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Amaç: Yumuşak doku sarkomları, malignitelerin yaklaşık %1’ini oluşturan, 50’den fazla histolojik altgrubu olan bir kanser türüdür. Adjuvan kemoterapi alan hastaların hastalıksız sağkalımlarının uzadığınıbirçok çalışma ve metaanaliz gösterse de, genel sağkalıma ilişkin çalışmalar arasında fark vardır.Çalışmamızın amacı, merkezimizde yumuşak doku sarkomu nedeniyle adjuvan kemoterapi uygulananhastaların klinik seyirlerini incelemektir.Gereç ve Yöntemler: Çalışma retrospektif olarak planlanmıştır. İstanbul Üniversitesi Onkoloji EnstitüsüTıbbi Onkoloji polikliniğinde; lokal, lokal ileri olup opere olan veya metastatik olup hem lokal cerrahihem de metastazektomi yapılan ve sonrasında adjuvan tedavi almış 18 yaşın üstündeki yumuşak dokusarkomu hastaları alınmış ve adjuvan kemoterapinin hastalığın seyrine olan etkisi incelenmiştir.Bulgular: 40 hasta çalışmaya dahil edildi. Hastalar medyan 53 ay (5-155) takip edildi. Hastaların%55’i Evre 1 (%10 Evre 1A, %45 Evre 1B), %15 Evre 3 (%5 Evre 3A, %10 Evre 3B), %30 Evre 4’tür.Hastalara medyan dört kür adjuvan kemoterapi verildi ve hastaların %80’i Adriamisin - İfosfamid aldı.Hastaların yarısında hastalık nüks ederken, nüks eden hastalarda hastalıksız sağkalım medyan 12aydır. Hastaların medyan toplam sağkalımı 39 aydır.Sonuç: Yaptığımız çalışmanın sonucunda adjuvan tedavinin hem hastalıksız hem de total sağkalımıkatkısı sağlayabileceğini ve bu katkının hem ekstremite hem de ekstremite dışı yumuşak dokusarkomlarında olabileceğini düşünüyoruz ama kesin bir kanıya varmak için daha geniş hasta sayıları ileyapılacak prospektif çalışmaların daha yararlı olabileceğini düşünüyoruz., Aim: Soft tissue sarcomas are a type of cancer with more than 50 histological subgroups, constitutingapproximately 1% of malignancies. It is seen at a rate of about 5/100000. Even in patients with localdisease, the survival rate is 59%; pushed clinicians to different searches. Although many studies andmeta-analyses show that patients receiving adjuvant chemotherapy have a prolonged disease-freesurvival, there is a difference between studies on overall survival. In our study, we examined patientswho received adjuvant chemotherapy in our center for soft tissue sarcoma.Material and Methods: The study was planned retrospectively. In Istanbul University OncologyInstitute Medical Oncology Polyclinic; In this study, patients with soft tissue sarcoma over the age of18 who were operated locally or locally advanced, or metastatic, who underwent both local surgeryand metastasectomy and subsequently received adjuvant treatment, were recruited and the effect ofadjuvant chemotherapy on the course of the disease was investigated.Results: Forty patients were included in the study. The patients were followed up for a median of 53 months (5-155). 55% of the patients are Stage 1 (10% Stage 1A, 45% Stage 1B), 15% are Stage 3 (5% Stage 3A, 10% are Stage 3B), 30% are Stage 4. Patients received a median of four cycles of adjuvant chemotherapy, and 80% of patients received Adriamycin - Ifosfamide. While the disease relapses in half of the patients, the median disease-free survival in patients with relapse is 12 months. The median overall survival of patients was 39 months.Conclusion: As a result of our study, we think that adjuvant therapy may contribute to both disease-free and total survival, and that this contribution may be in both extremity and extra-extremity soft tissue sarcomas, but we think that prospective studies with larger patient numbers would be more useful to reach a definite conclusion.

