[Show abstract][Hide abstract] ABSTRACT: Introduction: Lung cancer is the leading cause of cancer mortality worldwide. Smoking cigarettes is the predominant risk factor. Chemotherapy (CT) plays an integral part in treating locally advanced-non-small cell carcinoma of the lung (LA-NSCLC) as it improves survival in all subgroups of patients. In this study, our aim was to perform a retrospective overview of our data in LA-NSCLC patients and to explore which CT regimen is more effective during chemoradiotherapy (CRT). Materials and methods: One hundred and thirty-two patients were included in this study. Seventy-six of the patients received 60 Gy radiotherapy (RT) concomitantly with chemotherapy at a weekly dose of 20 mg/m2 docetaxel and 20 mg/m2 cisplatin (P). Five patients received P 50 mg/m2 intravenously (IV) on days 1, 8, 29, and 36 as well as etoposide (E) 50 mg/m2 IV on days 1-5 and 29-33 concurrently with 60 Gy chest RT. Nine patients received weekly doses of carboplatin AUC 2 and paclitaxel 50 mg/m2 and fortytwo patients received only cisplatin 20 mg/m2 concurrently with 60 Gy chest RT. Results: The median age of the deceased patients was 61.20±9.96 and 57.70±8.60 for surviving patients. Following concomitant CRT, 26 patients (20%) showed complete response and 66 (50%) showed partial response (total response rate was 70%). The median follow-up period was 22 months (range: 8-36 months). Esophagitis developed in ten (13%) patients, neutropenia in fifteen (9%) patients and pneumonitis in eleven (12%) patients, as grade III-IV toxicity advanced due to concomitant CRT. Consolidation chemotherapy was given to patients with partial response. Conclusio: There are no clinical trials that have established the optimal regimen for concurrent CRT. In our study, the most effective regimen with CRT was carboplatin and paclitaxel. This finding should be evaluated in larger clinical trials.
[Show abstract][Hide abstract] ABSTRACT: Background: We aimed to investigate the impact of RRM1 and ERCC1 expression on response to cisplatin and/or gemcitabine chemotherapy in patients with lung, ovarian or pancreatic cancer. Material and methods: Patients with lung, ovarian or pancreatic cancer, who used cisplatin and/or gemcitabine therapy were included; hospital files were examined and RRM1 and ERCC1 expression were evaluated with an immunohistochemical method on tissue cross sections from paraffin blocks of the tumour. Results: Out of 89 patients, 51%, 30% and 19% had lung, ovarian and pancreatic cancer, respectively. The response rates to the therapy in patients with lung and ovarian cancer having low ERCC1 expression were 62% and 90%, respectively (p = 0.028 and p = 0.044, respectively). No significant association was found between ERCC1 expression and response to therapy in patients with pancreatic cancer (p = 0.354). Therapeutic response rates in patients with lung and pancreatic cancer with low RRM1 expression were 60% and 82%, respectively. Survival rates were higher in patients with lung cancer in which ERCC1 and RRM1 expressions were low. Median survival duration in patients with ovarian cancer showing low ERCC1 and RRM1 expressions was longer than that seen in patients with high expressions. Although no significant correlation was found between ERCC1 and the survival in ovarian cancer (p = 0.183), there was a significant correlation between RRM1 expression and survival in patients with pancreatic cancer (p = 0.005). Conclusions: Our results suggest a predictive value of ERCC1 in lung and ovarian cancers, and also RRM1 in lung and pancreatic cancers.
