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Öğe Comparative assessment of three different second-line regimens in chemotherapy resistant/refractory small-cell lung cancer(Zerbinis Publications, 2021) Hacibekiroglu, I.; Ozkul, O.; Cakir, E.; Kostek, O.; Karatas, F.; Esenkaya, A.; Demirci, A.Purpose: Small cell lung cancer (SCLC) patients unresponsive or relapsing within 90 days following frontline chemotherapy have poor prognosis and they should be treated with different chemotherapy regimens other than those used in the first-line regimen. Currently there is no globally accepted standard chemotherapeutic regimen for the treatment of these patients. This retrospective study was designed to compare CAV (Cyclophosphamide, Doxorubicin, Vincristine), weekly topotecan and weekly irinotecan regimens and to evaluate the efficacy of the three regimens in patients with chemotherapy resistant/refractory (CRR) SCLC. Methods: A total of 67 CRR-SCLC patients, who were treated with CAV, weekly topotecan and weekly irinotecan were reviewed for weekly irinotecan (27 for 60 mg/m2 intravenously on days 1, 8 and 15 of a 28-day cycle,24 for CAV (Cyclophosphamide 750 mg/m2 on day 1, Doxorubicin 50 mg/m2 on day 1 and Vincristine 1.4mg/m2 on day 1 every 3 weeks), 16 for weekly topotecan (4 mg/m2 intravenously on days 1, 8 and 15 of a 28-day cycle). Results: The median follow-up time was 12.45 months, there was no difference about disease control rates (DCR) between three chemotherapy regimens (DCR; 25.9% with irinotecan, 29.2% with CAV and 31.3% with topotecan, p=0.92). Objective response rates (ORR) for irinotecan, CAV and topotecan groups were 3,7%, 8,8%, and 0%, respectively (p=0.63). Median progression free survival (PFS) and overall survival (OS) were similar according to irinotecan, CAV, and topotecan (PFS: 1.93 months, 2.30 months and 3.45 months; OS: 2.89 months, 4.79 months and 5.81 months, respectively). The adverse events were generally mild and manageable for both hematological and nonhematological toxicities in all three arms. Conclusions: Weekly irinotecan, CAV and weekly topotecan are similarly effective and safe chemotherapy protocols for the treatment of CRR-SCLC patients. © 2021 Zerbinis Publications. All rights reserved.Öğe Comparison of skeletal muscle mass loss in patients with metastatic colorectal cancer treated with regorafenib or TAS-102(Zerbinis Publications, 2019) Hacioglu, M.B.; Kostek, O.; Kurt, N.; Kucukarda, A.; Gokyer, A.; Ustabasioglu, F.E.; Karatas, F.Purpose: To assess whether regorafenib and TAS-102 treatments are associated with a change in Skeletal Muscle Area (SMA) as well as to compare Skeletal Muscle Mass (SMM) loss levels between regorafenib and TAS-102 treatments and prognostic significance in the patients with metastatic colorectal cancer (mCRC). Methods: A total of 36 mCRC patients, who received regorafenib or TAS-102 in the third-line and subsequent settings were assessed in the analysis. SMM changes were assessed with CT scans findings, and they were categorized into two groups as SMM-loss (SMM decrease ?2%) and SMM-stable (SMM change <2%). Results: The SMM change after regorafenib therapy was significantly worse compared with TAS-102 therapy (p=0.001). The median overall survival (OS) was longer in SMM-stable group than in SMM-loss group (12.8 months; 95%CI:9.8-15.7) vs. 6.4 months; 95%CI:5.2-7.7, respectively;p=0.04). Cox regression analysis showed that SMM loss was independent prognostic indicator for OS (HR, 2.87; 95%CI: 1.07-7.42, p=0.03). Conclusion: Although patients who received regorafenib had more SMM loss than those who received TAS-102, there was no difference in OS between drugs. © 2019 Zerbinis Publications. All rights reserved.Öğe The impact of primary tumor localization on survival and treatment outcomes in patients with metastatic colorectal cancer-a multicenter study(Zerbinis Publications, 2019) Sahin, S.; Karatas, F.Purpose: To investigate the effects of sidedness on survival and treatment outcomes in patients with metastatic colorectal cancer (mCRC), since the accumulated data have increasingly reported that patient with right-sided mCRC are found to be associated with worse overall survival (OS) and poor response to anti-epidermal growth factor receptor (anti-EGFR) agents. Methods: This was a multi-center retrospective analysis of 177 patients with mCRC, who were treated and followed between 2014 and 2018 in different parts of Turkey. Patients were divided into 2 groups according to the primary tumor localization as right or left colon cancer. Clinical and demographic characteristics, treatment outcomes, and survival were analyzed to determine whether there was any association with tumor localization. Results: There were 53 (30%) patients with mCRC in the right group and 124 (70%) in the left group, with no difference between the groups in terms of clinical and demographic characteristics. There was no difference in OS between the left and right side localization in any RAS-mutant mCRC patients (22.1 vs. 27.9 months, respectively, p=0.19), whereas patients with all RAS-wild type tumor in the right colon were associated with a worse OS than left-sided counterparts (19.4 vs 29.9 months, respectively, p=0.01). Multivariate analysis revealed that the right-sided tumor (HR, 1.74; 95% CI: 1.165-2.608; p=0.007), the presence of comorbid disease (HR, 1.58; 95% CI: 1.079-2.321, p=0.019), body mass index (BMI) <25 (HR, 1.61; 95% CI: 1.108-2.352, p=0.013), grade III tumor (HR, 1.65; 95% CI: 1.109-2.457, p=0.014), and being unable to metastasectomy (HR, 2.10; 95% CI: 1.235-3582, p=0.006) were found to be independent predictors of worse survival. Conclusion: While right side localization was an independent negative predictor of survival in patients with mCRC, tumor sidedness was not found to be associated with response to treatment. The worse OS in right localization may be due to the aggressive nature of right-sided colon tumors which show faster progression, since their response to treatment does not appear to be different. © 2019 Zerbinis Publications. All rights reserved.