Browsing by Author "Kut, E"
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Item Effect of Postoperative Adjuvant Radiotherapy on Quality of Life, Anxiety, and Depression in Adult Female Breast Cancer PatientsParvizi, M; Kut, E; Akyol, M; Ay, SAim: This study aims to identify anxiety and depression caused by adjuvant radiotherapy in breast cancer cases to determine the deterioration in the quality of life and investigate the effect of early treatment. Materials and Methods: In this study, the Beck Depression Inventory, Beck Anxiety Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) Turkish 3.0 forms were evaluated in 63 breast cancer patients before the start of radiotherapy treatment (T1) and at six weeks after the end of radiotherapy treatment (T2). Results: A high level of anxiety was detected in 77.8% of patients, and depression was found in 25.4% of patients in T1. When depressive cases were evaluated with EORTC QLQ-C30 scores, the general health status (p = 0.043), role function (p = 0.027), emotional (p < 0.002), cognitive (p < 0.001), and social (p < 0.0001) scales were statistically lower in T1, whereas pain (p = 0.045) and insomnia (p < 0.0001) symptoms were higher in T1. Anxiety and EORTC QLQ-C30 scores in terms of emotional function (p = 0.015), social function (p < 0.003), and symptoms of insomnia (p = 0.027) were found to be statistically higher in T1 anxious cases. However, anxiety was detected in only 3% of T2 cases, and no depression was found in any of the cases. Anxiety and EORTC QLQ-C30 scores and symptom scales were evaluated in terms of role function (p < 0.0001), emotional (p = 0.041) and social scales (p = 0.014), fatigue (p = 0.028), pain (p = 0.033), insomnia (p = 0.011), and constipation (p < 0.0001); these were found to be statistically significant in T2. Conclusion: This study revealed that early diagnosis and treatment of anxiety before initiating adjuvant radiotherapy reduces the development of long-term anxiety-related depression in the future. Therefore, it is recommended that patients be evaluated for anxiety and depression before starting adjuvant radiotherapy.Item Evaluation of F18 FDG PET/CT According to Mandard Classification in Locally Advanced Rectal Cancer Patients Receiving Neoadjuvant ChemotherapyAras, F; Parvizi, M; Nalbant, OA; Ozkol, V; Kut, EItem Prognostic Significance of Hemoglobin/Prognostic Nutritional Index and Hemoglobin/Red Blood Cell Distribution in Rectal CancerTuncel, ET; Parvizi, M; Kut, E; Aydin, M; Kasap, EBackground: We aimed to investigate the effect of hemoglobin/prognostic nutritional index and hemoglobin/red blood cell distribution, which are indicators of inflammation and nutrition, on prognosis and survival in patients with rectal cancer. Methods: The retrospective study reviewed medical records of 138 patients with rectal cancer who were followed up between 2010 and 2021. The effects of hemoglobin/red blood cell distribution, hemoglobin/prognostic nutritional index, tumor stage, and lymph node status on survival and prognosis were evaluated using univariate and multivariate analyses. Overall survival and disease-free survival were calculated for both groups. Results: Survival and prognosis were found to be significantly better in nonanemic patients with the hemoglobin/prognostic nutritional index higher than the cut-off value than in anemic patients with a normal or lower hemoglobin/prognostic nutritional index. Similarly, survival and prognosis were found to be significantly better in nonanemic patients with a hemoglobin/red blood cell distribution higher than the cut-off value than in anemic patients with a normal or lower hemoglobin/red blood cell distribution. Conclusion: The results indicated that nutrition and inflammatory markers have independent prognostic significance in rectal cancer. These markers are simple, inexpensive, and useful biomarkers commonly used in clinical practice, and they were found to predict overall survival and disease-free survival independently.Item Epidermal growth factor receptor expression and adjuvant chemoradiotherapy in rectal cancer Epidermal growth factor recepto in operated rectal cancerParvizi, M; Demir, D; Kut, E; Ergin, E; Ayhan, S; Doganavsargil, BAim: Epidermal Growth Factor Receptor (EGFR) is a trans-membrane protein with tyrosine kinase activity and is expressed in 25-80% of colon cancer cases. EFGR expression is prognostic in patients with metastatic colorectal cancer, and anti-EGR- based