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: Kaposi sarcoma is an angioproliferative disease. Kaposi sarcoma is clinicopathologically classified into four subgroups based on epidemiological data. For its systemic treatment, in addition to some chemotherapeutics, taxanes have also been used during the recent years for their anti-angio-genic properties. In this study, we aimed to compare paclitaxel and non-paclitaxel chemothera-peutic regimens in terms of efficacy and side effects. PATIENTS AND METHODS: In our center, de-mographical, clinical and histopathological characteristics of a total of 13 patients diagnosed with Kaposi sarcoma who received therapy were retrospectively recorded based on their medical files. RESULTS: Among these subjects, 7 have been treated with paclitaxel and 6 with non-paclitaxel therapies. Eleven patients were male. Twelve patients were found to have classical type of Ka-posi Sarcoma. The recurrence was observed in 2 patients treated with paclitaxel and in 1 patient treated with non-paclitaxel therapy. No statistically significant difference was found between the therapeutic modality, the stage of the disease and the percentage of the recurrence. Neu-ropathy developed in 3 patients treated with pa-clitaxel, whereas there was no neuropathy in the other group. Although the recurrence-free survival was worse in the patients treated with pa-clitaxel, there was no statistically significant difference. DISCUSSION: Cytotoxic chemotherapy is effective in treating patients with Kaposi Sarcoma, although it is palliative. Taxanes have demonstrated effectiveness against AIDS-associated Kaposi Sarcoma. The experience suggests that paclitaxel is an effective alternative in the treatment of classical form Kaposi's sarcoma. CONCLUSIONS: There was no difference in efficacy between paclitaxel and non-paclitaxel therapies whereas difference in occurrence of neuropathy which is one of the side effects, showed borderline statistical significance.
European review for medical and pharmacological sciences 01/2015; · 1.21 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND:
The aim of this study was to investigate the general characteristics of patients with deep vein thrombosis (DVT) and pancreatic cancer as well as evaluate the relationship between mean platelet volume (MPV), DVT and survival.
MATERIALS AND METHODS:
Seventy-seven patients with pancreatic cancer, who were admitted to Cukurova University Medical Faculty, Department of Medical Oncology, were enrolled in the study.
Results: The mean age was 59±20. Forty-nine (63.6%) were men and 28 women (36.4%) . Sixty-eight (88.3%) patients had adenocarcinoma and 9 (11.7%) had a malignant epithelial tumor. Thirty-six (46.7%) had liver metastasis at diagnosis. Twenty-six (33.8%) patients were alive, 20 (26%) were dead and in 31 (40.2%) the status was unknown. Only 14 (18.1%) patients had DVT. In 42 (54.5%) patients MPV values were normal, in 28 (36.4%) patients they were above normal, and in 7 (9.1%) patients they were below normal. There was no statistically significant difference between gender, tumour localization, chemotherapy and survival rates (p:0.56, p:0.11, p:0.21). There was no significant difference between DVT, gender, localisation, histological subtype, the presence of metastasis, stage and if the patient had been treated with chemotherapy (p:0.5, p:0.6, p:0.2, p:0.32, p:0.1, p:0.84). There was also no significant difference between MPV and DVT (p:0.57) but there was a significant difference between liver metastasis and DVT (p:0.02). Age, stage, the presence of metastasis and DVT were prognostic in pancreatic cancer patients.
Cases of pancreatic cancer with liver metastasis should be studied more carefully as thrombosis is more common in these patients.
Asian Pacific journal of cancer prevention: APJCP 11/2014; 15(21):9143-6. DOI:10.7314/APJCP.2014.15.21.9143 · 2.51 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Actinomycosis is a chronic suppurative infection, for which immune suppression is a predisposing factor. In unusual cases, this disease may present as an abdominal wall involvement simulating a soft tissue tumor as seen in the present case. The presented patient had no signs of trauma or surgical approach and the pathology was considered to be a primary abdominal wall actinomycosis. Preoperative diagnosis is difficult due to the nonspecific nature of clinical presentation, radiographic and laboratory findings. Surgery combined with antibiotic treatment is a curative approach for this relatively rare infection. Surgeons must be aware of this disease in order to ensure correct diagnosis and to prevent performing any unnecessary procedures. The present study describes a case of abdominal actinomycosis with multiple myeloma, together with a review of important points related to this disease.
