1,721,041 research outputs found
Retrospective Results of Malignant Glioma Patients Receiving Primary and/or Postoperative Radiotherapy and Comparison with Different Prognostic Indices
No full textObjective: This study aimed to retrospectively evaluate malignant glioma (MG) patients and compare the prognostic factors with different indices. Material and Methods: A total of 204 patients diagnosed as malignant glioma and received primary and/or postoperative radiotherapy (RT) were retrospectively evaluated. Median follow up was nine months (1-90), median survival was 10 months, one-year survival rate was 42%. Of the patients, 16% had grade III anaplastic astrocytoma, 84% had grade IV glioblastoma multiforme. While surgical operation was limited with stereotactic biopsy in 59 (29%) patients, 59 (29%) underwent subtotal and 86 (42%) underwent gross total resection. Prognostic factors affecting survival were tested with univariate and multivariate analyses. Results: In univariate analysis, histology, age, preRT Karnofsky performance status (KPS), preoperative KPS, onset time of symptoms, history of seizures, tumor's not being multicentric, complete surgical resection and RT dose were found to be the factors affecting survival. In multivariate analysis, histology, age, onset time of symptoms, surgery type and RT dose were detected as independent prognostic factors. When the data of our patients were classified according to Radiation Therapy Oncology Group Recursive Partitioning Analysis classification, the survival was 70,13,11,8, 3 months for groups 1 and 3-6, respectively; it was 24, 13, 9, 8 and 4 months for groups 1-5, respectively according to Medical Research Council prognostic index; and 13, 7 and 5 months for groups 1-3, respectively according to Dokuz Eylul University prognostic index (long rank test p<0.0001). Conclusion: As treatment options, contribution of surgery and/or radiotherapy to survival is limited when applied to patients diagnosed with malignant glioma. Additional treatment modalities are needed in addition to these treatment modalities. Prognostic classifications should be used for determination of the treatment
Rechallenge with dabrafenib plus trametinib in anaplastic thyroid cancer: A case report and review of literature
No full textIntroduction: Anaplastic thyroid carcinoma (ATC) is a highly aggressive, undifferentiated rare tumor. Median overall survival is usually between 8 and10 months, with a 1-year survival rate of 20%. Conventional anthracycline based chemotherapy regimens demonstrate low response rates with short duration. Novel therapeutic agents including BRAF and MEK inhibitors based on the molecular landscape of ATC have been investigated. Case presentation: We herein report the rechallenge of a 52-year-old ATC patient with BRAF V600E mutation with dabrafenib plus trametinib. She presented with recurrent and progressive disease despite surgery, radiation therapy, 3 different chemotherapy regimens, and combination of dabrafenib-trametinib in different settings. She was rechallenged with dabrafenib-trametinib, and had a good response. Conclusion: To our knowledge, this is the first ATC case who responded to dabrafenib-trametinib rechallenge, reported in the literature. We want to emphasize that combination of dabrafenib and trametinib might be a good choice for resistant locoregional and metastatic ATC patients with BRAF V600E mutation, particularly in whom rapid clinical response is urgently needed. Moreover, rechallenge with this combination should be kept in mind in selected cases. (c) 2020 Elsevier Inc. All rights reserved
Clinical and prognostic features of plasmacytomas: A multicenter study of Turkish Oncology Group-Sarcoma Working Party
No full textTo identify the outcomes of prognostic factors of solitary plasmacytoma mainly treated with local radiotherapy (FIT). The data were collected from 80 patients with solitary plasmacytoma (SP). Forty patients (50.0%) received radiotherapy (FIT) alone while 38 of them (47.5%) were treated with surgery (S) and FIT. The median radiation dose was 46 Gy (range 30-64). The median follow up was 2.41 years (range 0.33-12.33). Ten-year overall survival (OS) and local relapse-free survival (LRFS) were 73% and 94%, respectively. The median progression-free survival (PFS) and multiple myeloma-free survival (MMFS) were 3.5 years and 4.8 years, respectively. On multivariate analyses, the favorable factors were radiotherapy dose of >= 50 Gy and RT + S for PFS and younger age for MMFS. For the patients with medullary plasmacytoma, the favorable factor was younger age for MMFS. RT at >= 50 Gy and RT + S may be favorable prognostic factors on PFS. Younger patients, especially with head-neck lesion and without pre-RT macroscopic tumor, seem to have the best outcome when treated with RT +/- S. Progression to MM remains as the main problem especially for older patients
Prognostic value of modified Glasgow prognostic score in recurrent high-grade glial tumors treated with systemic treatment
