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Öğe The comparison of FOLFOX regimens with different doses of 5-FU for the adjuvant treatment of colorectal cancer: a multicenter study(Springer, 2021) Akdeniz, Nadiye; Kaplan, Muhammet Ali; Uncu, Doğan; İnanç, Mevlüde; Kaya, Serap; Dane, Faysal; Küçüköner, Mehmet; Demirci, Ayşe; Bilici, Mehmet; Durnalı, Ayse Gök; Koral, Lokman; Şendur, Mehmet Ali Nahit; Erol, Cihan; Türkmen, Esma; Ölmez, Ömer Fatih; Açıkgöz, Özgür; Laçin, Şahin; Şahinli, Hayriye; Urakçı, Zuhat; Işıkdoğan, AbdurrahmanPurpose We aim to compare the efficiency and toxicity of three different 5-fluorouracil (5-FU) administration types in 5-FU, leucovorin, and oxaliplatin (FOLFOX) combination treatment for adjuvant therapy in colorectal cancer (CRC). Methods Five hundred and seventy patients with stage III colorectal carcinoma who received different FOLFOX regimens after curative resection were included. Patients were divided into three groups as FOLFOX-4, modified FOLFOX-6 (mFOLFOX-6), and mFOLFOX-4 for comparison of toxicity and disease-free survival (DFS) and overall survival (OS) times. Results Three-year DFS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 65%, 72%, and 72%, respectively. Five-year OS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 69%, 75%, and 67%, respectively. There was no statistically significant difference between the three treatment groups in terms of DFS and OS (p = 0.079, and p = 0.147, respectively). Among grade 1-2 adverse events (AE), thrombocytopenia, neuropathy, and stomatitis were more common in the mFOLFOX-6-treated group. The frequency of grade 1-2 nausea and vomiting were similar in mFOLFOX-6 (36.3% and 24%, respectively) and mFOLFOX-4 (32.4% and 24.7%, respectively) groups but were higher than that in the FOLFOX-4 (19.5% and 11.3%, respectively) group. Among the most common grade 3-4 AE, neutropenia (53.4%, 9%, and 13.5%, respectively) and diarrhea (10.5%, 2.2%, and 2.4, respectively) were more common in FOLFOX-4. The rate of anemia and febrile neutropenia was similar in treatment groups (p = 0.063, and p = 0.210, respectively). Conclusion In the adjuvant treatment of stage III CRC patients, three different 5-FU administration types in FOLFOX combination treatment can be used with similar efficiency and manageable toxicity.Öğe Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy(BioMed Central Ltd, 2023) Karaçin, Cengiz; Öksüzoğlu, Berna; Demirci, Ayşe; Baytemür, Naziyet Köse; Yılmaz, Funda; Kalkan, Ziya; Keskinkılıç, MerveBackground There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the efectiveness of systemic treatments after CDKi and whether there is a survival diference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in frst-line (group A, n:202), second-line (group B, n: 153) and≥3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p=0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p=0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p=0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p=0.047), 6.7 vs. 5.0 (p=0.164), 6.7 vs. 3.9 (p=0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as efective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after frst-line CDKi compared to monotherapy ET.Öğe Seroprevalence investigation of Hepatitis B and Hepatitis B core antigen in oncology patients(Galenos Yayıncılık, 2020) Kalkan, İrem Akdemir; Demirci, Ayşe; Çınar, Gule; Çelen, Mustafa KemalObjectives: Hepatitis B virus (HBV) affects a significant part of society and is characterized by high mortality and morbidity. Hepatitis B affects approximately 350 million people worldwide, many of whom are chronic patients. Especially being under immunosuppressive therapy is a risk factor for the reactivation of the disease. The aim of this study was to investigate the seroprevalence of HB in oncology patients. Materials and Methods: In this study, the seroprevalences of hepatitis B surface antigen (HBsAg), anti-hepatitis C virus, anti-HBs, and anti-hepatitis B core antibody (anti-HBc) immunoglobulin G (IgG) were retrospectively evaluated from the medical records of 84 patients who were diagnosed of cancer, and were admitted to the outpatient clinic of medical oncology in the Batman State Hospital within a period of one year (between January and December 2017). Results: Anti-HBc IgG was positive in 44 patients (52.2%),16 (36.4%) have received treatment for the prevention of HBV reactivation six of these patients were HBsAg positive No reactivation and no side effects occur in patients who received prophylactic antiretroviral treatment. Conclusion: In our study, both the proportion of patients with HBsAg positivity and the proportion of patients with natural immunity were found to be slightly higher than those in Turkey and worldwide. No patients with HB reactivation is important evidence of necessity effectiveness of prophylactic antiviral treatmentÖğe Where should enzalutamide be in the metastatic Castration Resistant Prostate Cancer (mCRPC): A multi-center study(Kare Publishing, 2023) Koca, Sinan; Ökten, İlker Nihat; Beşiroğlu, Mehmet; Telli, Tuğba Akın; Demirci, Ayşe; Karaağaç, Mustafa; Oruç, ZeynepObjectives: Enzalutamide(ENZ) is an effective hormonal treatment modality in mCRPC. It can be used before or after docetaxel(DTX) in this setting. Herein, we aimed to show the efficacy of ENZ before or after DTX use and the factors predicting the efficacy. Methods: We retrospectively collected the data of 320 patients from 12 centers who were treated with ENZ in mCRPC. The initial stage, age, line of treatment, serum prostate-specific antigen (PSA) levels before ENZ treatment and at nadir, site of metastasis, gleason score were evaluated. Results: Median age of 320 patients were 69. At a median follow-up of 56 months, 271/320 (84.7%) disease progression and 230/320(71.9%) death had been observed. Median PFS was 11(8.9-13)) and median OS was 25(22.1-27.8) months in all patients group. Median PFS was 10(7.4-12.5) months, 11(8-13.9) months in pre-DTX and post-DTX groups respectively. Median OS was higher in the post-DTX group than the pre-DTX group (28(25.7-30.2) vs 19(15.0-22.9-46.6) (p:0.000). Gleason score≥8 (HR 0.59, 95%CI 0.46-0.77, p=0.00), presence of non-visceral metastasis (HR 0.72, 95%CI 0.53-0.97, p=0.031), initial PSA value<43(median) (HR 0.70, 95%CI 0.54-0.91, p=0.009), PSA at nadir <2 (HR 0.61, 95%CI 0.44-0.85, p=0.004), >50% decline in PSA (HR 0.27, 95%CI 0.19-0.36, p=0.000) significantly predicted ENZ response regarding rPFS. Conclusion: ENZ has shown equal efficacy before and after DTX treatment in mCRPC regarding rPFS. But OS rate was significantly better in the pre-DTX group. Therefore, we recommend starting with DTX in patients who can tolerate chemotherapy in mCRPC setting.
