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  1. Article ; Online: Ipsilateral lung dose as a correlative measure for radiation pneumonitis in patients treated with definitive concurrent radiochemotherapy.

    Kirakli, Esra Korkmaz / Erdem, Sevilay / Susam, Seher / Erim, Eser

    Journal of cancer research and therapeutics

    2023  Volume 19, Issue 5, Page(s) 1153–1159

    Abstract: Objective: Mean lung dose (MLD) and percent of total lung (TL) volume that receive a dose greater than 20 Gy (V: Methods: Between 2010 and 2017, clinical-radiological findings of NSCLC patients treated with RCT were evaluated in terms of RP, ... ...

    Abstract Objective: Mean lung dose (MLD) and percent of total lung (TL) volume that receive a dose greater than 20 Gy (V
    Methods: Between 2010 and 2017, clinical-radiological findings of NSCLC patients treated with RCT were evaluated in terms of RP, retrospectively. MLD, V
    Results: There were 75 patients. There was ≥Grade 2 RP in 33 cases (%44). In univariate analysis, ipsilateral MLD, ipsilateral V
    Conclusions: In NSCLC patients treated with RCT, MLD, V
    Advances in knowledge: Cutoff values for RP risk were determined as 18Gy, 35%, and 28% for ipsilateral MLD, ipsilateral V
    MeSH term(s) Humans ; Radiation Pneumonitis/diagnosis ; Radiation Pneumonitis/etiology ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/complications ; Radiotherapy Dosage ; Retrospective Studies ; Lung/diagnostic imaging ; Carcinoma, Non-Small-Cell Lung/radiotherapy ; Carcinoma, Non-Small-Cell Lung/complications ; Chemoradiotherapy/adverse effects
    Language English
    Publishing date 2023-10-03
    Publishing country India
    Document type Journal Article
    ZDB-ID 2187633-2
    ISSN 1998-4138 ; 0973-1482
    ISSN (online) 1998-4138
    ISSN 0973-1482
    DOI 10.4103/jcrt.jcrt_618_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Can consolidative thoracic radiotherapy improve outcomes in extensive-disease small cell lung cancer after chemotherapy with complete/near-complete responders?

    Kirakli, Esra Korkmaz / Yilmaz, Hasan / Akcay, Cimen / Komurcuoglu, Berna / Yilmaz, Ufuk

    Journal of cancer research and therapeutics

    2020  Volume 16, Issue 4, Page(s) 752–756

    Abstract: Background: In extensive-disease-small cell lung cancer (ED-SCLC), the median survival is 8-10 months and 2-year survival is <5%. Primary tumor progression occurs in 90% of patients approximately within 1 year. The role of consolidative thoracic ... ...

    Abstract Background: In extensive-disease-small cell lung cancer (ED-SCLC), the median survival is 8-10 months and 2-year survival is <5%. Primary tumor progression occurs in 90% of patients approximately within 1 year. The role of consolidative thoracic radiotherapy (C-TRT) for the postchemotherapy residue with the aim of improving local control (LC) and survival is currently of great interest. The objective of this study is to determine the effectiveness of C-TRT on LC, progression-free survival (PFS), and overall survival (OS) in ED-SCLC.
    Materials and methods: Medical records of patients diagnosed as SCLC between January 2010 and December 2015 were evaluated retrospectively. Patients who received C-TRT were identified. Pre- and post-chemotherapy radiological evaluations, radiotherapy schedules, relapse patterns, toxicity incidence, LC, PFS, and OS were analyzed.
    Results: Among 552 SCLC patients, 26 ED-SCLC patients who underwent C-TRT were analyzed. Median follow-up was 7.5 months (range, 6.5-8.5 months). Nearly 50% of the patients had >4 metastatic lesions. Restaging was performed mostly by positron emission tomography/computed tomography and cranial magnetic resonance imaging. All patients had complete or near-complete response distantly. C-TRT was 10 × 300 cGy (n = 1), 23 × 200 cGy (n = 2), 25 × 200 cGy (n = 7), 30 × 200 cGy (n = 12), and 33 × 200 cGy (n = 4). There was no toxicity ≥ Grade 3. LC rate was 77%; there was no isolated local relapse. PFS was 3 months. Median survival was 13 months. The 1- and 2-year OS rates were 62% and 8%, respectively.
    Conclusion: In ED-SCLC patients, C-TRT may prevent isolated local recurrence and may improve 1-year survival. This survival improvement might be the reflection of high intrathoracic control achieved in 77% of patients.
    MeSH term(s) Humans ; Lung Neoplasms/drug therapy ; Lung Neoplasms/mortality ; Lung Neoplasms/pathology ; Lung Neoplasms/radiotherapy ; Neoplasm Metastasis ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/radiotherapy ; Neoplasm Staging ; Positron Emission Tomography Computed Tomography/methods ; Remission Induction ; Retrospective Studies ; Small Cell Lung Carcinoma/drug therapy ; Small Cell Lung Carcinoma/mortality ; Small Cell Lung Carcinoma/pathology ; Small Cell Lung Carcinoma/radiotherapy ; Survival Rate ; Treatment Outcome
    Language English
    Publishing date 2020-05-20
    Publishing country India
    Document type Journal Article
    ZDB-ID 2187633-2
    ISSN 1998-4138 ; 0973-1482
    ISSN (online) 1998-4138
    ISSN 0973-1482
    DOI 10.4103/jcrt.JCRT_776_17
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Fasting Blood Glucose Level in Locally Advanced Non-Small Cell Lung Cancer: a New Prognostic Factor?

