Scopus İndeksli Yayınlar Koleksiyonu
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Item National Multi-Center Observational Retrospective Study to Understand Treatment Patterns and Outcomes for Stage III Non-Small Cell Lung Cancer Patients in Turkey: Turkish Society for Radiation Oncology Study, STONE Trial(2022) Onal, Cem; Demiral, Ayse Nur; Atalar, Banu; Yalman, Deniz; Dagoglu, Nergiz; Hurmuz, Pervin; Erpolat, Petek; Akyurek, Serap; Gul, Sute Karabulut; Berber, Tanju; Guler, Ozan Cem; Umay, Cenk; Sert, Fatma; Karahacioglu, Eray; Birgi, Sumerya Duru; Yaprak, Gokhan; Saglam, Esra KaytanThis study investigated treatment patterns and outcomes in patients with inoperable stage III non-small cell lung cancer (NSCLC) treated with radiotherapy (RT) in Turkey. We included 492 patients with stage III NSCLC in this multi-center retrospective study. Pa-tient demographics, clinical characteristics, and clinical treatment patterns from the time of the initial diagnosis to disease progression were recorded. Additionally, the prognostic factors predicting overall survival (OS) and progression-free survival (PFS) were analyzed. For the initial treatment, 429 patients (89.2%) received chemotherapy and RT, whereas 53 patients (10.8%) were treated only with RT. The first disease progression occurred in 288 patients (58.4%) at 9.3 months (median) after the initial treatment, and 64.6% re-ceived treatment after first progression. The second disease progression occurred in 30 patients, and 20 patients (66.7%) received treatment. Median OS and PFS were 27.0 months and 13.4 months, respectively. Age (p< 0.001), stage (p= 0.04), poor performance score (PS) (p= 0.03) and RT doses (p= 0.002) were independent predictors for OS and PFS in our multivariate analysis. Additional significant predictors for OS in the multivariate analysis were gender (p= 0.004), treatment period (0.02), and irradiation technique (p= 0.02). Disease progression occurred in nearly 58% of the patients, and one-third of these patients remained untreated during the disease progression. These findings indicate a need for additional treatment options in patients with unresectable stage III NSCLC with high-risk features, namely older age, stage IIIB disease, poor PS, and lower RT doses.Item Response to first-line chemotherapy regimen is associated with efficacy of immune checkpoint blockade therapies in patients with metastatic urothelial carcinoma(2021) Sumbul, Ahmet Taner; 34762201Background Atezolizumab (ATZ) has demonstrated antitumor activity in previous studies in patients with metastatic platinum-resistant urothelial carcinoma. However, the response rate of ATZ was modest. Therefore, finding biologic or clinical biomarkers that could help to select patients who respond to the immune checkpoint blockade remains important. Patients and methods In this study, we present the retrospective analysis of 105 patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy. Data of patients were obtained from patient files and hospital records. The association between response to first-line chemotherapy and ATZ was using Fisher's exact test. Median follow-up was calculated using the reverse Kaplan-Meier method. OS was estimated by using the Kaplan-Meier method. Results The median follow-up time was 23.5 months. Forty (74.1%) of patients who experienced clinical benefit after firs-line chemotherapy also had clinical benefit after atezolizumab, while only 14 (25.9%) of patients with initial PD after first-line chemotherapy subsequently experienced clinical benefit with ATZ (p = 0.001). The median OS on ATZ of 14.8 and 3.4 months for patients with clinical benefit and progressive disease in response to first-line chemotherapy, respectively (p = 0.001). Three of the adverse prognostic factors according to the Bellmunt criteria were independent factors of short survival: liver metastases {Hazard ratio [HR] = 1.9; p = 0.04}, ECOG PS >= 1 (HR = 2.7; p = 