Browsing by Author "Göksel G."
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Item The efficacy and tolerability of intermediate high dose interferon alpha 2B treatment as an adjuvant therapy of high risk malignant melanoma; [Yüksek riskli malign melanomun adjuvan tedavisinde orta yüksek doz i̇nterferon alfa-2B tedavisinin etkinliǧi ve tolerabilitesi](2005) Karabulut B.; Sezgin V.C.; Göksel G.; Şanli U.A.; Uslu R.; Göker E.There are still ongoing clinical trials and debates about adjuvant treatment of malignant melanoma. Between 1995 and 2004, fourty-nine patients with high risk operated non-metastatic malignant melanoma who had been treated with intermediate dose of interferon alpha were enrolled to the study. Twenty-three patients had regional lymph node metastasis at the time of diagnosis. Patients were treated with interferon alpha 2b (10 million units/day, five times a week for four weeks) as an induction therapy, followed by interferon alpha 2b (10 million units/day interferon three times a week for eleven months) as a maintanence therapy. The median follow-up time was 35 months (range 2-101 months). In this period, 7(14%) of patients had local recurrence, 12 (24%) of patients had regional lymph node metastasis and 20 (41%) of patients had distant metastasis. The 5-years overall survival, disease free survival and distant metastasis free survival rate of patients were 68%, 32% and 54% respectively. Therapy was well tolerated, no grade 4 toxicity related to therapy was observed. Comparing to natural history of malignant melanoma, these results are found to be encouraged.Item The effect of the gastrectomy on survival in patients with metastatic gastric cancer: A study of ASMO(Future Medicine Ltd., 2016) Yazici O.; Özdemir N.; Duran A.O.; Menekşe S.; Nahit Şendur M.A.; Karaca H.; Göksel G.; Arpaci E.; Hacibekiroʇlu I.; Bilgetekin I.; Kaçan T.; Özkan M.; Aksoy S.; Aksoy A.; Çokmert S.; Uysal M.; Elkiran E.T.; Çiçin I.; Büyükberber S.; Zengin N.Aim: To investigate the role of surgical resection of primary tumor on overall survival (OS) in advanced gastric cancer patients at the time of diagnosis. Patients & methods: The survival rates of metastatic gastric cancer patients whose gastric primary tumor was resected at time of diagnosis were compared with metastatic gastric cancer patients whose primary tumor was nonresected. Results: The median progression-free survival and OS in operated and nonoperated group were 10 versus 6, 14 versus 9 months, respectively (p < 0.001). In multivariate analysis, gastric resection of primary tumor, Eastern Cooperative Oncology Group performance status, second-line chemotherapy had a significant effect on OS (hazard ratio [HR]: 0.52 [95% CI: 0.38-0.71], HR: 0.57 [95% CI: 0.42-0.78], HR: 1.48 [1.09-2.01]; p ≤ 0.001, p = 0.001 and p = 0.012, respectively). Conclusion: Subpopulations of patients with metastatic gastric cancer might benefit from surgical removal of primary tumor. © 2016 Future Medicine Ltd.Item A Rare Case Report of Skin Metastasis in Gastric Cancer(Springer, 2021) Şahin M.; Ekinci F.; Çelik C.; Temiz P.; Erdoğan A.P.; Göksel G.[No abstract available]Item Level of COVID-19 fear in cancer patients(Springer Science and Business Media Deutschland GmbH, 2022) Erdoğan A.P.; Ekinci F.; Acar Ö.; Göksel G.Background: Cancer patients are in the high-risk group of getting COVID-19 infection and experiencing a severe course. Anxiety of cancer patients about how they pass this pandemic process and how changes in the health system would influence their treatment has increased together with the COVID-19 pandemic. Influence of COVID-19 on psychology of cancer patients is also a subject needed to be investigated as well as its course and prognosis. Thus, it is aimed to measure fear levels of cancer patients by a validated scale. Patients accepting to fill in the validated Fear of COVID-19 (FCV-19S) scale were included in our study. Higher scores obtained from the scale means high level of COVID-19 fear was experienced. Results: A total of 66.8% of 486 patients expressed that they are very afraid of coronavirus, and 66.3% expressed that they fear from losing their lives due to coronavirus. The level of fear in the patient group having adjuvant therapy has been found statistically to be significantly higher compared with groups having neoadjuvant and metastatic/palliative therapy (p: 0.004). Conclusions: Because the increase of level of fear may lead to vital outcomes such as weakening of immune system, disturbance of treatment compliance, and worsening of prognosis, a psychological approach to cancer patients is compulsory in order to prevent fear of COVID-19 infection. © 2022, The Author(s).Item Factors affecting the serologic response to SARS-CoV-2 vaccination in patients with solid tumors: A prospective study(Elsevier B.V., 2022) Erdoğan A.P.; Ekinci F.; Akçalı S.; Göksel G.Objective: To evaluate the factors affecting seropositivity and antibody levels after SARS-CoV-2 vaccines in patients with cancer because they were excluded from clinical studies of SARS-CoV-2 vaccines. Methods: This prospective, observational, single-center study included 290 patients with solid tumors followed up in our medical oncology clinic between March 2021 and August 2021. SARS-CoV-2 antibody status was determined before the first dose