[Show abstract][Hide abstract] ABSTRACT: Özet Giriş: Osteosarkomlar patolog, radyolog, ortopedist, radyasyon onkoloğu ve medikal onkolog tarafından multidisipliner olarak yönetilmesi gereken bir hastalıktır. Biz bu çalışmada merkezimizdeki osteosarkom tanılı hastaların demografik özellikleri ve tedavi modalitelerini incelemeyi amaçladık. Gereç ve Yöntem: Cukurova Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı'nda 1999-2010 tarihlerinde osteosarkom tanısıyla tedavi almış ve takip edilmiş hastaların verileri retrospektif olarak araştırıldı. Bulgular: Osteosarkom ta-nılı 119 hastanın %74 ü erkek, %26 sı kadın hastadan oluşmaktaydı. Medi-an yaş 19, median takip süresi 37 ay dı. En sık görülen patolojik alt tip, % 82.4 osteoblastik osteosarkomdu. Hastalığın lokalizasyonu %55 alt extremi-te, %14.1 i üst extremite, %13 baş-boyun bölgesi, %6.6 torakal bölge, %4.1 pelvik bölge idi. Hastaların %6.41 lokal, %25.64 lokal-ileri, %15.8 metastatik evre ve %14.10 nüks hastalıktı. 119 hastanın 77 si kemoterapi aldı. Hastala-rın %23.1 i preoperatif, %16.67 si postoperatif, %9.52 si palyatif, %33.33 ü preoperatif+postoperatif, % 2.38 postoperatif+palliative, %9.52 si preopera tif+postoperatif+palliative kemoterapi ve %4.76 hast ise kemoterapi almadı. Cerrahi yaklaşımlar radikal ve konservatif olarak yapıldı. En sık metastaz yeri %18.1 oranla akciğerdi. Genel sağ kalım süresi 65 ay dı (95%CI 30-59). Pre-operatif, postoperatif, preoperatif+postoperatif kemoterapi alanlar ve diğer grup arasında sağ kalım süreleri açısından fark izlenmedi (sırasıyla 23ay, 36 ay, 28 ay 44 ay) (p=0.8). Radyoterapi uygulanan ve uygulanmayanlar arasında istatistiksel olarak anlamlı sağkalım farkı gözlenmedi (p=0.06). Tartışma: Os-teosarkom cerrahi, kemoterapi ve radyoterapi yöntemleriyle tedavi edilebi-len bir hastalıktır. Çalışmamızda hastalara uygulanan kemoterapi yöntemle-ri arasında sağ kalım farkı izlenmemiştir. Bu sonuçlar cerrahi, kemoterapi ve radyoterapiyide içeren multidisipliner tedavinin önemini ortaya koymaktadır.
[Show abstract][Hide abstract] ABSTRACT: Paragangliomas are relatively rare chromaffin cell tumors which may be cured through resection. Patients with paragangliomas may develop metastatic diseases. There is no consensus regarding refractory chemotherapy for treatment of metastatic disease. In this report, we presented a case of a 43-year-old woman who was admitted to the hospital with a history of episodic headaches, diaphoresis, and weakness. Elevated plasma catecholamine levels and a right paraaortic mass were observed on computed tomography. The mass was excised, and a diagnosis of paraganglioma was confirmed. After 20 months of follow up, local recurrence and metastases were detected in the thorax, abdomen, and skeletal system. Plasma and urinary catecholamine levels were high. Chemotherapy was administered, and no improvement was observed. Therefore, following this palliative conventional chemotherapy, Sorafenib was administered for three months, and, finally, Positron Emission Tomography showed that the patient's lesions had completely regressed.
Cancer Research and Treatment 07/2014; 46(4). DOI:10.4143/crt.2013.093 · 3.32 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Aim of the study
Important signalling pathways play fundamental roles in the pathogenesis of thyroid carcinoma (TC). PTEN, mTOR, PI3K-p85 and K-Ras are the principal factors involved in these signalling pathways. To immunohistochemically examine the expressions of PI3K, mTOR and PTEN in patients suffering from follicular TC, papillary TC or variants thereof, as well as to investigate KRAS mutations via PCR to determine their clinical and prognostic relevance to differentiated thyroid cancer.
Material and methods
The expression of PTEN, PI3K-p85 and mTOR was immunohistochemically examined, and the mutation of K-Ras was examined via PCR. The results obtained were compared to the clinico-pathologic characteristics of the patients.
A significant correlation was found between p85 expression and lymphovascular invasions and between PTEN expression and multifocality (p = 0.048 and p = 0.04, respectively), and a correlation between p85 and capsular invasion was found, with a borderline statistical significance (p = 0.056). No expression of PTEN, p85 or Mtor was detected in normal tissue. K-Ras mutation was examined in 66 of the 101 patients (57.4%), and the percentage of patients exhibiting a K-Ras mutation was 17.4%. All of the patients exhibiting a K-Ras mutation were women (p = 0.047). The disease-free survival was 44.6 months (95% CI: 37.9–51.3) and was statistically significantly higher in the group that displayed level 1 or lower expression of p85 (p = 0.043).
