Browsing by Author "Inal A."
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Item The reliability and validity of Turkish version of Childhood Asthma Control Test(2012) Sekerel B.E.; Soyer O.U.; Keskin O.; Uzuner N.; Yazicioglu M.; Kiliç M.; Artaç H.; Ozmen S.; Can D.; Zeyrek D.; Cokugras H.; Canitez Y.; Aydogan M.; Kuyucu S.; Inal A.; Gurkan F.; Orhan F.; Yilmaz O.; Boz A.B.; Tahan F.; Cevit O.Introduction: The reliability and validity of Turkish version of Childhood Asthma Control Test (C-ACT). Purpose: The management of asthma is an important as well as difficult issue of physician's daily practice particularly in busy clinical settings. C-ACT was created to identify asthma control levels in children aged 4-11 years. Our aim was to evaluate the reliability, validity and responsiveness of C-ACT in a Turkish sample of children with asthma. Method: In this multicenter study, 368 children were enrolled. C-ACT was completed every month by parents and patients who were evaluated in 3 visits within 2 month intervals. At each visit, physicians interpret the control level and decided for the treatment step as established in GINA guidelines. Results: The internal consistency reliability of the Turkish version of C-ACT (C-ACT1 to C-ACT5) was found to be 0.82, 0.83, 0.82, 0.82 and 0.80, respectively (reliability statistics, Cronbach's alpha). Test-retest reliability was 0.71. There was significant correlation between C-ACT and physician's assessment of asthma control at visit 1 (r = 0.65, P <0.001). Conclusions: Turkish version of C-ACT is an accurate and reliable tool to evaluate asthma control in children aged 4-11 years. Its widespread use may facilitate appropriate assessment of asthma control and may lead to decrease the number of uncontrolled patients. © Springer Science+Business Media B.V. 2011.Item Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study(SAP - Slovak Academic Press, spol. s.r.o., 2012) Inal A.; Kos F.T.; Algin E.; Yildiz R.; Dikiltas M.; Unek I.T.; Colak D.; Elkiran E.T.; Helvaci K.; Geredeli C.; Dane F.; Balakan O.; Kaplan M.A.; Durnali A.G.; Harputoglu H.; Goksel G.; Ozdemir N.; Buyukberber S.; Gumus M.; Kucukoner M.; Ozkan M.; Uncu D.; Benekli M.; Isikdogan A.The majority of patients with pancreatic cancer is of advanced disease. Several randomized Phase II and III trials suggest that the combination of gemcitabine and cisplatin (GemCis) response rates were higher than Gemcitabine (Gem) alone, however the trials were not enough powered to indicate a statistically significant prolongation of survival in patients with advanced pancreatic adenocarcinoma. The aim of this retrospective multicenter study is to evaluated the efficiency of Gem alone versus GemCis in patients with locally advanced and/or metastatic pancreatic adenocarcinoma. A total of 406 patients, from fourteen centers were evaluated retrospectively. All patients received Gem or GemCis as first-line treatment between September 2005 to March 2011. Primary end of this study were to evaluate the toxicity, clinical response rate, progression-free survival (PFS) and overall survival (OS) between the arms. There were 156 patients (M: 98, F: 58) in Gem arm and 250 patients (M: 175, F: 75) in the combination arm. Gemcitabin arm patients older than the combination arm (median 63 vs 57.5, p=0.001). In patients with the combination arm had a higher dose reduction (25.2% vs 11.3%, p=0.001) and dose delay (34% vs 16.8%, p=0.001). Among patients with the combination and Gemcitabin arm gender, diabetes mellitus, performance status, cholestasis, grade, stage did not have a statistically difference (p>0.05). Clinical response rate to the combination arm was higher than the Gem arm (69.0% vs 49.7%, p=0.001). PFS was more favorable in the GemCis arm than Gem