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Introduction: F-1(8)-FDG PET/CT provides very effective results in detecting metastases of breast cancer. In our study, we investigated the relationship between maximum standard uptake value (SUVmax) and prognostic pathologic factors in breast cancer cases with isolated bone metastasis and whether there was any difference in terms of prognostic pathologic factors between the group with and without bone metastasis. Methods. Between 2013 and 2016, isolated bone metastases (55 female; 56 +/- 12 years; 32-87), and non-metastatic (46 female; 55 +/- 13 years; 30-81) patients who were referred to department of nuclear medicine and underwent F-18-FDG PET/CT for staging were included in the study. PET/CT images of patients and pathologic prognostic factors were evaluated retrospectively. SUVmax value of the most intense activity from metastatic bone lesions was calculated. p

Objectives: Megestrol acetate (MA) can induce significant secondary adrenal suppression. We designed this study to determine the extent of adrenal insufficiency in cancer patients receiving MA and whether ther was any predictive factor for this., Methods: Thirty-one patients (aged 48-83 years) who were receiving MA took part in this study. Serum concentrations of TSH, ACTH, free T4, cortisol were measuresd in samples obtained at 7 AM, at baseline and 1st month. Standart ACTH (250 mg) stimulation test was performed if cortisol levels were below 18 mu g/dl at any time., Results: 1 month after drug initiation, 32% of patients were accepted as adrenal insufficient. There wasn't any correlation between the basal cortisol, ACTH levels, any biochemical parameter and overall survival. There was negative correlation between 1 month cortisol levels and survival time (p=0.04) If cortisol levels were lower at month of theraphy survival time was longer. Cox regression analysis showed that patients having lower cortisol levels at first month had 98% lower risk of death compared to patients having higher cortisol levels (p=0.02: OR 0.12 (0.02-0.75))., Conclusion: It is important to evaluate adrenal functions especially during episodes of infection or after withdrawal of MA therapy since this may require prompt corticosteroid treatment.

OBJECTIVE: This study aimed to evaluate the efficacy and safety profile of capecitabine and oxaliplatin (CAPOX) and 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) regimens as adjuvant treatment in patients with stage III colon cancer. METHODS: A total of 243 patients who received CAPOX and FOLFOX chemotherapy between 2014 and 2018 for stage III colon cancer in two centers were retrospectively studied. Among the patients, 106 (43.6%) and 137 (56.4%) were treated using CAPOX and FOLFOX regimens, respectively. Efficacy, treatment-related side effects, and overall survival rates with these two regimens were compared. RESULTS: The rate of disease progression was significantly higher in the presence of moderately/poorly differentiated histology, and KRAS and NRAS mutations. An increased number of metastatic lymph nodes and prolonged time from surgery to chemotherapy significantly increased disease progression. Patients who received CAPOX were significantly older than those who received FOLFOX. Disease progression, metastasis, and mortality rates were significantly higher in the FOLFOX arm than in the CAPOX arm. There was no significant difference in the overall survival rate between the two regimens. CONCLUSION: The CAPOX regimen is preferred in older patients. Disease progression, metastasis, and mortality rates are higher with FOLFOX than with CAPOX.

Objectives: Megestrol acetate (MA) can induce significant secondary adrenal suppression. We designed this study to determine the extent of adrenal insufficiency in cancer patients receiving MA and whether ther was any predictive factor for this. Methods: Thirty-one patients (aged 48-83 years) who were receiving MA took part in this study. Serum concentrations of TSH, ACTH, free T4, cortisol were measuresd in samples obtained at 7 AM, at baseline and 1st month. Standart ACTH (250 mg) stimulation test was performed if cortisol levels were below 18 mu g/dl at any time. Results: 1 month after drug initiation, 32% of patients were accepted as adrenal insufficient. There wasn't any correlation between the basal cortisol, ACTH levels, any biochemical parameter and overall survival. There was negative correlation between 1 month cortisol levels and survival time (p=0.04) If cortisol levels were lower at month of theraphy survival time was longer. Cox regression analysis showed that patients having lower cortisol levels at first month had 98% lower risk of death compared to patients having higher cortisol levels (p=0.02: OR 0.12 (0.02-0.75)). Conclusion: It is important to evaluate adrenal functions especially during episodes of infection or after withdrawal of MA therapy since this may require prompt corticosteroid treatment.