therapies are routinely used in the treatment of patients with metastatic colorectal cancer. To the best of our knowledge, the relationship between EGFR expression and prognosis in directly operated patients who did not receive neoadjuvant treatment and subsequently received chemo-radiotherapy is unknown. Therefore, we retrospectively evaluated patients with stage 3 rectal cancer who underwent surgery without any preoperative treatment in our center and aimed to investigate the relationship between EGFR expression and prognosis in patients who received adjuvant chemoradiotherapy. Material and Methods: The data of patients who underwent surgery for rectal cancer and received chemoradiotherapy between 2010 and 2016 at Manisa State Hospital were retrospectively analyzed. Results: According to EGFR expression, it was 127.01 (95% CI, 85.43-168.59) months in the group with 10% less staining and 47.44 (95% CI, 26.77-68.12) months in the group with 10% or more staining. Lymphovascular invasion (p=0.032), perineural invasion (p=0.023), histologic grade (p=0.004) and EGFR expression percentage (p=0.005) were significantly associated with survival in multivariate analyses Discussion: The presence of 10% or more EGFR expression, LVI, PNI, and histological grade are significantly associated with survival in stage 3 rectal cancer patients who have undergone surgery and received postoperative chemotherapy. These markers can be used as prognostic biomarkers in the follow-up and treatment of these patients.Item Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy (vol 23, 136, 2023)Karacin, C; Oksuzoglu, B; Demirci, A; Keskinkiliç, M; Baytemür, NK; Yilmaz, F; Selvi, O; Erdem, D; Avsar, E; Paksoy, N; Demir, N; Göksu, SS; Türker, S; Bayram, E; Çelebi, A; Yilmaz, H; Kuzu, ÖF; Kahraman, S; Gökmen, I; Sakin, A; Alkan, A; Nayir, E; Ugrakli, M; Acar, Ö; Ertürk, I; Demir, H; Aslan, F; Sönmez, Ö; Korkmaz, T; Celayir, ÖM; Karadag, I; Kayikçioglu, E; Sakalar, T; Öktem, IN; Eren, T; Erul, E; Mocan, EE; Kalkan, Z; Yildirim, N; Ergün, Y; Akagündüz, B; Karakaya, S; Kut, E; Teker, F; Demirel, BÇ; Karaboyun, K; Almuradova, E; Ünal, OÜ; Oyman, A; Isik, D; Okutur, K; Öztosun, B; Gülbagci, BB; Kalender, ME; Sahin, E; Seyyar, M; Özdemir, Ö; Selçukbiricik, F; Kanitez, M; Dede, I; Gümüs, M; Gökmen, E; Yaren, A; Menekse, S; Ebinç, S; Aksoy, S; Imamoglu, GI; Altinbas, M; Çetin, B; Uluç, BO; Er, Ö; Karadurmus, N; Erdogan, AP; Artaç, M; Tanriverdi, Ö; Çiçin, I; Sendur, MAN; Oktay, E; Bayoglu, IV; Paydas, S; Aydiner, A; Salim, DK; Geredeli, Ç; Yavuzsen, T; Dogan, M; Hacibekiroglu, IItem Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapyKaracin, C; Oksuzoglu, B; Demirci, A; Keskinkiliç, M; Baytemür, NK; Yilmaz, F; Selvi, O; Erdem, D; Avsar, E; Paksoy, N; Demir, N; Göksu, SS; Türker, S; Bayram, E; Çelebi, A; Yilmaz, H; Kuzu, ÖF; Kahraman, S; Gökmen, I; Sakin, A; Alkan, A; Nayir, E; Ugrakli, M; Acar, Ö; Ertürk, I; Demir, H; Aslan, F; Sönmez, Ö; Korkmaz, T; Celayir, ÖM; Karadag, I; Kayikçioglu, E; Sakalar, T; Öktem, IN; Eren, T; Urul, E; Mocan, EE; Kalkan, Z; Yildirim, N; Ergün, Y; Akagündüz, B; Karakaya, S; Kut, E; Teker, F; Demirel, BÇ; Karaboyun, K; Almuradova, E; Ünal, OÜ; Oyman, A; Isik, D; Okutur, K; Öztosun, B; Gülbagci, BB; Kalender, ME; Sahin, E; Seyyar, M; Özdemir, Ö; Selçukbiricik, F; Kanitez, M; Dede, I; Gümüs, M; Gökmen, E; Yaren, A; Menekse, S; Ebinç, S; Aksoy, S; Imamoglu, GI; Altinbas, M; Çetin, B; Uluç, BO; Er, Ö; Karadurmus, N; Erdogan, AP; Artaç, M; Tanriverdi, Ö; Çiçin, I; Sendur, MAN; Oktay, E; Bayoglu, IV; Paydas, S; Aydiner, A; Salim, DK; Geredeli, Ç; Yavuzsen, T; Dogan, M; Hacibekiroglu, IBackground There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and >= 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.Item Real-life comparison of afatinib and erlotinib in non-small cell lung cancer with rare EGFR exon 18 and exon 20 mutations: a Turkish Oncology Group (TOG) studyGursoy, P; Tatli, AM; Erdem, D; Goker, E; Celik, E; Demirci, NS; Sakin, A; Atci, MM; Bayram, E; Telli, TA; Bilgin, B; Bilici, A; Akangunduz, B; Balli, S; Demirkazik, A; Selçukbiricik, F; Menekse, S; Cavdar, E; Ozturk, A; Bekmez, ET; Turhal, S; Kilickap, S; Yildirim, HC; Oyan, B; Aksoy, A; Turkoz, FP; Kut, E; Katgi, N; Sakalar, T; Akyol, M; Ellez, HI; Topcu, A; Erdogan, AP; Pilanci, KN; Hedem, E; Arak, H; Akdeniz, N; Alan, Ö; Yapar, B; Nart, D; Yumuk, PFObjectives To compare the survival of first- and second-generation tyrosine kinase inhibitors (TKIs) in patients