Fadil Akyol

Hacettepe University, Engüri, Ankara, Turkey

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Publications (74)250.11 Total impact

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    ABSTRACT: To evaluate the radioprotective efficacy of amifostine on irradiated mature rat retina. A total of 108 Wistar albino rats were categorized into 3 groups, namely, apoptosis (n = 48), acute effects (n = 40), and late changes in retinal cell layers (n = 20). Each group was further subcategorized into 4 arms: control, amifostine (A), radiotherapy + placebo (RT), and RT + A arms, respectively. Intraperitoneal amifostine (260 mg/kg) was administrated to A and RT + A arms 30 minutes before irradiation. Control and A groups were sham-irradiated, whereas a single dose of 20 Gy whole-cranium irradiation was delivered to RT and RT + A arms. Apoptosis was assessed in 8, 12, and 18 hours after irradiation. Electron microscope was used 2 weeks after irradiation for evaluation and scoring of early morphologic changes in retina. Late effects were assessed and scored accordingly by using both the electron and the light microscope on Week 10. At acute phase, although no notable change was seen in 8 hours, significant increase in apoptosis was detected in 12 hours in RT arm (P = 0.029). Comparative analyses between the groups in 3 different time points displayed a higher apoptotic rate in RT group than the RT + A group (P = 0.008). Similarly, comparisons between groups for late effects on the basis of electron microscopic findings revealed lower scores in the RT + A than the RT arm (P < 0.001). This study suggested a potential radioprotective role for amifostine on mature rat retina by reducing radiation-induced apoptosis in retinal cells. These results form a basis for such preclinical investigations and call for future clinical studies.
    Retina (Philadelphia, Pa.) 03/2015; 35(7). DOI:10.1097/IAE.0000000000000493 · 3.24 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the efficacy and toxicity of robotic CyberKnife (Accuray Incorporated, Sunnyvale, California)-based stereotactic body radiation therapy (SBRT) in patients with recurrent or metastatic abdominopelvic tumors. A total of 69 patients treated between May 2008 and January 2011 were evaluated retrospectively. Indication for SBRT was persistent disease in 3 (4%) patients, local recurrence in 29 (42%) patients, regional recurrence in 13 (19%) patients, and oligometastatic disease in 24 (35%) patients. Forty-two (61%) patients were previously irradiated to the same region and 27 (39%) patients were treated for the first time. The median age was 59 years (range, 24-86 years). There were 31 (45%) male and 38 (55%) female patients. The median total dose was 30 Gy (range, 15-60 Gy) delivered with a median 3 fractions (range, 2-5 fractions). The tumor response to treatment was assessed by computed tomography, magnetic resonance imaging, or positron emission tomography. At the 12-month (range, 2-44 months) median follow-up, local control was 65% and median overall survival (OS) was 20 months. A larger gross tumor volume (≥ 67 cm(3)) was significantly correlated with worse 1-year OS (81% vs 48%, P = .03). The patients with local recurrence occurring <11 months had a significantly shorter 1-year local control rate than patients with ≥11 months (31% vs 91%, P < .001). Grade 3-4 acute and late toxicities were seen in 7% and 15% of patients, respectively. The patients with previous radiotherapy history had significantly higher rate of acute toxicity (19% vs 0%, P = .019). Late toxicity was significantly higher in pelvic tumors than in abdominal tumors (3% vs 28%, P = .004). The SBRT seems to be feasible and resulted in good treatment outcomes in patients with recurrent or metastatic abdominopelvic tumors. © The Author(s) 2015.
    Technology in cancer research & treatment 02/2015; 90(1). DOI:10.1177/1533034615571353 · 1.73 Impact Factor
  • P. Hurmuz · F. Akyol · G. Ozyigit · Y. Ozdemir · E. Karabulut · H. Ozen ·