Objective This study aimed to evaluate the efficacy and safety profile of capecitabine and oxaliplatin (CAPOX) and 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) regimens as adjuvant treatment in patients with stage III colon cancer. Methods A total of 243 patients who received CAPOX and FOLFOX chemotherapy between 2014 and 2018 for stage III colon cancer in two centers were retrospectively studied. Among the patients, 106 (43.6%) and 137 (56.4%) were treated using CAPOX and FOLFOX regimens, respectively. Efficacy, treatment-related side effects, and overall survival rates with these two regimens were compared. Results The rate of disease progression was significantly higher in the presence of moderately/poorly differentiated histology, and KRAS and NRAS mutations. An increased number of metastatic lymph nodes and prolonged time from surgery to chemotherapy significantly increased disease progression. Patients who received CAPOX were significantly older than those who received FOLFOX. Disease progression, metastasis, and mortality rates were significantly higher in the FOLFOX arm than in the CAPOX arm. There was no significant difference in the overall survival rate between the two regimens. Conclusion The CAPOX regimen is preferred in older patients. Disease progression, metastasis, and mortality rates are higher with FOLFOX than with CAPOX. C1 [Degirmencioglu, Serkan; Demiray, Atike Gokcen; Dogu, Gamze Gokoz; Yaren, Arzu] Pamukkale Univ, Sch Med, Dept Med Oncol, Denizli, Turkey. [Tanriverdi, Ozgur] Mugla Sitki Kocman Univ, Sch Med, Dept Med Oncol, Mugla, Turkey. [Senol, Hande] Pamukkale Univ, Sch Med, Med Biostat Dept, Denizli, Turkey.

AimThe goal of this study is to evaluate possible factors affecting the survival of patients treated with gonadotropin-releasing hormone (GnRH) analogues. MethodsDemographic characteristics, treatment modalities, overall survival (OS) and the possible factors affecting the survival a total of 554 premenopausal breast cancer patients in Turkey evaluated retrospectively. ResultsThe median duration of GnRH analogues use was 2213.6 (range, 1-87) months. Patients were divided into three groups according to the duration of GNRH analogues use; 4-12 months (Group A), 13-24 months (Group B) and 25 months (Group C). Overall, 530 patients were analyzed; 23.2%, 45.8%, 30.9% of the patients were in Group A, B and C, respectively. The median follow-up duration was 34 +/- 30.3 (range, 4-188) months. The OS in patients 35 years of age was found to be significantly longer than that of patients >35 years of age in Group B (log rank, P = 0.023). The disease-free survival of the patients in Group A was significantly shorter than that of patients in Group C (log rank, P = 0.003). The OS of Group A patients was significantly shorter in comparison to that of Group B and Group C patients (log rank, P = 0.000) and the OS of Group B patients was significantly shorter than Group C (log rank, P = 0,000). ConclusionThere is currently no definite data on the optimal duration of GnRH analogues use. One of the important results of this study that will provide an insight to the future studies is the improvement gained in OS by the increase in the duration of GnRH analogues use.

There are outstanding studies on the importance of survivin and inhibition of apoptosis in many cancers, including lung. Evaluation of the relationship between survivin expression in lung cancer and prognosis is the aim of this study. A total of 50 patients with a diagnosis of squamous cell lung carcinoma were included in this study. Survivin levels that were obtained with IHC (immunohistochemical) and RT-PCR (reverse transcription-polymerase chain reaction) methods from the tumor and metastatic lymph node tissues embedded in paraffin blocks were evaluated along with clinical parameters. The median age of the patients was 60 years (range 54-69). All patients were male and all of them were smokers. The mean duration of follow-up and disease-free survival was 42.08 +/- 22.46 months and 40.62 +/- 22.46 months, respectively. Significant associations were found among survivin levels in metastatic lymph nodes and duration of smoking (IHC and RT-PCR), angiolymphatic invasion (IHC), the number of mitosis (RT-PCR) (p= 0.05 and p= 0.05, p< 0.001, p= 0.02, respectively). Survivin showed statistically significant associations with angiolymphatic invasion and stage in multivariate analysis (p< 0.001, p= 0.04, respectively). An association was not found between survivin levels in tumor and lymph nodes and survival. Higher survivin levels in lymph nodes detected by IHC was associated with shorter survival but that didn't reach statistical significance (65.22 +/- 5.16 vs 42.33 +/- 11.97, p= 0.72). Further larger studies done with larger numbers of patients are required in order to evaluate its effects in our society.

