Person: ALSAN ÇETİN, İLKNUR
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ALSAN ÇETİN
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İLKNUR
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Publication Metadata only Kanser ile barışmak(Dünya Yayınları, 2023-02-01) ALSAN ÇETİN, İLKNUR; Alsan Çetin İ.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 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 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.Publication Metadata only Hemotolojide geraitrik hastalara önerilen doz ve şemalar(zeus, 2023-12-01) ALSAN ÇETİN, İLKNUR; Alsan Çetin İ., Demiröz Abakay C., Ünal D.Publication Open Access Dosimetric analysis of patients receiving radiotherapy with VMAT technique in localized prostate cancer and its correlation with side effects(2023-07-01) ALSAN ÇETİN, İLKNUR; Akay S. U., ALSAN ÇETİN İ., Bekiroğlu G. N.Aim: The aim was to study the relationship between dosimetric data of localized prostate cancer patients who have been treated with curative radiotherapy (RT) and gastrointestinal (GIS), genitourinary (GUS), anal and sexual side effects, and whether there was a difference between dosimetric data and clinical findings between risk groups. Methods: Eighty-seven patients who received curative radiotherapy for localized prostate cancer between 2014 and 2019 were included in the study. Dosimetrically; whether there was a relationship between V30, V40, V50, V60, V65, V70, V75 for rectum and bladder; D90 for the penile bulb, V72, V74, V76 for the bulbomembranous urethra, V30, V45, V53, Dmax for the anus, and V45 (cc) for the intestine data and the side effects were analyzed. It was evaluated whether there was a relationship between testosterone values and sexual side effects. The Kolmogorov-Smirnov test, one-way analysis of variance (ANOVA) (F-test), and paired-sample t-test were used as statistical methods. For statistical significance, P < 0.05 was accepted. Results: : The mean age of the patients was 69 (50-86), the mean Prostat specific antigen (PSA) (ng/dL) before RT was 25.1 (0.9-339), the median RT dose was 76 Gy (74-78 Gy), and the mean follow-up period was 38.2 months. PTVmax, PTVmean, PTVmin, bladder V40, bladder V50, rectum V30, rectum V40, rectum V50, and intestinal V45 (cc) were determined as dosimetric data showing differences between risk groups. A statistically significant relationship was found between rectum V30 (P = 0.017), V60 (P = 0.019), V65 (P = 0.008), V70 (P = 0.007), and V75 (P = 0.034) and chronic GIS side effects. G2 GIS side effects were observed in four patients (4.6%) in the entire patient group during the acute period. A statistically significant relationship was found between the patients receiving hormonotherapy (P = 0.021) and testosterone values at the last control (P ≤ 0.001) and chronic sexual side effects. Conclusion: Attention should be paid to the rectum V30, V60, V65, V70, and V75 values to minimize the long-term GIS side effects in patients who have undergone RT. Testosterone level and ADT status affect chronic sexual toxicity.Publication Metadata only Nüks yüksek gradli gli̇al tümörlerde bevasi̇zumabin sağkalim üzeri̇ne etki̇si̇(2012-04-19) DANE, FAYSAL; ATASOY, BESTE MELEK; ÖZGEN, ZERRİN; ALSAN ÇETİN, İLKNUR; YUMUK, PERRAN FULDEN; Dane F., Atasoy B. M., Aktaş B., Özgen Z., Alsan Çetin İ., Abacıoğlu U., Yumuk P. F.Amaç: Bu çalışmada, yüksek gradlı glial tümör tanısı alarak standart tedaviler sonrası nüks etmiş hastalarda tedaviye bevasizumab eklenmesinin sağkalıma etkisinin incelenmesi amaçlanmıştır. Gereç-Yöntem: Şubat 2005-Temmuz 2010 tarihleri arasında 17’si glioblastoma olmak üzere yüksek gradlı glial tümör tanısı almış ortanca yaşı 50 (aralık, 25-62 yaş) toplam 21 (12K:9E) hastanın geriye dönük verileri incelendi. Subtotal eksizyon yapılmış iki ve biyopsi ile tanı konmuş bir hastanın dışında tüm hastalarda (n=18) primer tümör total olarak eksize edilmişti. Postop radyoterapi, eş zamanlı temozolamid 75 mg/m2 ile ortanca 60 Gy olarak uygulanmıştı. Adjuvan dönemde temozolamid 150-200 mg/m2/1-5.günler/28 günde bir olmak üzere ortanca 8 kür (aralık 2-19 kür) devam etmişti. Klinik ve radyolojik progresyon izlenen hastalarda bevasizumab (10 mg/kg/1-14. günler 28. günde bir) tek başına (n=19) ya da irinotekan (n=2) ile birlikte uygulandı. Sağkalım sonuçları Kaplan-Meier eğrisi çizdirilerek elde edildi. Bulgular: Tüm hastalarda cerrahiden itibaren ortanca takip 25 ay (aralık 12-68 ay) idi. Nüks eden hastalardan dördüne cerrahi, altısına Gamma Knife ile stereotaktik radyocerrahi ve altısına da adjuvan temozolamid sonrası yeniden temozolamid (2-10 kür) uygulandı. Standart adjuvan tedavi (kemoradyoterapi ve adjuvan temozolamid) sonrası nüks durumunda doğrudan bevasizumab başlanan dokuz hasta vardı. Nüksten sonra bevasizumab ortanca 6 kür (aralık, 2-27 kür) uygulandı. Hiçbir hastada bevasizumaba bağlı ölüm izlenmedi. Tüm hastalarda cerrahiden itibaren iki yıllık genel sağkalım %62.5 idi. Bevasizumab sonrası ortanca progresyonsuz sağkalım 5 ay (%95 güven aralığı 2.2- 7.8 ay) ve ortanca genel sağkalım 8 ay (%95 güven aralığı 5.1-10.9 ay) idi. Altı aylık progresyonsuz sağkalım %49.1, 6 ve 12 aylık genel sağkalımlar sırasıyla %73.7 ve %39.3 oldu. Sonuç: Nüks yüksek gradlı glial tümörlerde bevasizumab uygulaması diğer tedavilere göre daha yüksek progresyonsuz sağkalım ve genel sağkalım sonuçlarıyla ümit verici bir tedavi olma özelliği göstermektedir.