    Radiotherapy and Oncology 12/2014; 111:S88. DOI:10.1016/S0167-8140(15)31418-3 · 4.36 Impact Factor
  • F. Yedekci · M. Yeginer · H. Kivanc · M. Gürkaynak · F. Akyol ·

    Radiotherapy and Oncology 12/2014; 111:S151-S152. DOI:10.1016/S0167-8140(15)31594-2 · 4.36 Impact Factor
  • G. Ozyigit · F. Akyol · Y. Ozdemir · P. Hurmuz · E. Karabulut · H. Ozen ·

    Radiotherapy and Oncology 12/2014; 111:S89. DOI:10.1016/S0167-8140(15)31420-1 · 4.36 Impact Factor
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    ABSTRACT: Treatment choices for recurrent glioblastoma patients are sparse and the results are not satisfactory. In this retrospective analysis, we evaluated the results of re-irradiation of locally recurrent glioblastoma patients with an image-guided, fractionated, frameless stereotactic radiotherapy (SRT) technique. We treated 37 patients with the diagnosis of recurrent glioblastoma from September 2009 to December 2011. SRT was performed in a median five fractions (range, 1–5 fractions) with CyberKnife® (Accuray Incorporated, Sunnyvale, CA, USA). The dose given ranged from 14 to 32 Gy (median, 30 Gy). The median volume of the GTV was 24 cc (range, 2–81 cc). Median follow-up was 9.3 months. Five patients had regression in their lesions, 14 had stable disease, progression was observed in eight patients, and seven patients had pseudoprogression. The median survival following SRT was 10.6 months (range, 1.1–20 months) and overall survival following initial treatment was 35.5 months. The time to progression following SRT was 7.9 months in median. Patients with pseudoprogression had significantly longer survival after the first magnetic resonance imaging (MRI) compared to those with regression, stable or progressive disease (p = 0.012). The median survival after SRT for patients with pseudoprogression was 20 months. Patients who had GTV
    Journal of Neuro-Oncology 07/2014; 120(1). DOI:10.1007/s11060-014-1524-0 · 3.07 Impact Factor
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    Meme Sagligi Dergisi / Journal of Breast Health 05/2014; 10(2):106-110. DOI:10.5152/tjbh.2014.2018
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    ABSTRACT: This study aimed to compare the therapeutic outcomes and fatal carotid blow out syndrome (CBOS) incidence rates between two different stereotactic body radiotherapy (SBRT) protocols. The study included 75 patients with inoperable locally recurrent head and neck cancer treated with SBRT in our department between June 2007 and March 2011. The first 43 patients were treated sequentially (group I). Then our SBRT protocol was changed due to the high rate of CBOS, and the following 32 patients were treated every other day in a prospective institutional protocol (group II). Median overall survival in group I and group II was 11 months and 23 months, respectively (P = 0.006). We observed 11 cases of CBOS. Only 1 of 7 patients (14%) with CBOS survived in group I, whereas 2 of 4 patients (50%) in group II remain alive. CBOS free median overall survivals were 9 months, and 23 months in group I and group II respectively (P = 0.002). The median radiation dose received by the carotid artery in patients with CBOS was 36.5 Gy (range: 34--42.8 Gy), versus 34.7 Gy (range: 0--44 Gy) in the patients that didn't have CBOS (P = 0.15). CBOS did not occur in any of the patients with a maximum carotid artery radiation dose <34 Gy. Every other day SBRT protocol for re-irradiation of recurrent head and neck cancer is promising in terms of decreasing the incidence of fatal CBOS.
    Radiation Oncology 10/2013; 8(1):242. DOI:10.1186/1748-717X-8-242 · 2.55 Impact Factor
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    ABSTRACT: The aim of this retrospective study is to evaluate our therapeutic results in patients with paranasal sinus (PNS) or nasal cavity (NC) malignancies treated with robotic stereotactic radiosurgery (SRS). Between August 2007 and October 2008, 27 patients with PNS or NC tumors were treated in our department using SRS. Median age was 53 years (range, 27-84 years). Eleven patients were female and sixteen were male. Most common histopathology was SCC (44%). The disease involved the maxillary sinus in 15 patients (55%). SRS was applied to 6 patients (22%) for reirradiation, while the others received it as a primary treatment. Seven patients had SRS as a boost dose to external beam radiotherapy. SRS was delivered with cyberknife (Accuray Incorporated, Sunnyvale, CA, USA). The median dose to the tumor was 31 Gy (range, 15-37.5 Gy) in median 5 fractions (range, 3-5 fractions). After a median follow-up of 21.4 months (range, 3-59 months), 76% of the patients were free of local relapse. Three patients showed local progression and 3 developed distant metastases. One- and two-year survival rates for the entire group were 95.2% (SEM = 0.046) and 77.1% (SEM = 0.102), respectively. We observed brain necrosis in 2 patients, visual disorder in 2 patients, bone necrosis in 2 patients and trismus in 1 patient as a SRS related late toxicity. Robotic SRS seems to be a feasible treatment strategy for patients with PNS tumors. Further prospective studies with longer follow up times should be performed.