OBJECTIVE: Prostate cancer is among the most common cancers in males. Prostate cancer is androgen dependent in the beginning, but as time progresses, it becomes refractory to androgen deprivation treatment. At this stage, docetaxel has been used as standard treatment for years. Cabazitaxel has become the first chemotherapeutic agent which has been shown to increase survival for patients with metastatic Castrate Resistant Prostate Cancer (mCRPC) that progresses after docetaxel. Phase 3 TROPIC study demonstrated that cabazitaxel prolongs survival.

There is very little information about breast cancer characteristics, treatment choices, and survival among elderly patients. The purpose of this multicenter retrospective study was to examine the clinical, pathologic, and biologic characteristics of 620 breast cancer patients age 70 years or older. Between June 1991 and May 2012, 620 patients with breast cancer, recruited from 16 institutions, were enrolled in the retrospective study. Patients had smaller tumors at diagnosis; only 15% of patients had tumors larger than 5 cm. The number of patients who had no axillary lymph node involvement was 203 (32.7%). Ninety-three patients (15.0%) had metastatic disease at diagnosis. Patients were characterized by a higher fraction of pure lobular carcinomas (75.3%). The tumors of the elderly patients were also more frequently estrogen receptor (ER) positive (75.2%) and progesterone receptor (PR) positive (67.3%). The local and systemic therapies for breast cancer differed according to age. An association between age and overall survival has not been demonstrated in elderly patients with breast cancer. In conclusion, the biologic behavior of older patients with breast cancer differs from younger patients, and older patients receive different treatments.

A study was designed to evaluate the frequency of complementary/alternative therapy (CAM) knowledge and usage in cancer patients. A 23-item survey questionnaire was administered to 494 patients who received chemotherapy in the medical oncology department of three hospitals between June 2011 and December 2011. After giving written informed consent, patients completed a self-administered questionnaire. Differences among participants were assessed by using the SPSS 17.0 software. Of the 494 patients, 48% had heard of CAM, and 23.5% had used at least one CAM model. Herbs and vitamins were the most frequently used approach (82.2%). The most commonly used herb was the stinging nettle (55.5%). Marital status (p=0.003), educational status (p

Objectives: This study aims to evaluate whether the collagen membrane (membrane) wrapping around the methotrexate (MTX)-containing calcium-phosphate cement (CPC) reduces the side effects on soft tissue healing. Material and methods: In 36 rats, femoral bone defects were created and treated in six groups which were CPC only, CPC and membrane wrapping around, CPC containing 2% MTX, CPC containing 2% MTX and membrane wrapping around, CPC containing 5% MTX, CPC containing 5% MTX and membrane wrapping around. Results: Histological examinations revealed a statistically significantly improved healing in the connective tissue samples of the CPC containing 5% MTX group wrapped around by membrane compared to those without membrane (p=0.04). However, this was not seen in other groups. Conclusion: Membrane wrapping around the CPC containing MTX reduces the side effect of MTX on cellular proliferation at its highest concentration, particularly. Membrane wrapping may allow administration of higher doses of an anti-neoplastic drug which can be more effective. Keywords: Animal model; calcium-phosphate cement; collagen membrane; methotrexate; soft tissue healing.

AIMS AND BACKGROUND: Small cell lung cancer (SCLC) is a chemotherapy-responsive tumor and associated with alterations in the coagulation system. Addition of low-molecular-weight heparin (LMWH) to combination chemotherapy (CT) had resulted in increase in survival. The present retrospective trial was designed to determine whether the duration of dalteparin usage has an effect on progression and survival. MATERIALS AND METHODS: The medical records of 67 patients with SCLC who were given cisplatin-etoposide and concomitant LMWH (dalteparin) was evaluated retrospectively. RESULTS: Median follow-up of patients was 11.3 months. Outcome: 10.6% complete response, 3.0% good partial response, 36.4% partial response, 10.6% stable disease, and 39.4% progressive disease. Side-effects were seen in 40.3% of the patients. Median dalteparin duration was 6,1 months. According the duration of dalteparin patients were grouped in three: who took dalteparin less than 4 months (Group A), 4-6 months (Group B) and more than 6 months (Group C). Mean overall survival (OS) in Group A was 6.5 months, in Group B 11.8 months, and Group C 14.6 months. Mean OS in Group B and C were statistically significantly (P < 0.001) longer than Group A, between Group B and C there was not any significant difference (P = 0.037). Mean progression free survival (PFS) was 9 months. CONCLUSIONS: The CT plus LMWH minimum 4 months long is well-tolerable, and may improve PFS and OS in patients with SCLC. For treatment of patients with SCLC CT plus LMWH may be considered as effective future-therapy, and further multi-centre randomised prospective clinical trials must be done to determine the new standard treatment approach for SCLC.

