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Biomedical subjects

C Aygun

Publications and source records attributed to C Aygun.

15 recordsLinked to original sources

Does birth weight discordance in preterm twins affect neonatal outcome?

OBJECTIVE: To compare neonatal morbidity and mortality between hospitalized discordant and concordant preterm twin pairs. STUDY DESIGN: This was a retrospective, hospital-based study of preterm twins, followed in neonatal intensive care unit. Twins were classified as discordant when the difference in birth weight was >15%. Morbidity and mortality rates were compared between discordant and concordant groups. RESULTS: Of 136 preterm twins in the study, 54 were discordant and 82 were concordant. In discordant twins hypoglycemia and cesarean delivery rate was higher than concordant pairs. The mortality rate did not differ between concordant and discordant groups. CONCLUSIONS: Hospitalized preterm discordant twin pairs have an increased risk of hypoglycemia compared to concordants. Discordant growth is not a risk factor for prolonged hospitalization and increased mortality.

Adult↗

Neurofibroma of the bladder wall in von Recklinghausen's disease.

Neurofibromatosis, or von Recklinghausen's disease, is an autosomal dominant disease with multiple neurofibroma and café-au-lait spots. However, neurofibroma in the bladder wall is a rare condition in von Recklinghausen's disease. A 31-year-old man with neurogenic voiding dysfunction due to sacral meningocele and acute urinary retention with neurofibroma of the bladder wall is presented with detailed radiologic evaluation. Patients with von Recklinghausen's disease should be carefully evaluated if urological symptoms exist.

Adult↗

A case of incidentally detected Castleman's disease with retroperitoneal paravertebral localization.

Castleman's disease, or angiofollicular lymph node hyperplasia, is a fairly rare benign tumor of lymphoid origin. The expected localization is mediastinum and rarely retroperitoneum. An asymptomatic case is reported with multimodality imaging and postoperative findings. The lesion was detected incidentally on routine chest radiogram. Surgical exploration revealed a retroperitoneal mass and the mass was resected successfully through a thoracoabdominal flank incision. Castleman's disease should be included in the list of differential diagnosis of retroperitoneal masses which are mostly malignant tumors.

Adolescent↗

Small cell carcinoma of the prostate: a case report and review of the literature.

Primary small cell carcinoma of the prostate is rare. A case of primary small cell prostate cancer treated with radiation and chemotherapy is presented, and 33 previously published case reports are reviewed. Most of the patients (61%) had mixed tumors (small cell and adenocarcinoma) at diagnosis or had a history of adenocarcinoma of the prostate. Prostate specific antigen (PSA) data was available in 11 patients and was abnormal in 4 (36%). Once small cell carcinoma was diagnosed, 70% of patients had metastatic disease. Visceral metastases were common. Only one of seven patients responded to hormonal therapy, and two of eight patients responded to chemotherapy. Overall prognosis was poor.

Biopsy↗

Long-term clinical and prostate-specific antigen follow-up in 500 patients treated with radiation therapy for localized prostate cancer.

During a 14-year period, 500 consecutive patients having localized prostate cancer were treated with external beam radiotherapy with curative intent. Patients were staged according to the Whitmore-Jewett and TNM systems. Median follow-up for all patients was 69 months. Local recurrence included failures detected by rectal examination and/or prostate biopsy. Progressively elevated prostate-specific antigen (PSA) values at follow-up with no evidence of systemic disease also was considered a local treatment failure. Overall 5- and 10-year survival rates were 65% and 37%, respectively. Cause-specific 5- and 10-year survival rates were 79% and 55%, respectively. Five- and 10-year local control rates for all patients were 72% and 52%, respectively. No patient with a T1 a tumor failed locally. When follow-up PSA data were included in control criteria, 10-year local control rates for patients with T1b, T2a, and T2b-T4 tumors were 66%, 55% and 44%, respectively. If only an abnormal rectal examination and/or a positive post-treatment biopsy was considered as evidence of local failure, control rates were significantly better. Approximately one third of the study patients had died of cancer or intercurrent disease before the PSA test was used routinely. Of the 244 patients (49%) for whom follow-up PSA values were available, 116 had a normal post-treatment PSA with no evidence of disease; 94 were alive and 22 died with no evidence of prostate cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Trichoepithelioma 100 years later: a case report supporting the use of radiotherapy.

