Browsing by Author "Akkus, Berna"

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    The Comparision of Breast Cancer in the Young and Elderly Patients
    (2019) Petek Erpolat, Ozge; Yuce Sari, Sezin; Ergen, Sefika Arzu; Aydin, Barbaros; Akkus, Berna; Gultekin, Melis; Copan Oksuz, Didem; Arican, Zumre; Onal, Cem; Gursel, Bilge; Akmansu, Muge; Ozyigit, Gokhan; Bilkay Gorken, Ilknur; Yildiz, Ferah
    OBJECTIVE To compare the tumor characteristics, treatment approaches, recurrence patterns and survival results rates of young and elderly patients with breast cancer. METHODS In this study, Between between 2000-2013, a total of 779 patients were treated for breast cancer at nine radiation oncology departments were evaluated retrospectively. Three-hundred eight four of these patients were young (<= 35 years), and 395 of those the patients were elderly (>= 70 years). RESULTS Young patients were more likely to present with aggressive tumor features. They were more often received comprehensive lymphatic irradiation, tumor bed boost and intense chemotherapy. No difference was found for 5 and 10-year loco-regional recurrence- free survival rates were (96% and 93% for young, 97% and 97% for elderly). The 5 and 10-year distant recurrence- free survival rates were lower in the young patients (77% and 67% for young, 85% and 85% for elderly, p<0.0001). No difference was found in 5 and 10-year breast cancer- specific survival (91% and 79% for young, 92% and 87% for elderly). The 5 and 10-year overall survival rates were higher in the young patients (92% and 78% for young, 78% and 63% for elderly, p<0.0001). CONCLUSION The reason for the similarity between the age groups in terms ofregarding loco-regional recurrence- free survival can be more comprehensive lymphatic irradiation and tumor bed boost, the young patients received. The distant recurrence- free survival rates rates were significantly lower in the young patients even though they received more intensive chemotherapy. Future studies aimed at more effective systemic regimens to decrease distant recurrence in young patients are warranted.
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    Concurrent versus sandwich treatment in adjuvant treatment in high risk operated gastric cancer: A single center experience
    (2020) Sezer, Ahmet; Akkus, Berna; Guler, Ozan Cem; Onal, Huseyin Cem; Sumbul, Ahmet Taner; 0000-0001-6908-3412; 0000-0002-2742-9021; 33277854; AAC-5654-2020; D-5195-2014
    Purpose: In this study we compared postoperative early vs sandwich chemoradiotherapy in operated stage IIA-IIIC gastric cancer patients in terms of effectiveness and outcome. Methods: The data of 201 gastric cancer patients treated in the same center between December 2006 and June 2017 were retrospectively evaluated. One hundred forty nine patients who were eligible for the study criteria were divided into two groups according to the postoperative treatment modality. The first group included 85 patients who were given chemoradiotherapy simultaneously (ETG) and the second group icluded 64 patients who received sandwich (chemotherapychemoradiotherapy-chemotherapy) (STG) treatment. Overall survival (OS) and disease-free survival (DFS) were evaluated as primary endpoints. Results: The median follow-up time for all patient groups was 26.7 months (1.3-136.5 months). Adjuvant chemotherapy and radiotherapy were initiated concurrently in patients receiving concomitant therapy. Half of the planned chemotherapy, then chemoradiotherapy and then the remaining chemotherapy treatments were given to the sandwich treatment group. A total of 50.4 Gy radiotherapy was given to the concurrent chemoradiotherapy group and a total of 45 Gy radiotherapy to the group receiving the sandwich treatment. OS was 30.6 months (23.7-37.5) in all groups, 30.4 months (23.7-35.0) in concurrent therapy (ETG) and 35.6 months (26.3-45) in sandwich therapy (STG) (p=0.73). DFS was 26.6 months (21.3-32.0) in all groups and 24.5 months (18.1-31.0) in the group receiving ETG, 32.5 months (22.242.8) in STG. (p=0.46). The most common grade 3 and above toxicities were; acute upper gastrointestinal toxicity (19.1% in ETG vs. 9.0% in STG, p=0.01) and hematological toxicity (31.8% in ETG vs. 13.9% in STG; p=0.002). Early cessation of treatment was similar in both groups. In multivariate analysis, female gender (p=0.01), stage III disease, grade III disease were seen as negative predictive factors for overall survival. In DFS multivariate analysis, there was no difference between the groups in terms of gender, T stage, N stage, and AJCC stage. Conclusion: In this study, superiority of sandwich treatment over concurrent treatment was observed in patients with operated stage IIB-IIIC gastric cancer, but the difference was not statistically significant. If this study is performed in larger patient series, the difference of sandwich treatment may become meaningful.