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Item Metadata only Survival outcomes of patients with oligometastatic non-small cell lung cancer who were treated with radical therapy: a multicenter analysis(Turkiye Klinikleri, 2023) 0000-0002-1273-1674; Açikgöz, Özgür; Bilici, Ahmet; Tataroğlu Özyükseler, Deniz; Göktaş Aydin, Sabin; Rzazade, Rashad; Ölmez, Ömer Fatih; Başak Çağlar, Hale; N/A; Selçukbiricik, Fatih; Faculty Member; School of Medicine; 202015Background/aim: Oligometastatic disease for nonsmall cell lung cancer (NSCLC) patients is generally thought to represent a better prognosis with a quieter biology, limited number of disease sites and long-term disease control. In this study, we aimed to determine the efficacy of radical treatment options for patients with oligometastatic NSCLC. Materials and methods: This retrospective trial included totally 134 patients with oligometastatic NSCLC. The presence of oncodriver mutation, tumor stages and nodal status, the number of metastases and involved metastatic site, treatment of primary tumor and oligometastasis, response rate, overall survival (OS) and progression-free survival (PFS) were evaluated. Results: Of 134 patients 66.4% were defined as adenocarcinoma, 26.1% were squamous cell carcinoma and 7.5% of patients were in other histology. Based on the treatment of primary tumor, in 36 patients (26.9%) curative surgery has undergone, in addition, 19 (14.2%) patients were received chemotherapy, 73 (54.5%) were treated with chemoradiotherapy, while immunotherapy and targeted therapy were used in 1 (0.7%) and 2 (1.4%), respectively. The preferred treatment for oligometastatic lesions were SBRT in 72.4% of patients, surgery in 10.5%, and both SBRT and surgery in 17.1% of patients. At the median follow up of 31.3 months (range: 9.5–48.5), the median PFS and OS times were 17 and 24.4 months, respectively. Moreover, OS-2 after progression was also 7.2 months. Conclusion: Based on our real-life experience, we demonstrated a significant correlation between good response to first treatment and survival in oligometastatic disease, we also understand that local ablative treatment modalities prolong and also delay both OS and PFS in oligometastatic NSCLC patients OS-2. © TÜBİTAK.Item Metadata only Taboo words in pediatric oncology: communication experiences of nurses and physicians with dying children and their families(Elsevier, 2023) 0000-0002-0083-7754; Aydın A, Bingöl H, Kebudi R.; N/A; Umaç, Eyşan Hanzade; PhD Student; Graduate School of Health SciencesPurpose: Despite the numerous benefits of effective communication between patients, families, and healthcare professionals, there are still substantial barriers and communication challenges. This study investigated the experiences of nurses and doctors working in different pediatric hematology-oncology units in Turkey communicating with children and their parents about end-of-life issues. Method: This qualitative study was conducted with twenty-four physicians and nurses. A descriptive phenomenological approach was used. Data were analyzed using Braun and Clarke's six-step reflexive thematic analysis. The MAXQDA software was used to facilitate data management. Results: The findings revealed three main themes describing end-of-life communication experiences of physicians and nurses: Avoiding communication with a dying child, Everyone knows but nobody talks, and Complicating aspects of the setting. Conclusions: Communication with dying children and their families is essential. However, multiple barriers remain for healthcare providers to do so. That issue burdens the child and their family more during the end-of-life, which is already a challenging experience to handle. Healthcare professionals need urgent training in communication with the dying children and their families.Item Metadata only Nance-horan syndrome: characterization of dental, clinical and molecular features in three new families(BMC, 2023) 0000-0003-0376-499X; 0000-0002-1326-0608; 0000-0002-7674-7384; 0000-0002-3172-5368; 0000-0002-3734-489X; Kalayci, Tugba; Altunoglu, Umut; Uyguner, Zehra