The expression levels of the aforementioned markers were significantly higher in TC cells than in normal tissue. A significant correlation was detected between K-Ras mutation and gender. This study demonstrates that p85 and PTEN are markers that should be evaluated in further studies of TC.
[Show abstract][Hide abstract] ABSTRACT: Sweet syndrome, also referred to as acute febrile neutrophilic dermatosis, is characterized by tender, red inflammatory nodules or papules that occur in association with infection, malignancy, connective tissue disease, or following exposure to certain drugs. Here, we present Sweet syndrome in a case with small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) which is a relatively rare co-occurrence.
Conflict of interest:None declared.
[Show abstract][Hide abstract] ABSTRACT: Purpose:
Multiple myeloma (MM) patients relapse after a period of time despite longer disease-free survival due to novel treatment options. In this study we aimed to assess the value of real-time polymerase chain reaction (RT-PCR) for detecting the immunoglobulin heavy chain (IgH) gene rearrangement using allele-specific molecular beacons as fluorescence probes to quantify minimal residual disease (MRD) and also to correlate post-treatment flow cytometric detection of plasma cells' (PCs) expression of CD19, CD38, CD45, CD56 and CD138 in MM.
After diagnosis of 17 MM patients, the CDR1, CDR2 and CDR3 regions of the IgH gene were analysed and sequenced to identify IgH's clonal nature. Unique sequences of the clonal IgH rearrangement were used to design specific molecular beacon probes for each MM patient. Examined were also the co-expression of CD19, CD38, CD45, CD56, and CD138 molecules in bone marrow aspirates of patients with MM by flow cytometry.
Detection of MRD was positive in 13 (76%) of 17 patients by RT-PCR. The infiltration ratio was significantly correlated with CD138 expression (p=0.009). Significant correlation was also found between RT-PCR detection of MRD and CD138 expression (p=0.006). Nevertheless, no correlation was observed among other surface antigens (CD38, CD45, CD56).
Our results indicated that RT-PCR with specific molecular beacons provide a feasible, accurate and reproducible method for the determination of MRD in MM. Flow cytometry detection of CD138 expression may be used as a disease marker in addition to RT-PCR.
Journal of B.U.ON.: official journal of the Balkan Union of Oncology 07/2013; 18(2):442-447. · 0.74 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Purpose:
Mutations that activate the PIK3CA oncogene and inhibit the tumor suppressor gene PTEN action are commonly found in breast tumors. Akt is a key activator of cell survival. p53 is frequently found mutated in human tumors, and mutant p53 protein actively contributes to tumorigenesis. In selected cases of breast cancer, trastuzumab (TZMB) is incorporated in the primary treatment in the adjuvant and metastatic settings. Many studies have reported that selected patients are resistant to TZMB due to the presence of p95 HER2 fragments. To address this, we analysed PTEN, Akt, MAPK, p53 and p95 expression in breast cancer patients treated with TZMB.
Out of 90 patients histologically diagnosed with breast cancer between 2004 and 2011, analysed were 25 patients with HER2 positive, and estrogen (ER) and progesterone receptors (PR) negative, metastatic or locally advanced disease. All 25 patients were treated with TZMB and resistance to TZMB was assessed. All patients were on anthracycline-and taxane-containing regimens. Tissue samples were obtained from paraffin blocks and evaluated immunohistochemically for PTEN, Akt, MAPK, p53, and p95 expression.
TZMB resistance was detected in 5 (20%) patients. Akt expression was positive in 2 patients (8%) and MAPK, p95, and p53 expression was positive in 1 patient (4%); PTEN expression was negative in 3 patients (12%). No significant differences were found between TZMB resistance and PTEN, Akt, MAPK, p53, and p95 expression. Subgroup analysis was carried out in the neoadjuvant treatment group. Complete pathologic response was detected in 3 patients (21.4%). Statistically significant differences were not found between the complete response rate and PTEN, Akt, MAPK, and p95 expression. There was a statistically significant correlation between p53 expression and complete pathologic response (p=0.02).
