Person: ALSAN ÇETİN, İLKNUR
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ALSAN ÇETİN
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İLKNUR
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Publication Open Access Oncological outcomes for encapsulated papillary carcinoma of the breast: Multicentric study of Turkish Society for Radiation Oncology breast cancer study group (TROD 06-014 study).(2022-12-04) ALSAN ÇETİN, İLKNUR; Gurdal N., Yildirim B. A. , Gursel O. K. , Ozkurt S., Ibis K., Gultekin M., Tepetam H., Gul S. K. , Guzeloz Z., Oksuz D. C. , et al.Publication Open Access Role of baseline Ga-68-PSMA PET/CT-derived whole-body volumetric parameters in predicting survival outcomes of metastatic castration-resistant prostate cancer patients receiving first-line treatment(2022-08-01) AKIN TELLİ, TUĞBA; ÖZGÜVEN, SALİH; FİLİZOĞLU, NUH; ÖZTÜRK, MEHMET SAADEDDİN; ARIKAN, RUKİYE; DEMİRCAN, NAZIM CAN; BAŞOĞLU TÜYLÜ, TUĞBA; ALSAN ÇETİN, İLKNUR; ÖNEŞ, TUNÇ; DANE, FAYSAL; YUMUK, PERRAN FULDEN; AKIN TELLİ T., ÖZGÜVEN S., Alan O., Filizoglu N., ÖZTÜRK M. S. , Sariyar N., Isik S., Arikan R., DEMİRCAN N. C. , BAŞOĞLU TÜYLÜ T., et al.Objective We aimed to evaluate whether baseline Ga-68-PSMA PET/CT-derived whole-body volumetric parameters could be used as predictive biomarkers for survival in metastatic castration-resistant prostate cancer (mCRPC) patients receiving first-line treatment. Materials and methods This retrospective study included 54 mCRPC patients, who underwent baseline Ga-68-PSMA PET/CT imaging within 1 month before starting first-line treatment. Pre-treatment prostate-specific antigen (PSA) levels and treatments were recorded. SUVmax, SUVmean, whole-body PSMA-derived tumor volume (wbPSMA-TV), and whole-body total lesion PSMA (wbTL-PSMA) were calculated for all patients. PSA response was defined as a decline of >= 50% from pre-treatment value at 12 weeks. Overall survival (OS) was measured from the start of the first-line treatment for mCRPC. Results Docetaxel and abiraterone/enzalutamide were administered to 32 and 22 patients in the first-line setting, respectively. wbPSMA-TV (rho = 0.582, p = 0.004) and wbTL-PSMA (rho = 0.564, p = 0.007) showed moderate positive correlations with PSA levels. Older age (p = 0.02), higher wbPSMA-TV (p = 0.007), higher PSA (p = 0.01), higher number of bone metastases (p = 0.02), and lack of PSA response (p = 0.03) were significantly associated with an increased risk of mortality. Multivariate analysis determined wbPSMA-TV (HR: 1.003, 95% CI 1.001-1.004, p = 0.001) and PSA response (HR: 2.241, 95% CI 1.189-4.222, p = 0.01) as independent predictors of OS. Conclusion The wbPSMA-TV may be a useful tool to reflect tumor burden and predict survival outcomes in patients with mCRPC.Publication Open Access Dosimetric comparison of anterior posterior-posterior anterior 2-field three-dimensional conformal radiotherapy, 4-field three-dimensional conformal radiotherapy and forward plan intensity modulated radiotherapy techniques in female lymphoma patients irradiated to neck and mediastinum(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2018) ALSAN ÇETİN, İLKNUR; Cini, Nilsu; Umay, Cenk; Ozdemir, Okan; Cetin, Ilknur Alsan; Epik, Hakan; Demiral, Ayse NurAim: Dosimetric comparison of three different techniques in female lymphoma patients who had radiotherapy (RT) to the neck and mediastinum. Setting and Design:: Retrospective clinical study. Materials and Methods: Computerized tomography-simulator images of eight patients were obtained retrospectively. Using 6 MV-X photon energy, RT plans were formed with three different techniques (anterior posterior-posterior anterior 2-field three-dimensional conformal RT [AP-PA 2-field 3D-CRT], 4-field 3D-CRT and forward plan intensity modulated RT [FPIMRT]). Comparisons were in terms of homogeneity index (HI), conformity index (CI), and inhomogeneity coefficient for planning target volume (PTV); mean lung dose, V-5Gy, V-10Gy, V-20Gy, V-30Gy for lung; D-mean, V-7.5Gy, V-15Gy, V-25Gy for heart; D-mean, V-3.5Gy, V-10Gy, V-20Gy for breast; D-max for spine; D-mean, V-10Gy, V-18Gy, V-25Gy, V-30Gy for thyroid. Statistical Analysis Used: Since nonparametric