Purpose: This study aimed to evaluate the personalized dosimetric approach by calculating the cumulative renal absorbed dose (cRD) and assessing its impact on renal functions in patients diagnosed with metastatic castration-resistant prostate cancer who underwent four or more cycles of [¹⁷⁷Lu] Lu-PSMA − 617 therapy. Methods: The study included 110 patients who received ≥ 4 cycles of [¹⁷⁷Lu] Lu-PSMA − 617 therapy. Whole-body static and abdominal SPECT-CT imaging was performed at 4, 24, and 96 h post-administration. Kidney function was assessed using dynamic renal scintigraphy and biochemical tests conducted prior to treatment. Estimated glomerular filtration rate (eGFR) levels were calculated using the CKD-EPI formula before each treatment cycle and at the 6th week post-treatment. Results: Pearson correlation analysis reveal no significant relationship between cRD and CKD-EPI values (p >.05). No significant differences were observed between pre-treatment CKD-EPI levels and those measured after the 4th, 5th, 6th, 7th, and 8th cycles (p >.05). Among patients reaching a cRD of 23 Gy, a statistically significant difference was observed between pre- and post-treatment CKD-EPI values (p <.05). Of the 13 patients exceeding cRD of 28 Gy, five maintained CKD-EPI levels above 90 mL/min/1.73 m² post-treatment. Conclusion: Despite treatment-related declines in eGFR levels, our findings indicate that a personalized dosimetric approach may enable extended cycles of [¹⁷⁷Lu] Lu-PSMA-617 therapy with manageable nephrotoxicity. Considering the significant inter-patient variability, establishing universal absorbed dose-response relationships remains challenging. Prospective multicenter studies are crucial to refining toxicity thresholds and advancing tailored treatment strategies to optimize safety and efficacy.

Background: Optic pathway gliomas (OPG) are rare tumors in children. Lesion extent, visual functions, neurofibromatosis 1 (NF1), and age are factors that guide treatment. This study evaluates the clinical characteristics, treatment, and outcome of children and adolescents with OPG treated over a 31‐year period in a single center. Methods: Ninety‐five patients with OPG diagnosed between January 1990 and December 2021 were retrospectively evaluated. First‐line chemotherapy regimen consisted of vincristine and carboplatinum for 1 year. Radiotherapy was not used as first‐line treatment and tried to be avoided in the ones who progressed after first‐line treatment. Results: Ninety‐five children (44 male, 51 female) with a median age of 52 (1–216) months were evaluated. Sixty‐three (66.3%) had NF1 and 10 (10,5%) diencephalic syndrome. The most common presenting symptoms were visual abnormalities and/or proptosis, nistagmus, and behavioral changes. Twenty‐one (22.1%) patients with NF1 had stable disease throughout the follow‐up period and received no treatment. Sixty‐three of 74 patients received treatment at diagnosis and 11 due to progression during follow‐up. Only one adolescent received radiotherapy at progression. Patients who progressed, received further line systemic treatment (vinblastine; bevacizumab; vincristine–cisplatinum–etoposide). Ten‐year overall survival in all patients, in patients with NF1, and without NF1 were 97.2%, 98%, and 95.8% ( p > .05), respectively; 10‐year progression‐free survival (PFS) in all patients, in patients with NF1, and without NF1 were 71.6%, 85.7%, and 54.2% ( p = .001), respectively. Conclusions: In children with symptomatic/progressive OPG, chemotherapy consisting of vincristine–carboplatinum (VC) is effective. Radiotherapy may be avoided, especially in patients with NF1.

İstanbul Üniversitesi Yayın Projesi

Background: This study aims to evaluate the contribution of clinical and radiomic features to machine learning-based models for survival prediction in patients with locally advanced cervical cancer. Methods: Clinical and radiomic data from 161 patients were retrospectively collected from a single center. Radiomic features were obtained from contrast-enhanced magnetic resonance imaging (MRI) T1-weighted (T1W), T2-weighted (T2W), and diffusion-weighted (DWI) sequences. After data cleaning, feature engineering, and scaling, survival prediction models were created using the CatBoost algorithm with different data combinations (clinical, clinical + T1W, clinical + T2W, clinical + DWI). The performance of the models was evaluated using test accuracy, precision, recall, F1-score, ROC curve, and Bland–Altman analysis. Results: Models using both clinical and radiomic features showed significant improvements in accuracy and F1-score compared to models based solely on clinical data. In particular, the CatBoost_CLI + T2W_DMFS model achieved the best performance, with a test accuracy of 92.31% and an F1-score of 88.62 for distant metastasis-free survival prediction. ROC and Bland–Altman analyses further demonstrated that this model has high discriminative power and prediction consistency. Conclusions: The CatBoost algorithm shows high accuracy and reliability for survival prediction in locally advanced cervical cancer when clinical and radiomic features are combined. The addition of radiomics data significantly improves model performance.

Amaç: Yumuşak doku sarkomları, malignitelerin yaklaşık %1’ini oluşturan, 50’den fazla histolojik alt grubu olan bir kanser türüdür. Adjuvan kemoterapi alan hastaların hastalıksız sağkalımlarının uzadığını birçok çalışma ve metaanaliz gösterse de, genel sağkalıma ilişkin çalışmalar arasında fark vardır. Çalışmamızın amacı, merkezimizde yumuşak doku sarkomu nedeniyle adjuvan kemoterapi uygulanan hastaların klinik seyirlerini incelemektir. Gereç ve Yöntemler: Çalışma retrospektif olarak planlanmıştır. İstanbul Üniversitesi Onkoloji Enstitüsü Tıbbi Onkoloji polikliniğinde; lokal, lokal ileri olup opere olan veya metastatik olup hem lokal cerrahi hem de metastazektomi yapılan ve sonrasında adjuvan tedavi almış 18 yaşın üstündeki yumuşak doku sarkomu hastaları alınmış ve adjuvan kemoterapinin hastalığın seyrine olan etkisi incelenmiştir. Bulgular: 40 hasta çalışmaya dahil edildi. Hastalar medyan 53 ay (5-155) takip edildi. Hastaların %55’i Evre 1 (%10 Evre 1A, %45 Evre 1B), %15 Evre 3 (%5 Evre 3A, %10 Evre 3B), %30 Evre 4’tür. Hastalara medyan dört kür adjuvan kemoterapi verildi ve hastaların %80’i Adriamisin - İfosfamid aldı. Hastaların yarısında hastalık nüks ederken, nüks eden hastalarda hastalıksız sağkalım medyan 12 aydır. Hastaların medyan toplam sağkalımı 39 aydır. Sonuç: Yaptığımız çalışmanın sonucunda adjuvan tedavinin hem hastalıksız hem de total sağkalımı katkısı sağlayabileceğini ve bu katkının hem ekstremite hem de ekstremite dışı yumuşak doku sarkomlarında olabileceğini düşünüyoruz ama kesin bir kanıya varmak için daha geniş hasta sayıları ile yapılacak prospektif çalışmaların daha yararlı olabileceğini düşünüyoruz.