Trichoepitheliomas are rare skin tumors which can cause significant cosmetic and functional impairment when they occur in the head and neck area. Multiple methods of treatment including plastic surgery, dermabrasion, cryosurgery and laser surgery have been reported in the literature. A 32-year-old male with multiple coalesced lesions in his ear canals was treated with radiation therapy after he failed more conventional methods of treatment. He is free of tumor in the radiated area 17.5 months after treatment with significant functional improvement. Various aspects of this tumor were reviewed. More data are still needed to define the proper place for radiation in the management of this disease.

Adult↗

Treatment of non-small cell lung cancer with external beam radiotherapy and high dose rate brachytherapy.

Between August 1985 and September 1989, 62 patients with medically inoperable or surgically unresectable, non-small cell lung cancer were treated with both external beam radiotherapy and high dose rate bronchial brachytherapy. Treatment consisted of external beam radiotherapy (5000-6000 cGy in 5-6 1/2 weeks) and weekly high dose rate bronchial brachytherapy (three to five fractions, 500 cGy at 1 cm from the source) delivered either concurrently or sequentially. Median survival for all patients was 13 months (m). Stage I and Stage IIIA-B patients had median survivals of 20 m and 10 m, respectively. Patients without nodal disease (No) had a significantly longer median survival compared to patients with regional node metastases (N1-3), 17 m versus 9 m. A total of 54 patients were evaluable for local tumor control analysis. Local tumor control was achieved in six of eight patients who had a normal pre-treatment radiograph. Patients with measurable tumor on the pre-treatment radiograph and negative regional nodes had local tumor control in eight of twenty-two (36%) cases. In patients with regional lymphadenopathy, loco-regional tumor control was achieved in four of eight cases. Additionally, there were sixteen patients with non-measurable tumor due to associated effusion, atelectasis and/or infiltrate. Four of these (25%) were considered to have local tumor control. Of 60 evaluable patients, there were nine occurrences of fatal hemorrhage, one of whom was disease-free (NED) at autopsy. The remaining eight patients had either clinical or pathological evidence of recurrent or persistent tumor. Patients who had follow up bronchoscopies were found to have varying degrees of concentric narrowing in the treated areas. One such patient had total lung collapse with no evidence of tumor. While this form of treatment may yield high local control rates in earlier stages, this study suggests the potential risk of fatal complication. Additional studies are warranted to further investigate the use of this modality in the treatment of lung cancer.

Adenocarcinoma↗

Radiation therapy for transitional cell bladder carcinoma. A ten-year experience.

From 1969 to 1979, 185 patients with transitional cell bladder carcinoma were curatively irradiated; 147 were treated with radiation alone (RT) and 38 received a combined radiation + surgery (RT + S). At presentation, 40 percent of the patients had obstructive uropathy which yielded a much lower five-year survival (18%) than when it was absent (50%). The overall five-year disease-free survival was 30 percent and 53 percent for patients treated with radical RT and RT + S, respectively. Among patients subjected to preoperative irradiation, downstaging was seen in 40 percent of postsurgical specimens, with 27 percent of the specimens showing no evidence of tumor; these patients had excellent survival. Severe complications were seen in 3 percent, 10 percent, and 27 percent of patients in the radical RT, RT + S, and radical RT + salvage cystectomy groups. Survival results, pelvic controls, and patterns of failure are presented.

Adult↗

Patient immobilization during CT for treatment planning of head and neck cancer.

Immobilizers are described that have been used during computed tomography (CT) to ensure reproducibility of patient position during all phases of radiation treatment planning and delivery. The immobilizer causes no degradation or artifact on CT images; hence, the value of the images in radiation treatment planning is not compromised.

Head and Neck Neoplasms↗

Effects of radiation therapy on T-lymphocyte subpopulations in patients with head and neck cancer.

Cellular immunity was assessed in 85 patients with head and neck cancer with monoclonal antibodies to lymphocyte surface antigens that identify total T cells, helper cells, and suppressor cells. The control group consisted of 22 healthy volunteers. Nine patients who had surgical procedures for benign diseases were also studied. Compared with the controls, the patients with cancer who received radiation therapy had a significant decrease in total lymphocytes, T cells, helper cells, suppressor cells, and decreased helper/suppressor cell ratio. Significant decreases in lymphocyte subpopulations were not detected in patients tested before treatment or in patients treated with surgery alone. The immune deficits observed were prolonged in duration, with some present in the patients studied up to 11 years after radiation therapy. This long-lasting immune depression may have relevance to tumor recurrences and second primaries in patients with head and neck cancer treated by radiation therapy and to attempts at increasing cure rates with adjuvant agents that improve immune reactivity.

Carcinoma, Squamous Cell↗

Carcinoma of the floor of the mouth: a 20-year experience.

