OBJECTIVESTo assess the survival ratios of patients with brain metastasis after whole brain radiotherapy according to recursive partitioning analysis (RPA) classification and other prognostic factors. METHODSWhole brain radiotherapy results and prognostic factors of 62 patients with brain metastasis were studied retrospectively. RESULTSThe median survival rate in our study was 6.9 months. Single variation analysis demonstrated statistically significant survival results independently in female patients, with Karnofsky performance scale value of 70 and over, patients with controlled primary disease, RPA class I, and diagnosed with breast cancer (p<0.05). The results obtained from multi-variation analysis demonstrated statistically significant survival results among female patients, patients with an age of 65 years old and below as well as patients with solitary metastasis and who had undergone surgery (p<0.05). CONCLUSIONPrognostic factors of patients must be considered in the treatment of brain metastases by selecting the most suitable process through radiosurgical, surgical resection, and/or whole brain radiotherapy.Key words: Brain metastasis; prognostic factors; RPA; survival. AMAÇÇalışmamızda beyin metastazlı hastaların tüm beyin radyoterapi sonrası "recursive partitioning analysis (RPA)" sınıflama-sına ve diğer prognostik faktörlere göre sağkalım oranlarını değerlendirdik. GEREÇ VE YÖNTEMBeyin metastazlı 62 hastanın tüm beyin radyoterapi sonuçları ve prognostik faktörleri geriye dönük olarak incelendi. BULGULARÇalışmamızda ortanca sağkalım 6.9 aydı. Tek değişkenli analizde; cinsiyet olarak kadın, Karnofsky performans skala değeri 70 ve üzerinde, primer hastalığın kontrol altında, RPA sınıf I ve primer hastalığın meme karsinomu olan hastalarda istatistiksel olarak anlamlı sağkalım sonuçları elde edilmiştir (p<0.05). Çok değişkenli analiz sonuçlarına bakıldığında da cinsiyet olarak kadın, yaş 65 ve altı, tek metastazlı ve cerrahi yapılmış hastalarda istatistiksel olarak anlamlı sağkalım sonuçları elde edilmiştir (p<0.05). SONUÇBeyin metastazlarının tedavisinde radyocerrahi veya cerrahi rezeksiyon ve/veya tüm beyin radyoterapisi seçeneklerinden en uygun olanı hastaların prognostik faktörleri göz önüne alı-narak seçilmelidir.Anahtar sözcükler: Beyin metastazı; prognostik faktörler; RPA; sağ-kalım.

Aims: It was aimed to inves gate postopera ve conformal radiotherapy planning that provides the best target volume and the least dose for cri cal organs in cancers of stomach. Methods: This study was conducted on the CT simula on images of thirty pa ents diagnosed with gastric cancer. Target volumes and the organs at risk were contoured. AP-PA reciprocal parallel field conven onal plan and three-and four-field 3D conformal plans were created using linear accelerator. Target volumes and doses consumed by organs at risk were compared by dose-volume histograms. Results: While a sufficient dose could be applied to target volumes in all plans with conformal planning, average figures showed that 95% of porta hepa s area failed to take the prescribed dose (D95) in some plans by using AP-PA reciprocal parallel zone conven onal plans. The most convenient protec on for spinal cord, heart and kidneys was obtained by conformal four-field technique and the liver doses were increased in conformal four-field plans but did not exceed the tolerance dose. And also, in the conven onal AP-PA reciprocal parallel field plans, tolerance dose of spinal cord (4500 cGy) was exceeded. Conclusion: In this study, conformal four-field technique was superior considering target volume dose distribu ons, and especially spinal cord doses in all localiza ons and heart doses in cardia tumors. Kidney doses were also reduced in conformal four-field planning, but failed to reach sta s cal significance. There was a not exceeding tolerance limits dose increase in liver.

Ge lifl Ta ri hi/Re cei ved: 07.02.2013 Ka bul Ta ri hi/ Ac cep ted: 06.10.2013 ÖzetGliomatozis serebri, nadir görülen bir primer diffüz beyin tümörüdür. Beynin ikiden fazla lobunu tutan neoplastik glial hücrelerin diffüz proliferasyonu ile karakterizedir. Kesin tanı için histopatolojik inceleme gereklidir. Gelişmiş manyetik rezonans görüntüleme yöntemleri tümörün preoperatif tanısında, evrelendirilmesinde ve tedavi sonrası takiplerinde oldukça faydalıdır. Bu makalede anaplazi gösteren bir gliomatozis serebri olgusu manyetik rezonans görüntüleme, difüzyon ağırlıklı görüntüleme ve manyetik rezonans spektroskopi bulguları eşliğinde sunulmuştur. Ayrıca manyetik rezonans spektroskopinin gliomatozis serebri tanı ve evrelemesindeki, rolü ve önemi değerlendirilmiştir. (Türk Nöroloji Dergisi 2014; 20:16-9) Anah tar Ke li me ler: Gliomatozis serebri, anaplazi, difüzyon ağırlıklı görüntüleme, MR spektroskopi Sum maryGliomatosis cerebri is a rare primary diffuse cerebral malignity. ''It is characterized by the diffuse proliferation of neoplastic glial cells that involve more than two cerebral lobes. For a definitive diagnosis histopathological examination is required. Advanced magnetic resonance imaging techniques are very useful in the pretreatment diagnosis-staging and post-treatment follow-up. In this report a patient with gliomatozis cerebri was presented with magnetic resonance, diffusion weighted imaging and magnetic resonance spectroscopy findings. In addition, the importance and the role of magnetic resonance spectroscopy in the diagnosis and staging of gliomatosis cerebri is discussed. (Turkish Journal of Neurology 2014; 20:16-9)

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