tests had to be used due to the study population being < 30, Friedman and Wilcoxon signed-rank tests were implemented in trilateral and bilateral comparison of techniques, respectively. For statistical significance, P value was required to be <0.05. Results: When FPIMRT was compared with AP-PA and 4-field techniques with respect to, HI (AP-PA/FPIMRT P: 0.017; 4-field/FPIMRT P: 0.03) and CI (AP-PA/FPIMRT P: 0.018; 4-field/FPIMRT P: 0.042), FPIMRT was more advantageous. In addition, FPIMRT was found more useful in terms of D-max (AP-PA/FPIMRT P: 0.012; 4-Field/FPIMRT P: 0.012) for spinal cord and D-mean (AP-PA/FPIMRT P: 0.012; 4-field/FPIMRT P: 0.012) for thyroid. Conclusion: FPIMRT was superior in terms of PTV homogeneity and conformity. However, it was observed that for normal tissues, FPIMRT was advantageous only for spinal cord and thyroid; but it was not the most advantageous technique for some of the dose-volume parameters of the breast, lung, and heart.Publication Open Access Breast Brachytherapy and a Case Report(KARE PUBL, 2019) ALSAN ÇETİN, İLKNUR; Cetin, Ilknur Alsan; Kucucuk, Seden; Aslay, IsikFor women who had breast-conserving surgery (BCS), brachytherapy can be used along with external beam radiation as a way to add an extra boost of radiation to the tumor site. It may also be used as a form of accelerated partial breast irradiation. Tumor size, location and other factors may affect brachytherapy decision. The patient was 47 years old and applied to Istanbul University Oncology Institute Radiation Oncology Department. A mass in the upper outer quadrant was detected. Invasive ductal cancer was diagnosed with biopsy. MKC and sentinel lymph node biopsy were performed in 2013. Histological and nuclear grade II, ER (+++), PG (+++), cerbB2 (-), lympho vascular invasion (-), pT1N0 was revealed. In 2013, 50 Gy/25 frx ERT was applied to the left breast tangent. After 16 days, HDR was performed twice daily (BID) (4x3Gy), 14-channel ISI breast implants. The reference dose is defined as 3 Gy GTV.Publication Open Access Prostate-specific antigen nadir within 1 year of radiotherapy combined with hormone therapy predicts cancer-specific mortality and biochemical recurrence-free survival in prostate cancer patients(2022-11-01) ALSAN ÇETİN, İLKNUR; Alsan Çetin İ., Akay S. U. , Şengöz K. M.Background In this study, we investigated the ability of prostate-specific antigen (PSA) 12 months after (nPSA12) external beam radiotherapy (EBRT) combined with androgen deprivation therapy (ADT) to predict biochemical recurrence-free survival (BRFS), overall survival (OS), and prostate cancer-specific mortality (PCSM) in intermediateand high-risk prostate cancer patients. Methods We retrospectively reviewed the clinical data of 338 intermediate- and high-risk prostate cancer patients treated with EBRT with ADT at our institution between 2000 and 2018. The median radiation dose was 76 Gy, the median initial PSA level was 17 ng/mL (range, 1–228 ng/mL), and the median duration of ADT was 24 months (range, 6–167 months). The median PSA level 1 months after EBRT was 0.06 ng/mL (range, 0–25.6 ng/mL). Univariate and multivariate analyses were performed. Patient survival was assessed using the Kaplan-Meier method and Cox proportional hazards regression analyses. Results The median follow-up time was 5 years (range, 1–20 years). Multivariate analysis revealed that nPSA was an independent and significant factor associated with OS, PCSM, and BRFS (P = 0.008, P = 0.001, P = 0.04). Furthermore, the time to nPSA12 was an independent predictor of PCSM and BRFS (P = 0.042, P = 0.021). Pelvic irradiation was also significantly associated with worse OS and PCSM (P = 0.004, P = 0.01). Additionally, age (≤ 70 or > 70 years) and hormone therapy duration (6 months, 1–3 years, or > 3 years) were significantly associated with OS and PCSM, respectively (P = 0.004, P = 0.02). For high risk, nPSA and nPSA12 were an independent predictor for BRFS. (P = 0.021, P = 0.029) Conclusion The nPSA12 level of > 0.06 ng/mL may independently predict worse PCSM and BRFS in intermediateand high-risk prostate cancer patients undergoing EBRT and ADT. Additionally, for high risk, nPSA > 0.06 ng/mL and nPSA12 > 0.06 ng/mL may independently predict worse BRFS.Publication Open Access The oncological outcomes of postoperative radiotherapy in patients with stage II and III upper rectal cancer(2022-01-01) ALSAN ÇETİN, İLKNUR; ALSAN ÇETİN İ., Akay s. u.Objective: We assessed the oncological outcomes of postoperative radiotherapy and chemotherapy in patients with stage II or III upper rectal cancer who had undergone curative surgery. Patients and Methods: We retrospectively investigated 133 patients who underwent primary curative resection of stage II or III upper rectal cancer. The median age was 62 years (range 30–82 years). Among these patients, 48% were stage II and 52% stage III. All received postoperative radiotherapy, and most received adjuvant 5-fluorouracil-based chemotherapy for 6 months after radiotherapy ceased. Survival curves were plotted using the Kaplan–Meier method, and survival was compared using the log-rank test. Results: The median follow-up was 71.4 months. The 5-year local recurrence-free survival, cancer specific survival, and overall survival (OS) rates were 91.6%, 80.6%, and 75.4%, respectively. Nodal stage 2 (p = 0.02, p = 0.05) was a significant predictor of poor local recurrence-free survival and cancer specific survival rates. In the multivariate analysis, older age (p = 0.01) and a higher N stage (p = 0.01) were independent risk factors for poor OS. Conclusion: The nodal state was predictive of all endpoints in patients with upper rectal stage II or III cancer.Publication Open Access Current Approach in Radiation Therapy for Prostate Cancer(GALENOS YAYINCILIK, 2020-06-05) ALSAN ÇETİN, İLKNUR; Cetin, Ilknur AlsanProstate cancer is one of the most common malignancies in men. Radiotherapy is one of the main treatment modalities in the treatment of prostate cancer. The reflection of technological advances in the field of radiation oncology enables the safe application of higher doses of radiotherapy in the treatment of prostate cancer. In addition, improvements in normal tissue preservation are reflected in patients' quality of life. Radiotherapy can be applied in all stages of prostate cancer and postoperative radiotherapy can be applied in appropriate indication. Side effects are expected to be observed more in patients undergoing postoperative radiotherapy. The treatment decision should be based on personal preference after informing the patient about the advantages and disadvantages of each treatment approach.Publication Open Access Communication Skills between the Relatives and the Doctors of Patients with Cancer Treated in Radiation Oncology: A Cross-sectional Questionnaire Study(KARE PUBL, 2021) ALSAN ÇETİN, İLKNUR; Cetin, Ilknur Alsan; Akay, Sitki Utku; Ucum, Mehmet Faruk; Nohut, Ahmet Rasit; Kaya, Muhammed Ikbal; Kara, Ibrahim; Ulu, Ahmet AbdurrahmanOBJECTIVE To evaluate the communication between relatives and the doctors of patients with cancer treated in the radiation oncology department using a questionnaire composed of two sections. METHODS Relatives of 168 patients were selected through simple randomization after having obtained informed consent from the patients. A questionnaire form, which was developed based on the patient-physician communication scale, which had the sub-dimensions of information, empathy and confidence and included questions regarding socio-demographic data, and which used a Likert-type scale, was applied. Statistical analyses were performed using the Mann-Whitney U test and the Kruskal Wallis test. RESULTS A statistically significant difference was determined in the information and empathy sub-dimensions concerning the gender and the education level of the relatives (p=0.03, p=0.01, p=0.001) and the frequency of seeing the doctor and the doctor's tolerance (p=0.007, p=0.02); in the confidence possession sub-dimension, a difference was found between the age groups of the relatives and the tumor groups of the patients (p=0.039, p=0.002), duration of seeing the doctor and talking with the doctor (p=0.004, p=0.009), between the relatives' praying and all sub-dimensions (p=0.009, p<0.0001); in the information sub-dimension, a difference was found with