of vaccine. Fifty-one patients with positive prevaccine baseline antibody tests were excluded from the study, regardless of whether they had previously confirmed SARS-CoV-2 PCR positivity. To determine the quantitative IgG antibody response of the vaccines, blood samples were collected at least 28 days after each dose of vaccine. Quantitative IgG levels against virus spike protein receptor binding domain (RBD) were measured using chemiluminescent enzyme immunoassay (CLIA). Demographic and clinical features affecting seropositivity were analyzed. Results: One hundred and fifty-one (69.3%) patients were vaccinated with two doses of CoronaVac followed by one dose of BNT162b2 (Biontech) (group 1). Sixty-seven (30.7%) patients were vaccinated with three doses of BNT162b2 (group 2). The proportion of patients who developed seropositivity was significantly higher in group 2 (78.6% vs. 54.9%, p < 0.012). Antibody response increased significantly after the second dose of vaccine in both groups. Female sex, being younger than 65 years, and chemotherapy status were significantly related to higher anti-SARS-CoV-2 S antibody levels (p = 0.033, p = 0.036, and p = 0.047, respectively). Antibody levels were significantly higher in patients who had previously received chemotherapy than in patients receiving active chemotherapy (p = 0.042). Conclusions: Our study is the first to evaluate basal SARS-CoV-2 IgG levels before the first dose of vaccine and after three doses in patients with solid tumors. The rate of development of seropositivity with two doses of mRNA vaccine was found to be higher than with two doses of inactivated SARS-CoV-2 vaccine. More attention should be paid to preventive measures in addition to vaccination in patients aged over 65 years and men with cancer diagnoses. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious DiseasesItem Effects of Nutritional Support on the Quality of Life of Cancer Patients(Turkiye Klinikleri, 2022) Karadaş G.; Erdoğan A.P.; Ekinci F.; Çivi M.; Göksel G.Objective: In this study, we investigated the effects of nutritional support on the quality of life of cancer patients, determined nutritional deficiencies, eliminated it at the earliest, and established a built-in system to prolong patient survival. Material and Methods: We included 459 patients admitted to the medical oncology outpatient clinic, diagnosed with cancer and receiving chemotherapy; 59 of 459 patients were diagnosed with malnutrition in the study using the Nutritional Risk Screening (NRS) 2002 nutritional status scale. Appropriate enteral nutrition support was provided to the patients, and control evaluations were made four times at intervals of 28 days. In these controls, information on the height, weight, and the right and left middle arm circumference of the patients was recorded. Along with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-30) Quality of Life Scale, the Hospital Anxiety and Depression Scale was also used. Results: A statistically significant difference was found in the NRS 2002 scores of the patients regarding the adequacy of intake, protein and calorie requirement, functional status, and the symptom scale. The anxiety and depression scores of the patients decreased in all the controls, and the most noticeable decrease occurred at the end of the third control. Conclusion: Evaluating malnutrition and providing adequate nutritional support to cancer patients improves body composition and the quality of life by reducing anxiety and depression. © 2022 by Turkish Society of Medical Oncology.Item Palliative Biliary Drainage Has No Effect on Survival in Pancreatic Cancer: Medical Oncology Perspective(Springer, 2022) Erdoğan A.P.; Ekinci F.; Yıldırım S.; Özveren A.; Göksel G.Purpose: Removal of obstructive jaundice in metastatic pancreatic cancer is an important part of palliative therapy. However, it is not known whether invasive procedures reduce cancer-related mortality. In this study, the effect of palliative biliary drainage on survival outcomes in pancreatic cancer patients was evaluated. Methods: Patients diagnosed with pancreatic cancer and undergoing biliary drainage in two different centers between 2010 and 2019 were evaluated retrospectively. Results: Biliary drainage was applied to 73 patients, constituting 20.6% of 355 patients included in the study. The median progression-free survival (PFS) of patients with biliary stent was 5 months, while the median PFS of patients without stenting was 5.5 months and the median overall survival (OS) was 11.1 and 11.5 months, respectively (p: 0.424, p: 0.802). Conclusions: A positive effect of palliative biliary drainage on median PFS and OS could not be demonstrated in our study group. In pancreatic cancer, predictive markers are needed to select patients who can derive a survival benefit from biliary drainage. © 2021, Springer Science+Business Media, LLC, part of Springer Nature.Item The Confusion Caused by the Fear of COVID 19 in the Future of Cancer Patients(Ibn Sina Trust, 2023) Ekinci F.; Ateş G.A.; Erdoğan A.P.; Çelik C.; Dirican A.; Göksel G.Objective: The “centrality of events scale” (CES) was formed to determine to what extent this localisation of a traumatic memory is formed. The CES was used in this study to determine how overshadowed the cancer disease was by fear of COVID-19 