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PURPOSE This paper aims to investigate the diagnostic performance of magnetic resonance imaging (MRI) in predicting the pathologic stage of locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (CRT) and the role of MRI in selecting patients with a pathologic complete response (ypCR). METHODS Restaging MRI (yMRI) examinations of 136 patients with LARC treated with neoadjuvant CRT followed by surgery were retrospectively analyzed by two radiologists. All examinations were performed on a 1.5 Tesla MRI machine with a pelvic phased-array coil. T2-weighted turbo spin-echo images and diffusion-weighted imaging were obtained. Histopathologic reports of the surgical specimens were the reference standard. The accuracy, sensitivity, specificity, positive and negative predictive values (PPV and NPV) of yMRI in predicting the pathologic T-stage (ypT), N-stage, and ypCR were calculated. The inter-observer agreement was evaluated using kappa statistics. RESULTS The yMRI results showed 67% accuracy, 59% sensitivity, 80% specificity, 81% PPV, and 56% NPV in identifying ypT (ypT0-2 versus ypT3-4). In predicting the nodal status, the yMRI results revealed 63% accuracy, 60% sensitivity, 65% specificity, 47% PPV, and 75% NPV. In predicting ypCR, the yMRI results showed 84% accuracy, 20% sensitivity, 92% specificity, 23% PPV, and 90% NPV. The kappa statistics revealed substantial agreement between the two radiologists. CONCLUSION Utilization of yMRI showed high specificity and PPV in predicting the tumor stage and high NPV in predicting the nodal stage; in addition, yMRI revealed moderate accuracy in the T and N classifications, mainly due to underestimating the tumor stage and overestimating the nodal status. Finally, yMRI revealed high specificity and NPV but low sensitivity in predicting the complete response. [ABSTRACT FROM AUTHOR]

Background: Nanomedicine has provided promising tools for the imaging, diagnosis, and treatment of cancer. Gold nanoparticles (GNPs) may be useful in enhancing the efficacy of radiotherapy, such as radiosensitization, in cancer therapy. Aims: To develop a nanodrug complex containing cetuximab (C225, CTX) and cisplatin (CDDP) conjugated with GNPs and to investigate its cytotoxic effects on oral cavity cancer cells when combined with radiotherapy. Study Design: In vitro cell culture study. Methods: The GNPs were synthesized and successfully conjugated with cetuximab and cisplatin. Cell viability was monitored by the xCELLigence real-time cell analysis (RTCA) single-plate (SP) system in GNP-treated UPCI-SCC-131 cells for 48 hours. Cells with/without GNPs were irradiated with 6 MV X-rays, and colony formation was assayed to investigate the long-term effects of GNPs and the nanodrug complex after irradiation on radiotherapy-resistant oral cavity cancer cells. Results: The GNPs entered the tumor cells, and GNP-CDDP (P < .0001) and GNP-CDDP-CTX (P < .0001) were shown to cause a decrease in cell viability. GNP and GNP-CTX combined with radiotherapy led to greater reduction on UPCI-SCC-131 colony numbers, than radiation alone (P = .0369) and radiation with free CTX, with sensitizing enhancement ratios of 1 : 2 and 1 : 9, respectively. Conclusion: The cetuximab and cisplatin-conjugated gold nanodrug complex has a great potential to increase cytotoxicity and overcome resistance to radiotherapy, in the treatment of oral cavity cancer. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Sağ meme radyoterapisi (RT) uygulamalarında, karaciğer risk altındaki normal dokulardandır. Karaciğer fonksiyon testleri (KFT)(alanin aminotransferaz (ALT), aspartat aminotransferaz (AST), gama glutamiltransferaz (GGT)) çeşitli nedenlerle oluşan hepatobilier hasarın biyokimyasal belirteçleridir. Bu çok merkezli, kesitsel çalışmada sağ meme kanseri nedeniyle RT uygulananlarda RT öncesi (preRT) ve sonrası (postRT) akut dönemde KFT değişimlerine karaciğer doz-hacim etkisi değerlendirilmiştir. Gereç ve Yöntem: Ocak 2019 ve Kasım 2022 arasında üç merkezde adjuvan sağ meme RT alan toplam 100 hasta verisi retrospektif değerlendirilmiştir. Hedef