Amaç: RAS genleri, Epidermal Büyüme Faktörü Reseptörü (EGFR) tarafından indüklenen RAS-MAPK Sinyal yolağının bir üyesidir. Bu yolaktaki genlerde meydana gelen mutasyonlar kanser gelişimini tetiklemektedir. Kolorektal kanserde (KRK), RAS genlerinde meydana gelen mutasyonlar EGFR hedefli tedaviye karşı direnç gelişimine neden olur. EGFR monoklonal antikorları, kemoterapötik ajanlar olarak metastatik kolorektal kanser tedavisinde yaygın şekilde kullanılmaktadır. KRAS mutasyonları KRK’nın 30-50%’sinde, NRAS mutasyonları ise 2-3%’ünde bulunur. Bu çalışmada, KRK’lı hastalarda KRAS/NRAS mutasyonlarını analiz etmeyi amaçladık. Yöntem: EGFR-hedefli tedaviye direnç gösteren 100 metastatik KRK hastası, Real-Time Polimeraz Zincir Reaksiyonu yöntemi ile KRAS mutasyonu (ekzon 2, 3, 4) ve NRAS mutasyonu (ekzon 2, 3, 4) durumu için tarandı.Bulgular: Bu çalışma sonucunda, KRAS mutasyonu oranı 48% ve NRAS mutasyonu oranı 1,92% olarak bulundu. En yaygın KRAS mutasyonları kodon 12’de saptandı. Kodon 12 mutasyonlarının dağılımı G12V (25%), G12D (23%), G12C (14,5%) olarak elde edildi.Sonuç: Çalışmamızda saptanan KRAS ve NRAS mutasyon sıklıkları benzer raporlar ile uyumlu bulundu. Sonuçlarımız, RAS mutasyonlarının test edilmesinin EGFR-hedefli tedaviden fayda sağlayacak hastaları belirlemede hayati rolünü desteklemektedir., Objective: RAS genes are members of the RAS/Mitogen activated protein kinase pathway which is induced by Epidermal Growth Factor Receptor (EGFR). Mutations in genes in this pathway trigger cancer development. In colorectal cancer, mutations in RAS genes cause resistance to EGRF- targeted therapy. In the treatment of metastatic colorectal cancer, EGFR’s monoclonal antibodies are widely used as chemotherapeutic agents. Kirsten-RAS mutations are found in 30-50% and N-RAS mutations are found in 2-3% of colorectal cancer. In this study, we aimed to analyze Kirsten-RAS /N-RAS mutations in patients with metastatic colorectal cancer.Methods: One hundred of metastatic colorectal cancer patients resistant to EGFR- targeted therapy were scanned for the Kirsten-RAS mutations status (exon 2,3,4) and N-RAS mutation status (Exon 2,3,4) by Real-Time PCR (Polymerase Chain Reaction) method. Results: As a result of this study, Kirsten-RAS mutation was found 48% and N-RAS mutation was 1.92%. The most common Kirsten-RAS mutations were in codon 12. The distribution of codon 12 mutations were obtained as G12V (25%), G12D (23%), G12C (14.5%). Conclusion: In our study, the frequencies of Kirsten-RAS and N-RAS mutations were compitable with similar reports. Our results have supported that testing RAS genes mutations have a vital role in identifying patients who benefit from Epidermal Growth Factor Receptor- targeted therapy.

Background: CDK4/6 inhibitors combined with endocrine therapy have significantly improved treatment outcomes for metastatic hormone receptor-positive (HR+) breast cancer patients. However, the impact of low HER2 expression on treatment response and progression-free survival (PFS) remains unclear. Methods: This multicenter retrospective study included 204 HR+ breast cancer patients treated with a combination of CDK4/6 inhibitor and endocrine therapy. HER2-zero disease was detected in 138 (68%) and HER2-low disease in 66 (32%) patients. Treatment-related characteristics and clinical outcomes were analyzed, with a median follow-up of 22 months. Results: The objective response rate (ORR) was 72.7% in the HER2 low group and 66.6% in the HER2 zero group (p = 0.54). Median PFS was not significantly different between the HER2-low and HER2 zero groups (19 months vs.18 months, p = 0.89), although there was a trend toward longer PFS in the HER2-low group for first-line treatment (24 months progression-free survival rate 63% vs 49%). In recurrent disease, the median PFS was 25 months in the HER2-low group and 12 months in the HER2-zero group (p = 0.08), while in de novo metastatic disease, the median PFS was 18 months in the HER2-low group and 27 months in the HER2-zero group (p = 0.16). The order of CDK4/6 inhibitor use and the presence of visceral metastasis were identified as independent variables affecting PFS. Conclusion: Low HER2 expression did not significantly impact treatment response or PFS in HR+ breast cancer patients treated with a CDK4/6 inhibitor and endocrine therapy. Because of the conflicting results in the literature, further prospective studies are needed to evaluate the clinical significance of HER2 expression in HR+ breast cancer.

Objectives: The aim of this study is to investigate the radiosensitivity of Glioblastoma multiforme (GBM; U87 MG) and astrocyte (SVG p12) cell lines in vitro through the signalling pathways. Methods: GBM and astrocytes were treated with 2, 4, 6, and 8 gray of ionized radiation, followed by a clonogenic assay. The effective dose of radiation was determined as 2 gray. Immunofluorescence technics selected to analyse the macrophage migration inhibiting factor (MIF), nuclear factor of activated T-cells cytoplasmic 2 (NFATc2), osteopontin (OPN), mammalian target of rapamycin (mTOR) and stage-specific embryonic antigen-1 (SSEA-1). Additionally, p53 and cell cycle assays were performed. Results: On day 1, astrocytes showed decreased expression of MIF, OPN and mTOR and increased expression of SSEA-1 in the test group after 2 gray radiation. GBM showed decreased expression of p53 and mTOR, but increased expression of NFATc2. The results of MIF expression were found higher in GBM compared to astrocytes on day 1. Interestingly, on day 12, increased expression of SSEA-1, OPN and p53 were observed in both cell lines’ test groups. Further analysis showed that all control groups of GBM and astrocytes were significantly accumulated in the S phase. After radiotherapy application, percentage of GBM in G0/G1 phases and especially in G2/M phases increased; conversely, in the S phase it decreased. Moreover, percentage of astrocytes increased in the S phase and decreased in G0/G1 phases and in G2/M phases. Conclusions: This combination of findings suggests that as a result of the radiotherapy effect, GBM started to accumulate on check points. The central question in this study focused on changes in molecular protein expression in cancer cells after radiotherapy, particularly key signalling pathways of tumorigenesis and a new possible point of view for treating such diseases.