    Kirakli, Esra Korkmaz / Yilmaz, Ufuk / Yilmaz, Hasan / Komurcuoglu, Berna

    Hormones & cancer

    2018  Volume 9, Issue 3, Page(s) 188–196

    Abstract: Hyperglycemia may lead to proliferation, invasion, apoptosis inhibition, migration, and eventually metastasis of cancer cells by several mechanisms. In this study, the effect of hyperglycemia on overall survival (OS), disease-free survival (DFS), and ... ...

    Abstract Hyperglycemia may lead to proliferation, invasion, apoptosis inhibition, migration, and eventually metastasis of cancer cells by several mechanisms. In this study, the effect of hyperglycemia on overall survival (OS), disease-free survival (DFS), and locoregional recurrence (LRR) was investigated in NSCLC. One stage IIIA-IIIB NSCLC patient treated with chemoradiotherapy between 2010 and 2015 was enrolled. Fasting blood glucose (FBG) levels were recorded in pre-treatment, treatment, and post-treatment periods. Median age was 54 years (51-62). Fifty-two patients had squamous cell carcinoma (SCC); 19 had adenocarcinoma. Median follow-up was 19 (11-30), median survival was 19 (13-24), and DFS was 9 (7-11) months. Diabetic patients had shorter survival than non-diabetics 12 (95%CI, 10-14) vs. 25 months (95%CI,18-32), p = 0.005. Number of patients with LRR was also higher in diabetics compared to non-diabetics (8/12 vs. 11/37, p = 0.039). OS was shorter in patients with hyperglycemic-FBG and diabetic-FBG levels in pre-treatment period (log-rank p = 0.03 and 0.023, respectively). Diabetic-FBG level in pre-treatment period was found to be the only independent risk factor for survival. In subgroup analysis, these differences were apparent in SCC (log-rank p = 0.009 for hyperglicemic, log-rank p = 0.017 for diabetic-FBG). LRR was 68% in patients with diabetic-FBG, 36.5% in patients with non-diabetic-FBG in post-treatment period (p = 0.015). Patients with LRR had significantly higher median FBG value in post-treatment period compared to non-relapsing patients, 138 mg/dL (119-228) and 111 mg/dL (99-164), respectively (p = 0.022). The patients with hyperglycemic and diabetic-FBG levels in pre-treatment period had shorter survival compared to normoglycemic ones. The patients with diabetic-FBG level in post-treatment period had higher LRR, and relapsing patients had higher FBG levels in post-treatment period.
    MeSH term(s) Biomarkers, Tumor/metabolism ; Blood Glucose/metabolism ; Carcinoma, Non-Small-Cell Lung/diagnosis ; Carcinoma, Non-Small-Cell Lung/metabolism ; Carcinoma, Non-Small-Cell Lung/mortality ; Diabetes Complications/diagnosis ; Diabetes Complications/metabolism ; Diabetes Complications/mortality ; Female ; Follow-Up Studies ; Humans ; Hyperglycemia ; Lung Neoplasms/diagnosis ; Lung Neoplasms/metabolism ; Lung Neoplasms/mortality ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Survival Analysis
    Chemical Substances Biomarkers, Tumor ; Blood Glucose
    Language English
    Publishing date 2018-01-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2543318-0
    ISSN 1868-8500 ; 1868-8500
    ISSN (online) 1868-8500
    ISSN 1868-8500
    DOI 10.1007/s12672-018-0322-0
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  4. Article: Frequency of Silent Brain Metastasis Before Prophylactic Cranial Irradiation in Small Cell Lung Cancer.