alone, but the difference did not attain statistical significance (8.9 vs 6.0, p=0.08). OS was not significantly superior in the GemCis arm (12.0 vs 10.2, p>0.05). Grade III-IV hematologic and nonhematologic toxicity were higher in the combination arm. PFS was more favorable in the GemCis arm than Gem alone, but the difference did not attain statistical significance. OS was not significantly superior in the GemCis arm.Item Prognostic factors in patients with advanced pancreatic cancer treated with gemcitabine alone or gemcitabine plus cisplatin: Retrospective analysis of a multicenter study(2012) Inal A.; Kos F.T.; Algin E.; Yildiz R.; Berk V.; Tugba Unek I.; Colak D.; Kucukoner M.; Tamer Elkiran E.; Helvaci K.; Geredeli C.; Dane F.; Balakan O.; Ali Kaplan M.; Gok Durnali A.; Harputoglu H.; Goksel G.; Ozdemir N.; Buyukberber S.; Gumus M.; Ozkan M.; Benekli M.; Isikdogan A.Purpose: The majority of patients with pancreatic cancer present with advanced disease. Systemic chemotherapy for patients with pancreatic cancer has limited impact on overall survival (OS). Patients eligible for chemotherapy should be selected carefully. The aim of this study was to analyse prognostic factors for OS in advanced pancreatic cancer patients treated with first-line palliative chemotherapy with gemcitabine alone or gemcitabine plus cisplatin. Methods: We retrospectively reviewed 343 locally advanced or metastatic pancreatic cancer patients who were treated with gemcitabine or gemcitabine plus cisplatin as first-line chemotherapy between December 2000 and June 2011. Fifteen potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with OS. Univariate and multivariate statistical methods were used to determine prognostic factors. Results: Among the 15 variables of univariate analysis, 6 were identified to have prognostic significance: stage (p<0.001), cholestasis (p=0.02), weight loss, prior pancreatectomy, serum CEA level (p<0.001) and serum CA19-9 level (p<0.001). In addition, age, chemotherapy and liver metastasis were of borderline significance (p=0.06). Multivariate analysis (Cox proportional hazard model) included the 6 significant prognostic factors ofunivariate analysis and showed that stage was independent prognostic factor for OS, as were weight loss, and serum CEA level. Conclusion: Stage, weight loss, and serum CEA level were identified as important prognostic factors for OS in advanced pancreatic cancer patients. These findings may also facilitate pretreatment prediction of OS and can be used for selecting patients for treatment. © 2012 Zerbinis Medical Publications.Item Is lymph node ratio prognostic factor for survival in elderly patients with node positive breast cancer?: The Anatolian society of medical oncology(2013) Inal A.; Akman T.; Yaman S.; Ozturk S.C.; Geredeli C.; Bilici M.; Inanc M.; Harputoglu H.; Demirci U.; Suner A.; Cinkir H.Y.; Alici S.; Colak D.; Sonmez O.U.; Goksel G.; Dogu G.G.; Engin H.; Unal O.U.; Tamozlu T.; Buyukberber S.; Boruban C.M.; Isikdogan A.Several studies have now demonstrated that the lymph node ratio (LNR), as a superior indicator of axillary tumor burden to the number of excised nodes. While, about the prognostic value of LNR on the the survival of elderly patients is limited. The aim of this retrospective multicenter study is to evaluate the prognostic value of lymph node ratio in elderly patients with node positive breast cancer. METHODS: Onehundredeightyfour patient with operable breast cancer, recruited from 17 institutions, were enrolled into the retrospectively study Eleven potential prognostic variables were chosen for analysis in this study Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. RESULT: Among the eleven variables of univariate analysis, four variables were identified to have