Objective: To share our clinical experience with cognitive prostate biopsy and compare results of cognitive biopsies with standard biopsies.

Glofitamab is a CD3xCD20 bi-specific antibody with two fragments directed to the CD20 antigen and a single CD3-binding fragment. Encouraging response and survival rates were recently reported in a pivotal phase II expansion trial conducted in patients with relapsed/refractory (R/R) B-cell lymphoma. However, the real-world data of patients of all ages with no strict selection criteria are still lacking. Herein, this retrospective study aimed to evaluate the outcomes of diffuse large B-cell lymphoma (DLBCL) patients who received glofitamab via compassionate use in Turkey. Forty-three patients from 20 centers who received at least one dose of the treatment were included in this study. The median age was 54 years. The median number of previous therapies was 4, and 23 patients were refractory to first-line treatment. Twenty patients had previously undergone autologous stem cell transplantation. The median follow-up time was 5.7 months. In efficacy-evaluable patients, 21% and 16% of them achieved complete response and partial response, respectively. The median response duration was 6.3 months. The median progression-free survival (PFS) and overall survival (OS) was 3.3 and 8.8 months, respectively. None of the treatment-responsive patients progressed during the study period, and their estimated 1-year PFS and OS rate was 83%. The most frequently reported toxicity was hematological toxicity. Sixteen patients survived, while 27 died at the time of the analysis. The most common cause of death was disease progression. One patient died of cytokine release syndrome during the first cycle after receiving the first dose of glofitamab. Meanwhile, two patients died due to glofitamab-related febrile neutropenia. This is the largest real-world study on the effectiveness and toxicity of glofitamab treatment in R/R DLBCL patients. The median OS of 9 months seems promising in this heavily pretreated group. The toxicity related mortality rates were the primary concerns in this study.

Purpose The study aimed to evaluate the possible preventive effect of two concentrations (3 and 5% w/w) of Eugenia jambolana (EJ) extract against 5-FU-induced mucositis. Method Sixteen adult rats were separated into four groups: two control and two preventive groups. Animals in Groups 1, 2, and 3 were injected intraperitoneally with 60 mg/kg/day of 5-FU on Day 1 followed by 150 mg/kg/day on Day 5. The rats in Group 4 (negative control) were given physiological saline at the same times and doses. Furthermore, on the fifth day of the study, the cheek and sublingual mucosa were irritated by external superficial scratches using the tip of an 18-G needle, followed by the application 15 µL of 20% acetic acid, after which 3 and 5% EJ w/w gels were applied topically for animals in Groups 2 and 3, respectively. Results The weight and the mucositis scores were recorded. Antioxidant and anti-inflammatory markers and biochemical tests were analyzed. Significant differences were found between the study groups in weight loss, clinical mucositis scores, mortality rates, and antioxidant and anti-inflammatory parameters. Conclusion The preventive effect of 3% gel was significant, with no mortality rate, making it an option for preventive strategies. WOS:000800703000002 2-s2.0-85130847543 PMID: 35622166

Neoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4\%), DCF (17.4\%) and ECF (8.1\%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2\%, R0 resection rate 86.4\%, and D2 dissection rate was 66.8\%. Rate of pCR and near-CR (24\%), and R0 resection (84\%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95\% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95\% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68\%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients' multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results.

Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. Obesity is known as the major risk factor for endometrial cancer. The most common subtype of endometrial cancer is endometrioid endometrial carcinoma (EEC). Our study aims to investigate the demographic and clinicopathological characteristics of metastatic EEC patients and the effect of treatments on survival. The median age of the patients was 58 (39.4-81.9) years. Sixteen patients presented with abnormal vaginal bleeding. The median follow-up time was 43 (0.2-104.3) months. The median progression-free survival (PFS) was 39.9 months (95% confidence interval (CI): 35.0-79.1), and the median overall survival (OS) was 59.1 months (95% CI: 39.1-80.8). Patients receiving chemoradiotherapy had significantly longer PFS and OS than patients treated with chemotherapy alone (log-rank test, p=0.012 for PFS, p=0.015 for OS). Our study supports that chemoradiotherapy might be a treatment option for selected patient groups in the metastatic stage., Endometrium kanseri (EK) gelişmiş ülkelerde en sık görülen jinekolojik kanserdir. Obezite en önemli risk faktörü olarak kabul edilmektedir. Endometrium kanserleri içerisinde en sık görülen alt tip endometrioid endometrial karsinomdur (EEK). Çalışmamızda metastatik EEK hastalarının demografik ve klinikopatolojik özelliklerini, kullanılan tedavi yöntemlerinin sağ kalıma etkisini incelemeyi amaçladık. Hastaların medyan yaşı 58 (39,4-81,9) idi. On altı hastanın hastaneye başvuru şikayeti vajinal kanamaydı. Medyan takip süresi 43 (0,2-104,3) aydı. Hastaların medyan progresyonsuz sağkalım (PS) süresi 39,9 ay (%95 güven aralığı (GA): 35,0-79,1), medyan genel sağkalım (GS) süresi 59,1 ay (%95 GA: 39,1-80,8) saptandı. Kemoradyoterapi alan hastaların PS ve GS süresi sadece kemoterapi ile tedavi edilen hastalara göre istatistiksel anlamlı olarak daha uzundu (log-rank testi, PS için p=0,012, GS için p=0,015). Çalışmamız metastatik evrede seçilmiş hasta grubunda kemoradyoterapinin tercih edilebileceğini desteklemektedir.