0.001), and Hemoglobin level below 10 mg/dl (HR = 2.8; p < 0.001). In addition, patients with clinical benefit from first-line chemotherapy (HR = 0.39; p < 0.001) maintained a significant association with OS in multivariate analysis. Conclusions Our study demonstrated that clinical benefit from first-line chemotherapy was independent prognostic factors on OS in patients' use of ATZ as second-line treatment in metastatic bladder cancer. Furthermore, these findings are important for stratification factors for future immunotherapy study design in patients with bladder cancer who have progressed after first-line chemotherapy.Item Prediction of Peritoneal Recurrence in Patients with Gastric Cancer: a Multicenter Study(2020) Kus, Tulay; Kose, Fatih; Aktas, Gokmen; Arslan, Ulku Yalcintas; Sedef, Ali Murat; Cinkir, Havva Yesil; Dirikoc, Merve; Akkus, Gulsum; Ozdemir, Nuriye Yildirim; 0000-0002-0156-5973; 32578034; G-4827-2016Purpose The peritoneum is the common recurrence site of gastric cancer (GC) presenting with worse survival. Although some predictive clinicopathological factors have been identified, there is no comprehensive assessment of peritoneal recurrence risk prediction for patients treated with adjuvant chemotherapy (CR) or chemoradiotherapy (CRT) after surgery. We aimed to predict peritoneal recurrence and develop a new scoring model in GC. Methods This retrospective study included 274 GC patients who presented with recurrence after curative gastrectomy followed by adjuvant chemotherapy (CT) or chemoradiotherapy (CRT). Risk factors for peritoneal recurrence were analyzed using the following parameters: age, gender, tumor location and characteristics, and differences between treatment modalities. All parameters were assessed by binary logistic regression analysis to compare the patients with and without peritoneal recurrence. Then, a new risk scoring model was developed. Results Peritoneal recurrence was observed in 115 (44.1%) patients. Peritoneal recurrence was higher in female gender (odds ratio (OR), 1.93; 1.07-3.49,P = 0.030, 1 point), T4a-b stage (OR, 2.47; 1.14-5.36,P = 0.022, 1 point), poor/undifferentiated (OR, 2.04; 1.31-4.06,P = 0.004, 1 point), and signet cell carcinoma (OR, 2.04; 1.04-4.02,P = 0.038, 1 point) after adjusted for resection and dissection types. The risk scoring model was developed using the related parameters: Peritoneal recurrence rates were 24.6%, 42.6%, and 71.4% for group 1 (0 point), group 2 (1-2 points), and group 3 (3-4 points), respectively. Conclusion Female gender, T4 tumor stage, undifferentiated histopathology, and signet cell type had a tendency to peritoneal recurrence after adjusted for treatment modalities. Patients with 3 or 4 risk factors had an 8.8-fold increased risk for the development of peritoneal recurrence.Item RAB25 confers resistance to chemotherapy by altering mitochondrial apoptosis signaling in ovarian cancer cells(2020) Temel, Sehime Gulsun; Giray, Asli; Karaka, Bahriye; Gul, Ozgur; Kozanoglu, Ilknur; Celik, Husnu; Basaga, Huveyda; Acikbas, Ufuk; Sucularli, Ceren; Oztop, Sidika; Aka, Yeliz; Kutuk, Ozgur; 0000-0001-5653-6080; 0000-0001-9854-7220; 0000-0002-5268-1210; 32901335; AAJ-7911-2020; AAH-1671-2019; AAE-1241-2021Ovarian cancer remains one of the most frequent causes of cancer-related death in women. Many patients with ovarian cancer suffer from de novo or acquired resistance to chemotherapy. Here, we report that RAB25 suppresses chemotherapy-induced mitochondrial apoptosis signaling in ovarian cancer cell lines and primary ovarian cancer cells. RAB25 blocks chemotherapy-induced apoptosis upstream of mitochondrial outer membrane permeabilization by either increasing antiapoptotic BCL-2 proteins or decreasing proapoptotic BCL-2 proteins. In particular, BAX expression negatively correlates with RAB25 expression in ovarian cancer cells. BH3 profiling assays corroborated that RAB25 decreases mitochondrial cell death