prognostic significance for Overall survival (OS): patholo^c tumor size (T), No. oppositive nodes (N), LNR and estrogen receptor-positive (ER). Among the eleven variables of univariate analysis, two variables were identified to have prognostic significance for Disease-free survival (DFS): N and LNR. Multivariate analysis by Cox proportional hazard model showed that T, LNR and ER were considered independent prognostic factors for OS. Furthermore, LNR was considered independent prognostic factors for DFS. CONCLUSION: In conclusion, the LNR was associated with the prognostic importance for DFS and OS in elderly patients who were administered adjuvant treatments.Item Endocrine therapy alone vs chemotherapy plus endocrine therapies for the treatment of elderly patients with endocrine-responsive and node positive breast cancer: A retrospective analysis of a multicenter study (Anatolian Society of Medical Oncology)(2013) Inal A.; Akman T.; Yaman S.; Demir Ozturk S.; Geredeli C.; Bilici M.; Inanc M.; Harputoglu H.; Demirci U.; Balakan O.; Yesil Cinkir H.; Alici S.; Uysal Sonniez O.; Goksel G.; Gokoz Dogu G.; Umit Unal O.; Tamozlu T.; Buyukberber S.; Melih Bomban C.; Isikdogan A.Purpose: The extra benefit of adding chemotherapy to effective endocrine therapy (ET) has not been clearly or consistently identified in patients older than 70 years with estrogen receptor (ER) positive and node positive breast cancer. The aim of this study was to evaluate the efficacy of adjuvant ET vs chemotherapy plus endocrine therapies (Chemo/ET) in such patients. Methods: In this retrospective multicenter study 191 patients ≥ 70 years with operated hormone receptor positive breast cancer, who were administered adjuvant ET or Chemo/ET were assessed. Results: The median patient follow-up time was 29.0 months (range 1-252). Therefore disease free survival (DFS) and overall survival (OS) analysis was limited, due to the rather short median follow-up, and only 30-month cumulative percentages are reported herein. The 30-month DFS rates were 50.0% in the ET arm and 49.0% in the Chemo/ET arm (p=0.79). The 30-month OS rates were 86% in the ET arm and 96.0% in the Chemo/ET arm (p=0.08). Cox proportional hazard model showed that only surgery was independent prognostic factor for survival (p=0.047), while tumor size showed a strong trend for statistical significance (p=0.051). Conclusion: The addition of chemotherapy to endocrine therapy in older patients has no significant impact on DFS and OS.Item Prognostic factors of patients who received chemotherapy after cranial irradiation for non-small cell lung cancer with brain metastases: A retrospective analysis of multicenter study (Anatolian Society of Medical Oncology)(Wolters Kluwer Medknow Publications, 2018) Inal A.; Kodaz H.; Odabas H.; Duran A.; Seker M.; Inanc M.; Elkiran E.; Gunaydin Y.; Menekse S.; Topcu T.; Urakci Z.; Tastekin D.; Bilici M.; Cihan S.; Geredeli C.; Sezer E.; Uncu D.; Arpaci E.; Ozturk B.; Bal O.; Uysal M.; Tanriverdi O.; Gumus M.; Oven Ustaalioglu B.; Suner A.; Cokmert S.; Hacibekiroglu I.; Aydin K.; Isikdogan A.Purpose: Almost half of all patients diagnosed with non-small cell lung cancer (NSCLC) have distant metastases at presentation. One-third of patients with NSCLC will have brain metastases. Without effective treatment, the median survival is only 1 month. However, it is difficult to treat brain metastases with systemic chemotherapy since the agents have difficulty crossing the blood-brain barrier. Therefore, it is important to estimate the patient's survival prognosis. The aim of this study was to analyze prognostic factors for survival in Turkish patients who received chemotherapy after cranial irradiation for NSCLC with brain metastases. Methods: We retrospectively reviewed 698 