In this review, it is aimed to illuminate the place of testicular sparing surgery in childhood testicular tumors in the light of current literature. The importance of organ-sparing surgery is highlighted because a significant portion of childhood testicular tumors are benign and organ-sparing surgery reduces morbidity without affecting disease-related survival. Testis sparing surgery can be considered as an alternative to radical inguinal orchiectomy in synchronous bilateral testicular tumors, metachronous contralateral tumors, and in the presence of normal solitary testis if preoperative testosterone level is normal and the tumor size is less than 30% of the testicular volume. However, definite recommendations could not be determined due to the lack of literature data.

Background/Aim: There is an unmet need for effective prognostic models in small cell lung cancer. Lung immune prognostic index (LIPI) and Modified Glasgow Prognostic Score (mGPS) markers are prognostic in various cancers. We aimed to examine LIPI and GPS markers' prognostic effects on overall survival (OS) in extensive-stage small-cell lung cancer (SCLC) patients. Methods: Patients who were 18 years of age or older, diagnosed with extensive-stage small cell lung carcinoma who received platinum-based chemotherapy as first-line treatment were included in this retrospective observational study. Having concurrent or sequential radiotherapy to the thorax and receiving non-platinum-based chemotherapy as first-line treatment were the criteria for exclusion. We measured their pretreatment LIPI and mGPS markers and performed multivariate Cox regression analyses of progression-free survival (PFS) or OS in extensive stage-SCLC patients.Results: A total of 129 patients were included in the study. Twenty-eight patients (21.7%) were mGPS 0, 65 patients (50.4%) were mGPS 1, and 36 (27.9%) were mGPS 2. Fourteen percent of the patients were LIPI 0 (n=18), %38 were LIPI 1 (n=49), and %48 were LIPI 2 (n=62). The OS of the mGPS 0, mGPS 1, and mGPS 2 patients were 19.0 months (95% CI, 16.3-21.7), 8.4 months (95% CI, 7.1-9.8), and 6.4 months (95% CI, 3.1-9.6) respectively, and those of LIPI 0, LIPI 1, and LIPI 2 patients were 18.3 months (95% CI, 9.9-26.7), 11.7 months (95% CI, 5.3-18.1), and eight months (95% CI, 6.6-9.5), respectively. In the multivariate analysis, ECOG PS 0-1 and LIPI score 0-1 were associated with better PFS (P=0.035 and P=0.03 respectively) and OS (P=0.003 and P=0.036 respectively). Conclusions: LIPI score predicted an unfavorable prognosis, whereas mGPS was not associated with survival. It would be better to consider the use of the LIPI score when managing extensive-stage small cell lung cancer.

Background/Aim: Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor subtype with a poor prognosis despite various treatments. Some prognostic markers on survival (such as age, Eastern Cooperative Oncology Group Performance Score (ECOG-PS), isocitrated hydrogenase (IDH) status, alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation status, possibility of extensive surgery) have been defined. Prognostic Nutritional Index (PNI) has been evaluated in various cancers (such as lung, esophagus, and pancreas), and patients with a low PNI score have been associated with a poor prognosis for overall survival (OS). Our study aimed to examine the effectiveness of molecular and demographic characteristics and preoperative PNI score that may affect OS in GBM patients.Methods: In this retrospective cohort study, GBM diagnosed patients who were 18 years old or older, were included in the study. We measured their pretreatment PNI score and performed multivariate Cox regression analyses of OS in GBM patients.Results: A total of 107 patients were included in the study. Median age was 58 (range, 32-83) years. 72 patients (67.3%) were male and 35 patients (32.7%) were female. The mean preoperative PNI level was calculated as 50.5. The median overall-survival (mOS) was 19.7 months and the median time to progression (mTTP) was 8.1 months. There was no statistically significant result on overall survival in the univariate analysis of patients with PNI>50.5 (P=0.121). In multivariate analysis, being 70 years or older (P=0.012), IDH-1 wild and ATRX mutant patients (P=0.016), IDH-1 mutant and ATRX wild patients (P=0.037), and TTP 12 months and older (P

