Fadil Akyol's research while affiliated with Hacettepe University and other places

Publications (133)

Article
Purpose/Objective(s) Metastasis- directed therapy (MDT) utilizing stereotactic body radiotherapy (SBRT) for oligoprogressive lesions could provide a delay in next-line systemic treatment (NEST) change while undergoing androgen receptor–targeted agents (ARTA) treatment. We evaluated prognostic factors for prostate cancer–specific survival (PCSS) and...
Article
Purpose/Objective(s) Few studies have investigated the feasibility of MDT in metastatic castration-resistant prostate cancer (CRPC) patients with heterogeneous patient populations with different treatment strategies and various imaging modalities other than gallium prostate-specific membrane antigen-positron emission tomography (⁶⁸Ga-PSMA-PET/CT) f...
Article
Full-text available
Purpose We assessed the outcomes of stereotactic body radiotherapy (SBRT) to treat oligoprogressive castration-resistant prostate cancer (CRPC) patients with ≤5 lesions using gallium prostate–specific membrane antigen-positron emission tomography (⁶⁸Ga-PSMA-PET/CT). Methods The clinical data of 67 CRPC patients with 133 lesions treated with ⁶⁸Ga-P...
Article
Background: Defining the extent of disease spread with imaging modalities is crucial for therapeutic decision-making and definition of treatment. This study aimed to investigate whether clinical parameters and nomograms predict prostate-specific membrane antigen (PSMA)-positive lymph nodes in treatment-naïve nonmetastatic prostate cancer (PC) pati...
Article
Background: Metastasis-directed therapy (MDT) utilizing stereotactic body radiotherapy (SBRT) for oligoprogressive lesions could provide a delay in next-line systemic treatment (NEST) change while undergoing androgen receptor-targeted agents (ARTA) treatment. We evaluated prognostic factors for prostate cancer-specific survival (PCSS) and progress...
Article
Purpose: To evaluate the outcomes of metastasis-directed treatment (MDT) using stereotactic body radiotherapy (SBRT) for bone-only oligometastasis (OM) detected with gallium prostate-specific membrane antigen (68Ga-PSMA) PET/CT in castration-sensitive prostate cancer (PC) patients. Methods: In this multi-institutional study, clinical data of 74...
Article
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The aim of the study is to investigate factors that may cause radiation-induced lung disease (RILD) in patients undergoing stereotactic body radiotherapy (SBRT) for lung tumors. Medical records of patients treated between May 2018 and June 2019 with SBRT were retrospectively evaluated. All patients should have a diagnosis of either primary non-smal...
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Intravesical prostatic protrusion (IPP) is associated with increased urinary toxicities after radical prostatectomy. The aim of the current study is to investigate the effect of IPP on treatment outcomes and toxicity in prostate cancer patients who underwent definitive radio- therapy (RT). Medical records of 130 patients who received RT between Apr...
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Purpose: To evaluate dosimetric differences between point-based 2-dimensional (2D) vaginal brachytherapy (VBT) treatment planning technique and volume-based 3-dimensional (3D) VBT method for endometrial cancer (EC). Material and methods: Ten patients with uterine-confined EC treated with VBT were included in this study. All patients received 27.5 G...
Article
Purpose: Cisplatin based chemoradiation has been commonly used as a definitive treatment for muscle-invasive bladder cancer (MIBC). The aim of the current study is to evaluate oncologic results and toxicity profile of bladder-sparing treatment with external beam radiother- apy (EBRT) and gemcitabine chemotherapy (ChT) in patients with MIBC. Materia...
Conference Paper
Purpose: To investigate whether clinical parameters, prostate-specific membrane antigen (PSMA) uptake, and clinical nomograms can predict PSMA-positive lymph node metastasis in treatment-naïve non-metastatic prostate cancer (PC) patients. Materials and Methods: The clinical data of 368 PC patients (83% high-risk and 17% intermediate-risk) treated w...
Article
Full-text available
PurposeThe aim of this study was to evaluate the outcomes of 68Ga prostate-specific membrane antigen (68Ga-PSMA) positron-emission tomography (PET)/CT-based metastasis-directed treatment (MDT) for oligometastatic prostate cancer (PC).Methods In this multi-institutional study, clinical data of 176 PC patients with 353 lesions receiving MDT between 2...
Article
Purpose To evaluate the distribution of metastatic lymph nodes (LN) detected on ⁶⁸Ga-PSMA-positron emission tomography/computed tomography (PET/CT) in treatment-naïve prostate cancer (PC) patients and to analyze the LN coverage rates of the pelvic fields defined in the GETUG trial and RTOG guidelines and a pelvic field extending superiorly from the...