    Technology in cancer research & treatment 08/2013; 13(5). DOI:10.7785/tcrtexpress.2013.600264 · 1.73 Impact Factor
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    F Zorlu · M Gultekin · M Cengiz · F Yildiz · F Akyol · M Gurkaynak · G Ozyigit ·
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    ABSTRACT: Chordomas are uncommon neoplasms and there is still controversy regarding establishment of diagnosis and management. The aim of this study was to evaluate efficacy and toxicity of fractionated stereotactic radiosurgery (FSRS) in skull base chordomas. There were 4 female (36%) and 7 male (64%) patients. FSRS was delivered with CyberKnife (Accuray Inc., Sunnyvale, CA). The median tumor volume was 14.7 cc (range, 3.9-40.5 cc). The median marginal tumor dose was 30 Gy (range, 20-36 Gy) in a median 5 fractions (range, 3-5 fractions). The median follow-up time was 42 months (range, 17-63 months). At the time of analysis, 10 (91%) patients were alive and 1 (9%) had died due to tumor progression. Of 10 patients, 8 (73%) had stable disease and the remaining 2 (18%) had progressive disease. The actuarial overall survival (OS) after FSRS was 91% at two-years. Two patients developed radiation-induced brain necrosis as a complication in the 8th and 28th months of follow-up, respectively. Our results with robotic FSRS in skull base chordomas are promising for selected patients. However, due to the slow growth pattern of skull base chordomas, a longer follow-up is required to determine exact treatment results and late morbidity.
    Technology in cancer research & treatment 06/2013; 13(1). DOI:10.7785/tcrt.2012.500354 · 1.73 Impact Factor
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    ABSTRACT: Purpose: The authors evaluated the absorbed dose received by the gonads during robotic stereotactic radiosurgery (SRS) for the treatment of different tumor localizations. Methods: The authors measured the gonad doses during the treatment of head and neck, thoracic, abdominal, or pelvic tumors in both RANDO phantom and actual patients. The computerized tomography images were transferred to the treatment planning system. The contours of tumor and critical organs were delineated on each slice, and treatment plans were generated. Measurements for gonad doses were taken from the geometric projection of the ovary onto the skin for female patients, and from the scrotal skin for male patients by attaching films and Thermoluminescent dosimeters (TLDs). SRS was delivered with CyberKnife (Accuray Inc., Sunnyvale, CA). Results: The median gonadal doses with TLD and film dosimeter in actual patients were 0.19 Gy (range, 0.035-2.71 Gy) and 0.34 Gy (range, 0.066-3.18 Gy), respectively. In the RANDO phantom, the median ovarian doses with TLD and film dosimeter were 0.08 Gy (range, 0.03-0.159 Gy) and 0.05 Gy (range, 0.015-0.13 Gy), respectively. In the RANDO phantom, the median testicular doses with TLD and film dosimeter were 0.134 Gy (range 0.056-1.97 Gy) and 0.306 Gy (range, 0.065-2.25 Gy). Conclusions: Gonad doses are below sterility threshold in robotic SRS for different tumor localizations. However, particular attention should be given to gonads during robotic SRS for pelvic tumors.
    Medical Physics 04/2013; 40(4):041703. DOI:10.1118/1.4794180 · 2.64 Impact Factor
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    ABSTRACT: Sinonasal mucosal melanoma (SNMM) is a rare entity originating from melanocytes of the sinonasal mucosa. Postoperative radiotherapy is recommended in all cases to increase local control. However, external radiotherapy is rarely used as a definitive treatment modality. In this report, we present 4 cases of SNMM treated with CyberKnife (Accuray, Sunnyvale, CA). All patients were immobilized with a thermoplastic mask. A planning CT scan with 1-mm thickness was obtained, and these images were fused with MRI for the contouring procedure. Multiplan (Accuray) inverse planning software was used for treatment planning. Robotic stereotactic body radiotherapy (SBRT) was delivered with CyberKnife. Median follow-up was 26 months. Three patients had complete response to CyberKnife, and 1 patient had partial response. Robotic SBRT seems to be an appealing treatment option for local control. Effective systemic treatment is required to prevent distant metastases. © 2011 Wiley Periodicals, Inc. Head Neck, 2013