Simple Summary Most breast cancers are small and can be treated using breast-conserving surgery. Since these tumors are non-palpable, they require a localization step that helps the surgeon to decide which tissue needs to be removed. The oldest localization technique is a guidewire placed into the tumor before surgery, usually using ultrasound or mammography. Afterwards, the surgeon removes the tissue around the wire tip. However, this technique has several disadvantages: It can cause the patient discomfort, requires a radiologist or another professional specialized in breast diagnostics to perform the procedure shortly before surgery, and 15-20% of patients need a second surgery to completely remove the tumor. Therefore, new techniques have been developed but most of them have not yet been examined in large, prospective, multicenter studies. In this review, we discuss all available techniques and present the MELODY study that will investigate their safety, with a focus on patient, surgeon, and radiologist preference. Background: Surgical excision of a non-palpable breast lesion requires a localization step. Among available techniques, wire-guided localization (WGL) is most commonly used. Other techniques (radioactive, magnetic, radar or radiofrequency-based, and intraoperative ultrasound) have been developed in the last two decades with the aim of improving outcomes and logistics. Methods: We performed a systematic review on localization techniques for non-palpable breast cancer. Results: For most techniques, oncological outcomes such as lesion identification and clear margin rate seem either comparable with or better than for WGL, but evidence is limited to small cohort studies for some of the devices. Intraoperative ultrasound is associated with significantly higher negative margin rates in meta-analyses of randomized clinical trials (RCTs). Radioactive techniques were studied in several RCTs and are non-inferior to WGL. Smaller studies show higher patient preference towards wire-free localization, but little is known about surgeons\" and radiologists\" attitudes towards these techniques. Conclusions: Large studies with an additional focus on patient, surgeon, and radiologist preference are necessary. This review aims to present the rationale for the MELODY (NCT05559411) study and to enable standardization of outcome measures for future studies.

AIM: It was aimed to evaluate in-vivo whether darbepoetin-alpha (DPO) application has a preventive role in the cisplatin-induced ototoxic effect.MATERIALS and METHODS: In the study, four groups were formed using 28 Wistar albino rats. Group 1 (intraperitoneal) IP saline given control group, Group 2 cisplatin (16mg/kg IP single dose), Group 3 DPO (25 μg/kg IP), and Group 4 is the group in which a single dose of 25 μg/kg IP DPO was administered 24 hours before and half an hour after cisplatin administration. Distortion product otoacoustic emission (DPOAE) and brainstem auditory evoked potentials (BAEP) were performed on rats before agent administration and on the 7th day of the experiment. After hearing measurements, the rats were sacrificed. Apoptotic cell death in ear tissue, caspase-3, -8, -9 expression, Inducible Nitric Oxide Synthase (iNOS), Neuronal Nitric Oxide Synthase (nNOS) expression levels, antioxidant Nrf2 (Nuclear factor (erythroid-derived 2)) - like 2) and related Heme oxygenase-1 (HO-1), NAD(P)H quinone oxidoreductase 1 (NQQ1) were studied by immunohistochemical method. Serum glutathione (GSH) and anti-inflammatory TNF-α and IL-1β protein levels were determined using ELISA kits.RESULTS: The hearing loss was detected at all frequencies showing ototoxic effects compared to control in hearing measurements with cisplatin application. In the examinations performed at the immunohistochemical tissue level, structural changes in the inner ear, necrosis, and necroptosis in the brain and nerve tissues were detected in the cisplatin-administered group. The preventive effects of darbepoetin on the inner ear and brain damage induced by cisplatin are detected by apoptotic protein expressions and oxidative stress-related markers, iNOS and nNOS, Nrf-2 and related HO-1, NQO1, serum GSH, and TNF-α and IL-1β proteins.CONCLUSION: In this study, the protective effects of DPO in ototoxicity caused by cisplatin were demonstrated by reducing apoptosis, increasing antioxidant Nrf-2 and target proteins and glutathione levels, and through anti-inflammatory proteins., Amaç: Darbepoetin-alfa (DPO) uygulamasının sisplatine bağlı ototoksik etkiyi önleyici rolü olup olmadığının in-vivo olarak değerlendirilmesi amaçlandı. Materyal metod: Çalışmada 28 adet wistar albino rat kullanılarak 4 grup oluşturuldu. Grup 1 (intraperitoneal) IP salin verilen kontrol grubu, Grup 2 sisplatin (16mg/kg IP tek doz), Grup 3 DPO (25 μg/kg IP), Grup 4 sisplatin verilmeden 24 saat önce ve verildikten yarım saat sonra 25 μg/kg tek doz IP DPO uygulanan grup. Ratlara ajan uygulamalarından önce ve deneyin 7. gününde distorsiyon ürünü otoakustik emisyon (DPOAE) ve işitsel uyarılmış beyin sapı potansiyelleri (ABR) yapıldı. İşitme ölçümleri sonrasında ratlar sakrifiye edildi. Apoptotik hücre ölümü kulak dokusunda kaspaz-3, -8, -9 ve Nrf2 ve Hem oksijenaz-1 (HO-1), NQQ1, Glutatyon (GST) gibi Nrf2 ilişkili antioksidan ve iNOS, nNOS ekspresyon düzeyleri immünohistokimyasal yöntemle çalışıldı. Serum glutatyon (GSH) ve anti-inflamatuar TNF-α ve IL-1 protein düzeyleri ELISA kitleri kullanılarak belirlendi. Bulgular: Sisplatin uygulaması ile işitme ölçümlerinde kontrole göre ototoksik etkileri gösteren tüm frekanslarda işitme kaybı saptandı. İmmunohistokimyasal doku düzeyinde gerçekleştirilen incelemelerde sisplatin uygulanan grupta iç kulakta strüktürel değişiklikler, beyin ve sinir dokularında nekroz ve nekroptoz saptandı. Darbepoetinin sisplatinin ortaya çıkardığı iç kulak ve beyin hasarlarını önleyici etkileri hem apoptotik protein ekspresyonları hem de oksidatif stres ile ilişkili belirteçler olan Nrf-2 ve ilişkili HO-1, NQO1, iNOS ve nNOS, GST ve anti-inflamatuar proteinleri üzerinden saptandı.Sonuç: Bu çalışmada sisplatinin oluşturduğu ototoksisitede DPO’in koruyucu etkileri apoptozun azaltılması, antioksidan Nrf-2 ve hedef proteinler ve glutatyon düzeylerinin artışı yanında anti-inflamatuar proteinler üzerinden geliştiği gösterilmiştir.