Oya; N/A; N/A; N/A; N/A; N/A; Kayserili, Hülya; Börklü Yücel, Esra; Eraslan, Serpil; Altunoğlu, Umut; Saraçoğlu, Hilal Pırıl; Faculty Member; Other; Other; Faculty Member; PhD Student; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Graduate School of Health Sciences; 7945; N/A; N/A; 126174; N/ABackgroundNance-Horan syndrome (NHS; MIM 302,350) is an extremely rare X-linked dominant disease characterized by ocular and dental anomalies, intellectual disability, and facial dysmorphic features.Case presentationWe report on five affected males and three carrier females from three unrelated NHS families. In Family 1, index (P1) showing bilateral cataracts, iris heterochromia, microcornea, mild intellectual disability, and dental findings including Hutchinson incisors, supernumerary teeth, bud-shaped molars received clinical diagnosis of NHS and targeted NHS gene sequencing revealed a novel pathogenic variant, c.2416 C > T; p.(Gln806*). In Family 2, index (P2) presenting with global developmental delay, microphthalmia, cataracts, and ventricular septal defect underwent SNP array testing and a novel deletion encompassing 22 genes including the NHS gene was detected. In Family 3, two half-brothers (P3 and P4) and maternal uncle (P5) had congenital cataracts and mild to moderate intellectual deficiency. P3 also had autistic and psychobehavioral features. Dental findings included notched incisors, bud-shaped permanent molars, and supernumerary molars. Duo-WES analysis on half-brothers showed a hemizygous novel deletion, c.1867delC; p.(Gln623ArgfsTer26).ConclusionsDental professionals can be the first-line specialists involved in the diagnosis of NHS due to its distinct dental findings. Our findings broaden the spectrum of genetic etiopathogenesis associated with NHS and aim to raise awareness among dental professionals.Item Metadata only Frameless hypofractionated gamma knife radiosurgery for residual or recurrent craniopharyngioma(Lippincott Williams and Wilkins, 2023) 0000-0003-3057-3355; 0000-0001-8952-6866; 0000-0001-7126-6373; N/A; N/A; 0000-0001-8325-2382; Essibayi, Muhammed Amir; Askeroglu, Mehmet Orbay; Budak, Mustafa; Karakose, Fatih; N/A; N/A; N/A; N/A; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Askeroğlu, Mehmet Orbay; Budak, Mustafa; Karaköse, Fatih; Essibayi, Muhammed Amir; Faculty Member; Faculty Member; Other; Other; Other; Other; School of Medicine; School of Medicine; N/A; N/A; N/A; N/A; Koç University Hospital; 11480; 275252; N/A; N/A; N/A; N/ABACKGROUND:The management of craniopharyngiomas is challenging, usually requiring multidisciplinary care. Gamma Knife radiosurgery (GKRS) is an essential technique for residual/recurrent craniopharyngiomas.OBJECTIVE:To evaluate the efficacy of frameless hypofractionated GKRS (hfGKRS) for craniopharyngioma and factors which affect tumor control and complications.METHODS:This retrospective study involved 24 patients managed with hfGKRS. Clinical and radiological data, tumor characteristics, and procedural details were analyzed.RESULTS:There were 15 (62.5%) female patients. The median age was 38.5 years (range, 3-66 years). The mean tumor volume was 2.4 (1.93) cm(3), with a mean solid volume of 1.6 (1.75) cm(3). The median marginal dose was 20 Gy (range, 18-25 Gy) delivered in a median of 5 fractions (range, 3-5). During a median radiological follow-up of 23.5 months (range, 12-50 months), tumor progression was noted in 5 (20.8%) patients. The 2-year and 4-year progression-free survival were 81.8% and 61.4%, respectively. No deaths were identified at a median clinical follow-up of 31.3 months (range, 12-54 months). Visual deficits attributable to progression were noted in 3 (12.5%) patients with pre-GKRS visual field defects. An additional 4 (16.7%) patients with pre-GKRS visual deficit developed new minor visual field defects. Four (16.7%) patients showed improvement of vision after GKRS. There were no new-onset post-GKRS hormonal deficits.CONCLUSION:The management of craniopharyngioma requires a multidisciplinary approach, and irradiation represents effective treatment option for residual/recurrent tumors after surgery. To