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Öğe Comparison of three different chemotherapy regimens for concomitant chemoradiotherapy in locally advanced non-small cell lung cancer(Springer Japan Kk, 2020) Akdeniz, Nadiye; Kucukoner, Mehmet; Kaplan, Muhammet Ali; Urakci, Zuhat; Karhan, Ogur; Sezgin, Yasin; Bilen, ErkanPurpose The optimal chemotherapy regimen for concurrent chemoradiation in locally advanced non-small cell lung cancer (NSCLC) remains unclear. Cisplatin-etoposide regimen related toxicity is high, weekly regimens have been investigating. We aimed to compare the efficacy and safety of different concurrent chemotherapy regimens in the context. Methods A total of 225 patients with locally advanced, unresectable stage III NSCLC were included. Patients who were treated with weekly docetaxel-platin (DP), paclitaxel-platin (PP) and standard dose etoposide-platin (EP) chemotherapy regimens were selected and divided into groups for the comparison of toxicity, response rate, progression free survival (PFS), and overall survival (OS) times. Results There was a statistically significant difference between overall response rate of each treatment groups (DP: 96.1%, PP: 94% and EP: 76.7%,p < 0.001). The median PFS time of patients who were treated with DP, PP and EP was 16, 15 and 13.3 months, respectively (p = 0.435). The median OS time of patients treated with DP, PP and EP was 19.2, 29.7 and 28.3 months, respectively (p < 0.001). The rates of adverse events such as nausea, vomiting, neuropathy and anaphylaxis was similar. Grade 1-2 mucositis or esophagitis, anemia, pneumonitis were significantly higher in PP group than other groups. However, hematologic toxicities were higher in the EP group than other groups. Conclusions Compared to the weekly chemotherapy regimens with the standard dose, our study demonstrated similar PFS, but a prolonged OS with the EP regimen. The clinical response rate of weekly regimens was better than the full-dose regimen. Adverse events and toxicity rates were different and depended on the type of chemotherapy regimen used.Öğe Factors influencing HER2 discordance in nonmetastatic breast cancer and the role of neoadjuvant therapy(Future Medicine Ltd, 2022) Ebinc, Senar; Oruc, Zeynep; Sezgin, Yasin; Karhan, Ogur; Bilen, Erkan; Yerlikaya, Halis; Kalkan, ZiyaPlain language summary HER2 is an important and targetable molecule in breast cancer. In the early stages of breast cancer, a treatment modality called neoadjuvant therapy, which now includes anti-HER2 therapies, is administered before surgery in order to achieve disease regression and make the patient suitable for a more minor operation. In breast cancer, HER2 status may be positive in the initial biopsy specimen and negative in the surgical specimen. HER2 status plays an important role in treatment decisions. In this study, we investigated the factors causing HER2 status to change in early-stage breast cancer. This study has a retrospective design and includes 400 female patients with early-stage breast cancer. The results of the study identified the factors causing HER2 status to change to negative as receipt of neoadjuvant therapy, small tumor size and younger age. Objective: The rates of and the factors influencing HER2 discordance in patients receiving neoadjuvant therapy for breast cancer are investigated. Methods: This study retrospectively examines the rates of HER2 and hormone receptor discordance between the biopsy and postoperative resection specimens of 400 female early-stage breast cancer patients. Results: One hundred and thirty-three (33.3%) patients had received neoadjuvant therapy. The rate of HER2 discordance between biopsy and resection specimens was 1.7% in the control group and 5.3% in the neoadjuvant therapy group (p = 0.018). The rate of HER2 discordance was higher in younger patients and in patients with T1 tumors in the neoadjuvant therapy group. Conclusion: Neoadjuvant therapy, age <40 years and smaller tumor size were independent risk factors for HER2 discordance.