    Yılmaz, Ufuk / Kırakli, Esra Korkmaz / Gürlek, Ümit / Özdoğan, Yasemin / Gümüş, Bahri / Akşit, Salih

    Turkish thoracic journal

    2017  Volume 18, Issue 1, Page(s) 11–13

    Abstract: Objectives: Prophylactic cranial irradiation (PCI) decreases incidence of brain metastasis and improves survival in patients with limited disease-small cell lung cancer (LD-SCLC) who achieved complete response (CR) after treatment. There is no ... ...

    Abstract Objectives: Prophylactic cranial irradiation (PCI) decreases incidence of brain metastasis and improves survival in patients with limited disease-small cell lung cancer (LD-SCLC) who achieved complete response (CR) after treatment. There is no satisfactory evidence about the necessity of new brain imaging for asymptomatic metastasis immediately prior to PCI. The present study aimed to evaluate the frequency of brain metastasis in SCLC patients without neurological symptoms who are candidates for PCI.
    Material and methods: The data files of 243 patients with SCLC referred for cranial irradiation were retrospectively reviewed. The patients with following characteristics were enrolled to the study; 1) LD-SCLC patients with CR after chemoradiotherapy who are candidates for PCI. 2) No neurological signs or symptoms of brain metastasis after chemoradiotherapy. 3) Having brain imaging at initial diagnosis and before PCI.
    Results: Ninety-nine patients (83 male, 83.3%) were included in this study. Median age was 60 years. Time interval between initial and reevaluation for brain metastasis was median 5.5 months (range; 4.7-7.1). Asymptomatic brain metastasis rate was 20.2% (18/99).
    Conclusion: Even if local disease is under control, asymptomatic brain metastasis is not rare. Therefore, patients who are candidates for PCI after completion of chemoradiotherapy should be reimaged for brain metastasis before PCI.
    Language English
    Publishing date 2017-01-01
    Publishing country Turkey
    Document type Journal Article
    ISSN 2148-7197
    ISSN 2148-7197
    DOI 10.5152/TurkThoracJ.2017.16022
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  5. Article ; Online: New Pulmonary Infiltrates Observed on Computed Tomography-Based Image Guidance for Radiotherapy Warrant Diagnostic Workup for Coronavirus Disease 2019.

    Warren, Graham W / Lim, Vun-Sin / Chowdhary, Mudit / Marwaha, Gaurav / Abd Elbadee, Osama Mostafa / Kirakli, Esra Korkmaz / Billiet, Charlotte / Marin, Alexandra Giraldo / Ramos, Monica / Suppli, Morten Hiul / McGinnis, Gwendolyn J / Adjei, Alex A

    Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer

    2021  Volume 16, Issue 11, Page(s) 1946–1951

    Abstract: Introduction: Screening for coronavirus disease 2019 (COVID-19) exposure, coupled with engaged decision making to prioritize cancer treatment in parallel with reducing risk of exposure and infection, is crucial in the management of COVID-19 during ... ...

    Abstract Introduction: Screening for coronavirus disease 2019 (COVID-19) exposure, coupled with engaged decision making to prioritize cancer treatment in parallel with reducing risk of exposure and infection, is crucial in the management of COVID-19 during cancer treatment. After two reported case studies of imaging findings during daily computed tomography (CT)-based image-guided radiotherapy (RT) scans, a call for submission of anonymized case reports was published with the objective of rapidly determining if there was a correlation between the onset of new pulmonary infiltrates found during RT and COVID-19. We hereby report the results of the aggregate analysis.
    Methods: Data of deidentified case reports for patients who developed biochemically confirmed COVID-19 during RT were submitted through an online portal. Information requested included a patient's sex, age, cancer diagnosis and treatment, and COVID-19 diagnosis and outcome. Coplanar CT-based imaging was requested to reveal the presence or absence of ground-glass opacities or infiltrates.
    Results: A total of seven reports were submitted from Turkey, Spain, Belgium, Egypt, and the United States. Results and imaging from the patients reported by Suppli et al. and McGinnis et al. were included for a total of nine patients for analysis. All patients were confirmed COVID-19 positive using polymerase chain reaction-based methods or nasopharyngeal swabs. Of the nine patients analyzed, abnormalities consistent with ground-glass opacities or infiltrates were observed in eight patients.
    Conclusions: This is the largest case series revealing the potential use of CT-based image guidance during RT as a tool for identifying patients who need further workup for COVID-19. Considerations for reviewing image guidance for new pulmonary infiltrates and immediate COVID-19 testing in patients who develop new infiltrates even without COVID-19 symptoms are strongly encouraged.
    MeSH term(s) COVID-19 ; COVID-19 Testing ; Humans ; Lung ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/radiotherapy ; SARS-CoV-2 ; Tomography, X-Ray Computed
    Language English
    Publishing date 2021-06-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2432037-7
    ISSN 1556-1380 ; 1556-0864
    ISSN (online) 1556-1380
    ISSN 1556-0864
    DOI 10.1016/j.jtho.2021.06.005
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  6. Article ; Online: Definitive chemoradiotherapy in Stage III nonsmall cell lung cancer: Turkey experience.