regard to the duration of therapy (p=0.03). It was also determined that all relatives wished to obtain correct information and have confidence in the doctor. CONCLUSION The results show the expectations and the content of information, empathy and confidence sub-dimensions of the communication process between relatives and the doctors of the patients.Publication Open Access Evaluation of the satisfaction, quality of life andanxiety among cancer patients and patient relatives in theradiotherapy unit during the covid-19 pandemic:a cross-sectional survey study(2023-09-01) ALSAN ÇETİN, İLKNUR; ALSAN ÇETİN İ., DEVRAN B. Z., Şükürov T., akarçay m. k., onaylar z. m., anlar e. g., demir m.Objective: It was aimed to investigate the psychological effects of the coronavirus disease-2019 (COVID-19) pandemic on cancer patients receiving radiotherapy and their relatives, as well as their satisfaction level and the effects of the pandemic on patients' quality of life. Material and Methods: 118 cancer patients who applied to our clinic between November 2021-February 2022 and 111 patients relatives were included in the study. The Short Form-36 Quality of Life Scale was only applied to patients, whereas the Hospital Anxiety and Depression Scale and COVID-19 Knowledge and Satisfaction survey were applied to both patients and their relatives. Results: A statistically significant difference was found between gender and anxiety and depression in females (p=0.009). While there was a significant difference between social functioning and age (p =0.041), no significant difference was found in other parameters. Comparison of anxiety levels among patient and patient relatives demonstrated that anxiety levels were significantly higher among patient relatives (p=0.044). Comparison of the quality of life among gender groups demonstrated that physical function was significantly higher among males compared to females (p=0.043). Comparison of the quality of life among different cancer types demonstrated that physical function was lower in the breast and gynecology cancer group than in the genito-urinary cancer group (p=0.020). Conclusion: It was determined that female gender was more inclined toward anxiety, social functioning was better in the old age group, patient relatives exhibited higher anxiety levels than patients, and physical function scores were higher in men than in women.Publication Open Access Clinical outcomes of adjuvant radiotherapy for nodal negative T1 and T2 breast cancer(2022-07-01) ALSAN ÇETİN, İLKNUR; ALSAN ÇETİN İ., Akay S., Ozkok H., Sengoz M.The objective of this study was to determine the long -term results of postoperative radiotherapy (RT) in patients with node -negative T1 –T2 breast cancer and the prognostic factors affecting these results. Materials and Methods : We retrospectively evaluated 382 node -negative breast cancer patients (pT1a –c, T2) treated with surgery. All patients underwent postoperative RT and 80% of patients received hormone therapy. Prognostic variables included patient characteristics, disease characteristics, and intervention factors. The primary endpoint was overall survival (OS). Survival curves were estimated using the Kaplan –Meier method. Differences in observed survival distributions among patient subgroups were evaluated using a two -sided long -rank test. We applied univariate and multivariate Cox models to evaluate predictive factors. Statistical significance was evaluated at a level of P < 0.05. Results : The median follow -up was 143 months. The 10 -, 15 -, and 20 - year OS rates were 92%, 86%, and 80%, respectively. Univariate analysis showed that age (< 45, 45 –65, > 65 years; P < 0.0001), comorbidity (P = 0.008), menopausal status (P = 0.03), and tumor stage (T1a –c, T2; P = 0.006) (table 1) were significant predictors of OS. Multivariate analysis showed that age (< 45, 45 –65, > 65; P = 0.01) and tumor stage (T1a –c, T2; P < 0.0001) were independent predictors of OS. At age 15 years, the OS rate of patients with T1b, T1c, or T2 stage cancer was 87.5%, 81%, or 77%, respectively. Conclusions : Age and tumor stage were independent prognostic factors for women with node -negative early breast cancer.