hacim ve normal dokular RTOG atlasına göre konturlanmıştır. Hastalara CTV'ye toplam 50 Gy/25 fr RT, gerekli olgulara tümör yatağına boost uygulanmıştır. PreRT ve postRT ilk iki haftadaki KFT değerlerinin değişim yüzdesi (DY=(preRT-postRT)/preRT.100)(%) hesaplanmıştır. İstatistiksel olarak karaciğer dozları(cGy) ve karaciğer x dozun aldığı hacminin (Vx)(cc) DY'ye etkisi Kolmogorov-Smirnova, Mann Whitney U testi ve SPSS 22 programı ile analiz edilmiş, istatistiksel anlam p<0.05 kabul edilmiştir. Bulgular: Toplam 100 hastada medyan yaş 56 (29-79)'dır. Meme koruyucu tedavi oranı %75'dir. En sık T ve N evreleri sırasıyla %53, T1 ve %53, N0'dır. Hiçbir hastada uzak metastaz ve RT ile eşzamanlı sistemik tedavi yoktur. Adjuvan RT tekniği %67 IMRT, %33 VMAT'dır. Medyan CTV hacmi 802 (214-2724) cc'dir. Hastaların %28'ine elektron, %51'ine IMRT/VMAT ile medyan doz 10 (10-16) Gy boost uygulanmıştır. Karaciğer medyan hacmi 1423 (825-2312) cc, medyan Dmin 3.4 (0-206.1), medyan Dmax 4814 (110-206.1), medyan Dmean 203 (15-1497) cGy'dir. İstatistiksel analizler, preRT ve postRT dönemde her üç KFT elde olunan 57 hastada yapılmıştır. Bu grupta medyan CTV hacmi 806 (214-2519) cc'dir. Karaciğer medyan hacmi 1457 (825-2218) cc, medyan Dmax 5005 (110-5969), medyan Dmin 5.8 (0-206), medyan Dmean 208 (15-1497) cGy'dir. Karaciğer medyan V50, V40, V30, V20, V10, V5 değerleri sırasıyla 0 (0-24.8), 1 (0-87.23), 2.81 (0-180.78), 4.8 (0-387.7), 11.8 (0-949.1), 17.2 (0-1352.9) cc'dir. PreRT ve postRT medyan değerler sırasıyla AST için 19 (11-35) ve 21 (10-52,32); ALT için 18 (1.97-39) ve 20 (8-55); GGT için 20 (12-44) ve 19 (10-85) U/L'dur. Medyan DY; AST için %-13 (-120 ve 54.5); ALT için %-3.03 (-292 ve 46.1); GGT için %6 (-93.18 ve 42.86)'dır. Karaciğer doz-hacim ve DY ilişkisinde, ALT için karaciğer Dmean (p=0.03) ve AST için karaciğer Dmin (p=0.007), Dmean (p=0.023) değerlerinin yüksek olması istatistiksel anlamlı olumsuz faktör bulunmuştur. GGT için ise, tüm karaciğer doz-hacim değerlerinin yüksekliği istatistiksel anlamlı bulunmuştur (p<0.05). RT tekniği, CTV hacmi, boost tekniğinin ise istatistiksel anlamlı etkisi gösterilememiştir. Sonuç: Sağ meme ışınlamalarında anatomik yerleşim, planlama tekniği, memenin postürü gibi nedenlerle karaciğer çeşitli miktarda doz alabilmektedir. Uzun sağkalım beklentisi olan meme kanseri hastalarında RT'ye sekonder karaciğer toksisitesinden hastayı korumak önemlidir. Çalışmamızda, sistemik herhangi bir tedavi almayan veya risk faktörü bulunmayan hastalarda RT hemen öncesine kıyasla RT hemen sonrasında akut karaciğer hasarını gösteren enzimlerde ortalamada %15'e yaklaşan yükselme olduğu ve karaciğer Dmean 208 cGy altında tutulması anlamlı bulunmuştur. KFT değerleri üzerine etkileyen pek çok faktör olmakla beraber RT planlaması sırasında karaciğere dozlarına daha fazla dikkat edilmesi, takipte ise düzenli KFT kontrolü önemlidir. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In this study, long-term follow-up results and prognostic determinants of tripple negative breast cancer patients treated with adjuvant radiotherapy (RT) according to the protocol of Dokuz Eylul Breast Tumors Group were evaluated retrospectively. Materials and Methods: Between January 1992 and December 2005, 215 tripple negative breast cancer patients were included in the study. Ninety-nine (46%) patients underwent breast conserving surgery (BCS), and 115 (53.5%) patients underwent modified radical mastectomy (MRM). Five patients (2.3%) underwent sentinal lymph node biopsy and 208 patients (96.7%) underwent axillary dissection. 50 Gy or more radiotherapy was applied to peripheral lymphatics together with chest wall or breast in 53 patients (75.4%), and to chest wall or breast in 53 (24.6%) patients. One hundred and thirty-two (61.4%) patients received an additional dose of 10-16 Gy. One hundred and seventy-three patiants (80.5%) received adjuvant or 15 (7%) received neoadjuvant chemotherapy (CT) (6 cycles of CAF - CEF, 4 cycles of AC or CMF or equivalent). The staging was done according to AJCC-2018, and the survival analyzed by Kaplan-Meier and the variables were analyzed by Log-Rank and Cox regression analysis. Results: Patients were aged between 25-75 years and median age was 47 years. The median follow-up was 142 months. 