    Yilmaz, Ufuk / Yılmaz, Ulku / Yasar, Zehra / Kıraklı, Esra Korkmaz / Ulger, Sukran / Ozdogan, Yasemin / Demirci, Nilgun Yilmaz / Erol, Serhat / Ozdogan, Ilker / Sahin, Burcu / Koksal, Deniz / Akcay, Cimen

    Journal of cancer research and therapeutics

    2016  Volume 12, Issue 1, Page(s) 334–339

    Abstract: Aim: Concurrent chemoradiotherapy (CRT) is the standard therapy for patients with unresectable Stage III nonsmall cell lung cancer (NSCLC). The aim of this study was to assess the efficacy and safety of concurrent CRT in unresectable Stage III NSCLC in ... ...

    Abstract Aim: Concurrent chemoradiotherapy (CRT) is the standard therapy for patients with unresectable Stage III nonsmall cell lung cancer (NSCLC). The aim of this study was to assess the efficacy and safety of concurrent CRT in unresectable Stage III NSCLC in Turkey.
    Patients and methods: The study included 82 patients with histologically proven unresectable Stage III NSCLC, Eastern Cooperative Oncology Group performance status 0-1, who received concurrent CRT in two different referral centers. Treatment consisted of two cycles of cisplatin at 50 mg/m 2 on days 1, 8, 29, and 36 and etoposide 50 mg/m 2 between days 1 and 5, 29-33 and concurrent radiotherapy administered once daily, 1.8-2.0 Gy per fraction, at a total dose of 60-66 Gy.
    Results: The stages of the patients were Stage IIIA in 39 (47.5%) and IIIB in 43 (52.5%) patients. Complete and partial responses were achieved in 15 (18.2%) and 31 (37.8%) of the patients, respectively. Twenty-eight (34.2%) patients had stable disease and 8 (9.8) had progressive disease. Forty-one (50%) patients recurred during follow-up. The primary site of recurrence was as distant metastasis in 19 (23.2%) patients. Median overall survival (OS) was 20 months (95% confidence interval; 12.9-27.09 months), 3 and 4 years survivals were 27.9% and 20.9%, respectively. Median progression-free survival (PFS) was 9 months, 3 and 4 years PFSs were 20.1% and 16.1%. Myelosuppression was the most common toxicity. In 15 (19.2%) patients grade 2-3 lung toxicity and in seven (8.5%) patients' grade 2-3 dysphagia were reported.
    Conclusion: Concurrent CRT with cisplatin and etoposide schedule is a well-tolerated regimen with acceptable toxicity profile and survival rates in patients with unresectable Stage IIIA/IIIB NSCLC. Median survival and OS results were consistent with the literature.
    MeSH term(s) Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/radiotherapy ; Chemoradiotherapy ; Cisplatin/administration & dosage ; Combined Modality Therapy ; Disease-Free Survival ; Etoposide/therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Turkey ; Vinblastine/administration & dosage
    Chemical Substances Vinblastine (5V9KLZ54CY) ; Etoposide (6PLQ3CP4P3) ; Cisplatin (Q20Q21Q62J)
    Language English
    Publishing date 2016-01
    Publishing country India
    Document type Journal Article
    ZDB-ID 2187633-2
    ISSN 1998-4138 ; 0973-1482
    ISSN (online) 1998-4138
    ISSN 0973-1482
    DOI 10.4103/0973-1482.163682
    Database MEDical Literature Analysis and Retrieval System OnLINE

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