    Head & Neck 03/2013; 35(3). DOI:10.1002/hed.21895 · 2.64 Impact Factor
  • P Hurmuz · M Cengiz · G Ozyigit · G Yazici · F Akyol · F Yildiz · M Gurkaynak · F Zorlu ·
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    ABSTRACT: We evaluated the treatment results of robotic stereotactic radiosurgery (SRS) in our patients with unresectable glomus jugulare tumors (GJTs). The medical charts of fourteen patients with GJT, who were treated with robotic SRS, were retrospectively evaluated. The gross tumor volume was described as the clinical target volume. The median dose to the tumor was 25 Gy in median 5 fractions. The dose was normalized to 80% isodose line. All patients were evaluated for tumor growth and clinical outcome every 6 months in the first 2 years and then annually. Median follow-up was 39 months (range, 7-60 months). Lesions were stable in 8 patients, and tumor regression was observed in 6 patients. We did not observe any treatment related toxicity in our patients. In conclusion, according to our early experience, robotic SRS seems to be successful treatment option in the management of unresectable GJTs.
    Technology in cancer research & treatment 09/2012; 12(2). DOI:10.7785/tcrt.2012.500303 · 1.73 Impact Factor
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    ABSTRACT: The purpose of this study was to investigate the prognostic factors and treatment results of T1N0M0 glottic laryngeal carcinoma irradiated with 2.3 Gray (Gy) per fraction. A total of 183 patients with glottic carcinoma treated between June 1998 and January 2007 were retrospectively evaluated. Of the 183 patients, 163 patients (89%) had T1a and 20 patients (11%) had T1b disease. All patients received 2.3 Gy per fraction to a median total dose of 64.4 Gy. The median follow-up was 63 months. The 5-year overall survival (OS), local control, and cancer-specific survival rates were 89%, 81%, and 90%, respectively. Multivariate analysis showed overall treatment time and age to be significant prognostic factors for local control and OS. We observed no grade IV or grade V acute toxicity. Trachea-esophageal fistula as late toxicity was observed in only 1 patient. High daily fraction scheme seems to be a feasible schedule for early glottic carcinomas.
    Head & Neck 07/2012; 34(7):1009-14. DOI:10.1002/hed.21860 · 2.64 Impact Factor
  • F Biltekin · G Özyigit · D Celik · M Yeginer · F Akyol · M Cengiz · F Yildiz ·
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    ABSTRACT: Purpose: In this study, the neutron measurements were performed in free in air and RW3 solid water phantom to estimate the secondary malignancy risk for three dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT) techniques in prostate cancer treatment. Methods: Neutron dose were measured in 18 MV Elekta Synergy Platform and Varian Clinac linear accelerators by using bubble detector for personal neutron dosimetry (BD-PND). To determine the neutron equivalent dose in different depths and different distance from the edge of treatment field RW3 solid water phantom was used and organs location was defined in Alderson Rando phantom with respect to target (prostate) position in the treatment field. By using these data, we determined the neutron equivalent dose and effective dose for the standard prostate cancer patient treated with 3D-CRT and IMRT with 18 MV photon energy. The total dose was 70 Gy in 3D-CRT and 76 Gy in IMRT treatment in the current study. For both of these treatment techniques, we estimated the risk of secondary malignancies due to the neutron contamination by using the International Commission on Radiological Protection (ICRP) report 103. Results: The equivalent dose and effective dose due the neutron contamination were considerably high in 18 MV IMRT technique. The secondary malignancy risk estimation for 3D-CRT and IMRT were found to be 0.44% and 1.15% for Elekta Synergy Platform linear accelerator, 0.92% and 2.38% for the Varian Clinac DHX High Performance linear accelerator, respectively. Conclusions: Therefore, one should take care of the secondary malignancy risk in case of using 18 MV in IMRT applications.
    Medical Physics 06/2012; 39(6):3751. DOI:10.1118/1.4735269 · 2.64 Impact Factor