Öğe Meme kanserli hastalarda Pet - BT ile tümör özellikleri arasındaki ilişki(Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2022) Sezgin, Yasin; Karhan, Oğur; İleri, Serdar; Ebinç, Senar; Bilen, Erkan; Ürün, Muslih; Yerlikaya, HalisAmaç: Meme kanseri dünya çapında kadınlarda en sık görülen ve en sık ölüme yol açan kanserdir. Pozitron emisyon tomografisi (PET) - bilgisayarlı tomografinin (BT) onkolojide kullanımı giderek artan öneme sahip olmaktadır. Çalışmamızda tümörün bazı özelliklerine göre 18 F-floro-2-deoksi-D-glukoz ( 18 F-FDG) tutulum yoğunluğu arasındaki ilişkiyi araştırmayı planladık. Gereç ve Yöntem: Çalışmamızda onkoloji kliniğimize meme kanseri teşhisi ile başvuran ve PET-BT çekimi yapılan 414 hastanın dosyası retrospektif incelendi. Çalışmaya 18-90 yaş aralığında olan meme kanserli hastalar dahil edildi. İkincil malignitesi olan, akli dengesi yerinde olmayan, 18 yaşından küçük ve 90 yaşından büyük hastalar çalışma dışı bırakıldı. Moleküler alt tiplere, tümör boyutlarına, vücut kitle indeksine ve proliferasyon indekslerine göre FDG tutulumları araştırıldı. Bulgular: Çalışmaya dahil edilen 414 hastanın yaş ortalaması 48.8 yıldı. Hastaların büyük çoğunluğunun alt tipi; invaziv duktal karsinom idi. Tanı anında 86 hasta metastatik evrede iken, 327 hasta lokal veya lokal ileri evredeydi. Çalışmada Ki-67 artışı ile FDG tutulumunun artışı arasında korelasyon saptandı ve istatiksel olarak anlamlı bulundu. Sonuç: Çalışmada tümör boyutu büyük olanlarda daha fazla FDG tulumu mevcut idi. Aynı şekilde proliferasyon indeksi artışında ve invaziv duktal karsinomda daha yüksek FDG tutulumu mevcut idi. Tümör özellikleri ile FDG tutulumları arasındaki ilişki gelecekte bireyselleştirilmiş tedavi için prediktif bir belirteç olarak kullanılabilir.Öğe Prognostic importance of primary tumor location in RAS mutant metastatic colorectal cancer(Dicle Üniversitesi Tıp Fakültesi, 2019) Akdeniz, Nadiye; Kaplan, Muhammet Ali; Küçüköner, Mehmet; Urakçı, Zuhat; Sezgin, Yasin; Ebinç, Senar; Bilen, Erkan; Karhan, Oğur; Laçin, Şahin; Büyükbayram, Hüseyin; Işıkdoğan, AbdurrahmanObjective: The prognostic value of tumor location in patients with metastatic colorectal cancer (mCRC) was reported by recent analyses in RAS wild-type patients. However, there is no enough specific data regarding prognostic value of primary tumor location in RAS mutated mCRC patients. We aimed to find if there is any relation between tumor prognosis and primary tumor location in patients with RAS mutated mCRC. Method: This retrospective study included 57 patients with mCRC who were diagnosed and treated in our hospital between January 2011 and December 2017. Characteristics features of the patients were obtained from our institution patient medical records. Patients were included to the present study if KRAS or NRAS mutation was detected in tumor tissues.Results: Twenty-nine (50.9%) of patients were female and the median age of all patients was 52 (18-80) years. Forty (70.2%) of 57 patients were defined as left side (LS) and 17 (29.8%) of patients were located in the right side (RS). As first line systemic treatment, twenty-five (43.9%) patients had received oxaliplatin-based chemotherapy while 32 (56.1%) patients had received irinotecan-based chemotherapy. Tumor sidedness did not affect on progression-free survival (PFS) (mPFS, 10.9 months for LS vs 8.1 months for RS, p=0.400) and overall survival (OS) (mOS, 20.9 months for LS vs 20.8 months for RS, p=0.930).The patients who had oxaliplatin based chemotherapy regimens showed better OS rate than irinotecan based regimens (28.7months vs16.3 months, p=0.017, respectively). Conclusion: Our study results support the thought that claims the sidedness of primary CRC in metastatic setting does not have effect on PFS and OS in patients with RAS mutant mCRC. However, our findings also underline the necessity of studies with larger patient populations and subgroup analyzes to evaluate potential prognostic and molecular features to determine the standart approach to this specific subgroup of the disease.