Objective: Pancreatic cancer (PCa) is the fourth leading cause of cancer-related deaths. Thus, there is a need for prognostic in-dicators that can aid in disease classification and subsequent selection of appropriate treatment options. Albumin-bilirubin (ALBI) grade, which is calculated using a logarithmic formula, is indicative of liver function. The present study evaluated the prognostic performance of the initial ALBI grade for metastatic PCa in patients receiving first-line chemotherapy. Material and Methods: In this retrospective study, the medical records of 114 patients with de novo liver metastatic PCa and unresectable liver metastasis were evaluated. The ALBI grade was calculated using the formula (log10 bilirubin × 0.66) + (albumin ×-0.085), and based on the grade, patients were divided into 3 groups, namely, ALBI Grade 1, ≤-2.60; ALBI Grade 2, between −2.60 and-1.39; and ALBI Grade 3, ≥-1.39. Results: Median progression-free survival (PFS) was 13 months [95% confidence interval (CI), 7.3-18.6]. The estimated PFS was 16 months for ALBI Grade 1 (95% CI, 13.0-20.4), 8 months for ALBI Grade 2 (95% CI, 7.5-9.9), and 5 months for ALBI Grade 3 (95% CI, 4.3-5.6). Median overall survival (OS) was 11 months (95% CI, 9.0-12.9). The estimated OS was 18 months for ALBI Grade 1 (95% CI, 14.4-21.5), 9 months for ALBI Grade 2 (95% CI, 7.8-10.1), and 6 months for ALBI Grade 3 (95% CI, 4.1-7.8; p

Purpose The present study aims to develop an explanatory framework to gain a deeper understanding of the resilience process in women diagnosed with gynecological cancers. Method Informed by Salutogenesis Model, a Straussian-grounded theory study was conducted. In-depth interviews were conducted with 20 women with gynecological cancer between January and August 2022. Data were analyzed using open, axial, selective coding, and constant comparative methods. Results The core category encapsulated that most women defined resilience as having a dynamic process that could be promoted throughout the process. However, they expressed that they needed “individual resources for resilience” and “generated resources by the supportive interventions” to be resilient. They emphasized that these resources should make the process manageable, meaningful, and comprehensible to promote resilience. Furthermore, they defined in detail which components should be included in supportive interventions. They stated“some reflections of resilience on their cancer process” and “life gains from the process.” Conclusion This study developed a grounded theory that provides a guideline for healthcare professionals on how women could be encouraged to have resilience and what is the importance of resilience on women's cancer process and their lives. Salutogenesis may help to understand the resilience process in women with gynecological cancer and provides direction for how healthcare professionals should shape their clinical interventions to promote the resilience process. No sponsor

The aim of this multicentre retrospective study was to compare the efficacy of adjuvant chemotherapy regimens both with and without oxaliplatin and tumor sidedness in stage IIB (pT4aN0) colon cancer patients. This study included patients with stage IIB colon cancer who underwent curative surgery and received adjuvant chemotherapy. The patients were divided into two groups (one with and one without oxaliplatin) to compare the overall survival (OS) in right- and left-sided tumors. The study population included 298 patients with stage IIB colon cancer (median age: 57) of whom 69.1% were male. Forty-four per cent of these patients (n = 131) were diagnosed with right-sided colon cancer. The median follow-up duration was 35.9 months. In the entire population, a median OS was not reached, and the five-year OS was 83%. The median disease-free survival (DFS) was 12 months. There was no significant difference in terms of the five-year OS between right- (82%) and left-sided (84%) colon tumors (p = 0.67). In addition, the five-year OS of patients treated with and without oxaliplatin were 76% and 89%, respectively, and there was no statistically significant difference (p = 0.23). The five-year OS of the patients treated with and without oxaliplatin were 83% and 96.5%, respectively, (p = 0.8) in right-sided colon tumors, while it was 75% and 93% (p = 0.06), respectively, in left-sided colon tumors. Tumor sidedness and the addition of oxaliplatin to adjuvant chemotherapy were not found to be associated with the OS in stage IIB colon cancer patients in our study. Further large prospective studies that also include MSI, RAS and BRAF status data are warranted in colon cancer patients.