the best of our knowledge, this is the first study that addresses the efficacy of frameless hfGKRS in managing craniopharyngiomas over sufficient follow-up.Item Metadata only Long-term efficacy of gamma knife radiosurgery on pain control in trigeminal neuralgia(Turkish Neurosurgical Soc, 2023) 0000-0003-3057-3355; 0000-0001-8952-6866; Ozturk, Gulsah; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 11480; 275252AIM: To investigate the efficacy of Gamma Knife radiosurgery (GKRS) in patients with Burchiel type 1 and 2 trigeminal neuralgia (TN). MATERIAL and METHODS: A retrospective analysis of prospectively collected data of 163 patients who underwent GKRS between December 2006 and December 2021 was performed. The median follow-up was 37 (range, 6-168) months. The target was the cisternal portion of the trigeminal nerve, and the median prescribed dose was 85 (range, 75-90) Gy. Pain severity was evaluated using the Barrow Neurological Institute (BNI) pain intensity score. All patients had BNI IV or V before GKRS. BNI IIIb or better was defined as adequate pain relief. Logistic regression analysis was conducted to determine the prognostic significance of different pretreatment and treatment variables. RESULTS: The initial pain relief rate was 85%, with a median period of 25 (range, 1-90) days. At the final follow-up, 62.5% of patients had adequate pain relief. BNI I was achieved in 8% of patients within the first 24 h after GKRS; this rate was 22% at the final follow-up. The pain-free interval was significantly shorter in the 75 Gy group than in the 90 Gy group (p=0.04). The predicted adequate pain relief rates at the 3rd and 6th month and 1st, 3rd, 5th, and 7th year were 84%, 79%, 76%, 67%, 59%, and 55%, respectively. The complication rate was 8%, with disturbing facial sensorial dysfunction in four patients, decreased corneal reflex in three patients, and masseter dysfunction in six patients. Univariate and multivariate logistic regression analyses revealed Burchiel type 1 TN (p=0.001) and male gender (p=0.037) as predictors of increased initial pain relief rate and shorter time to initial pain relief day, respectively. CONCLUSION: Appropriate patient selection is the key to successful TN treatment. GKRS can be recommended, especially for patients with Burchiel type 1 TN, with low complication rates and effective long-term pain relief.Item Metadata only Pallidal deep brain stimulation improves HPCA-Linked (DYT 2) dystonia(Wiley, 2023) 0000-0003-3057-3355; 0000-0001-8952-6866; Samanci, Bedia; Sahin, Erdi; Bilgic, Basar; Atasu, Burcu; Lohmann, Ebba; Hanagasi, Hasmet A.; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 11480; 275252Item Metadata only Letter: international tuberculum sellae meningioma study: surgical outcomes and management trends(Lippincott Williams and Wilkins, 2023) 0000-0003-3057-3355; 0000-0001-8952-6866; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 11480; 275252Trigeminal neuralgia affects approximately 2% of patients with multiple sclerosis (MS) and often shows higher rates of pain recurrence after treatment. Previous studies on the effectiveness of stereotactic radiosurgery (SRS) for trigeminal neuralgia did not consider the different MS subtypes, including remitting relapsing (RRMS), primary progressive (PPMS), and secondary progressive (SPMS). Our objective was to investigate how MS subtypes are related to pain control (PC) rates after SRS. METHODS: We conducted a retrospective multicenter analysis of prospectively collected databases. Pain status was assessed using the Barrow National Institute Pain Intensity Scales. Time to recurrence was estimated through the Kaplan-Meier method and compared groups using log-rank tests. Logistic regression was used to calculate the odds ratio (OR). RESULTS: Two hundred and fifty-eight patients, 135 (52.4%) RRMS, 30 (11.6%) PPMS, and 93 (36%) SPMS, were included from 14 institutions. In total, 84.6% of patients achieved initial pain relief, with a median time of 1 month; 78.7% had some degree of pain recurrence with a median time of 10.2 months for RRMS, 8 months for PPMS, 8.1 months for