From 1955 to 1975, 116 patients with squamous cell carcinoma of the floor of the mouth were primarily treated by irradiation in the Department of Radiation Oncology, University of Maryland at Baltimore. Of these, 93 evaluable patients yielded loco-regional control rates of 83, 85, 42 and 21% for Stages I-IV, respectively. A palisading technique of radium needle implants was used, either alone or combined with external beam therapy, for early tumors (Stages I-II). Similar control rates were achieved by these two techniques: 13/14 for interstitial irradiation alone and 16/24 for combined interstitial and external irradiation. In selected early cases (Stages I-II), errors in staging were minimized by the systematic use of a needle biopsy of the submaxillary triangle for suspicious submaxillary swellings. Patients with early lesions and truly negative nodes (N0) only received irradiation to the primary tumor bed. No subsequent nodal neck failures have occurred in 13 of such patients. The overall complication rate for the entire series was 17% with only 8 patients requiring surgery. No differences in complication rates were found among the treatment modalities employed. The distribution of lymph nodal involvement by anatomical level, correlation of histological differentiation or tumor aggressiveness at presentation, the dosimetric analysis of the palisading interstitial technique, the spread and failure patterns and other observations are discussed.

Adult↗

Primary mediastinal seminoma.

Three new cases of primary mediastinal seminoma are presented, and 124 other cases in the literature are reviewed. These tumors primarily affect white males in the third decade. Chest pain is the most common symptom, but 20 per cent of the patients can be asymptomatic. Testicular atrophy occurred in only 7 patients. In one of these a testicular seminoma developed seven years after treatment of a primary mediastinal tumor. Supraclavicular adenopathies were found in 10 patients. Chest x-ray films typically show an anterior mediastinal noncalcified mass with smooth lobulated borders. Twenty-eight of 74 surgical resections attempted were successful; 13 of these received adjuvant irradiation. Of 64 cases in which radiation therapy was the primary mode of treatment, local failures occurred only in 7 cases. These tumors spread primarily by distant metastases. Theories of tumoral origin and patterns of spread are discussed. A dose of 3,000 rad in three weeks and 4,500 rad in four and one-half weeks to the mediastinum and supraclavicular areas is recommended for minimal and bulky disease. Primary mediastinal seminoma is as radiosensitive as its testicular counterpart.

Adult↗

Improved survival in cases of intracranial ependymoma after radiation therapy. Late report and recommendations.

A publication from the University of Rochester Cancer Center in 1975 suggested an improvement in the survival time of patients with intracranial ependymomas in whom an aggressive postoperative radiation therapy approach had been adopted. The regimen was tailored to the aggressiveness and spread patterns of these tumors and therefore considered the patient's age, tumor histopathology and location, and status of the subarachnoid space and cerebrospinal fluid (CSF). The authors proposed using whole brain (WB) fields for all patients with low-grade supratentorial tumors, and WB with cervical cord field extensions for low-grade infratentorial tumors if either group had no CSF or subarachnoid evidence of spinal metastases. They also proposed using craniospinal irradiation for all patients with high-grade ependymomas (regardless of location) or with low-grade infratentorial tumors with positive CSF or subarachnoid findings of spinal metastases. Recommended doses were as follows: 4500 rads to the whole brain, 5500 rads to the primary tumor volume, and 3000 to 4000 rads to the spine, depending on its subarachnoid status. Children aged 3 years or under were to receive 80% of these doses and more protracted daily treatments. Analysis of the updated experience indicates that in 51 patients treated with this approach these criteria have yielded a beneficial and consistent increase in the survival time. A 69% 10-year survival rate has been observed (75% for low-grade and 67% for high-grade ependymomas). A multifactorial analysis of survival by prognostic factors and by grouping of prognostic factors, analysis of failures, autopsy findings, and quality of survival is presented and discussed.

Adolescent↗

Treatment of unresectable lung cancer with brachytherapy.

Endobronchial brachytherapy is an evolving treatment modality. Although standard clinical indications and dosage schedules have not yet been established, the wide range of individual experience overwhelmingly demonstrates its efficacy in palliating lung cancer patients who generally have limited treatment options. Although the exact complication rate is not known, it appears to be low and the potential benefits far outweigh the risks. The role of endobronchial brachytherapy for cure is less clear. For most instances "prolonged palliation" would be a more suitable term than "cure." Further data is needed to clarify the proper place of endobronchial brachytherapy as a boost to external beam radiation therapy. The dose, fractionation scheme, and timing relative to external beam radiation therapy are based on institutional preference at this time. The historical evolution, treatment technique, results, and complications of endobronchial brachytherapy are reviewed here.

Brachytherapy↗