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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 IPS-3 Validation in 1012 cases with classical hodgkin lymphoma(Pergamon-Elsevier Science LTD, 2021) Paydaş, Semra; Laçin, Şahin; Doğan, Mutlu; Barışta, İbrahim; Yıldız, Birol; Seydaoğlu, Gülşah; Civriz, Sinem; Kaplan, Muhammed Ali; Yağcı, Münci; Gürkan, Emel; Erçolak, VehbiThe aim of this study is to validate the IPS-3 scoring system as a prognostic indicator in 1012 patients with advanced stage classical Hodgkin Lymphoma (cHL) treated by doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD). According to the IPS-3 scoring system only 3.5 % had high risk and 50.8 % had low risk disease disease and 45.8 % of the cases had intermediate risk disease. Each factors of IPS-7 and IPS-3 scoring systems (age, sex, stage hemoglobin, albumin, lymphocyte count and white cell count) were found to be significant for overall survival (OS) and progression free survival (PFS) according to univariate analyses. Two different multivariate Cox analyses were performed for OS and PFS including the IPS-3/ IPS-7 scoring system parameters. Among 7 risk factors of IPS scoring system, gender and albumin were not found as independent risk factors for both OS and PFS according to cox regression model. But all parameters such as age, stage and hemoglobin those included in IPS-3, were found to be independent significant risk factors for both models obtained for OS and PFS. The results of the study shows that the IPS-3 scoring system can be used as a prognostic indicator in ABVD treated patients in every day practice which is more easily calculate according to the IPS-7.Öğe Kolorektal kanserli hastalarda tümör taraflılığının önemi ve diğer klinikopatolojik özelliklerle ilişkisi(Kafkas Üniversitesi, 2021) Söğütçü, Nilgun; Laçin, Şahin; Yerlikaya, Halis; Yılmaz, DenizAmaç: Kolorektal kanser (KRK) en yaygın ve ölümcül hastalıklardan biridir ve hastaların sınıflandırılmasında prognostik faktörler çok önemlidir. Bu çalışmada, KRK hastalarında CDX2 ekspresyonu, serum CEA düzeyi ve tümör taraflılığının önemini değerlendirmeyi amaçladık. Materyal ve Metot: Eylül 2014-Aralık 2019 tarihleri arasında hastalık evresine bakılmaksızın kolorektal kanser tanısı alan hastalar dahil edildi. KRK tanısı primer veya metastatik lezyondan elde edilen patolojik doku bulguları ile doğrulandı. Serum CEA düzeyi, primer tümör taraflılığı (sağ taraf veya sol taraf), CDX2 ekspresyonu ve elde edilen diğer demografik özellikler çalışma değişkeni olarak kaydedildi. Tüm çalışma analizleri SPSS sürüm 22 istatistik yazılımı (IBM Corporation) kullanılarak yapıldı. Bulgular: KRK'lu 152 hasta dahil edildi, 64 hasta (% 42.1) kadın, 88 hasta (% 57.9) erkek, ortalama yaş 55 (18-93 yaş) idi. Serum CEA düzeyi 3.5 ng / ml olan hastalarda ortalama sağkalım sırasıyla 35.1 ve 26.6 aydı ve gruplar arasındaki fark istatistiksel olarak anlamlıydı (p = 0.006). Hastalık evresi ile serum CEA düzeyi arasında pozitif korelasyon vardı, metastatik hastalarda serum CEA düzeyi metastatik olmayan hastalara göre daha yüksekti (p = 0.009). Doku CDX2 ekspresyonu açısından, on bir hastada (% 7.2) CDX2 ekspresyon negatif, 136 hastada (% 89.5) CDX2 ekspresyon pozitif bulundu. CDX2 ekspresyon durumuna göre hastaların OS oranları arasındaki fark anlamlı değildi (p = 0.7). Sol taraflı hastaların sağ taraflılara göre daha uzun süre hayatta kalmasına rağmen, fark anlamlı değildi, medyan OS sırasıyla 67.6 ve 29.7 aydı (p = 0.3). Ortalama takip süresi 24.1 aydı. Sonuç: Serum CEA düzeyi, CRC hastaları için belirgin bir prognostik faktör olarak bulundu. Ek olarak CDX2 ekspresyonu pozitif ve sol taraflı primer tümörlerin literatürde bildirildiği gibi daha uzun sağkalımı vardı. Ayrıca, tümör taraflılığı ve serum CEA düzeyine dayanan hasta sınıflama modelimiz umut verici sonuçlar elde etmiştir, ancak daha büyük ve prospektif çalışmalarla doğrulanması gerekmektedir.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.