Purpose: Triple-negative breast cancers account for 15% of breast carcinomas and, when present as early-stage disease, they are associated with higher rates of recurrence and early distant metastasis risk when compared to hormone receptor positive and human epidermal growth factor receptor (HER-2) positive breast cancers. In this study we aimed to explore the basic clinicopathological characteristics, prognostic factors and recurrence patterns of non-metastatic triple negative breast cancer patients. Methods: In this study 561 non-metastatic triple-negative breast cancer female patients admitted to 8 different cancer centers in Turkey between 2000 and 2010 were retrospectively evaluated through their medical records, to identify the basic clinico-pathological characteristics, prognostic factors and recurrence patterns. Results: The ratio of triple-negative breast cancer was 12%. The median age of patients was 48 years, of whom 311 (55.4%) were premenopausal. The majority had early-stage breast cancer at the time of diagnosis (16.8% stage I, 48.1% stage II, 35.1 % stage III) and the most commonly identified variant was invasive ductal carcinoma (84.1%). Grade II and III tumors were 27.1 and 48.5%, respectively. Adjuvant chemotherapy was administered to 90.5% of women and adjuvant radiotherapy to 41.2%. Median patient follow up was 28 months (range 3-290). During the follow up period 134 (23.8%) patients developed metastatic disease. In most of these cases, metastatic sites were bone, soft tissue, and lung. Factors affecting disease free survival (DFS) and overall survival (OS) were age (both p

Purpose: The extra benefit of adding chemotherapy to effective endocrine therapy (ET) has not been clearly or consistently identified in patients older than 70 years with estrogen receptor (ER) positive and node positive breast cancer. The aim of this study was to evaluate the efficacy of adjuvant ET vs chemotherapy plus endocrine therapies (Chemo/ET) in such patients. Methods: In this retrospective multicenter study 191 patients >= 70 years with operated hormone receptor positive breast cancer, who were administered adjuvant ET or Chemo/ET were assessed. Results: The median patient follow-up time was 29.0 months (range 1-252). Therefore disease free survival (DFS) and overall survival (OS) analysis was limited, due to the rather short median follow-up, and only 30-month cumulative percentages are reported herein. The 30-month DFS rates were 50.0% in the ET arm and 49.0% in the Chemo/ET arm (p=0.79). The 30-month OS rates were 86% in the ET arm and 96.0% in the Chemo/ET arm (p=0.08). Cox proportional hazard model showed that only surgery was independent prognostic factor for survival (p=0.047), while tumor size showed a strong trend for statistical significance (p=0.051). Conclusion: The addition of chemotherapy to endocrine therapy in older patients has no significant impact on DFS and OS.

Malignant pleural mesothelioma (MPM) is a relatively rare, but aggressive tumor that causes high mortality. The major risk factor involved in the etiology is environmental and occupational exposure to asbestos. The optimal modality of therapy is controversial. The present study retrospectively evaluated the data pertinent to 282 patients who were examined and treated in 11 different medical oncology centers in Turkey. There were 161 males (57.1 %) and 121 females (42.9 %), with a mean age of 56.38 ± 12.07 years. Surgery was used in 74 patients, 21 patients (28.4 %) received only chemotherapy and 28 patients (37.8 %) received chemoradiotherapy after surgery. The median survival in patients who were administered adjuvant therapy after surgery was 24 months, while the median survival in patients who had only surgery was 6 months (p = 0.029). 106 patients were administered pemetrexed-platinum combination and 35 patients were administered gemcitabine-platinum combination as front-line chemotherapy. Median survival, 1- and 2-year survival rates in patients who received platinum analogues and pemetrexed or gemcitabine combinations were found statistically similar (p = 0.15). The median survival for all patients with MPM in our study was 18 months. The main factors influencing the overall survival were stage of the disease (p = 0.020), performance status (p < 0.001), asbestos exposure (p = 0.030) and mesothelioma histological subtypes (p < 0.001). Results of our study suggest that multi-modality treatment regimens consisting of surgery, radiotherapy and chemotherapy prolong overall survival. Survival rates in patients who received combining platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were found similar. © 2012 Springer Science+Business Media, LLC.