No statistically significant correlation between TZMB resistance and the expression of these biomarkers was noted. In patients with HER2-positive breast cancer that were treated with 4 dose-dense sequential cycles of doxorubicin and cyclophosphamide, followed by TZMB and paclitaxel combination therapy in the neodjuvant setting, p53 expression could predict complete response to chemotherapy.
Journal of B.U.ON.: official journal of the Balkan Union of Oncology 04/2013; 18(1):44-50. · 0.74 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
No factor has thus far been identified to predict the efficacy of bevacizumab therapy for colorectal cancer. We here therefore studied PTEN, VEGF, HER2 and p53 by immunohistochemistry as possible prognostic and predictive factors.
Materials and methods:
A total of 34 retrospectively collected tumor samples were evaluated, all from patients receiving bevacizumab-based regimens. VEGF-A, PTEN, HER2, p53 were assessed and data was compared with clinicopathologic characteristics of patients and the bevacizumab response rate.
In this study, the median age of the 34 metastatic colorectal cancer patients was 55.5 (24-75), twelve (35.3%) being women and 22 (64.7%) men. PTEN, VEGF, HER2, p53 expressions were compared with bevacizumab response and other chacteristics of disease. Statistical significant differences were not found between bevacizumab response rates and different expression levels of VEGF, PTEN, HER2 and p53 (respectively p=0.256, p=0.832, p=0.189, p=0.131). However, a survival difference was noted in the VEGF expression negative group (median OS:55 months; 95%CI, 22-88 months) (p=0.01). There was no statistically significant OS difference in other groups (PTEN p=0.6, HER2 p=0.189, p53 p=0.13).
We did not find any predictive factor for BV therapy in our study. VEGF negative expression could be an important prognostic factor in metastatic colorectal carcinoma.
Asian Pacific journal of cancer prevention: APJCP 12/2012; 13(12):6397-401. DOI:10.7314/APJCP.2012.13.12.6397 · 2.51 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Neurofibromatosis type 1 (NF1) is a genetic syndrome that predisposes patients to benign and malignant tumor development. Patients with NF1 develop multiple neurofibromas that can transform into aggressive sarcomas known as malignant peripheral nerve sheath tumors. In contrast, malignant tumors unrelated to the nervous system rarely coexist with neurofibromatosis. The aim of this article was to present four cases of adult NF1 patients with malignant tumors unrelated to the nervous system as well as a bibliographic search for papers describing these tumors in NF1, focusing on osteosarcomas, gastrointestinal stromal tumors (GISTs), leiomyosarcomas and somatostatinomas and their genetic alterations in NF1.
Search engines such as PubMed and MEDLINE were browsed for English-language articles since 1989 using a list of keywords, as well as references from review articles. Search terms were NF1, osteosarcoma, leiomyosarcoma, somatostatinoma and GIST. Data were summarized in a table at the end of the Results section.
In our four NF1 cases, there were one osteosarcoma, one leiomyosarcoma, one somatostatinoma and GIST and one GIST. NF1 was diagnosed at an adult age when these patients were admitted to our oncology department. The results generated by the literature search yielded 75 articles about NF and GIST. We summarized the clinical characteristics of 43 patients with NF1 and somatostatinoma. Forty-five articles involving NF and osteosarcoma were found, and of these, 26 involved NF1; from these articles, we identified the clinical features of 8 patients. Twenty-five articles were found concerning NF1 and leiomyosarcoma, and of those, we summarized the clinical features of 15 patients.
Here we reviewed somatostatinomas, GISTs, osteosarcomas and leiomyosarcomas occurring in NF1 patients. Patients with NF1 who present with gastrointestinal symptoms, should be carefully evaluated carefully with a high index of suspicion of potential GISTs, periampullary and duodenal tumors. Patients with pathological fractures or bone pain along with NF1 should be carefully screened for malignant bone tumors. Patients with NF1 can develop leiomyosarcoma less frequently than other malignancies, but the association of uterine leiomyoma and NF1 may not be fortuitous. Somatic mutations were defined for frequent tumors, including neurogenic tumors and GISTs but not for sarcomas due to the complexity of underlying mechanisms of the disease and tumorigenesis. Based on the findings; all NF patients can develop malignant tumors, including the less frequently observed ones. Therefore, we recommend that new genetic studies should be performed for rare malignancies in cases of NF1.