119 (55.3%) of the patients were premenopausal. Histologically, 131 patients (60.9%) had invasive ductal carcinoma (IDC), 21 patients (9.8%) had invasive lobular carcinoma (ILC), 11 patients (5.1%) had both ILK and IDC, and 52 (24.2%) had other histopathologic types. Pathologic T stages of the patients were 4 (1.9%) pT1a, 5 (2.3%) pT1b, 52 (24.2%) pT1c, 124 (57.7%) pT2, 18 (8.4%) pT3, 7 (3.3%) pT4b, 5 (2.3%) as pT4d; N stages were staged as 82 (38.1%) pN0, 65 (30.2%) pN1, 45 (20.9%) pN2, 23 (10.7%) pN3. Distribution of patients according to stages were; stage 1; 38 patients (17.6%), stage 2; 103 patients (47.9%), stage 3; 74 patients (33.5%). Pericapsular invasion (PCI) was positive in 69 (32.1%) patients. Skin invasion was present in 13 (6%) patients and surgical margin was positive in 11 (5.1%) patients. While 67 (31.2%) of the patients had distant recurrence during follow-up, 11 (5.1%) had local recurrence. 5, 10, 15 and 20-year overall (OS) and disease-free survival (DFS) rates, respectively; 77.5%, 64.1%, 57.2%, 49.7% and 72.5%, 66.2%, 64.8%, 61.9%. In univariate analyzes, menopause status, surgery type, PCI, pT3-4 disease, pN, stage, CT scheme, distant invasion, and skin invasion were significant factors affecting prognosis on both OS and DFS, while local spread and pT were significant for DFS. In multivariate analyzes, stage is a significant prognostic factor for OS and DFS. Conclusion: In tripple negative breast cancer patients, stage has a significant effect on survival regardless of molecular subtype at long follow-up. Disease-free survival of our patients during median 10-year follow-up is quite good. [ABSTRACT FROM AUTHOR]

Objective: Invasive breast carcinoma is the most common cancer in women. Accurate staging after diagnosis is very important in predicting prognosis and evaluating treatment response. According to the TNM classification of breast cancer, tumors that show direct extension to the chest wall and/or skin regardless of size are considered pT4. However, to diagnose pT4 breast cancer, skin invasion must be accompanied by ulceration or macroscopically defined skin nodules. Only the presence of dermal invasion is not sufficient for the pT4 stage. In this study, we aimed to evaluate the effect of epidermal ulceration on prognosis in breast cancer patients with microscopic dermal invasion. Materials and Methods: The study included 193 patients diagnosed with breast cancer in our hospital between 2002 and 2016 who had microscopic dermal invasion. Preparations were re-evaluated for tumor type, histological grade, tumor size, lymphovascular invasion, receptor and HER2 status as well as the presence of epidermal ulceration. Local recurrence and overall survival data of the patients whose treatment was continued in our hospital after diagnosis and followed up were obtained and statistical analysis was performed using SPSS 15.0. Results: 184 patients were female and their ages ranged between 26-91 (mean 59.5). Microscopic epidermal ulceration was detected in 17.6% of the patients. The most common tumor type was invasive ductal carcinoma (45.8%) and most of the patients (62.4%) were grade 2. The presence of microscopic epidermal ulceration was significantly associated with blood vessel invasion (p=0.035). Distant metastasis was detected in 76.2% of the patients who had epidermal ulceration in pathology specimens (p=0.006). In patients with a mean follow-up of 76.7 months, distant metastasis was significantly associated with survival (p<0.001). The presence of epidermal ulceration did not show a significant relation ship with survival. Conclusion: Although the presence of microscopic epidermal ulceration is significantly associated with blood vessel invasion and distant metastasis, it is not related to overall survival. However, in breast cancer patients with microscopic dermal invasion accompanied by epidermal ulceration, chemotherapy can be planned more effectively for distant metastasis. [ABSTRACT FROM AUTHOR]