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Öğe Assessment of the life quality in head and neck cancer patients.(AMER SOC CLINICAL ONCOLOGY, 2012) Akkas, Ebru Atasever; Yucel, Birsen; Kilickap, Saadettin; Okur, Yillar; Kacan, Turgut; Eren, Mehmet Fuat; Babacan, Nalan Akgul…Öğe A Case of Multifocal Skin Metastases from Lung Cancer Presenting with Vasculitic-type Cutaneous Nodule(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2015) Babacan, Nalan Akgul; Kilickap, Saadettin; Sene, Saner; Kacan, Turgut; Yucel, Birsen; Eren, Mehmet Fuat; Cihan, SenerAlthough cutaneous metastasis occurs usually at the terminal stage of the disease, it may be rarely concurrent with the diagnosis and may also present as the first sign of the illness. A 55-year-old male patient presented with vasculitic-type cutaneous nodular lesions and a necrotic distal phalangeal lesion developed over the last month. He was a tradesman and smoked 40 packets year. On physical examination, he was found to have multiple cutaneous lesions on the skin of the face, limbs, neck, scalp, dorsal side, ingers, subungual side, right leg, and feet. A skin lesion punch biopsy was performed and squamous cell carcinoma metastasis was detected. He was diagnosed as having squamous cell lung cancer with bronchoscopic biopsy. Although it is very rare, cutaneous metastases that is concurrent with the diagnosis of lung cancer may be the first sign of the disease. In patients with suspicious skin lesions, the patient's age, smoking history, and other symptoms should be evaluated and a biopsy should be performed.Öğe Could the Neutrophil to Lymphocyte Ratio be a Poor Prognostic Factor for Non Small Cell Lung Cancers?(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2014) Kacan, Turgut; Babacan, Nalan Akgul; Seker, Metin; Yucel, Birsen; Bahceci, Aykut; Eren, Ayfer Ay; Eren, Mehmet Fuat; Kilickap, SaadettinBackground: Although many prognostic factors have been identified for lung cancers, new ones are needed to determine the course of the disease. Recently, a high neutrophil to lymphocyte ratio (NLR) prior to surgery or treatment has been shown to be an indicator of prognosis for cancer. The aim of this study was to investigate the value of NLR as a prognostic factor and the correlation between NLR and other probable clinical prognostic factors in non small cell lung cancer patients prior to treatment. Materials and Methods: Data of patients who were diagnosed with non-small cell lung cancer in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristics were recorded. NLR was calculated before the application of any treatment. Results: A total of 299 patients, 270 (90%) males and 29 (10%) females, were included in the study. Age (p<0.001) stage (p<0.001), Eastern Cooperative Oncology Group performance status (p<0.001), weight loss (p<0.001), anemia (p<0.001), histopatology (p<0.001), NLR >= 3 (p=0.048), NLR >= 4 (p=0.025) and NLR >= 5 (p=0.018) were found to be the prognostic factors. Age, anemia, Eastern Cooperative Oncology Group performance status, the stage, NLR (>= 5) were an independent prognostic factors. There was a positive correlation between NLR and the Eastern Cooperative Oncology Group performance status (0.23, p=0.001), the C reactive protein levels (r=0.36, p<0.001). Conclusions: Prior to treatment high NLR was found as an independent poor prognosis factor. Besides, NLR correlated with Eastern Cooperative Oncology Group performance status and the C reactive protein levels.Öğe Effect of the patient's age on radiotherapy-based adverse effect(AMER SOC CLINICAL ONCOLOGY, 2012) Okur, Yillar; Yucel, Birsen; Akkas, Ebru Atasever; Eren, Mehmet Fuat; Babacan, Nalan Akgul; Kacan, Turgut; Kilickap, Saadettin…Öğe The impact of radiotherapy on quality of life for cancer patients: a longitudinal study(SPRINGER, 2014) Yucel, Birsen; Akkas, Ebru Atasever; Okur, Yillar; Eren, Ayfer Ay; Eren, Mehmet Fuat; Karapinar, Hanife; Babacan, Nalan Akgul; Kilickap, SaadettinThe aim of this study was to assess for changes in quality of life (QOL) among cancer patients who undergo radiotherapy (RT) and to identify factors that influence QOL in this group. Three hundred sixty-seven cancer patients who received curative RT were investigated using the EORTC QLQ-C30 questionnaire at the start of RT, end of RT, and 1 and 6 months post-RT. The patients were 49 % women, 51 % men, and median age at