Background There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.

FDG PET-CT (F18-Flourodeoxyglucose Positron Emission Tomography-Computed Tomography) imaging is very useful in detection, staging, re-staging and monitoring therapy in various tumors. Rhabdomyosarcoma is known as an aggressive tumor and have a tendency of metastasize. Herein we report an alveolar rhabdomyosarcoma case in a 22 year old male patient with a very rare pancreatic metastases.

Colorectal cancers are seen at a high rate in developed countries. The 5-year survival rate varies according to the stage of the disease at the time of diagnosis. Therefore, it is very important to detect the disease at an early stage, to stage it correctly and to determine the appropriate treatment options according to the stage. Surgical resection, neoadjuvant chemoradiotherapy and adjuvant chemotherapy are the treatment options according to the staging of the disease at the time of first diagnosis. Positron Emission Tomography-Computed Tomography (PET-CT) is used in the indications of diagnosis, staging, restaging, detection of recurrence and evaluation of treatment response in colorectal cancers. In this review, the limitations of current imaging methods and the place of PET-CT imaging in colorectal cancer staging and its potential future uses will be explained.

The aim of this case series is to decide the diagnostic value of the additional SPECT/CT imaging during gastrointestinal bleeding site definition by scintigraphy as well as to determine the time point to perform. The outcomes of the patient included in this case series revealed that the 24th hour imaging might bear false positive findings of gastrointestinal bleeding and early SPECT/CT should be preferred. Additional findings in CT proportion of the study must be carefully interpreted in patients with known primary intraabdominal malignancy.

F-18 FDG PET/CT has a documented role in diagnosis of the patients with radioiodine refractory differentiated thyroid carcinoma (RAIR-DTC) and there are ongoing studies about the treatment response evaluation for tyrosine kinase inhibitor treatment response evaluation. This case report is about the treatment response evaluation of a unique patient with multiple unusual metastatic lesions of RAIR-DTC.

Background/aim: Ischemia/reperfusion (I/R) injury occurs during breast cancer surgery, especially those involving a modified radical mastectomy, lumpectomy, and axillary lymph node dissection. Tissue damage and stress due to I/R alter immune system functions, especially those of the myeloid cells. The immunologic impact of this I/R injury on myeloid-derived cancerous cells remains unknown. We sought to investigate the effect of I/R injury in the extremity close the breast tumor location on myeloid cell population in the liver and liver metastasis. Methods: 4T1 breast tumors were created in the left inguinal breast region of the experimental animals. When the tumor reached 0.5 cm in diameter, ischemia was produced on the left down-extremity for 90 min and reperfusion was induced for short (3 days), middle (7 days), and long terms (14 days). At the end of the reperfusion period, proximal limbs and livers were harvested. The limb and liver samples were histopathologically examined with H&E staining. Immune cell percentages were determined in the liver by flow cytometry. Results: there was an increase in muscle fiber degeneration and disorganization in the I/R induced proximal legs on days 3 and 7 of I/R in both tumor free and tumor bearing animals with a further impact in tumor bearing mice. Even though I/R injury did not affect tumor metastasis to the liver, it had an impact on liver myeloid cell percentages in both tumor free and tumor bearing animals. Additionally, tumor bearing mice demonstrated higher myeloid cell percentages in both the pre-I/R and post-I/R experimental groups. There was a remarkable change in the levels of granulocytic, and monocytic myeloid cells and macrophages due to the I/R injury. Conclusion: with the formation of short-term I/R injury in a distant site, tumor development and/or seeding to metastasis sites after surgery could be prevented. This study contributes to the understanding of the inflammatory process after I/R injury occurring during interventions., NA

Simple Summary Patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 are an even greater challenge for hematologists. To better clarify their outcome, we describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Overall, 343 (76.2%) patients received treatment for HM, and an overall response rate was observed in 140 (40.8%) patients after the first line of treatment. Thirty-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004). Statistical analysis showed that, together with age, severe/critical COVID-19, >= 2 comorbidities, lack of HM treatment was an independent risk factors for mortality. These observations suggest the importance of HM treatment in these patients; therefore, it should be delivered as soon as possible for patients requiring immediate therapy. Background: The outcome of patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 is unknown and there are no specific treatment guidelines. Methods: We describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Results: Acute leukaemia and lymphoma were the most frequent HM (35.8% and 35.1%, respectively). Overall, 343 (76.2%) patients received treatment for HM, which was delayed for longer than one month since diagnosis in 57 (16.6%). An overall response rate was observed in 140 (40.8%) patients after the first line of treatment. After a median follow-up of 35 days, overall mortality was 177/450 (39.3%); 30-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004), either before and/or after COVID-19, or compared to patients receiving HM treatment at least after COVID-19 (15.2%, p < 0.001). Age, severe/critical COVID-19, >= 2 comorbidities, and lack of HM treatment were independent risk factors for mortality, whereas a lymphocyte count >500/mcl at COVID-19 onset was protective. Conclusions: HM treatment should be delivered as soon as possible for patients with simultaneous diagnosis of COVID-19 and HM requiring immediate therapy.