We assessed whether single nucleotide polymorphisms (SNPs) in MDR1 gene C3435T predicted the outcome of platinum-based chemotherapies and survival in our non small cell lung cancer (NSCLC) patients. A total of 79 non-small cell lung cancer patients were enrolled to study. We determined the MDR1 C3435T single nucleotide gene polymorphisms. Median age was 60years: 91.7% male, 8.9% female. We found that CC, CT, TT genotype and T, C allele frequencies in lung cancer patients as 24.1%, 62%, 13.9% and 44.3%, 55.7%, respectively. Patients with CT genotype had a higher response rate (11.4%) than the other genotypes. However, this difference is not statistically significant (p=0.743). Cox regression analysis for overall survival showed that ECOG PS status 0 (HR PS 1 vs. 0, 5.68 p=0.002; HR of PS 2 vs. 0 is 21.579, p=0.001; HR of PS 3 vs. 0 is 35.35, p=0.001), stage ≤II (HR of stage III vs. I+II is 17.77; p=0.016, HR of stage IV vs. I+II is 26.97, p=0.006), and albumin level ≥3g/dl (HR of albumin

Malignant pleural mesothelioma (MPM) is a relatively rare, but aggressive tumor that causes high mortality. The major risk factor involved in the etiology is environmental and occupational exposure to asbestos. The optimal modality of therapy is controversial. The present study retrospectively evaluated the data pertinent to 282 patients who were examined and treated in 11 different medical oncology centers in Turkey. There were 161 males (57.1 %) and 121 females (42.9 %), with a mean age of 56.38 +/- A 12.07 years. Surgery was used in 74 patients, 21 patients (28.4 %) received only chemotherapy and 28 patients (37.8 %) received chemoradiotherapy after surgery. The median survival in patients who were administered adjuvant therapy after surgery was 24 months, while the median survival in patients who had only surgery was 6 months (p = 0.029). 106 patients were administered pemetrexed-platinum combination and 35 patients were administered gemcitabine-platinum combination as front-line chemotherapy. Median survival, 1- and 2-year survival rates in patients who received platinum analogues and pemetrexed or gemcitabine combinations were found statistically similar (p = 0.15). The median survival for all patients with MPM in our study was 18 months. The main factors influencing the overall survival were stage of the disease (p = 0.020), performance status (p < 0.001), asbestos exposure (p = 0.030) and mesothelioma histological subtypes (p < 0.001). Results of our study suggest that multi-modality treatment regimens consisting of surgery, radiotherapy and chemotherapy prolong overall survival. Survival rates in patients who received combining platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were found similar.

Testicular cancer is the most common malignancy that develops in men between the ages of 20 and 40 years. Most testicular tumors are of germ cell origin and they are more sensitive to chemotherapy. After orchidectomy, while adjuvant radiotherapy, surveillance or adjuvant chemotherapy are recommended for early stage testicular seminomatous patients, surveillance; for early stage non-seminomatous patients, adjuvant chemotherapy, or retroperitoneal lymph-node dissection are proposed. In advanced germ cell tumors, conventional chemotherapy can cure up to 80% of patients. The combination of cisplatin, bleomycin, and etoposide has become the gold standard in this disease. Some patients with recurrent disease are candidates for salvage treatment. Recently, some studies have been reported that new potent anticancer agents, such as paclitaxel, gemcitabine, oxaliplatin, and irinotecan, can cause high complete response rates in germ cell tumors. In addition, the number of studies of targeted therapies has been increasing in these patients. In this review, we discussed the management of germ cell tumors, including conventional treatments, high dose chemotherapy, and new therapeutic agents.

Background: Nasopharyngeal carcinoma is a rare disease in most parts of the world with a multifactorial etiology involving an interaction of genetic, viral, environmental and dietary risk factors. This is the first epidemiologic study aimed to evaluate the risk factors of nasopharyngeal carcinoma in the Turkish population. Methods: We conducted a multicentric, retrospective, case-control study using a standardized questionnaire which captured age, sex, occupation, household type, blood group, dietary habits, smoking, alcohol consumption and oral hygiene. The study included 183 cases and 183 healthy controls matched by sex and age. Multiple logistic regression and univariate analysis were employed. Results: The peak age incidence was 40-50 years and the male to female ratio was 2:1. We observed significant associations between elevated nasopharyngeal carcinoma risk and low socioeconomic status, rural household type (OR: 3.95, p0.05); furthermore salty foods had a borderline p value (OR: 2.14, p=0.053). Blood type A increased the risk (OR: 2.03, p=0.002) while blood type 0 was a protective factor (OR: 0.53, p=0.009). Rare habit of teeth brushing (OR: 6.17, p= 10 decayed teeth before diagnosis (OR: 2.17, p