on these topics: steps of radiotherapy, side effects and precautions, simulation, main points in simulation, deep breathing for patients operated on the left chest, significance of crunches, doing deep breathing exercise, the factors in skin care during RT, lymphedema, protection from lymphedema, making a breast self-examination, importance of inspection, importance of preventive health screenings and its intervals, importance of nutrition and activity in breast cancer. In line with the demands of patients, they had dietician and psychiatry support. However, radiotherapy skin reactions that may develop on the patient\"s skin during treatment was followed up regularly and complaints were answered. HAD (HAD-A2, HAD-D2) and BAS (BAS-2) were applied again after RT completed. RESULTS: Mean HAD-A1 was 4.9 (0 -15) SD 0.36, whereas HAD-A2 was 1.6 (0-5) SD 1.56. HAD-D1 resulted with average 3.7 (0-16) SD at 3.89 and HAD-D2 with mean 1.08 (0-5) SD 1.17. BAS-1 resulted mean 44.50 (33-50) SD 4.67 and BAS-2 with 46.68 (36-50) SD 3.74. HAD-A scores for 39 patients had decreased with only one increased and 10 remained same. Comparison of anxiety before and after treatment were made by Wilcoxon test; statistically it was found decreased significantly (p <0.05). HAD-D scores of 5 patients over 11 points returned to normal in second test. While HAD-D scores of 35 patients had decrement, 3 patients had mild increase and 12 remained stable. There was a statistically significant improvement in the depression scale (p<0.05). After the treatment, BAS scores had statistically significant increase (p<0.05). DISCUSSION: Anxiety in 3 patients and depression in 5 patients were high but regressed to normal. BAS scores had increment. Patients having regularly information had decreased anxiety and depression scales. It has been found increase in BBS scores. CONCLUSION: HAD-A, HAD-D and BAS scales helped monitoring positive effect of information on patients on RT. Keywords: Breast cancer, Radiotherapy, Hospital anxiety depression scale, Body appreciation scale, Breast cancer education nurse.
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    Long-term neuromusculoskeletal side effects and quality of life in nasopharyngeal cancer patients receiving radiochemotherapy
    (SPRINGER, 2020) ATASOY, BESTE MELEK; Kefeli, Aysegul Ucuncu; Sanal-Toprak, Canan; Asedov, Ruslan; Ozen, Zeynep; Akyuz, Gulseren; Dane, Faysal; Atasoy, Beste M.
    Aim In this study, we aimed to evaluate the neuromusculoskeletal late side effects and their impact on the quality of life of patients with nasopharyngeal carcinoma treated with radiochemotherapy. Patients and methods Twenty-seven patients were included. The mean follow-up was 61 months (range, 18-111 months). The median external radiotherapy dose applied to the nasopharynx and primary tumor was 70 Gy (range, 61-73 Gy). The mean dose received by the temporomandibular joint in the dose-volume histograms of these patients was 60.7 Gy. The maximal doses of the muscles responsible for cervical motion in different ranges were greater than 60 Gy, and the mean doses were greater than 40 Gy in the muscle groups, except for the extensor muscles. Results Two patients had brachial plexus involvement, while 89% of the patients had restriction in flexion and extension movements. Of the patients, 52% had trismus. There was a significant correlation between extension restriction and general heath score and the physical subscale of the quality-of-life questionnaire (p = 0.01). There was also a correlation between trismus and pain killer usage (p = 0.004). Conclusion This is the first study to analyze long-term muscle and nerve toxicity and their correlation between doses in nasopharyngeal cancer patients following radiochemotherapy. Despite the advances in radiotherapy techniques, it is necessary to pay attention to the doses of the nerves and muscles for late effects.
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    PublicationOpen Access
    Mucositis-Induced Pain due to Barrier Dysfunction may have a Direct Effect on Nutritional Status and Quality of Life in Head and Neck Cancer Patients Receiving Radiotherapy
    (KARE PUBL, 2020) ATASOY, BESTE MELEK; Atasoy, Beste M.; Kayhan, Kivanc Bektas; Demirel, Birsen; Akdeniz, Esra
    OBJECTIVE To maintain the barrier function against mucositis-induced pain and to improve the nutritional status and quality of life in head and neck cancer patients during radiotherapy. METHODS All patients (n=30) used oral gel to reduce mucositis-induced pain. Patients were examined weekly for the severity of mucositis, pain and nutritional status. The quality of life parameters was measured at the beginning and at the end of treatment. There was no restriction for pain killers against mucositis. RESULTS The only significant factor affecting the severity and frequency of mucositis was the cumulative radiation dose (p<0.001). Despite the regular use of oral gel, weight loss was observed in 65% of the patients. There was no difference concerning the severity of mucositis, cumulative radiation doses, or mean dose of oral mucosa between patients with no risk or at risk, according to SGA. However, self-assessment pain scores were significantly better in the well-nourished group (p=0.05 vs. 0.015) with better scores for dry mouth (p=0.043), social eating (p=0.006), swallowing difficulties (p=0.001) and communication (p=0.049). CONCLUSION Supporting the barrier function alone does not help to reduce the severity and frequency of mucositis, nor the oral pain in high doses. Mucositis-induced pain may have a direct effect on malnutrition risk and quality of life in head and neck cancer patients. Powerful strategies are required to manage pain due to mucositis during curative radiotherapy.