patients with brain metastases resulting from NSCLC. Ten potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with overall survival (OS). Results: Among the 10 variables for univariate analysis, six were identified to have prognostic significance; these included sex, smoking history, histology, number of brain metastases, extracranial metastases, and neurosurgical resection. Multivariate analysis by the Cox proportional hazard model showed that a smoking history, extracranial metastases, and neurosurgical resection were independent negative prognostic factors for OS. Conclusion: Smoking history, extracranial metastases, and neurosurgical resection were considered independent negative prognostic factors for OS. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for more appropriate treatment options. © 2017 Journal of Cancer Research and Therapeutics | Published by Wolters Kluwer - Medknow.Item Efficacy and safety of folfiri plus aflibercept in second-line treatment of metastatic colorectal cancer: Real-life data from Turkish oncology group(Wolters Kluwer Medknow Publications, 2022) Erol C.; Sendur M.A.N.; Bilgetekin I.; Garbioglu D.B.; Hamdard J.; Akbas S.; Hizal M.; Arslan C.; Sevinc A.; Kucukarda A.; Erdem D.; Kahraman S.; Cakir E.; Demirkiran A.; On S.; Dogan I.; Erdogan A.P.; Koca S.; Kubilay P.; Eren O.O.; Cilbir E.; Celik E.; Araz M.; Ozyukseler D.T.; Yildirim M.E.; Bahceci A.; Taskaynatan H.; Oyman A.; Deniz G.I.; Menekse S.; Kut E.; Gulmez A.; Sakin A.; Nayir E.; Acar R.; Sen E.; Inal A.; Turhal S.; Kaya A.O.; Paydas S.; Tastekin D.; Hacibekiroglu I.; Cincin I.; Bilici A.; Mandel N.M.; Dede D.S.; Akinci M.B.; Oksuzoglu B.; Uncu D.; Yalcin B.; Artac1 M.Aims: The addition of aflibercept to the fluorouracil and irinotecan (FOLFIRI) regimen significantly improved clinical outcomes in patients with metastatic colorectal cancer (CRC) previously treated with oxaliplatin. We aimed to investigate the efficacy and safety of second-line FOLFIRI and aflibercept combination in patients with metastatic CRC in real-life experience. Materials and Methods: Four hundred and thirty-three patients who treated with FOLFIRI and aflibercept in the second-line were included in the study. The clinical and pathological features of the patients were recorded retrospectively. Survival (overall and progression-free survival [PFS]), response rates, and safety data were analyzed. Results: The median age was 61. Majority of patients (87.5%) received first-line bevacizumab and 10.1% of patients received anti-epidermal growth factor receptor agents. About 80% of patients had KRAS, 18.6% of patients had NRAS, and 6.4% of patients had BRAF mutations. The median OS was 11.6 months (95% confidence interval [CI], 10.6-12.6) and the median PFS was 6 months (95% CI, 5.5-6.5). About 4.6% of patients had complete response and 30.6% of patients had partial response as best tumor response. Grade 1-2 toxicities were seen in 33.4% of patients, while grade 3-4 toxicities were recorded in 27% of patients. Eight patients (2%) died due to treatment toxicity. Conclusions: Overall and PFS were similar in routine clinical practice compared to phase III pivotal VELOUR trial. However, response rates were found to be higher. It was observed that there were fewer adverse events compared to the VELOUR trial. © 2022 Authors. All rights reserved.Item Treatment efficacy of ribociclib or palbociclib plus letrozole in hormone receptor-positive/HER2-negative metastatic breast cancer(Newlands Press Ltd, 2023) Kahraman S.; Erul E.; Seyyar M.; Gumusay O.; Bayram E.; Demirel B.C.; Acar O.; Aksoy S.; Baytemur N.K.; Sahin E.; Cabuk D.; Basaran G.; Paydas S.; Yaren A.; Guven D.C.; Erdogan A.P.; Demirci U.; Yasar A.; Bayoglu İ.V.; Hizal M.; Gulbagci B.; Paksoy N.; Davarci S.E.; Yilmaz