priming. Suppressing RAB25 by means of RNAi or RFP14 inhibitory hydrocarbon-stapled peptide sensitizes ovarian cancer cells to chemotherapy as well as RAB25-mediated proliferation, invasion and migration. Our data suggest that RAB25 is a potential therapeutic target for ovarian cancer.Item A multi-institutional analysis of sequential versus 'sandwich' adjuvant chemotherapy and radiotherapy for stage IIIC endometrial carcinoma(2019) Onal, Cem; Sari, Sezin Yuce; Yildirim, Berna Akkus; Yavas, Guler; Gultekin, Melis; Guler, Ozan Cem; Akyurek, Serap; Yildiz, Ferah; 0000-0002-2742-9021; 30887753; D-5195-2014Objective: To analyze the outcomes of sequential or sandwich chemotherapy (ChT) and radiotherapy (RT) in patients with node-positive endometrial cancer (EC). Methods: Data from 4 centers were collected retrospectively for 179 patients with stage IIIC EC treated with postoperative RT and ChT (paclitaxel and carboplatin). Patients were either treated with 6 cycles of ChT followed by RT (sequential arm; 96 patients) or with 3 cycles of ChT, RT, and an additional 3 cycles of ChT (sandwich arm; 83 patients). Prognostic factors affecting overall survival (OS) and progression-free survival (PFS) were analyzed. Results: The 5-year OS and PFS rates were 64% and 59%, respectively, with a median followup of 41 months (range, 5-167 months). The 5-year OS rates were significantly higher in the sandwich than sequential arms (74% vs. 56%; p=0.03) and the difference for 5-year PFS rates was nearly significant (65% vs. 54%; p=0.05). In univariate analysis, treatment strategy, age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology, rate of myometrial invasion, and grade were prognostic factors for OS and PFS. In multivariate analysis, non-endometrioid histology, advanced FIGO stage, and adjuvant sequential ChT and RT were negative predictors for OS, whereas only non-endometrioid histology was a prognostic factor for PFS. Conclusion: Postoperative adjuvant ChT and RT for stage IIIC EC patients, either given sequentially or sandwiched, offers excellent clinical efficacy and acceptably low toxicity. Our data support the superiority of the sandwich regimen compared to the sequential strategy in stage IIIC EC patients for OS.Item The retrospective analysis of patients with uterine sarcomas: A single-center experience(2016) Terek, Mustafa Cosan; Akman, Levent; Hursitoglu, Behiye Seda; Sanli, Ulus Ali; Ozsaran, Zeynep; Tekindal, Mustafa Agah; Dikmen, Yilmaz; Zekioglu, Osman; Ozsaran, Ahmet Aydin; 27072256Background: Uterine sarcomas are rare, malignant, gynecological tumors and show diverse histopathological features. Therefore, there is no consensus on risk factors for poor outcome and optimal treatment. The aim of this retrospective analysis is to report the clinical outcome of patients with uterine sarcoma treated at a single center. Materials and Methods: The data was obtained regarding the patient's demographic characteristics, pathological results, treatments given, survival, and complications of all uterine sarcoma patients treated in a single center between the years 2000 and 2012. The 80-month overall survival (OS) was determined with respect to prognostic factors including age, stage of disease, histopathological type, and adjuvant treatment. Results: A total of 57 case records are retrieved for this retrospective analysis. The mean age of the patients is 62.5 +/- 11.2 years. International Federation of Gynecology and Obstetrics (FIGO) stage distribution is stage I: 29; stage II: 13; stage III: 9; stage IV: 6. Fifty-seven patients underwent surgery, 33 received postoperative radiotherapy (PORT), and 32 received chemotherapy. Median follow-up period was 25 months (range 2-85 months). The 80-month OS for the entire group of patients was 36.7%. The significant prognostic factors for survival are age under 50 years, stage of disease, and adjuvant chemotherapy. Conclusion: Although limited by small sample size