diagnosis was 57 years (range, 16-86 years). Compared to pre-RT, at the end of RT, the global health status score (p < 0.001), nausea/vomiting (p < 0.001), and apetite loss scores (p < 0.001) were significantly poorer. Compared to the end of RT, at 1 and 6 months post-RT, global health status, all functional, and all symptom scores were significantly improved (p < 0.001). Patient sex influenced scores for pain (p = 0.036), appetite loss (p = 0.027), and financial difficulty (p = 0.003). Performance status influenced scores for global health status (p = 0.006), physical functioning (p < 0.001), cognitive functioning (p = 0.001), and role functioning (p = 0.021). Comorbidity influenced fatigue score (p < 0.001). Cancer stage influenced scores for physical functioning (p = 0.001), role functioning (p = 0.010), and fatigue (p < 0.001). Treatment modality (chemoRT vs. RT alone) influenced scores for physical functioning (p = 0.016), fatigue (p < 0.001), nausea/vomiting (p = 0.009), and appetite loss (p < 0.001); and RT field influenced scores for nausea/vomiting (p = 0.001), appetite loss (p = 0.003), and diarrhea (p = 0.037). Radiotherapy dose functioning (p < 0.001), cognitive functioning (p < 0.001), social functioning (p < 0.001), fatigue (p < 0.001), and pain (< 60 vs a parts per thousand yen60 Gy) had an effect on scores for physical functioning (p < 0.001), role functioning (p < 0.001), emotional (p < 0.001), insomnia (p < 0.001), constipation (p < 0.001). While RT negatively affects cancer patients' QOL, restoration tends to be rapid and patients report significant improvement by 1 month post-RT. Various patient- and disease-specific factors and RT modality affect QOL in this patient group. We advocate measuring cancer patients' QOL regularly as part of routine patient management.Öğe Lack of Impact of Age on Acute Side Effects and Tolerance of Curative Radiation Therapy(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2013) Yucel, Birsen; Okur, Yillar; Akkas, Ebru Atasever; Eren, Mehmet FuatAim: The aim of this study was to determine the impact of age on the occurrence, severity, and timing of acute side effects related to radiotherapy. Materials and Methods: We analysed the data of 423 patients. Results: Of the patients, 295 (70%) were under the age of 65 (group 1) and 128 (30%) were over the age of 65 (group 2). The frequencies of radiotherapy-induced side effects were 89% in group 1 and 87% in group 2 (p=0.286). The mean times to occurrence were 2.5 +/- 0.1 weeks in group 1 and 2.2 +/- 0.1 weeks in group 2 (p=0.013). Treatment was ended in 2% of patients in group 1 and 6% of those in group 2 (p=0.062). Treatment interruption was identified in 18% of patients in group 1 and 23% in group 2 (p=0.142). Changes in performance status were greater in older patients (p=0.013). There were no significant differences according to the frequency or severity of side effects, except skin and genitourinary complications, between the groups. Conclusions: Early normal tissue reactions were not higher in older versus younger patients, though there was a tendency towards an earlier appearance.Öğe Prognosis of Colorectal Cancer With Peritoneal Carcinomatosis: Is a New Staging Necessary?(AMER SOC CLINICAL ONCOLOGY, 2012) Kesikli, S. Altug; Eren, Mehmet Fuat; Babacan, Nalan Akgul; Kilickap, Saadettin…Öğe Retrospectively evaluate prognosis and treatment results of patients with non small cell lung cancer(DRUNPP-SARAJEVO, 2012) Yucel, Birsen; Okur, Yillar; Akkas, Ebru Atasever; Eren, Mehmet FuatPurpose: The purpose of this study is to review the prognostic factors and treatment results of patients with non-small cell lung cancer (NSCLC) treated in our center. Methods: The data of 238 patients with NSCLC who registered at the Radiation Oncology Department of Cumhuriyet University Medical Research and Application Hospital between at 2006-2010 were obtained from patients files. Results: This study analysed data of 238 patients. The most observed histological type was squamous cell carcinoma at 97 (41%). The 2-year survival were 84% at stage I, 76% at stage II, 34% at stage III and 9% at stage IV. The prognostic factors were age, weight loss, ECOG, thrombocytosis and high level of lactate dehydrogenase, histopathology, and stage, the use of platinum and taxan and radiation dose. Conclusion: Results of this study were that the most important prognosis factors were stage, ECOG performance status and the use of cisplatin.