  • Radiotherapy and Oncology 05/2012; 103:S277. DOI:10.1016/S0167-8140(12)71046-0 · 4.36 Impact Factor

  • Radiotherapy and Oncology 05/2012; 103:S492-S493. DOI:10.1016/S0167-8140(12)71629-8 · 4.36 Impact Factor

  • Radiotherapy and Oncology 05/2012; 103:S568. DOI:10.1016/S0167-8140(12)71820-0 · 4.36 Impact Factor
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    ABSTRACT: In this single center study, we aimed to assess quality of life and cognitive and emotional distress in patients treated for high-grade glioma. A hundred and eighteen patients with high-grade glioma were prospectively enrolled. We assessed HRQoL at baseline (after surgery before radiotherapy), at the end of radiotherapy and during follow-up (every 3 months for the first 2 years and every 6 months between 2 and 5 years) using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC-C30), Brain Cancer Module-20 (BN-20), Minimental State Examination (MMSE) and Hospital Anxiety and Depression Scale (HADS). Baseline scores, and first 18-month follow-up period scores were included to statistical analysis. Sixty-five (55%) patients had progressive tumor. Global score, physical, role and emotional function, insomnia (p for each <0.001) and appetite loss (p: 0.008) scores of EORTC-C30 significantly related to disease progression. According to BN-20 seizure and leg weakness (p < 0.001), drowsiness and bladder control (p: 0.002), motor dysfunction (p: 0.001), future uncertainty (p: 0.04), visual disorder (p: 0.008) and communication deficit (p: 0.006) symptoms significantly related to disease progression. There were significant decrements in orientation, attention and calculation and language scores (p values were 0.017, 0.005 and 0.003, respectively) of MMSE. The baseline and follow-up anxiety and depression scores did not differ significantly. We conclude that there were many changes in patients with high-grade glioma during the course of the disease and most of them were related to disease progression.
    Supportive Care in Cancer 12/2011; 20(10):2315-25. DOI:10.1007/s00520-011-1340-4 · 2.36 Impact Factor

Publication Stats

612 Citations
250.11 Total Impact Points


  • 1992-2015
    • Hacettepe University
      • • Department of Radiation Oncology
      • • Department of Chest Diseases
      • • Department of Radiology
      Engüri, Ankara, Turkey
  • 2011
    • Hospital Universitario Puerta de Hierro-Majadahonda
      Махадаонда, Madrid, Spain