SPMS (P =.424). Achieving Barrow National Institute-I after SRS was a predictor for longer periods without recurrence (P =.028). Analyzing PC at the last available follow-up and comparing with RRMS, PPMS was less likely to have PC (OR = 0.389; 95% CI 0.153-0.986; P =.047) and SPMS was more likely (OR = 2.0; 95% CI 0.967-4.136; P =.062). A subgroup of 149 patients did not have other procedures apart from SRS. The median times to recurrence in this group were 11.1, 9.8, and 19.6 months for RRMS, PPMS, and SPMS, respectively (log-rank, P =.045). CONCLUSION: This study is the first to investigate the relationship between MS subtypes and PC after SRS, and our results provide preliminary evidence that subtypes may influence pain outcomes, with PPMS posing the greatest challenge to pain management. © Congress of Neurological Surgeons 2023. All rights reserved.Item Metadata only Assessing the impact of distortion correction on gamma knife radiosurgery for multiple metastasis: volumetric and dosimetric analysis(Elsevier B.V., 2024) 0000-0003-3057-3355; 0000-0001-8952-6866; 0000-0001-7126-6373; 0000-0002-2535-9832; N/A; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Askeroğlu, Mehmet Orbay; Düzkalır, Ali Haluk; Faculty Member; Faculty Member; Other; Doctor; School of Medicine; School of Medicine; N/A; N/A; Koç University Hospital; 11480; 275252; N/A; N/AIntroduction: Magnetic resonance imaging (MRI) is a robust neuroimaging technique and is the preferred method for stereotactic radiosurgery (SRS) planning. However, MRI data always contain distortions caused by hardware and patient factors. Research question: Can these distortions potentially compromise the effectiveness and safety of SRS treatments? Material and methods: Twenty-six MR datasets with multiple metastatic brain tumors (METs) used for Gamma Knife radiosurgery (GKRS) were retrospectively evaluated. A commercially available software was used for distortion correction. Geometrical agreement between corrected and uncorrected tumor volumes was evaluated using MacDonald criteria, Euclidian distance, and Dice similarity coefficient (DSC). SRS plans were generated using uncorrected tumor volumes, which were assessed to determine their coverage of the corrected tumor volumes. Results: The median target volume was 0.38 cm3 (range,0.01–12.38 cm3). A maximum displacement of METs of up to 2.87 mm and a median displacement of 0.55 mm (range,0.1–2.87 mm) were noted. The median DSC between uncorrected and corrected MRI was 0.92, and the most concerning case had a DSC of 0.46. Although all plans met the optimization criterion of at least 98% of the uncorrected tumor volume (median 99.55%, range 98.1–100%) receiving at least 100% of the prescription dose, the percent of the corrected tumor volume receiving the total prescription dose was a median of 95.45% (range,23.1–99.5%). Discussion and conclusion: MRI distortion, though visually subtle, has significant implications for SRS planning. Regular utilization of corrected MRI is recommended for SRS planning as distortion is sometimes enough to cause a volumetric miss of SRS targets. © 2024 The AuthorsItem Metadata only Stereotactic radiosurgery for meningiomas in children and adolescents: an international multi-institutional study(Lippincott Williams and Wilkins, 2023) 0000-0003-3057-3355; 0000-0001-8952-6866; 0000-0001-7126-6373; Nabeel, Ahmed M.; Reda, Wael A.; Tawadros, Sameh R.; Abdelkarim, Khaled; El-Shehaby, Amr M. N.; Emad, Reem M.; Legarreta, Andrew; Fernandes Cabral, David; Anand, Sharath; Niranjan, Ajay; Lunsford, L. Dade; Tripathi, Manjul; Kumar, Narendra; Liscak, Roman; May, Jaromir; Lee, Cheng-chia; Yang, Huai-che; Moreno, Nuria Martinez; Alvarez, Roberto Martinez; Douri, Keiss; Mathieu, David; Pikis, Stylianos; Mantziaris, Georgios; Sheehan, Jason P.; Bernstein, Kenneth; Kondziolka, Douglas; N/A; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Askeroğlu, Mehmet Orbay; Faculty Member; Faculty Member; Other; School of Medicine; School of Medicine; N/A; Koç University Hospital; 11480; 275252; N/ABACKGROUND AND OBJECTIVES: Meningiomas in children are uncommon, with