Article
Full-text available
Purpose: Stereotactic body radiotherapy (SBRT) is an effective treatment option for patients with early-stage non-small cell lung cancer (NSCLC). In this study, we evaluated the treatment results using two different SBRT techniques and the effect of beam-on time (BOT) on treatment outcomes. Methods: Between July 2007 and January 2018, 142 patien...
Article
Aim The aim of this study was to determine the Inflection Points (IPs) of flattening filter free (FFF) CyberKnife dose profiles for cone-based streotactic radiotherapy. In addition, dosimetric field sizes were determined. Background The increased need for treatment in the early stages of cancer necessitated the treatment of smaller tumors. However...
Article
Purpose: To evaluate the efficacy and toxicity of hypofractionated radiotherapy in non-metastatic soft tissue and bone sarcomas. Patients and methods: Thirty patients underwent hypofractionated radiotherapy between 2007 and 2015. Overall, 17 patients underwent primary hypofractionated radiotherapy, nine underwent hypofractionated radiotherapy fo...
Article
Background: Testosterone level of < 50 ng/dL has been used to define castrate level after surgery or after androgen deprivation treatment (ADT) in metastatic prostate cancer (PC). Aim: To evaluate the effect of two different castrate testosterone levels, < 50 and < 20 ng/dL, on biochemical relapse free survival (BRFS) in patients with non-metast...
Article
To assess the role of Gallium-labeled-prostate-specific membrane antigen PET/CT (Ga-PSMA-PET/CT) in risk group definition and radiotherapy planning in the initially planned definitive radiotherapy (RT) for prostate cancer patients. Methods: The clinical data of 191 prostate cancer patients treated with definitive intensity-modulated RT were retro...
Article
Full-text available
Purpose To validate the clinical outcomes and prognostic factors in prostate cancer (PCa) patients with Gleason score (GS) 8–10 disease treated with external beam radiotherapy (EBRT) + androgen deprivation therapy (ADT) in the modern era. Methods Institutional databases of biopsy proven 641 patients with GS 8–10 PCa treated between 2000 and 2015 w...
Article
Full-text available
Background ⁶⁸Ga-PSMA Positron Emission Tomography/Computerized Tomography (PET/CT) has shown promising results for the detection of recurrent prostate cancer (RPCa). However, the diagnostic value of this method is yet to be validated. The aim of this study was to determine the influence of clinical and biochemical variables on the detection rate of...
Chapter
This chapter on genitourinary cancers is aiming to summarize the evidence-based current management for bladder & prostate cancer. We hope to ease the understanding in the appropriate delineation of tumor volumes/fields along with related case presentations covering diagnostic images, contouring, slice by slice final plan examples; accompanied by up...
Conference Paper
Purpose/Objective(s): The treatment strategy is arranged according to risk group in prostate cancer patients. For this reason, accurate staging is essential for radiation therapy (RT) planning and target volume definition. In this study, we analyzed the role of 68Ga-PSMA-PET/CT in RT planning and defining target volumes. Materials/Methods: The clin...
Chapter
Prostate cancer is one of the major health problems in the world. Active surveillance (AS), radical prostatectomy (RP) or radiotherapy (RT) options can be selected in patients with localized prostate cancer according to risk groups. RT can be given as external beam therapy (EBT) or as brachytherapy (BRT). EBT can be delivered by three-dimensional c...
Chapter
The use of radiotherapy (RT) in the treatment of bladder cancer has been decreasing through the years. There is no role of RT in carcinoma in situ and Ta and Tl tumors. However, irradiation may have a role in high-grade or recurrent T1 lesions. There is no prospective randomized trial comparing surgery with RT in muscle-invasive bladder cancer. In...
Chapter
Androgens are endocrine secretions produced mainly by the testes under stimulation of the pituitary gland. They are also synthesized from the adrenal glands in both sexes and from ovaries in females. Luteinizing hormone (LH) produced by the anterior pituitary gland regulates the secretion of androgens from the Leydig cells in the testes. LH secreti...
Chapter
The incidence of regional lymph node (LN) involvement in patients with prostate cancer depends on several factors like the tumor size and the Gleason score (GS). The risk of LN involvement is <10% in low-risk disease. A number of models were developed in order to predict the risk of LN involvement which helps the physicians to decide whether to per...
Chapter
The lower abdomen and pelvis encompass several organs at risk (OAR), some of which are vital and are inevitably affected during radiotherapy (RT). In this chapter, the contouring recommendations and dose-volume constraints of the rectum, bowel bag (i.e., the whole small and large bowel together with their meso), urinary bladder, penile bulb, proxim...
Chapter
In recent years, the use of intensity-modulated RT (IMRT) and image-guided RT (IGRT) has increased worldwide. These techniques are highly conformal and the target should be more precise. Therefore, target determination and delineation is crucial in the management of prostate cancer with modern radiotherapy techniques. In this chapter, we will brief...