and retrospective nature, age under 50 years, stage of disease, and adjuvant chemotherapy are significant prognostic factors for survival for uterine sarcomas.Item Flare Phenomenon in Advanced Colorectal Cancer: Cessation of evacizumab after Predefined Cycles of Therapy may not Affect Outcome(2017) Besen, A.Ali; Kose, Fatih; Sumbul, Ahmet T:; Ozdemir, Nuriye; Ozyilkan, Ozgur; Zengin, Nurullah; Abali, Huseyin; 0000-0002-5573-906X; 0000-0002-0156-5973; 0000-0002-7862-0192; 0000-0001-8825-4918; D-4793-2014; G-4827-2016; AAD-6910-2021; AAD-2817-2021Limited number of experimental and clinical studies showed rapid tumor regrowth after bevacizumab cessation in advanced colorectal cancer. We retrospectively evaluated rapid regrowth phenomenon in 105 patients those who were treated with the predefined number of chemotherapy cycles and grouped according to whether the chemotherapy regimen in the first line setting included bevacizumab (CT-Bev arm) or not (CT arm). Median age was 55 years old. Median overall and progression free survival times were 27 and 11 months, respectively. Rapid progression rates were 42% and 40% in CT arm and CT -Bev arm without no statistically significant difference (p= 0.84). In CT arm, significantly more patients with stable disease (SD) progressed rapidly compared to patients with complete (CR) or partial response (PR) (53% vs. 27%, p= 0.04). This result was also similar in CT-Bev arm (48% vs. 30%, p= 0.27) but could not reach to the significant p-value. Overall survival 2, the time from the end of last dose of chemotherapy +/- bevacizumab to death, was significantly shorter in both CT and CT -Bev arms for patients who showed SD compared to CR or PR (15 vs 38 months) (p< 0.001).Current study supports that withdrawal of bevacizumab after predefined treatment cycles may not have any adverse effect on patients' outcome of advanced CRC. This result is particularly acceptable for the patients who show CR or PR to the treatment.Item Prognostic factors and treatment outcomes in surgically-staged non-invasive uterine clear cell carcinoma: a Turkish Gynecologic Oncology Group study(2017) Sari, Mustafa Erkan; Meydanli, Mehmet Mutlu; Turkmen, Osman; Comert, Gunsu Kimyon; Turan, Ahmet Taner; Karalok, Alper; Sahin, Hanifi; Kocaman, Eda; Akbayir, Ozgur; 0000-0002-1741-7035; 28541637Objective: To assess the prognosis of surgically-staged non-invasive uterine clear cell carcinoma (UCCC), and to determine the role of adjuvant therapy. Methods: A multicenter, retrospective department database review was performed to identify patients with UCCC who underwent surgical treatment between 1997 and 2016 at 8 Gynecologic Oncology Centers. Demographic, clinicopathological, and survival data were collected. Results: A total of 232 women with UCCC were identified. Of these, 53 (22.8%) had surgically-staged non-invasive UCCC. Twelve patients (22.6%) were upstaged at surgical assessment, including a 5.6% rate of lymphatic dissemination (3/53). Of those, 1 had stage IIIA, 1 had stage IIIC1, 1 had stage IIIC2, and 9 had stage IVB disease. Of the 9 women with stage IVB disease, 5 had isolated omental involvement indicating omentum as the most common metastatic site. UCCC limited only to the endometrium with no extra-uterine disease was confirmed in 41 women (73.3%) after surgical staging. Of those, 13 women (32%) were observed without adjuvant treatment whereas 28 patients (68%) underwent adjuvant therapy. The 5-year disease-free survival rates for patients with and without adjuvant treatment were 100.0% vs. 74.1%, respectively (p=0.060). Conclusion: Extra-uterine disease may occur in the absence of myometrial invasion (MMI), therefore comprehensive surgical staging including omentectomy should be the standard of care for women with UCCC regardless of the depth of MMI. Larger cohorts are needed in order to clarify the necessity of adjuvant treatment for women with UCCC truly confined to the endometrium.