in cancer patients or how centralised the cognitive trauma was in this patient group.Materials and Methods: In the first paragraph of the short 7-item CES, it was written, “Please think about the most stressful or traumatic event in your life”, then 3 options were given. These alternatives were: A) I am currently being treated here for my disease., B) I am likely to catch COVID-19 and C) Other. After marking one of these options, the subjects were instructed to mark their level of agreement with the 7 items as stated by Berntsen and Rubin, and thus this section was the same as the original questionnaire. To be able to evaluate the questionnaire results taking the disease characteristics into account, a record was made of age, gender, treatment history (chemotherapy and radiotherapy), current treatment (chemotherapy, hoemone therapy, immunotherapy, monoclonal antibodies, tyrosine kinase inhibitors) treatment aim (adjuvant, neoadjuvant, palliative), disease status on presentation (no spread, local, metastatic).The questionnaires were administered to all the cancer patients who presented at the oncology clinic between 1 April and 1 October 2020. Results:This study was conducted to seek an answer to this question, and it was seen that of a total of 523 patients diagnosed with cancer, the vast majority (n:368, 70.4%) saw the most traumatic and stressful event of their life as cancer, with the response to option A on the questionnaire. The possibility of contracting COVID-19 was selected by 83 (15.9%) patients as the most stressful or traumatic event in their life. The option of C was marked by 72 (13.8%) patients. This showed that neither cancer nor fear of coronavirus infection was strong enough to replace the traumatic event experienced and centred in the identity of these 72 patients. These traumas of the patients were analyzed with the mean CES points. The highest points were obtained by those who marked option A, at 3.71, which was statistically significantly higher than the 3.29 points for B and 3.29 points for C (p:0.004).Conclusion:A trauma left in the past actually lives on in the cognitive memory and may even be established at the centre of the self and personal identity. Thus, by modifying the short 7-item CES, developed by Berntsen and Rubin to be an objective, measurable format, the results of this study demonstratated both the extent to which the possibility of contracting COVID-19 has started to be established in cancer patients and the unshakable but declining centrality of cancer in the traumatic past. © 2023, Ibn Sina Trust. All rights reserved.Item Biases and Reluctances Causing Cancer Patients in Dilemma for COVID-19 Vaccination(Ibn Sina Trust, 2024) Ekinci F.; Erdoğan A.P.; Göksel G.Background We have planned this study to determine opinions of this patient group, who are affected negatively both in physical aspect during the treatment process of cancer and who are fragile and sensitive for psycho-social aspects, their opposition level and misimpressions related to vaccine and for eliminating these reluctances if possible. Methods Between February 2021 and 15 April 2021, all cancer patients applying to our oncology clinic have been first asked to fill in the questionnaire, which includes three articles where suggestions expressing their attitude towards vaccination were asked and subsequently nine articles expressing suggestions about vaccine opposition Results According to responses to a decision for vaccination, we have learned that 446 (79,6%) patients thought to have the Covid-19 vaccine, 62 (11.1%) were hesitant, and 52 (9.3%) did not think to have a vaccine. Conclusions The most critical data obtained from this study is that there were severe biases related to adverse effects due to vaccines, although patients have a positive attitude about vaccination. The most important task of health authorities should be to eliminate reluctance without waiting for patients to take a more negative attitude on this subject. © 2024, Ibn Sina Trust. All rights reserved.Item Intestinal Ewing Sarcoma Misdiagnosed as an Adnexal Mass in a Young Woman(Galenos Publishing House, 2024) Hasdemir P.S.; Aliyeva A.; Mavili S.; Göksel G.Extraosseous Ewing’s sarcoma is an extremely rare tumor. In the literature, intestinal Ewing’s sarcoma was reported in 20 cases, and omental Ewing’s sarcoma was reported in only two cases. In this case report, we report a 23-year-old female who presented with the complaint of diffuse abdominal pain. Abdominal ultrasound and whole-body computed tomography revealed a mass starting from the adnexal area and extending between the intestinal loops. Serum levels of tumor markers were high. The serum levels of carbohydrate antigen-125 (CA-125) and carcinoembryonic antigen-19.9 (CA-19.9) were high (427.5 U/mL and 67.9 U/mL, respectively). Laparotomic exploration was performed with the preliminary diagnosis of an adnexal mass, and a mass originating from the small intestine meso and completely covered by the omentum was excised. Histological evaluation reported intestinal and omental origin of Ewing’s sarcoma. This case highlights the importance of rare extraosseous Ewing’s sarcoma, which should be included in the differential diagnosis of a young female with intra-abdominal mass. © 2024 Galenos Publishing House. All rights reserved.