Introduction: Brain metastasis (BM) is significantly seen in lung adenocarcinoma and adversely affects survival. We aimed to evaluate the factors affecting the prognosis in patients with BM diagnosed with lung adenocarcinoma. Materials and Methods: Patients with BM between 2012 and 2022 were reviewed retrospectively. Demographic characteristics of the patients, primary tumor characteristics, presence of mutation, BM number, localization, size, development time, and treatment characteristics were evaluated. Inflammatory indices at the time of BM were examined. The overall survival time was calculated. Results: About 92.9% of 113 patients were male, the median age was 62 years (54.5–68.5), and follow-up was 8 months (3–18). BM was detected at the time of diagnosis in 62 (54.9%) of the patients, whereas BM developed later in 51 (45.1%) patients. Systemic treatment was applied to 72.5% of the patients. Survival was lower in patients with BM at diagnosis (4 vs. 14 months, P < 0.001). Primary tumor maximum standardized uptake value level was higher on fluorodeoxyglucose-positron emission tomography-computed tomography at diagnosis in patients with late BM (P = 0.004). The development time of BM was 9 months (4–16), and the median survival was 8 months (6.2–9.8). There was no difference between tumor localization or inflammatory indices and the development of BM and prognosis. The presence of BM at diagnosis and lack of systemic treatment were found to be factors that independently reduced survival (P < 0.001, P = 0.007). Conclusion: The presence of BM at diagnosis significantly reduces survival. It has been observed that systemic treatments applied in addition to local treatments have a positive effect on the prognosis.

Background: The SARS-CoV-2 pandemic has also had a profound impact on cancer treatment delivery and organization. Oncology clinics have developed a number of procedures and used formulas related to radiotherapy doses to continue their activities. Aims and Objectives: We explored the impact of SARS-CoV-2 pandemy on the personnel and cancer patients undergoing radiotherapy in a radiotherapy department during the first year. Materials and Methods: 845 patients were treated over the course of a year, 195 of whom consented to participate in the study. The Elekta Mozoiq system and radiotherapy cards were evaluated, and the time intervals between the treatments during the radiotherapy were recorded. Biologically Effective Dose losses were calculated in the radiotherapy dose due to the interruption to treatment, and necessary calculations were made for the delivery of the initially planned dose. Results: The mean age of the patients was 59 years (range 19-78). There were 110 male (56.4%) and 85 female (43.5%) participants. The treatment of 4.6% (9 patients) of the patients was discontinued because of SARS-CoV-2 infection during radiotherapy. The greatest added fraction for a patient with prostate cancer was three while the lowest was one for a patient with lung cancer, based on the TDF calculation. During this period, 16% of the staff was infected with COVID-19. Conclusion: This study demonstrates the effect of the COVID-19 pandemy on patients and personnel in a radiotherapy clinic, and its management during one year.

Aims: We aimed to show the protective effect of carnitine and melatonin (MEL) on kidney which were applied before the radiotherapy. Materials and Methods: Seventy-two male Wistar Albino rats were divided six equal groups as Group 1 radiotherapy, Group 2 radiotherapy and MEL, Group 3 radiotherapy and carnitine, Group 4 MEL, Group 5 carnitine, and Group 6 control. Whole abdominal radiotherapy of 10 Gy was applied to the radiotherapy groups. Renal scintigraphy was performed under anesthesia on all rats after a follow-up period of 8 weeks. Histopathologic examination was performed in kidneys. Results: Group 1 showed a statistically significant deterioration of renal scintigraphy function (P < 0.05). Group 2 and Group 3 showed a better function of scintigraphical renal function and there was no significance between the control. There was no damage seen by light microscopy in Group 1, 2, 3. When evaluated histomorphological, there was a significant increase of glomerular width in Group 1 whereas Group 2 and Group 3's glomerular width decreases to the level of control group's (P < 0.00). Conclusion: As a conclusion, we consider that adding carnitine and MEL to the radiotherapy of patients who has a long-expected survival will prevent the complications due to radiotherapy.

Introduction: Prophylactic cranial irradiation (PCI) increases survival in patients with small-cell lung cancer. Although the underlying pathophysiology is not fully understood, it has been associated with posttreatment neurocognitive impairment. Our study aims to show the brain's glucose metabolism change after PCI with 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). Materials and Methods: A total of 17 patients who underwent PET/CT before and after PCI were evaluated retrospectively. 18F-FDG PET images of the brain before and after PCI were compared visually and semi-quantitatively using MI-Neurology Software. The brain was automatically segmented into eleven regions by this software. The mean standard uptake values (SUVmean) of all brain regions were measured within the automatically drawn region of interest area, and standard uptake value ratio (SUVR) values were found for each region by taking the brainstem SUVmean value as a reference. SUVR values were calculated from PET/CT scannings taken before and after PCI for each patient. The P < 0.05 value was considered statistically significant in comparisons. Results: We found a significant decrease in 18F-FDG uptake and glucose metabolism of the brain after PCI when compared with PET/CT before PCI in all brain regions identified according to the Combined-AAL atlas (all P < 0.001). Similarly, a significant decrease was found in brain 18F-FDG uptake on PET/CT taken after PCI in the brainstem used to calculate SUVR (P = 0.039). Conclusion: 18F-FDG PET/CT neuroimaging may be a new metabolic imaging technique for diagnosing radiation-induced cognitive impairment in the metabolic imaging era.