Faculty of Medicine
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Item type:Publication, Radiotherapy-induced thyroid dysfunction(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Secondary malignant neoplasms in patient with breast carcinoma after radio and chemotherapy(Македонско друштво на ортопеди и трауматолози = Macedonian Association of Orhopedics and Traumatology, 2017-06); ; ; ; Secondary malignant neoplasms (SMN) are cancers caused by treatment with radiotherapy and chemotherapy. They are unrelated to the first cancer that was treated and may occur months or even years after initial treatment. With advances in diagnosis and treatment there is an increasing number of long-term cancer survivors, but also there is growing concern about the risk of radiotherapy and chemotherapy induced malignant neoplasm. In our case report we present a patient that underwent radiotherapy and chemotherapy several times because of recurrence from a well differentiated breast carcinoma with characteristics of cilindroma. After 6 years from the initial treatment a solid renal tumor was found, the histopathological finding from the kidney tissue was “multilocular renal cell carcinoma”. After 11 years skin changes appeared, histopathologically classified as dermatofibrosarcomama. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RELATIONSHIP BETWEEN O(6)-METHYLGUANINE-DNA METHYLTRANSFERASE (MGMT) PROMOTER METHYLATION STATUS AND TUMOR SIZE ON PREOPERATIVE CONTRAST ENHANCED MRI IN PATIENTS WITH GLIOBLASTOMA MULTIFORME – SINGLE INSTITUTION EXPERIENCE(RAD Association, 2018-06-01); ; ; Bojovska, ValentinaIntroduction. O(6)-methylguanine-DNA methyltransferase (MGMT) promoter methylation status is considered as an important prognostic marker in patients with glioblastoma multiforme. Patients with methylated MGMT promoter are considered that have better prognosis, have longer disease free survival and overall survival. Methods. We performed retrospective analysis of 28 patients with glioblastoma multiforme intended to be treated with radiotherapy and with known MGMT promoter status. Volume of the tumor was measured on initial MR of the brain and it was delineated on transversal MR image DICOM datasets. “Tumor” was defined as contrast enhanced region in T1 weighted image after application of i.v. contrast. Results. From 28 patients, 14 patients were with methylated MGMT promotor (MGMT-M) and 14 with wild type MGMT promotor (MGMT-W). Mean MRI tumor volume in MGMT-M group was 45.41 cm3 (range 4.50 cm3 – 95.26 cm3) and in MGMT-W group 50.46 cm3 (range 3.81 cm3 – 134.79 cm3). Comparison of volumes of 2 groups has shown that there are no significant differences between tumor volumes in the groups p= 0.29864. Conclusion. In our study we can conclude that there is no correlation between MGMT methylation status and initial tumor volume in patients with glioblastoma multiforme. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Acute Mucosal Reactions in Patients with Advanced Head and Neck Cancer Treated with Concurrent Chemoradiotherapy(Association for Medical Physics and Biomedical Engineering, Skopje, Macedonia, 2010-11-06); ; ; We conducted a clinical study to analyze the acute reactions in the oral cavity and the oropharyngeal (OCOPH) mucosa in patients with advanced head and neck cancer (HNC) undergoing a definitive treatment consisted of 3-D conformal radiotherapy combined with concomitant chemotherapy. Twenty nine patients with HNC who were treated between February 2008 and October 2009 were included in the study. The median age was 55 years (range 29-70). The site distribution was as follows: oropharynx, 20.7%; hypopharynx, 41.4%; larynx, 37.9%. The radiation technique used for 3-D conformal radiotherapy was named “oblique photon fields” technique. The OCOPH mucosa as a critical normal tissue was delineated in every patient. Extraction of planning target volume (PTV50) from the volume of OCOPH mucosa led to formation of an OCOPH mucosa with extracted PTV50 (OCOPHEx mucosa). Acute mucosal reactions were recorded using Radiation Therapy Oncology Group (RTOG) grading system. The duration of a maximum grade of reaction was also recorded. A time intensity parameter, so-called Severity-Time Units (STU), quantifying the area under the acute reaction curve, was used to express the intensity of mucositis over time in every patient. Grade 3 acute mucosal reaction was manifested in 19 patients (65.5%). The median duration of confluent mucositis was 21 days (range 14-35). The STU less than 1000 mm2 and the STU more than 1500 mm2 was calculated in equal number of patients (9 patients, or 31.0%). Statistically significant difference in the distribution of the grade 3 reaction was found among patients with different site of the primary tumor (p = 0.003). Statistically significant difference was found between the grade of the acute mucositis and the volume of OCOPHEx mucosa, the dose in 50% of the volume of OCOPHEx (D50%, OCOPHEx) mucosa, and the mean dose to OCOPHEx mucosa (p = 0.02, p = 0.0002, p = 0.00001, respectively). The tested relation between STU and delineated volumes (PTV50 and OCOPHEx mucosa) showed the presence of statistically significant difference (p = 0.044 and p = 0.02, respectively). Statistically significant difference was also found between STU and the mean dose to OCOPHEx mucosa (p = 0.0003). Linear regression showed negative correlation between STU and the volume of OCOPHEx mucosa (r = - 0.7; p < 0.05). The incidence and the duration of confluent mucositis were significantly greater in patients with oropharyngeal primary lesions. The intensity in time of acute mucosal reactions was significantly higher in patients with the greatest PTV50 and in those with the smallest volumes of OCOPHEx mucosa. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact on Radiation Dose and Volume V57 Gy of the Brain on Recurrence and Survival of Patients with Glioblastoma Multiformae(Walter de Gruyter GmbH, 2017-12); ; Background. The aim of the study was to analyze impact of irradiated brain volume V57 Gy (volume receiving 57 Gy and more) on time to progression and survival of patients with glioblastoma. Patients and methods. Dosimetric analysis of treatment plan data has been performed on 70 patients with glioblastoma, treated with postoperative radiochemotherapy with temozolomide, followed by adjuvant temozolomide. Patients were treated with 2 different methods of definition of treatment volumes and prescription of radiation dose. First group of patients has been treated with one treatment volume receiving 60 Gy in 2 Gy daily fraction (31 patients) and second group of the patients has been treated with “cone-down” technique, which consisted of two phases of treatment: the first phase of 46 Gy in 2 Gy fraction followed by “cone-down” boost of 14 Gy in 2 Gy fraction (39 patients). Quantification of V57 Gy and ratio brain volume/V57Gy has been done. Average values of both parameters have been taken as a threshold value and patients have been split into 2 groups for each parameter (values smaller/ lager than threshold value). Results. Mean value for V57 Gy was 593.39 cm3 (range 166.94 to 968.60 cm3), mean value of brain volume has was 1332.86 cm3 (range 1047.00 to 1671.90 cm3) and mean value of brain-to-V57Gy ratio was 2.46 (range 1.42 to 7.67). There was no significant difference between two groups for both V57 Gy and ratio between brain volume and V57 Gy. Conclusions. Irradiated volume with dose 57 Gy or more (V57 Gy) and ration between whole brain volume and 57 Gy had no impact on time to progression and survival of patients with glioblastoma.