Background
Testicular cancer is a rare type of cancer in males. Since the disease is seen in young men and long-term survival is ensured following a high treatment success rate, fertility in ...testicular cancer patients is much more important. Prior to commencement of cancer treatment, patients are given counselling with regard to infertility and sexual function, and sperm banking is commonly carried out. The aim of this study was to assess the fertility status prior to and following treatment of monitored testicular cancer patients whose treatment had been completed.
Methods
110 patients diagnosed with and treated for testicular cancer at the Medical Oncology Clinic at Akdeniz University during the years 2000–2016 were evaluated for the study. The patients’ disease and treatment information was obtained from their records. The patients’ characteristics and fertility statuses were determined by means of interviews with the patients.
Results
The median age of the patients was 36 (20–73) and 39.1% of them (n = 43) were aged between 30 and 39. The average length of follow-up was 6.20 ± 3.36 (2–17) years. It was determined that 42.7% of the patients had banked sperm following diagnosis and that 74.5% of them had received counselling. Following treatment, 33 patients (30%) fathered children. The average time taken to father children after treatment was 3 years.
Conclusion
In testicular cancer patients, fatherhood is achieved spontaneously or with the cryopreservation process. Counselling plays an important role at the time of diagnosis. It is essential that health professionals in oncology clinics give counselling about fertility in testicular cancer.
Purpose
In this study our aim was to compare efficacy and toxicity profiles of two different schedule of carboplatin-paclitaxel regimen in elderly advanced non-small cell lung cancer (NSCLC) ...patients.
Methods
Data from the charts of 59 elderly patients with metastatic NSCLC, treated with weekly paclitaxel combined with two different schedule of carboplatin were collected retrospectively from three medical oncology centers in Turkey between September 2002 to March 2018. No prior systemic therapy or radiotherapy was allowed. Brain metastases were not considered as exclusion criteria unless symptomatic. Patients were analyzed in two treatment groups; CP3 (who received 3 weekly carboplatin and weekly paclitaxel), and CP1 (weekly carboplatin and weekly paclitaxel). Overall survival (OS) was the primary endpoint of the study. Secondary end points were as follows: progression free survival (PFS), response rates (RR), grade 3–4 toxicities, skipped cycles, dose reductions, and treatment discontinuation rates.
Results
Twenty-four patients received 3 weekly carboplatin and weekly paclitaxel schedule (CP3) while weekly carboplatin and weekly paclitaxel schedule (CP1) was performed in 35 patients. CP3 had a median OS of 14 months whereas CP1 had 9 months of median OS (
p
= 0.084). Both treatments (CP3 vs CP1) had similar median PFS (7 months vs 4 months,
p
= 0.109) and objective RR (20.9% vs 29.4%,
p
= 0.465). There was an increased incidence of grade 3–4 anemia and grade 3–4 neutropenia in CP3 compared to CP1 (
p
= 0.003 in both), but no major differences in febrile neutropenia and infection toxicity profiles (
p
= 0.289 and
p
= 0.770, respectively). Weekly schedule (CP1) had a tendency of increased grade 3–4 neurotoxicity (33.3% vs 42.9%,
p
= 0.461).
Conclusion
Weekly carboplatin and paclitaxel might be more tolerable and is as effective as 3 weekly carboplatin and weekly paclitaxel schedule in metastatic elderly NSCLC patients.
Purpose
In this study, we looked for whether treatment-induced rash predicts treatment efficacy in patients with recurrent/metastatic HNSCC treated with Cetuximab and chemotherapy.
Methods
Patients ...who were treated with platinum-based chemotherapy and cetuximab for the first line treatment of recurrent/metastatic HNSCC were recruited. Presence of rash, hypomagnesemia, hypopotassemia, anemia, neutropenia, thrombocytopenia during treatment and treatment response, date of progression, date of last visit and death were recorded.
Results
A total of 138 patients’ data were available for analysis. Any grade of rash was detected in 57 (44.5%) of the patients. The incidence of rash was significantly higher in patients with objective response than in patients with disease progression (%56.8 vs %14.3,
p
< 0.001). Progression free survival was 7.06 months (4.98–9.15) in patients treated with cetuximab and chemotherapy as first line treatment. In the multivariate analysis; rash was significantly correlated with longer PFS (HR 2.136; 95% CI 1.067–4.278;
p
= 0.032). Progression free survival was 9.65 months in patients who experienced rash, and 6.02 months in patients without rash, (
p
= 0.019, log-rank test). Overall survival was 11.24 months (9.65–12.82). In multivariate analysis, the survival of patients with rash was significantly longer than patients without rash (HR 1.954; 95% CI 1.162–3.285;
p
= 0.012). Overall survival was 15.08 months in patients who experienced rash, and 8.61 months in patients without rash (
p
= 0.05, log-rank test).