F.; Dogan O.; Orhan S.O.; Kayikcioglu E.; Aytac A.; Keskinkilic M.; Mocan E.E.; Unal O.U.; Aydin E.; Yucel H.; Isik D.; Eren O.; Uluc B.O.; Ozcelik M.; Hacibekiroglu I.; Aydiner A.; Demir H.; Oksuzoglu B.; Cilbir E.; Cubukcu E.; Cetin B.; Oktay E.; Erol C.; Okutur S.K.; Yildirim N.; Alkan A.; Selcukbiricik F.; Aksoy A.; Karakas Y.; Ozkanli G.; Duman B.B.; Aydin D.; Dulgar O.; Er M.M.; Teker F.; Yavuzsen T.; Aykan M.B.; Inal A.; Iriagac Y.; Kalkan N.O.; Keser M.; Sakalar T.; Menekse S.; Kut E.; Bilgin B.; Karaoglanoglu M.; Sunar V.; Ozdemir O.; Turhal N.S.; Karadurmus N.; Yalcin B.; Nahit Sendur M.A.Background: Ribociclib, palbociclib and abemaciclib are currently approved CDK4/6 inhibitors along with aromatase inhibitors as the first-line standard-of-care for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Methods: The authors report retrospective real-life data for 600 patients with estrogen receptor- and/or progesterone receptor-positive and HER2-negative metastatic breast cancer who were treated with ribociclib and palbociclib in combination with letrozole. Results & conclusion: The results demonstrated that the combination of palbociclib or ribociclib with letrozole has similar progression-free survival and overall survival benefit in real life for the patient group with similar clinical features. Specifically, endocrine sensitivity may be a factor to be considered in the treatment preference. © 2023 Future Medicine Ltd.Item Activity of CDK4/6 inhibitors and parameters affecting survival in elderly patients in age-subgroups: Turkish Oncology Group (TOG) retrospective study(BioMed Central Ltd, 2024) Kahraman S.; Hizal M.; Demirel B.C.; Guven D.C.; Gumusay O.; Uluc B.O.; Bayram E.; Gulbagci B.; Yasar A.; Davarci S.E.; Mocan E.E.; Acar O.; Isik D.; Aydin E.; Karakas Y.; Ozcelik M.; Keser M.; Okutur S.K.; Eren O.; Menekse S.; Aydin D.; Yilmaz F.; Dogan O.; Ozkanli G.; Yucel H.; Sunar V.; Aykan M.B.; Ozdemir O.; Duman B.B.; Keskinkilic M.; Sakalar T.; Inal A.; Karaoglanoglu M.; Aksoy A.; Er M.M.; Turhal N.S.; Kalkan N.O.; Sendur M.A.N.Highly selective inhibitors of cyclin-dependent kinase 4 and 6 (CDK4/6is) have emerged as a standart of care for first- and second-line therapies in combination with endocrine therapy (ET) for HR+/HER2- metastatic breast cancer (MBC) patients. It has been reported that combination therapy is more effective than ET alone and is safe in elderly patients as well as young patients. Nevertheless, elderly and very old patients with HR+/HER2-MBC treated with CDK4/6 inhibitor (CDK4/6i) combinations are relatively underrepresented in randomized controlled trials. To contribute to the literature, we investigated the real-world efficacy, factors associated with survival and the rates of adverse events (AEs) of the treatment with palbociclib or ribociclib plus ET in the HR+/HER2- MBC patient cohort over the age of 65 for age subgroups. In this retrospective study, 348 patients were divided into subgroups: 65–69 years old, 70–79 years old and 80 years and older. Median PFS (mPFS) for whole group was 18.3 (95% CI,14.3–22.3) months. There was no significant difference in mPFS between age groups (p = 0.75). The estimated median OS (mOS) was 39.5 (95% CI, 24.9–54.1) months and there was no significant difference between age groups (p = 0.15). There was a meaningfull numerical difference that did not reach statistical significance in patients who received CDK4/6i treatment as the first line for MBC. Grade 3–4 AEs were reported in 42.7% for the entire group, and neutropenia was the most common (37.3%). It can be concluded that combination therapy with palbociclib or ribociclib with an ET partner has similar efficacy and is safe among subgroups of older patients diagnosed with HR+/HER2-MBC. © The Author(s) 2024.