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    Comparison of the efficacy and safety of 3 months of CAPOX followed by 3 months of capecitabine and 6 months of CAPOX/FOLFOX in the adjuvant treatment of low-risk stage-III colon cancer treated surgically
    (Karger, 2023) Bardakci, Murat; Esmer, Derya; Hafizoglu, Emre; Yaslikaya, Sendag; Genc, Tugrul Burak; Ozcelik, Melike; Erdat, Efe Cem
    Introduction: In the adjuvant treatment of low-risk stage-III colon cancer treated surgically, 3 months of CAPOX followed by 3 months of capecitabine is not a common clinical practice. Since there are no data on this practice in the literature, we have no idea how often it is used. However, it should be noted that this application is used in some centers due to the cumulative neurotoxicity of oxaliplatin but there are insufficient data in the literature on its efficacy.Methods: The data of patients with colon cancer treated surgically who were followed up in 12 different oncology centers in Turkey between November 2004 and June 2022 were analyzed retrospectively.Results: The study included 194 patients. The treatment arms were as follows: 3 months of CAPOX followed by 3 months of capecitabine = arm A and CAPOX/FOLFOX (6 months) = arm B. There were 78 patients (40.2%) in arm A and 116 patients (59.8%) in arm B. The median age and sex distribution were similar between the treatment arms. The median follow-up period of all patients was 34.4 months (95% CI, 29.1-39.7). When arm A was compared with arm B, 3-year disease-free survival (DFS) was 75.3% vs. 88.4% and 5-year DFS was 75.3% vs. 82.8%, respectively. There were similar DFS outcomes between the treatment arms (p=0.09). Rates of any grade of neuropathy were numerically lower in arm A, but the difference between the treatment arms was not statistically significant (51.3% vs. 56.9%; p=0.44). The frequency of neutropenia was similar between the treatment arms.Discussion/Conclusion: In this study, the efficacy and safety of the 3 months of CAPOX followed by 3 months of capecitabine chemotherapy regimen in the adjuvant treatment of low-risk stage-III colon cancer treated surgically was proven. This result may also support the discontinuation of oxaliplatin at 3 months while continuing fluoropyrimidines, which is a common clinical practice but lacks sufficient data.
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    The Effectiveness of Adjuvant PD-1 Inhibitors in Patients With Surgically Resected Stage III/IV Acral Melanoma
    (Lippincott Williams & Wilkins, 2024) Arak, Haci; Erkilic, Suna; Yaslikaya, Sendag; Mocan, Eda Eylemer; Aktas, Gokmen; Ozdemir, Melek; Semiz, Huseyin Salih
    Our aim was to assess the efficacy of adjuvant programmed cell death protein-1 (PD-1) inhibitors and compare the other adjuvant treatments in patients with surgically resected stage III or IV acral melanoma. This study is a multicenter, retrospective analysis. We included 114 patients with stage III or IV acral malignant melanoma who underwent surgery within the past 10 years. We analyzed the effect of adjuvant programmed cell death protein-1 inhibitors on disease-free survival (DFS). The mean follow-up was 40 months, during which 69 (59.5%) patients experienced recurrence. Among the participants, 64 (56.1%) received systemic adjuvant therapy. Specifically, 48.4% received anti-PD-1 therapy, 29.7% received interferon, 14.1% received tezozolomide, and 7.8% received B-Raf proto-oncogene/mitogen-activated protein kinase inhibitors. Patients who received adjuvant therapy had a median DFS of 24 (10.9-37.2) months, whereas those who did not receive adjuvant therapy had a median DFS of 15 (9.8-20.2) months. Multivariate analysis for DFS revealed that the receipt of adjuvant therapy and lymph node metastasis stage were independent significant parameters (P = 0.021, P = 0.018, respectively). No statistically significant difference was observed for DFS between programmed cell death protein-1 inhibitor treatment and other adjuvant treatments. Regarding overall survival (OS), patients who received adjuvant treatment had a median OS of 71 (30.4-111.7) months, whereas those who did not receive adjuvant treatment had a median OS of 38 (16.7-59.3; P = 0.023) months. In addition, there were no significant differences in OS observed between various adjuvant treatment agents (P = 0.122). In our study, we have shown that adjuvant therapy had a positive effect on both DFS and OS in patients with stages III-IV acral melanoma who underwent curative intent surgery. Notably, we found no significant differences between anti-PD-1 therapy and other adjuvant therapies.
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    Prognostic Factors Associated with Resected Osteosarcoma: Efficacy of Adjuvant Setting, Real-World Experience
    (Akad Doktorlar Yayinevi, 2024) Majidova, Nargiz; Simsek, Fatih; Biter, Sedat; Yaslikaya, Sendag; Seyyar, Mustafa; Duygulu, Mustafa Emre; Arcagok, Murat
    Osteosarcoma is a curable tumor. Surgery is performed after neoadjuvant chemotherapy as the primary standard treatment, followed by adjuvant therapy again. However, it is seen in patients who have undergone surgery without neoadjuvant chemotherapy. Adjuvant treatment is always given in this group. However, it is controversial how many cycles of adjuvant treatment should be given. In our study, 42 patients with osteosarcoma who received only adjuvant treatment without neoadjuvant treatment were analyzed for the effects of epidemiologic factors, treatment regimens on overall survival and disease -free survival. Retrospectively, 42 osteosarcoma patients (5 centers) with a current age of 18years and older who were followed up between 2001-2022 were examined. Twenty-five (60.0%) were below 8 cm, and 16 (38.0%) were 8 cm and above. The median number of cycles of adjuvant chemotherapy was 4 (range; 1-6). The 4 -year DFS rate was 50.2%. In patients with primary tumors smaller and larger than 8cm, the 4 -year DFS rates were 66.1% and 22.2%, respectively. The 4 -year DFS rates for patients with 4 or less and more than 4 cycles of adjuvant chemotherapy were 27.1% and 69.2%, respectively. The 4 -year OS rate was 78.5% in patients with primary tumors smaller than 8 cm and 18.8% in patients with tumors larger than 8 cm. The 4 -year OS rate was 24.3% in patients who received 4 or less adjuvant cycles and 79.5% in patients who received more than 4 cycles. We have demonstrated that the number of adjuvant therapy courses above 4 and the presence of primary tumors smaller than 8 cm are influential over overall and disease -free survival in the patients who did not receive neoadjuvant therapy. The number of postoperative adjuvant treatment cycles should be forced as much as possible in these patients who haven't had neoadjuvant therapy.