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Objective: Metallic implants have impacts on dose distribution of radiotherapy. Our purpose is evaluating impact of metallic implants with different dose calculation algorithms on dose distribution. Material and Methods:Two patients with metallic implants on vertebral body were included in this study. They were treated with stereotactic radiotherapy. The data of the patients were retrospectively re-calculated with different TPSs and calculation algorithms. Ray-Tracing (Ry-Tc), Monte-Carlo (MC), Acuros XB (AXB) and analytical anisotropic algorithms (AAA) were compared.Results: Ry-Tc, AAA and AXB underestimated minimum and maximum doses of target volumes and critical organs compared with MC. Conclusion:MC seems more reliable for dose calculations in patients with metallic implants but more studies with more number of patients should be done to identify the best dose calculation algorithm for patients with metallic implants.

Aim: To evaluate retrospectively clinical outcomes of treated with stereotactic ablative radiotherapy (SABR) using the CyberKnife® (Accuray, Sunnyvale, CA, USA), for early primary and oligometastatic lung tumors. Methods: This descriptive study included thirty tumors from 29 patients with primary lung cancer (n=21) or oligometastatic lung tumors (n=9), who underwent SABR with robotic linear accelerator between March 2011 and July2015. Out of the 30 tumors, 21 were NSCLC, 9 were metastatic lung disease. Treatment was given using different tracking methods including fiducial tracking with Synchrony (21 patients), Xsight lung with Synchrony (4 patients) and Xsight spine (5 patients). Treatment was delivered two to three fractions per week and with different fractionations depending on location and other tumor related factors. Factors, potentially effective on local control and overall survival were investigated. Results: Median follow-up time for local control was 11 months (2.4-39 months). Of 25 patients with known follow-up data, local control (LC) rates for 1, 2 and 3 years were 82.8%, 82.8% and 55.2 %, respectively. Overall survival (OS) rates for primary lung tumor patients 1, 2 and 3 years were 72.2%, 64.2%, 51.4% and metastatic lung tumor patients for 1 year was 71%, respectively. Except for gender, none of the factors were statistically significantly associated with local control in univariate analysis; female gender was associated with worse local control (p=0.001). Also in univariate analysis of overall survival, there was a trend for worse survival in females, too (p=0.07). Conclusion: This small study may give some idea about utilizing different tracking ways for CyberKnife® with less toxicity.

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Fanconi anemia (FA) is a disease that could be accompanied by multiple abnormalities, such as growth retardation, bone marrow abnormalities, and cancer susceptibility. Among the FA patients, head and neck squamous cell cancer (HNSCC) is the most observed solid cancer. The life expectancy of patients with FA has increased with recent medical advances. Furthermore, HNSCC is diagnosed in 3% of FA patients, and half of these patients die because of their HNSCC. The median age of HNSCC patients with FA is 31, and according to the literature HNSCC incidence of FA, patients is more than 700-fold of the normal population. Here, we reported the treatment details and challenges we faced during hypopharyngeal cancer treatment in a FA patient.