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Öğe Comparison of survival with somatostatin analog and chemotherapy and prognostic factors for treatment in 165 advanced neuroendocrine tumor patients with Ki-67 20% or less(LIPPINCOTT WILLIAMS & WILKINS, 2017) Ozaslan, Ersin; Karaca, Halit; Koca, Sinan; Sevinc, Alper; Hacioglu, Bekir; Ozkan, Metin; Ozcelik, Melike; Duran, Ayse O.; Hacibekiroglu, Ilhan; Yildiz, Yasar; Tanriverdi, Ozgur; Menekse, Serkan; Aksoy, Asude; Bozkurt, Oktay; Urvay, Semiha; Uysal, Mukremin; Demir, Hacer; Ciltas, Aydin; Dane, FaysalThe objectives of this study were to compare progression-free survival (PFS) with somatostatin analog (SSA) versus chemotherapy (CTx) in first-line therapy and to determine the patient group in which these treatments were more effective in neuroendocrine tumors (NETs) with a Ki-67 index of 20% or less. Patients who received SSA or CTx and had unresectable locally advanced and metastatic NETs with a Ki-67 index of 20% or less were retrospectively selected from 13 centers in the Turkish database between 2000 and 2015. One hundred and sixty-five patients were enrolled. The median age was 56 years and the male-to-female ratio was 1.09. Seventy-four (45%) patients were of grade 1 NET and 91 (55%) were of grade 2. SSA was given to 104 patients, whereas 61 were treated with CTx. The objective response rate after SSA was 15.4%; another 73.1% had stable disease. The objective response rate after CTx was 36.1%, and 40.9% had stable disease (P = 0.008). The median PFS in SSA patients was 21 months (95% confidence interval: 12.4-29.6), and 8 months for CTx (95% confidence interval: 5.5-10.6) (P < 0.001). There was no significant difference between PFS of receiving SSA and CTx in pancreatic neuroendocrine tumor (PNET) patients; however, the PFS of receiving SSA was longer in non-PNET patients (P < 0.001). SSA was better treatment in advanced NET patients with a Ki-67 index of less than 5%, having a primary resected and a performance status of 0 (P < 0.05). SSA may be preferred over CTx in advanced NET patients with low-to-intermediate grade. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.Öğe Induction or consolidation chemotherapy for unresectable stage III non-small-cell lung cancer patients treated with concurrent chemoradiation: a retrospective study(2019) Urvay, Semiha; Yücel, BirsenAim: The objective of this study is to demonstrate the efficacy of induction or consolidation chemotherapy on survival in locally advanced non-small cell lung cancer ( NSCLC) patients who were treated by curative concurrent chemoradiotherapy (CCRT).Material and Methods: Patients were randomised to CCRT, induction chemotherapy followed by CCRT or CCRT followed by consalidation chemotherapy retrospectively. A platinum-based doub-let cytotoxic chemotherapy regimen used as induction/consalidation. Patients who received 60 Gy or more were included in the study. These patients had received two or more cycles of platinum-based chemotherapy concurrently with definitive radiation therapy.Results: A total of 114 patients were included in the study. 32 (28%) patients were in CCRT arm; 54 (47%) patients were in induction arm and 28 (25%) patients were in consalidation arm.Median overall survival (OS) was found as 21.9±14.0 months and 2 year and 3-year survival as %46 and 33% in all patients. Median OS did not differ between arms; with a median OS of 29.7±8.8 months, 23±2.9 months and 16.8±3.5 months in the CCRT arm, in the induction arm and in the consolidation arm (p:0.54). The 2 years OS was 53%, 50% and 32% (p:0.48) and 3 years OS was 40%, 33% and 25% ( p:0.40) in the CCRT arm, the induction arm in the consalidation arm without a significiant difference.Conclusion: In this retrospective study, platin-based chemotherapy as induction or consolidation with concurrent chemoradiotherapy failed to further prolong OS. The standart of care for unresectable stage III NSCLC is still concurrent chemoradiotherapy .Öğe Is thoracic CT adequate for diagnosis and differential diagnosis in patients with pleural thickening?(2018) Katrancıoğlu, Özgür; Şahinoğlu, Tuba; Karakuş, Kayhan; Md, Ozan Kandemir; Urvay, Semiha; Karakaya, Esra Aydın; Katrancıoğlu, NurkayObjective: Lung pathologies associated with pleural thickening are presented along with similar clinical and radiologicalfindings. The present study highlights the importance of the differential diagnosis verification of patients with pleuralthickening. Video-assisted thoracoscophic surgery (VATS) is one of the most common diagnostic and therapeutic methodused for this purpose. In this study, we aim to deliver our clinical investigation results on patients diagnosed with pleuralpathology in the light of recent literature.Method: In this study, data of 40 patients that were applied single-port VATS pleural biopsy in our clinic between May2012 and June 2014 were retrospectively assessed. Thoracic CT and pathology results were compared. Clinical diagnosis,radiologic findings, and biopsy results were evaluated retrospectively.Results: The average age of the patients is 59.15 ±12.13 (age range 23, 82). There was an environmental exposure toasbestos in 14 patients (35%). Twenty-five patients (62.5%) were followed-up with the diagnosis of mesothelioma withclinical and radiological findings, 8 patients (20%) of tuberculosis, 4 patients (10%) of pleural metastasis and 3 patients(7.5 %) of pleuritis. Histopathologically 8 patients (20%) were diagnosed with malignant mesothelioma, 1 patient (2.5%) was localized fibrous tumor, 2 patients were (5%) diagnosed with reactive mesothelial hyperplasia, 6 patients (15%)were malignant epithelial tumor metastasis, 16 patients (40%) were fibrinous pleuritis, 6 patients (15%) were chronicgranulomatous inflammation, and 1 patient (2.5%) was chronic lymphocytic inflammation.Conclusions: The present study demonstrates insufficiency of thoracic CT for diagnosis and differential diagnosis due tosimilar clinical and radiological findings associated with pathological pleural thickening. Histopathologic examination isrequired for diagnosis. However, thoracic CT is still a method of radiographic imaging that is actively used indetermination of pleural biopsy position, evaluation, and clinical monitoring of response to treatment.Öğe Overview of Survival and Related Parameters in Malignancies with Brain Metastasis(KARE PUBL, 2016) Erdis, Eda; Yucel, Birsen; Urvay, Semiha; Mayadagli, AlparslanOBJECTIVE Brain metastasis is the most common type of brain tumor. The present study is an investigation of prognostic factors for survival in patients with brain metastasis. METHODS We retrospectively investigated patients with brain metastasis who were treated at the Cumhuriyet University center for radiation oncology between 2006 and 2014. RESULTS The data of 277 patients were analyzed. Age of the patient, performance status, length of time to metastasis, site of primary disease, and performance of metastasectomy were determined to be factors that affect prognosis. Independent prognostic factors were found to be: time to metastasis (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.52-0.99; p=0.0047), performance status (HR: 1.40; 95% CI: 1.07-1.85; p=0.015), and metastasectomy (HR: 0.54; 95% CI: 0.33-0.89; p=0.017). CONCLUSION Survival rate was better in patients with breast cancer, longer time before metastasis, good performance, and those who had undergone metastasectomy. Therapeutic approaches should be planned with consideration that patients exhibiting these characteristics might have more favorable therapeutic outcomes.