distinct characteristics that set them apart from their adult counterparts. The existing evidence for stereotactic radiosurgery (SRS) in this patient population is limited to only case series. The objective of this study was to evaluate the safety and efficacy of SRS in managing pediatric meningiomas.METHODS: Children and adolescents who had been treated for meningioma with single-fraction SRS were included in this retrospective, multicenter study. The assessment included local tumor control, any complications related to the tumor or SRS, and the emergence of new neurological deficits after SRS.RESULTS: The cohort included 57 patients (male-to-female ratio 1.6:1) with a mean age of 14.4 years who were managed with single-fraction SRS for 78 meningiomas. The median radiological and clinical follow-up periods were 69 months (range, 6-268) and 71 months (range, 6-268), respectively. At the last follow-up, tumor control (tumor stability and regression) was achieved in 69 (85.9%) tumors. Post-SRS, new neurological deficits occurred in 2 (3.5%) patients. Adverse radiation effects occurred in 5 (8.8%) patients. A de novo aneurysm was observed in a patient 69 months after SRS.CONCLUSION: SRS seems to be a safe and effective up-front or adjuvant treatment option for surgically inaccessible, recurrent, or residual pediatric meningiomas.Item Metadata only Epilepsy associated with cerebral cavernous malformations managed with stereotactic radiosurgery: an international, multicenter study(Springer Heidelberg, 2023) 0000-0003-3057-3355; 0000-0001-8952-6866; 0000-0002-4154-5571; Dumot, Chloe; Mantziaris, Georgios; Pikis, Stylianos; Dayawansa, Sam; Xu, Zhiyuan; Ardor, Gokce D.; Peker, Selcuk; Nabeel, Ahmed M.; Reda, Wael A.; Tawadros, Sameh R.; Abdel Karim, Khaled; El-Shehaby, Amr M. N.; Eldin, Reem M. Emad; Elazzazi, Ahmed H.; Moreno, Nuria Martinez; alvarez, Roberto Martinez; Liscak, Roman; May, Jaromir; Mathieu, David; Tourigny, Jean-Nicolas; Tripathi, Manjul; Rajput, Akshay; Kumar, Narendra; Kaur, Rupinder; Picozzi, Piero; Franzini, Andrea; Speckter, Herwin; Hernandez, Wenceslao; Brito, Anderson; Warnick, Ronald E.; Alzate, Juan; Kondziolka, Douglas; Bowden, Greg N.; Patel, Samir; Sheehan, Jason P.; N/A; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Ardor, Gökçe Deniz; Faculty Member; Faculty Member; Researcher; School of Medicine; School of Medicine; N/A; Koç University Hospital; 11480; 275252; N/AObjectiveStereotactic radiosurgery (SRS) has been proposed as an alternative to resection for epilepsy control in patients with cerebral cavernous malformations (CCM) located in critical areas.MethodsThis multicentric, retrospective study evaluated seizure control in patients with a solitary CCM and a history of at least one seizure prior to SRS.Results109 patients (median age at diagnosis 28.9 years, interquartile range (IQR) 16.4 years] were included. Prior to SRS, 2 (1.8%) were seizure-free without medication, 35 (32.1%) were seizure-free with antiseizure medications (ASM), 17 (15.6%) experienced an improvement of at least 50% in seizure frequency/intensity with ASM, and 55 (50.5%) experienced an improvement of less than 50% in seizure frequency/intensity with ASM. At a median follow-up of 3.5 years post-SRS (IQR: 4.9), 52 (47.7%) patients were Engel class I, 13 (11.9%) class II, 17 (15.6%) class III, 22 (20.2%) class IVA or IVB and 5 (4.6%) class IVC. For the 72 patients who had seizures despite medication prior to SRS, a delay > 1.5 years between epilepsy presentation and SRS decreased the probability to become seizure-free, HR 0.25 (95% CI 0.09-0.66), p = 0.006. The probability of achieving Engel I at the last follow-up was 23.6 (95% CI 12.7-33.1) and 31.3% (95% CI 19.3-50.8) at 2 and 5 years respectively. 27 patients were considered as having drug-resistant epilepsy. At a median follow-up of 3.1 years (IQR: 4.7), 6 (22.2%) of them were Engel I, 3 (11.1%) Engel II, 7 (25.9%) Engel III, 8 (29.6%) Engel IVA or IVB and 3 (11.1%) Engel IVC.Interpretation47.7% of patients managed with SRS for solitary CCM presenting with seizures achieved Engel class I at the last follow-up.