Öğe IS LOW SERUM VITAMIN D LEVEL ASSOCIATED WITH CANCER?(Verduci Publisher, 2020) Inci, F.; Inci, H.; Karatas, F.; Adahan, D.Objective: The aim of this study is to determine the importance of serum Vitamin D (VD) levels in cancer pathogenesis and to investigate its relationship with cancer subtypes. Patients and Methods: This study included 4914 individuals, 1027 cancer patients and 3887 healthy subjects. The cancer patients were divided into five groups by cancer subtypes. The cancer patients and those in the control group were compared in terms of serum VD levels. Results: In the patients with cancer, the mean serum VD level was found to be significantly lower than that in the control group (16.1 +/- 10.6 ng/mL vs. 19.6 +/- 10.4 ng/mL, p = 0.000). The VD levels were higher in breast cancer (BC) group than those in other cancer groups. The mean serum VD level was significantly lower in the BC group compared to the control group (18.1 +/- 11.3 ng/mL vs. 19.6 +/- 10.4 ng/mL, p = 0.004). In the ROC analysis, the cut-off VD value was determined as 15.2 ng/mL between those with and without cancer (area 0.634, OR: 95% CI 0.612-0.656, p = 0.000). VD <15.2 ng/mL was independently associated with cancer (OR, 2.096; 95% CI: 1.595 - 2.756, p = 0.000). Moreover, the decreased VD level was found to be independently associated with the increased cancer risk (OR, 1.048; 95% CI: 1.032- 1.065, p = 0.000). Conclusions: Although there was no difference in VD levels among the cancer patients and there was less difference in the BC patients compared to the healthy individuals, the VD level was significantly lower in all cancer patients compared to healthy people. In addition, there was an independent positive association between VD levels and cancer, with the VD values below 15.2 ng/mL increasing the cancer risk.Öğe Mean platelet volume and platelet distribution width correlates with prognosis of early colon cancer(Zerbinis Publications, 2020) Sakin, A.; Sahin, S.; Sakin, A.; Karatas, F.; Samanci, N.S.; Yasar, N.; Arici, S.Purpose: Several platelet indices have been linked to prognosis of various cancers, including metastatic colorectal cancer. The aim of this study was to investigate the prognostic effect of mean platelet volume (MPV) and platelet distribution width (PDW) in early colon cancer (CC) patients. Methods: This retrospective study included early CC patients who were followed up and treated between 2005 and 2017. Relapse free survival (RFS) and overall survival (OS) were determined with respect to several demographic and clinical characteristics of patients, including MPV and PDW. The cut-off value was determined as >8.5 fL for MPV (sensitivity: 67.1%, specificity 54.5%) and ?16% for PDW (sensitivity: 66.7%, specificity: 60.0%). Results: The study included 394 patients, 53.3% of which were male. Stage I, II, and III patients constituted 8.9%, 46.4%, and 44.7% of the study population, respectively. Among all patients, RFS and OS were significantly longer in patients with MPV?8.5 fL and PDW>16 fL (p<0.001 and p=0.011 for MPV, respectively; and p<0.001 and p=0.026 for PDW, respectively). In patients with stage III disease, those with MPV?8.5 fL had significantly longer RFS and OS compared to those with MPV >8.5 fL (p<0.001 and p=0.001, respectively). On the other hand, those with PDW>16% had significantly longer RFS than that in those with PDW ?16 fL among stage III patients (p<0.001). In multivariate analysis, stage, perineural invasion, lymphovascular invasion, adjuvant treatment, CEA, CA19-9, PDW, and MPV were found the most significant factors affecting RFS. Conclusion: Our study suggests that elevated MPV and decreased PDW appear to be unfavorable prognostic factors in early CC, especially in patients with stage III disease. Considering the wide availability and accessibility of these indices, it is reasonable to designate further larger prospective studies to clarify and verify their potential roles in early CC. © This work by JBUON is licensed under a Creative Commons Attribution 4.0 International License.Öğe Paclitaxel-induced hepatic steatosis in patients with breast cancer(Zerbinis Publications, 2019) Inci, F.; Karatas, F.Purpose: Paclitaxel has been associated with serum aminotransferase elevations, however, paclitaxel induced hepatosteatosis has not been evaluated systematically. This study assessed the rate of paclitaxel-related hepatosteatosis. Methods: Forty one early breast cancer (BC) patients were included the study. Hepatic ultrasonograpy, demographic features and biochemical liver function tests before and after 12 weeks of paclitaxel were assessed. Results: New-onset hepatosteatosis was developed in 26.7% of the patients. Baseline triglyceride>200mg/dL (OR, 11.25; p=0.015), LDH at baseline >191.48 IU/L (OR, 4.93; p=0.048), and total bilirubin >0.51 mg/dL after paclitaxel (OR, 6.17; p=0.042) were found as independent prognostic markers for new-onset hepatosteatosis. Conclusion: Paclitaxel may induce hepatosteatosis in patients with BC. © 2019 Zerbinis Publications. All rights reserved.