with rare EGFR exon 18 and exon 20 mutation-positive non-small cell lung cancer (NSCLC). Materials and methods We retrospectively evaluated survival characteristics of 125 patients with EGFR exon 18 and exon 20 mutated NSCLC who received erlotinib or afatinib as first line treatment between 2012 and 2021 from 34 oncology centres. Since exon 20 insertion is associated with TKI resistance, these 18 patients were excluded from the study. Results EGFR exon 18 mutations were seen in 60%, exon 20 mutations in 16%, and complex mutations in 24% of the patients with NSCLC who were evaluated for the study. There were 75 patients in erlotinib treated arm and 50 patients in afatinib arm. Patients treated with erlotinib had progression-free survival time (PFS) of 8.0 months and PFS was 7.0 months in the afatinib arm (p = 0.869), while overall survival time (OS) was 20.0 vs 24.8 months, respectively (p = 0.190). PFS of exon 18 mutated arm was 7.0 months, exon 20 mutated arm was 4.3 months, and complex mutation positive group was 17.3 months, and this was statistically significant (p = 0.036). The longest OS was 32.5 months, seen in the complex mutations group, which was not statistically different than exon 18 and in exon 20 mutated groups (21.0 and 21.2 months, respectively) (p = 0.323). Conclusion In this patient group, especially patients with complex mutations are as sensitive to EGFR TKI treatment similar to classical mutations, and in patients with rare exon 18 and exon 20 EGFR mutation both first- and second-generation EGFR-TKIs should be considered, especially as first- and second-line options.Item The efficacy of palbociclib and ribociclib in the first-line treatment of metastatic hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer in male patients: a Turkish oncology group (TOG) studyYildirim, HÇ; Kutlu, Y; Mutlu, E; Aykan, MB; Korkmaz, M; Yalçin, S; Sakalar, T; Celayir, ÖM; Kayikçioglu, E; Aslan, F; Hafizoglu, E; Altintas, YE; Keskinkiliç, M; Chalabiyev, E; Çelebi, A; Dursun, B; Kapar, C; Özen, M; Acar, O; Dülgar,Ö; Kut, E; Biter, S; Kus, F; Almuradova, E; Erdogan, AP; Saray, S; Güven, DC; Simsek, ET; Üskent, N; Kemal, Y; Çakar, B; Acikgöz,Ö; Kiliçkap, S; Aksoy, SIntroductionMale breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 -) breast cancer in women, limited data exist on their effectiveness in male patients.We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer.IntroductionMale breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 -) breast cancer in women, limited data exist on their effectiveness in male patients.We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer.MethodsThis study is a multicenter, retrospective study. We included male patients with HR + and HER2-metastatic breast cancer who received palbociclib or ribociclib as first-line treatment. Our primary endpoints were progression-free survival (PFS), overall response rates (ORR), and drug-related adverse effects.ResultsA total of 46 male patients from 27 institutions were enrolled. The median age at initiation of CDK 4/6 inhibitors was 63.64 +/- 13.69 years, with a median follow-up of 21.33 (95% CI 14.92-27.74) months. The ORR were 84% for palbociclib and 76.2% for ribociclib. The mPFS for the entire cohort was 28.06 months (95% CI 18.70-37.42). No significant difference in PFS was observed between palbociclib and ribociclib (mPFS: 24.46 months (95% CI 11.51-37.42) vs 28.33 months (95% CI 14.77-41.88), respectively, p = 0.211). No new adverse events were reported.DiscussionThis study demonstrates that palbociclib and ribociclib are effective and safe options for first-line treatment in male patients with HR + /HER2 - metastatic breast cancer. However, further prospective studies are warranted to establish their efficacy in this population.Item Efficacy and safety of folfiri plus aflibercept in second-line treatment of metastatic colorectal cancer: Real-life data from Turkish oncology groupErol, C; Sendur, MAN; Bilgetekin, I; Garbioglu, DB; 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, AP; Koca, S; Kubilay, P; Eren, OO; Cilbir, E; Celik, E; Araz, M; Ozyukseler, DT; Yildirim, ME; Bahceci, A; Taskaynatan, H; Oyman, A; Deniz, GI; Menekse, S; Kut, E; Gulmez, A; Sakin, A; Nayir, E; Acar, R; Sen, E; Inal, A; Turhal, S; Kaya, AO; Paydas, S; Tastekin, D; Hacibekiroglu, I; Cincin, I; Bilici, A; Mandel, NM; Dede, DS; Akinci, MB; Oksuzoglu, B; Uncu, D; Yalcin, B; Artac, MAims: 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.