Öğe Survival Analysis and Prognostic Factors for Neuroendocrine Tumors in Turkey(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2013) Yucel, Birsen; Babacan, Nalan Akgul; Kacan, Turgut; Eren, Ayfer Ay; Eren, Mehmet Fuat; Bahar, Seher; Celasun, Mustafa Gurol; Seker, Mehmet Metin; Hasbek, ZekiyeBackground: This study aimed to determine the demographical distribution, survival and prognostic factors for neuroendocrine tumors monitored in our clinic. Materials and Methods: Data for 52 patients who were admitted to Cumhuriyet University Medical Faculty Training Research and Practice Hospital Oncology Center between 2006 and 2012 and were diagnosed and treated for neuroendocrine tumors were investigated. Results: Of the total, 30 (58%) were females and 22 (42%) were males. The localization of the disease was gastroenteropancreatic in 29 (56%) patients and other sites in 23 (44%). The most frequently involved organ in the gastroenteropancreatic system was the stomach (n=10, 19%) and the most frequently involved organ in other regions was the lungs (n=10, 19%). No correlation was found between immunohistochemical staining for proteins such as chromogranin A, synaptophysin, and NSE and the grade of the tumor. The patients were followed-up at a median of 24 months (1-90 months). The three-year overall survival rate was 71%: 100% in stage I, 88% in stage II, 80% in stage III, and 40% in stage IV. The three-year survival rate was 78% in tumors localized in the gastroenteropancreatic region, and 54% in tumors localized in other organs. In the univariate analysis, gender, age, performance status of the patients, grade, localization, surgical treatment, and neutrophil/lymphocyte ratio (<= 5 versus >5) affected the prognosis of the patients. Conclusions: Most of the tumors were localized in the gastroenteropancreatic region, and the three-year survival rate in tumors localized in this region was better than the tumors localized in other sites. Surgical treatment was a positive independent prognostic factor, whereas Grade 3 and a neutrophil/lymphocyte ratio of > 5 were negative independent prognostic factors.Öğe The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis(Mdpi, 2020) Eren, Mehmet Fuat; Eren, Ayfer Ay; Sayan, Mutlay; Yucel, Birsen; Elagoz, Sahende; Ozguven, Yildiray; Vergalasova, IrinaBackground and objectives:Everolimus (EVE) is a mammalian target of the rapamycin (mTOR) inhibitor that is widely used in cancer patients. Pulmonary toxicity, usually manifesting as interstitial pneumonitis, is a serious adverse effect of this drug. Radiation therapy, which is often administered in conjunction with chemotherapy for synergistic effects, also causes pulmonary fibrosis. In view of pulmonary damage development in these two forms of cancer treatment, we have examined the effect of EVE administration individually, in combination with radiation given in varying sequences, and its relation to the extent of pulmonary damage.Materials and Methods:We performed an experimental study in albino rats, which were randomized into five groups: (1) control group, (2) EVE alone, (3) EVE 22 h after radiation, (4) EVE 2 h after irradiation, and (5) only radiation. Sixteen weeks after thoracic irradiation, rat lung tissue samples were examined under light microscopy, and the extent of pulmonary damage was estimated. After this, we calculated median fibrosis scores in each group.Results:The highest fibrosis score was noted in Group 4. Among the five groups, the control group had a significantly lower median fibrosis score compared to the others. When the median fibrosis score of the group that received concurrent EVE with radiation therapy (RT) (Group 4) was compared with that of the control group, the difference was statistically significant (p= 0.0022). However, no significant differences were achieved among the study groups that received EVE only or RT only, whether concurrently or sequentially (p> 0.05).Conclusion:EVE is an effective treatment option for the management of several malignancies and is often combined with other therapies, such as radiation, for a more efficient response. However, an increased risk of pulmonary fibrosis should also be anticipated when these two modalities are combined, as they both can cause pulmonary damage, especially when administered concurrently.
