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BackgorundThe aim of this study was to evaluate dysphagia in patients with head and neck cancer (HNC) undergoing three-dimensional conformal radiation therapy using objective and subjective tools simultaneously and to associate the clinical correlates of dysphagia with dosimetric parameters.MethodsTwenty patients were included in the study. The primary tumor and the involved lymph nodes (LN) were treated with 66-70 Gy, the uninvolved LN were treated with 46-50 Gy. Six swallowing structures were identified: the superior pharyngeal constrictor muscle (SPCM), the middle pharyngeal constrictor muscle (MPCM), the inferior pharyngeal constrictor muscle (IPCM), the base of tongue (BOT), the larynx and the proximal esophageal sphincter (PES). Dysphagia was evaluated using videofluoroscopy and European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaire (QLQ-C30) and supplemental EORTC QoL module for HNC (QLQ-H&N35). The evaluations were performed before treatment, at 3 months and at 6 months following treatment.ResultsOn objective evaluation, the Dmax for the larynx and the sub-structures of the PCM were correlated with impaired lingual movement, BOT weakness and proximal esophageal stricture at 3 months, whereas the V65, the V70and the Dmax for the larynx was correlated with BOT weakness and the V65, the V70, the Dmax or the Dmean for the sub-structures of the PCM were correlated with impaired lingual movement, BOT weakness, reduced laryngeal elevation, reduced epiglottic inversion and aspiration at 6 months following treatment. On subjective evaluation, the V60, the Dmax and the Dmean for SPCM were correlated with QoL scores for HNSO at 3 months, whereas the V70 for SPCM were correlated with QoL scores for HNPA and the V60, the V65, the V70, the Dmax and the Dmean for SPCM were correlated with QoL scores for HNSO at 6 months following treatment.ConclusionsThe use of multiple dysphagia-related endpoints to complement eachother rather than to overlap with one another, as well as the use of multiple evaluations over time to represent a scale of early to late findings might provide a better insight in terms of the association of the clinical correlates of dysphagia with the dose-volume data for the dysphagia-related anatomical structures.

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Background: The prognostic impacts of histopathological classification, Masaoka staging system, extent of surgery, and adjuvant treatment approaches in thymic epithelial tumors (TETs) were investigated. Material and Methods: Records of 22 patients were retrospectively reviewed. Total thymectomy was performed on 5 patients and thymectomy on 17. Complete resection was achieved for 14 patients. Radiation therapy (RT) was considered for all patients with stage III or IV disease and all patients undergoing incomplete resections. Results: Local control had been achieved in all patients and all were alive with no evidence of disease (ANED) at 0.2-7.8 years (median, 2.3 years). Of 4 patients with stage II disease, 2 (favorable group) had undergone complete resections and 2 (intermediate group) had undergone incomplete resections. Those undergoing incomplete resections had received RT. Of these 4 patients, all were ANED. All 4 patients with Masaoka stage III disease that were involved in the study had undergone incomplete resections and had received RT. Also, these patients were ANED. Conclusions: Patients with TETs undergoing less than complete resections might be referred for RT in the postoperative setting, while the role of RT in patients undergoing complete resections remains unclear.

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Background. Anastomotic leakage (AL) following rectal surgery is associated with increased mortality and morbidity. Neoadjuvant radiotherapy disrupts the wound healing process in rectal surgery. Objectives.To evaluate the effects of intra-rectal ozone application on rectal anastomoses after radiotherapy. Materials and methods.This study was performed on animals. Thirty-two male Wistar rats were randomly divided into 4 groups: control group, ozone group, radiotherapy group, and radiotherapy/ozone group. Ozone was administered intrarectally in the ozone group and water was administered intrarectally in rthe control group for 5 days. The radiotherapy group received 20 Gy of pelvic radiotherapy. The radiotherapy/ozone group received 20 Gy of pelvic radiotherapy after the administration of ozone. Afterward, colon resection followed by an anastomosis were performed under general anesthesia in all groups. Anastomotic segments were resected to evaluate tissue hydroxyproline (HYP) and myeloperoxidase (MPO) levels, perform a histological evaluation, and measure bursting pressure.Results. There were no statistically significant differences between groups regarding tissue MPO levels (p = 0.55). Tissue HYP levels were significantly decreased in the radiotherapy group (p = 0.04). Bursting pressure was found to be significantly lower in the radiotherapy group (p < 0.05). No significant differences were found between adhesion scores in the control and ozone groups. Exudate formation was significantly lower in the radiotherapy group (p < 0.05). The lowest macrophage scores were found in the radiotherapy group (p < 0.05). Fibroblast scores were the highest in the control group and the lowest in the radiotherapy group (p < 0.05).Conclusions. Intra-rectal ozone application significantly improved the anastomotic healing process after radiation exposure.

Objective This study was carried out to explore the overall survival (OS) and disease-free survival (DFS) rates of patients with locally advanced head and neck cancer who were treated with chemoradiotherapy (CRT). Materials and Methods A total of 54 patients were included in our study. Among 54, 35 were treated with chemoradiotherapy and 19 were treated with radiotherapy only. The tumors were located in larynx (74%), hypopharynx (17%) and oral cavity (9%). According to TNM stage, among 54 case, one was T1, 10 were T2, 25 were T3 and 18 were T4 stage. Furthermore, 29 were N0, 11 were N1, 13 were N2 and one was N3 stage. The primary tumor was irradiated with conformal or intensity-modulated radiotherapy at an average dose of 70 Gy (64-74), and lymph nodes at a dose of 50 to 70 Gy depending on risk groups. Treatment response, OS and DFS rates were identified in 50 case. Results The follow-up period ranged from 3 months to 53 months (median=18 months). A clinically and radiologically complete response was observed in 36 (72%) of 50 patients after 2 months from completion of treatment. A partial response was detected in 12 patients (24%) and progression in 2 patients (4%). The rates of OS and DFS over the period of 3 years were found to be 51% and 58%, respectively. The most common side effect was mucositis detected in 40% of the patients. The most common side effects of systemic treatment were nausea, vomiting and leukopenia (34%). Dry mouth was found to be the most frequent late side effect. Conclusion Radical radiotherapy or chemoradiotherapy is an alternative treatment method of locally advanced head and neck tumors, with acceptable toxicity rates. Keywords Head and neck cancer; locally advanced stage; radiotherapy; chemoradiotherapy Öz Amaç Bu çalışma, kemoradyoterapi ile tedavi edilen, lokal ileri evre baş boyun kanserli hastaların genel sağkalım ve hastalıksız sağkalım oranlarını araştırmak amacıyla yapıldı.