Primary lung cancer is the most common cancer worldwide and is an increasingly common problem. The primary endpoint of this study was; to investigate the effect of radiotherapy dose and ...neutrophil-lymphocyte ratio (NLR) on overall survival (OS) and progression-free survival (PFS). We retrospectively examined 99 patients who were stage III A and stage III B at the time of diagnosis, who did not receive surgical treatment, and who received definitive chemoradiotherapy. Data of patients such as sex, age, ECOG status, tumor location, pathological subtype, radiotherapy dose, type of chemotherapy, neutrophil/lymphocyte ratio (NLR), and some biochemical parameters and PFS and OS were included in the study by scanning the patient's files. The radiotherapy cut-off value was accepted as 60 Gray. OS was statistically better in patients who received radiotherapy at doses of 60 Gray and above. When the patients with radiotherapy dose less than 60 Gy and patients with more than 60 Gray were evaluated in two groups, the overall survival was 8,569 ± 1,404 / month and 14,326 ± 1,209 / month, respectively. (p <0.05). When we evaluate the patients based on NLR; It was observed that the overall survival of patients below NLR 4 at the time of diagnosis was statistically significantly better. The overall survival of patients with NLR <4.0 and NLR> 4 was 14.32 ± 1.30 / month and 10.54 ± 1.16 / month, respectively. (p <0.05)
Primer akciğer kanseri dünya çapında en sık görülen kanserdir ve giderek yaygınlaşan bir sorundur. Bu çalışmanın birincil sonlanım noktası; radyoterapi dozu ve nötrofil-lenfosit oranının (NLR) genel sağ kalım (OS) ve progresyonsuz sağ kalım (PFS) üzerindeki etkisini araştırmaktır. Tanı anında evre III A ve evre III B olan, cerrahi tedavi olmayan ve definitif kemoradyoterapi alan 99 hastayı retrospektif olarak inceledik. Hastalara ait cinsiyet, yaş, ECOG durumu, tümör yerleşimi, patolojik alt tip, radyoterapi dozu, kemoterapi tipi, nötrofil/lenfosit oranı (NLR), bazı biyokimyasal parametreler ve PFS ve OS gibi veriler hastaların detaylı dosya taraması yapılarak çalışmaya dahil edildi. Radyoterapi cut-off değeri 60 Gray olarak kabul edildi. OS, 60 Gray ve üzeri dozlarda radyoterapi alan hastalarda istatistiksel anlamlı olacak şekilde daha iyiydi. Radyoterapi dozu 60 Gy'nin altında olan hastalar ve 60 Gray'in üzerinde olan hastalar iki grupta değerlendirildiğinde genel sağ kalım sırasıyla 8.569 ± 1.404 / ay ve 14.326 ± 1.209 / ay idi. (p <0.05). Hastaları NLR'ye göre değerlendirdiğimizde; tanı anında NLR 4'ün altındaki hastaların genel sağ kalımının istatistiksel olarak anlamlı derecede daha iyi olduğu gözlendi. NLO <4.0 ve NLO> 4 olan hastaların genel sağ kalımları sırasıyla 14.32 ± 1.30/ay ve 10.54 ± 1.16/ay idi. (p <0.05)
Acute sunitinib neurotoxicity GULMEZ, Ahmet; DIKILITAS, Mustafa; ELKIRAN, Emin Tamer ...
Cancer treatment and research communications,
2021, 2021-00-00, 2021-01-01, Letnik:
27
Journal Article
Recenzirano
Odprti dostop
Sunitinib malate is a multitargeted oral tyrosine kinase inhibitor (TKI) which is used in treatment of metastatic renal cell carcinoma with side effects such as diarrhea, mucositis, asthenia and ...myelosuppression. Serious toxicity associated with sunitinib is a rare situation. However; there are few cases reported in the literature. As a result of the inhibition that is caused by sunitinib malate agent at the receptor level, vascular endothelial growth factor (VEGF) level increases. These increased VEGF levels are considered to having a positive contribution on neurological side effects. Neurotoxicity that is related with the usage of sunitinib malate for two weeks will be presented in this case report.
Objective
Hepatocellular cancer (HCC) is an aggressive tumor with an increasing incidence in recent years. Life expectancy is limited, especially due to limited effective treatments and tumor ...biology. In this study, we aimed to examine the effect of neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), prognostic nutritional index (PNI) parameters of treatment efficacy of patients using sorafenib in primary systemic therapy, progression-free survival (PFS), and overall survival (OS).
Materials and Methods
In this study, we retrospectively analyzed 78 patients who used sorafenib as a first-line systemic treatment. NLR, PLR, and PNI values were calculated with the existing formulas. Cut-off values for these markers were determined by performing ROC curve analysis. These values were determined respectively as 2.88, 111.05, and 38.25. Patients were divided into two groups according to this threshold value. OS and PFS values were calculated using a Cox proportional risk model. The effects of markers on OS and PFS were examined based on the cut-off value.