Conclusion
Cetuximab-induced rash is associated with better ORR and longer PFS and OS in patients with recurrent/metastatic HNSCC treated with Cetuximab and platinum-based chemotherapy.
Venous thromboembolism which consists of pulmonary embolism and deep venous thrombosis is one of the most important problems in cancer patients. The mechanisms of cancer-associated thrombosis are ...multi-factorial and still unclear. Nutrition is an important factor in the treatment and prognosis of cancer. Assessment of the nutritional status of cancer patients is multifactorial and it should be performed at each visit. We aimed to assess the relationship between nutritional status and thrombosis risk in various cancer types. It was a cross-sectional and single-center study and 582 cancer patients were included. Patients nutritional status was evaluated with their height, weight, BMI, triceps skinfold thickness, waist circumference, and upper arm circumference. It was found that there was a statistically significant relationship between the thrombosis risk and nutritional parameters such as weight, BMI, and waist circumference which are important anthropometric measurements. As a result, thrombosis is an important cause of morbidity and mortality in cancer patients. Obesity and cachexia are both important conditions in cancer patients and should be well evaluated. It has been shown that increased weight, BMI, and waist circumference indicating obesity are important risk factors for thrombosis risk in cancer patients.
Introduction: Breast cancer is the most frequently diagnosed cancer in women worldwide. Aromatase inhibitors (AIs) are effective treatment options for both early-stage and advanced hormone ...receptor-positive breast cancer. Because of AIs are used long term in adjuvant therapy, side effects are also very important. It is considered that AIs may affect cognitive functions by decreasing the level of estrogen in the brain. The purpose of our study is that evaluate the relationship between duration of treatment and cognitive functions in patients with breast cancer who use AIs in adjuvant therapy.
Methods: Two-hundred patients diagnosed with breast cancer who were treated with AIs as adjuvant treatment were included. The patients were surveyed for demographic characteristics. Montreal Cognitive Assessment (MoCA) and Standardized Mini-Mental State Examination (SMMT) tests were performed to evaluate patients' cognitive functions. The total scores of the tests and the orientation, short-time memory, visuospatial functions, attention, language, executive functions which are the MoCA subscales were evaluated separately. Patients were grouped as 0-6, 6-12, 12-24, 24-36, 36, and more months according to the duration of AIs using time.
Results: The total MoCA and SMMT scores were affected by factors such as age, education level, and employment status. There was no relationship between duration of treatment and cognitive functions in patients with breast cancer who use AIs in adjuvant therapy (P > 0.05). In addition, no statistically relationship was found in the evaluation of MoCA subscales (P > 0.05).
Discussion: Prolonged adjuvant treatment with AIs does not affect cognitive functions in hormone receptor-positive breast cancer patients.
The monoclonal anti-vascular endothelial growth factor antibody bevacizumab is increasingly being used in the treatment of malignant tumors. It is the first molecular-targeted agent used in the ...treatment of several ovarian cancers. The typical side effects of this drug are hypertension and proteinuria. Bevacizumab-related acute pancreatitis (AP) has not been described before, but AP associated with other chemotherapeutic agents has been reported. Research has shown that patients can develop AP when taking sorafenib, a multiple tyrosine kinase inhibitor that inhibits VEGF.
We explored the case of a 48-year-old woman who presented with undefined upper abdominal pain after receiving a cisplatin-gemcitabine-bevacizumab combination treatment as second-line therapy for metastatic ovarian cancer. Our patient was hospitalized because of AP after two cycles of this treatment. The patient started experiencing abdominal pain after the first course of chemotherapy. The severity and duration of this pain increased after the second cycle of chemotherapy. Her abdominal pain and elevated serum amylase disappeared when treated by chemotherapy without bevacizumab; this also improved her clinical pancreatitis.
AP without other etiological factors can occur in patients treated by chemotherapy. Furthermore, bevacizumab might induce the side effects of AP.
Objective: Pazopanib is a multi-kinase inhibitor used in metastatic renal cell carcinoma or sarcomas (mRCC or mSTS). We aimed to investigate the relationship between pazopanib and macrocytosis and ...evaluate the clinical significant of this effect in mRCC or mSTS.
Methods: Patients diagnosed with mRCC and mSTS and have been treated with pazopanib were included. Drug-induced macrocytosis was defined as MCV >100 fL during any mount of treatment. ΔMCV was defined as difference between MCV during pazopanib treatment and baseline MCV. Data was collected retrospectively.