In our study, it was aimed to compare the volume of accelerated partial breast irradiation in patients diagnosed with early stage breast cancer in CyberKnife target and volume targeted virtual plans (APBI). A virtual plan was created in CyberKnife system for 5 patients who received radiotherapy in our unit, 6 Gy per day for Iris, fixed and multi-leaf collimator (MLC) and 30 Gy in total. Dosimetric parameters for three different collimators were analyzed according to the constraints of the NSABP-39/RTOG 0413 protocol. In the plans, it was ensured that critical organs were protected and PTV received 95% of the prescribed dose. The prescribed dose was defined by a minimum 80% isodose curve. Homogeneity index (HI), conformity index (CI), treatment time (min), monitor unit (MU) and doses received by critical organs were compared. The mean HI values for iris, fixed collimator, and MLC were 1.2- 1.2- 1.19, mean CI values were 1,08-1,06-1,07, mean treatment time was 47,6- 52,2- 25,4 (min) and MU values were found to be 19736,2-2026,.3- 7161,3 on average. Mean MU and duration of treatment were found in the lowest MLC. No significant difference was found for HI, CI. As a result of the comparison of the plans, a significant difference was found for MU and duration of treatment (p< 0,05).ipsilateral breast30 and V15 were found at the lowest MLC.for lung and heartDmax was no significant difference between. As a result, the target volume received the desired dose in each collimator. The contralateral breast and contra-lateral lung doses were the lowest in Iris. Fixed collimator was found to be more suitable for cardiac doses. But these values did not make a significant difference. In the fixed collimator (52,2 min), it may cause difficulties in clinical applications due to the long treatment time. The choice of collimator in breast SBRT applications with CyberKnife may vary depending on tumor size, proximity to critical organs and tumor localization., Çalışmamızda erken evre meme kanseri tanılı hastalarda hızlandırılmış kısmı meme ışınlamasında (HKMI) CyberKnife (CK) tedavi cihazında yapılan sanal planlarda hedef hacim ve kritik organ dozlarının karşılaştırılması amaçlanmıştır. Birimimizde radyoterapi almış 5 hasta için CyberKnife sisteminde Iris, sabit ve çok yapraklı kolimatör (ÇYK) için günlük 6 Gy toplam 30 Gy olacak şekilde sanal plan oluşturuldu. Üç farklı kolimatör için dozimetrik parametreler NSABP-39/RTOG 0413 protokolündeki kısıtlamalara göre analiz edildi. Planlarda kritik organların korunması ve PTV’nin reçete edilen dozun % 95’ini alması sağlandı. Reçete edilen doz minimum % 80’lik izodoz eğrisine tanımlandı. Homojenite indeksi (Hİ), konformite indeksi (Kİ), tedavi süresi (dk), monitör unit (MU) ve kritik organların aldığı dozlar karşılaştırıldı. Iris, sabit kolimatör, ÇYK için sırasıyla Hİ değerleri ortalama 1,2- 1,2- 1,19, Kİ değerleri ortalama 1,08- 1,06- 1,07 tedavi süresi ortalama 47,6- 52,2- 25,4 (dk) ve MU değerleri ortalama 19736,2- 20267,3- 7161,3 olarak bulunmuştur. Planların karşılaştırılması sonucunda MU, tedavi süresi için anlamlı fark bulunmuştur (p< 0,05). Ortalama MU ve tedavi süresi, en düşük ÇYK’da bulunmuştur Hİ, Kİ için anlamlı fark bulunmamıştır. Aynı taraf memenin V30 ve V15 değerleri en düşük ÇYK’da çıkmıştır. Akciğer ve kalp için Dmax değerleri arasında anlamlı bir fark bulunmadı. Sonuç olarak, hedef hacim her kolimatörde istenen dozu almıştır. Karşı meme ve karşı akciğer dozları en düşük Iris’te bulundu. Kalp dozları için sabit kolimatörün daha uygun olduğu bulundu. Fakat bu değerler anlamlı olarak fark yaratmadı. Sabit kolimatörde (52,2 dk), tedavi süresi uzun olduğu için klinik uygulamalarda zorluk çıkarabilir. CyberKnife ile meme SBRT uygulamalarında kolimatör seçimi, tümör boyutu, kritik organlara yakınlık durumu ve tümör lokalizasyonuna bağlı olarak değişebilir.