Results
The mean PFS was 7.1 (range 1–46) months, and the mean OS was 14.1 (range 1.5–94) months. The pre-treatment decreased NLR (< 2.88) value was prognostic for higher PFS and OS rates. These values were determined respectively as 9.23 ± 1.79 and 3.45 ± 0.32 months for PFS and 21.17 ± 4.53 and 5.32 ± 0.53 months for OS. Pre-treatment decreased PLR (< 111.05) was found to be a positively significant prognostic value for both survival. These values were determined respectively as 7.37 ± 1.43 months and 3.16 ± 0.47 months for PFS and 21.12 ± 5.52 months and 6.16 ± 0.87 months for OS. And also, low PNI (< 38.25) value was prognostic for lower PFS and rates. These values were determined respectively as 7.47 ± 0.59 months and 3.25 ± 0.21 months for PFS and 16.36 ± 4.37 months and 5.15 ± 0.42 for OS. All three parameters were found to be statistically significant (
p
< 0.05) for both OS and PFS as independent prognostic markers.
Conclusion
Today, as the standard first-line treatment of HCC has shifted to combinations with immunotherapy (IO), IO transportation is not possible in most countries of the world. However, there are also patients who achieve great survival with only sorafenib. The important point is to identify the biomarkers that predict which patient will benefit better from which treatment. With the markers in our study and a scoring system that can be obtained with these markers, it can be evaluated which patient will be given IO combination and which patient will be given only TKI treatment. We think that such a scoring system can be used to identify suitable patients, especially in countries where, for financial reasons, not every patient can access Immunotherapy. The advantage of these tests is that they are inexpensive, easily calculable and standardized.
Trial Registration
Number and date of registration: 2021/2088, 01–06-2021, retrospectively registered.
To investigate the prevalence of arthralgia in breast cancer patients taking aromatase inhibitors (AIs) and perform a detailed rheumatologic assessment including autoimmune serology, musculoskeletal ...sonography, and electromyography (EMG) in these patients.
Postmenopausal patients with stage I to III breast cancer who were taking adjuvant AIs were enrolled (n = 92). Patients who were not receiving hormone treatment were included as a control group (n = 28). Musculoskeletal sonography and EMG were applied to the patients and the controls along with markers of autoimmunity.
Thirty patients (32.6%) reported to have AI-related new-onset or worsening arthralgia. The most commonly affected joints were knee (70%), wrist (70%), and small joints of the hand (63%). Patients taking AIs had increased tendon thicknesses compared with those who never received AIs (P < .001). Patients with AI-related arthralgia had higher rates of effusion in hand joints/tendons than those without arthralgia (P = .033). More patients with AI-related arthralgia had EMG findings consistent with carpal tunnel syndrome (CTS) than those without arthralgia (P = .024). No significant difference was observed in erythrocyte sedimentation rates, C-reactive protein, antinuclear antibody, antidouble stranded DNA antibody, rheumatoid factor, or anticyclic citrullinated peptide levels between patients and controls or between those with and without arthralgia.
Patients with AI-related arthralgia often show tenosynovial changes suggesting tenosynovitis, exerting local problems but lacking a systemic inflammatory component. Our finding of increased CTS frequency also supports this hypothesis.
Abstract Central nervous system (CNS) metastases are detected in up to one third of patients with advanced breast cancer, but their incidence and outcomes by breast cancer subtypes are not precisely ...documented. Herein, we retrospectively analyzed clinicopathologic data of 259 breast cancer patients with CNS metastases to evaluate the association between breast cancer subtypes and CNS metastasis. The patient groups were classified according to their hormone receptor status and HER-2 expression. Median follow-up time among the patients was 42 months and median survival after CNS metastasis detection was 7.8 months. In HER-2 overexpressing group, median time period between the diagnosis of breast cancer and the detection of CNS metastasis (15.9 months) was significantly shorter compared to the other groups ( p = 0.01). The triple negative group had the shortest median survival time after CNS metastasis (6.6 months), although statistically not significant ( p = 0.3). In multivariate Cox regression analyses, having solitary CNS metastasis (HR 0.4, 95% CI; 0.2–0.7, p = 0.004), and receiving chemotherapy after CNS metastasis (HR 0.4, 95% CI; 0.287–0.772, p = 0.003) were independent prognostic factors for increasing survival after CNS metastasis. In conclusion, new and effective treatment strategies are required for breast carcinoma patients with brain metastasis considering the positive effect of the treatment on survival.
Rituximab maintenance therapy has emerged as an effective treatment for low-grade lymphomas. No major acute or cumulative toxicities were observed in patients receiving rituximab maintenance therapy ...compared with observation arms in clinical trials. However, B-cells are completely depleted throughout the maintenance period and even longer, which may render patients at high risk for infections. Several infections related to rituximab have been reported in the literature. Yet it is not clear whether rituximab maintenance therapy increases the infectious complications or not. To further investigate this topic, we have performed a systematic review and meta-analysis of randomised controlled trials (RCT). The meta-analysis of five RCTs showed that rituximab maintenance therapy significantly increased the relative risk of both infection and neutropenia in patients with lymphoma. On the basis of the available evidence, patients who received rituximab maintenance treatment have higher risk of neutropenia and infection than those who did not. Previously treated patients particularly with fludarabine containing regimens are more susceptible to infectious complications and require extended vigilance.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Data that support a differential benefit in patients with PR-negative tumors include the finding that patients with such tumors are likely to have HER-1-positive or HER-2-positive breast cancer, ...positive nodes, tumors with high rates of proliferation and aneuploidy, and lower median levels of estrogen receptors.
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