Results: 50 patients were included the study. During the pazopanib treatment, significant increase in MCV levels was observed and the mean MCV at the 0, 1, 3, 6, and 9 months were found as 86.7±7.6 fL, 87.8 ± 7.5, 92.4 ± 8.9, 94.8 ± 11.1 and 99.0 ± 10.7 fL, retrospectively (p
Amaç: Pazopanib, metastatik renal hücreli karsinom (mRHK) ve metastatik yumuşak doku kanserlerinde (mYDK) kullanılan multi-kinaz inhibitörüdür. Çalışmamızda pazopanib tedavisinin ortalama eritrosit hacmi (MCV) üzerine etkisinin ve progresyonsuz sağkalım süresi (PSS) ve genel sağkalım süresi (GSS) üzerine etkilerinin incelenmesi amaçlanmıştır.
Yöntem: Çalışmamız tek merkezli, retrospektif olarak planlandı ve mRHK veya mYDK tanılı ve pazopanib kullanan hastalar dahil edilmiştir. ΔMCV, tedavinin belli bir ayındaki MCV ile başlangıç MCV arasındaki fark; makrositoz ise tedavinin herhangi bir ayında MCV >100 fL olarak tanımlanmıştır. MCV artışı ve makrositoz ile sağkalım ilişkisi istatiksel olarak analiz edilmiştir.
Bulgular: Hasta sayısı 50 idi. Pazopanib ile 0.ay, 1.ay, 3.ay, 6.ay ve 9.ay ortalama MCV değerleri sırasıyla 86,7 ± 7,6, 87,8 ± 7,5, 92,4 ± 8,9, 94,8 ± 11,1 ve 99,0 ± 10,7 fL olarak hesaplandı (p
The most common age at which gastric cancer is diagnosed is 70 years, and the majority of patients diagnosed are at the metastatic stage. However, although gastric cancer is a geriatric disease, ...there is no suggestion to discriminate treatment for the general geriatric patient population. Here, we evaluated patients receiving palliative chemotherapy for gastric cancer owing to advanced age.
Multicenter data of geriatric patients receiving palliative chemotherapy because of metastatic gastric cancer were retrospectively reviewed.
In total, 262 geriatric patients with gastric cancer were included in the study. Of these, 167 patients, including 134 (51.8%) patients with metastasis at diagnosis and 33 patients with relapse after surgery, were evaluated for palliative therapy. Chemotherapy was started in 87 (52.1%) of 167 patients. The overall median survival of the patients receiving chemotherapy was 9.3 months. There was no difference in overall survival (OS) between patients aged >70 and <70 years. However, a significant difference was detected in OS of patients depending on their Eastern Cooperative Oncology Group (ECOG) performance status (PS) before treatment; survival was 15 months in the group with PS 0-1 and 7 months in the group with PS ≥2.
Advanced age chemotherapy receiving rates in patients with metastatic gastric cancer is decreasing. Survival is not associated with age, but pretreatment ECOG PS is important. Therefore, ECOG PS and comorbidities should be evaluated in detail, and combination therapies could contribute to patient survival.
To evaluate radiological and clinical features in metastatic anaplastic lymphoma kinase+ non-small cell lung cancer patients and crizotinib efficacy in different lines. This national, ...non-interventional, multicenter, retrospective archive screening study evaluated demographic, clinical, and radiological imaging features, and treatment approaches in patients treated between 2013-2017. Totally 367 patients (54.8% males, median age at diagnosis 54 years) were included. Of them, 45.4% were smokers, and 8.7% had a family history of lung cancer. On radiological findings, 55.9% of the tumors were located peripherally, 7.7% of the patients had cavitary lesions, and 42.9% presented with pleural effusion. Pleural effusion was higher in nonsmokers than in smokers (37.3% vs. 25.3%, P = .018). About 47.4% of cases developed distant metastases during treatment, most frequently to the brain (26.2%). Chemotherapy was the first line treatment in 55.0%. Objective response rate was 61.9% (complete response: 7.6%; partial response: 54.2%). The highest complete and partial response rates were observed in patients who received crizotinib as the 2nd line treatment. The median progression-free survival was 14 months (standard error: 1.4, 95% confidence interval: 11.2-16.8 months). Crizotinib treatment lines yielded similar progression-free survival (P = .078). The most frequent treatment-related adverse event was fatigue (14.7%). Adrenal gland metastasis was significantly higher in males and smokers, and pleural involvement and effusion were significantly higher in nonsmokers-a novel finding that has not been reported previously. The radiological and histological characteristics were consistent with the literature data, but several differences in clinical characteristics might be related to population characteristics.
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