Chapter
The term stereotactic implies that the target is localized relative to a fixed three-dimensional spatial coordinate system. Stereotactic body radiation therapy (SBRT) is defined as giving a high dose of radiation per fraction, in up to five fractions, using sophisticated image guidance to deliver a potent ablative dose to cancerous tissues while mi...
Article
There are limited data regarding effect of trastuzumab on radiation-induced cardiovascular toxicity when used sequentially or concomitantly. This experimental study aims to investigate effect of trastuzumab on radiation-induced cardiovascular toxicity with respect to the treatment sequence. One hundred and eight female Wistar albino rats were divid...
Article
Background: This study aimed to evaluate the efficacy and safety of hypofractionated stereotactic radiotherapy for reirradiation of recurrent pediatric tumors. Methods and materials: The study included 23 pediatric patients who were reirradiated using hypofractionated stereotactic radiotherapy in the radiation oncology department between January...
Article
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 + pla...
Article
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. Indicati...
Article
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 diagnosi...
Article
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Objective: The aim of this study was to find the most appropriate technique for postmastectomy chest wall (CW) and lymphatic irradiation. Materials and methods: Partially wide tangent, 30/70 photon/electron mix, 20/80 photon/electron mix and CW and internal mammary en face electron field, were studied on computerized tomography (CT) scans of 10...
Article
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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 4...
Article
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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...
Article
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 In...
Article
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 comput...
Article
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, Sunn...
Article
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...
Article
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 p...
Article
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 Pl...
Article
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...
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The assessment of Health-Related Quality of Life (HRQoL) in cancer patients has become increasingly important during the past decades. The aim of this study was to evaluate the HRQoL in patients treated for low-grade glioma (LGG). Forty-three adult patients with LGG were evaluated prospectively between September 2006 and December 2010. We assessed...
Article
In this study, we present our results of reirradiation of locally recurrent head-and-neck cancer with image-guided, fractionated, frameless stereotactic body radiotherapy technique. From July 2007 to February 2009, 46 patients were treated using the CyberKnife (Accuray, Sunnyvale, CA) at the Department of Radiation Oncology, Hacettepe University, A...
Article
We assessed therapeutic outcomes of reirradiation with robotic stereotactic radiotherapy (SBRT) for locally recurrent nasopharyngeal carcinoma (LRNPC) patients and compared those results with three-dimensional conformal radiotherapy (CRT) with or without brachytherapy (BRT). Treatment outcomes were evaluated retrospectively in 51 LRNPC patients rec...
Article
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In stage III non-small-cell lung cancer (NSCLC), the role of systemic chemotherapy preceding or following concurrent chemo-radiotherapy (CT-RT) is unclear. We carried out a randomized phase II study to study the toxicity involved-field CT-RT with either induction or consolidation cisplatin-docetaxel (Taxotere). Patients were randomly assigned to re...
Article
Full-text available
The purpose of this study is to elucidate if there is an additive or supra-additive toxic effects of radiotherapy (RT) and trastuzumab (T) on vascular structures when used concomitantly. Female Wistar albino rats were treated with either 8 or 15 Gy of thoracic RT. T was applied i.p. with a dose of 6 mg/kg 2 h before RT. Four rats in each arm were k...
Article
We investigated the efficacy of prophylactic radiotherapy for gynecomastia/breast pain induced by 150 mg bicalutamide in a prospective, randomized, multi-institutional trial. After definitive treatment for localized prostate cancer 125 patients were randomized to 12 Gy radiotherapy before bicalutamide as prophylactic radiotherapy (53) or bicalutami...
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In this study, we evaluated the efficiency and the toxicity of three dimensional conformal hemithoracic radiotherapy (3DCHRT) after extra pleural pneumonectomy (EPP). The median age of 14 patients were 51 years (range, 33-61 years). Most commonly seen histopathology was epitheliod type (79%). According to American Joint Commission on Cancer (AJCC)...
Article
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To assess the effectiveness of dynamic contrast-enhanced (DCE) T1- and T2-weighted magnetic resonance imaging (MRI) during the follow-up of patients with prostate cancer after undergoing external beam radiotherapy (EBRT) and to compare these imaging findings to pathological and transrectal ultrasound (TRUS) findings. In this retrospective study, th...
Article
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To observe the efficiency of reirradiation with high dose rate intraluminal brachytherapy in symptomatic palliation of recurrent endobronchial tumors. Between January 1994 and June 1998, 21 patients diagnosed with recurrent endobronchial tumors following external beam radiotherapy were treated palliatively with high dose rate intraluminal irradiati...
Article
Malignant pleural mesothelioma (MPM) is a relatively rare tumor which is often associated with occupational asbestos exposure or environmental erionite exposure. Trimodal therapies consisting a combination of surgical resection and adjuvant treatments seem to be a better therapeutic option for patients with unresectable MPM. In resected cases, beca...