No full textObjectives: Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor. We aimed to evaluate the prognostic value of modified Glasgow Prognostic Score (mGPS), which is combination of C-reactive protein (CRP) and albumin, in recurrent high-grade glioma patients treated with systemic treatment. Patients and Methods: Data of 85 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 was retrospectively collected and analyzed. Patients were grouped according to mGPS criteria: mGPS-0: CRP 10 mg/L and albumin 3.5 g/dL or CRP 10 mg/L and albumin > 3.5 g/dL; and mGPS-2: CRP > 10 mg/L and albumin < 3.5 mg/L. We investigated the prognostic role of mGPS groups, mutations and survival outcomes. Results: There were 42 (49.4 %), 25 (29.6 %), and 18 (21 %) patients in mGPS-0, mGPS-1, and mGPS-2 groups, respectively. Median follow-up duration was 10 months (1-70 months). Median OS was 8.1 months. According to mGPS-0,-1 and-2; median OS was 13.8 months, 7.3 months and 3.6 months respectively (p = 0.003). mGPS, ATRX and IDH-1 mutation status, and ECOG PS were found to be independent prognostic factors for OS. Conclusion: In our study, mGPS was found to be an independent prognostic factor in patients with recurrent high-grade gliomas. If validated, mGPS can be used as an objective, easily calculated, cheap, and readily available prognostic model in routine practice
Concomitant chemoradiotherapy with low-dose weekly gemcitabine for nonmetastatic unresectable pancreatic cancer
No full textBackground/aims: This study aimed to demonstrate the efficacy and tolerability of low-dose weekly gemcitabine as a radiosensitizer in unresectable pancreatic cancer patients treated with chemoradiotherapy. Methods: Twenty-four histologically confirmed pancreatic carcinoma patients (female/male: 10/14, median age: 60) were evaluated. Seven (29%) patients received gemcitabine either as a single agent or in combination prior to chemoradiotherapy. Concurrent 75 mg/m(2) gemcitabine was infused weekly. Radiotherapy was delivered to the primary tumor and positive lymphatics with 3D-conformal radiotherapy to a total dose of 4500 cGy. Local progression-free survival, distant metastasis-free survival and overall survival were evaluated by Kaplan-Meier method. Results: Median follow-up was 36 weeks. Median local progression-free survival, distant metastasis-free survival and overall survival were 22 weeks (95% confidence interval [CI]: 5-59 weeks), 19 weeks (95%CI: 6.9-31 weeks) and 36 weeks (95%CI: 28-43 weeks), respectively. All patients completed radiotherapy as scheduled. Concurrent gemcitabine was given fully in 58.3% of patients. Gemcitabine was terminated in four (16.6%) patients due to grade 3 neutropenia (n=1), grade 3 nausea/vomiting (n=2) or patient's reluctance (n=1). Patients with local response and stable disease to chemoradiotherapy revealed a median survival of 39 weeks (95%CI: 30-47.9 weeks) compared to 36 weeks (95%CI: 9.7-62.2 weeks) in patients with locally progressive disease (p=0.52). Pain was improved in 50% of patients. Conclusions: Weekly low-dose radiosensitizing gemcitabine is effective and safe in unresectable pancreatic cancer patients
Design and characterization of polycaprolactone-gelatin-graphene oxide scaffolds for drug influence on glioblastoma cells
No full textThree-dimensional (3D) scaffolds that mimic in vivo tumor microenvironments can be used to study tumor response to anticancer treatments, since most preclinical combination treatment strategy for anti-glioma were evaluated with traditional 2D cell culture. In this research, the nanofiber scaffolds of polycaprolactone (PCL) containing gelatin (Gel) nano/microparticles coated with different concentrations of graphene oxide (GO) and were successfully produced by combining electrospinning and electrospraying techniques. Scanning electron microscope (SEM), Fourier-transform infrared (FT-IR) spectroscopy and mechanical testing were used to characterize the structure and properties of the composites. The results show that gelatin and graphene particles can be well dispersed in the polycaprolactone nanofiber matrix by using the combination technique of electrospinning and electrospraying. The presence of 1 wt% graphene oxide increased mechanical strength of PCL/Gel scaffold and was found to be well consistent with the drug treatments (temozolomide and bortezomib) and radiotherapy by not showing additional toxicity
Effects of resveratrol against scattered radiation-induced testicular damage in rats
No full textObjectives: To investigate the possible protective effects of resveratrol against oxidative testicular damage due to scattered radiation during pelvic ionizing radiation exposure in rats. Methods: Rats were divided into 5 groups; control, radiation, and radiation + resveratrol therapy in early and late periods. Under anesthesia, 20 Gy ionizing radiation was applied to prostatic region. Resveratrol was administered (10 mg/kg/day) orally before ionizing radiation exposure. Animals were decapitated at the end of 1st and 10th weeks. Biochemical markers of oxidative stress; caspase-3 and sirtuin-1 protein expressions; testosterone levels were evaluated, histological examinations were performed. Results: Significant increases in malondialdehyde, 8-hydroxy-deoxyguanosine levels, myeloperoxidase, and caspase-3 activities were observed after ionizing radiation exposure, also superoxide dismutase and glutathione activities were significantly decreased. Radiotherapy increased caspase-3 and decreased sirtuin-1 protein expressions. Resveratrol treatment significantly reversed these parameters and also reversed the decrease in testosterone levels back to control levels in late period. Conclusion: Resveratrol showed antioxidant and sirtuin-activating properties against oxidative damage caused by scattered radiation to testis and provided hormonal protection. These results suggest that resveratrol may be an alternative protective agent on testicular tissues against the effects of scattered pelvic radiation
Evaluation of food safety awareness in individuals diagnosis with cancer
No full textLisansüstü Programlar Enstitüsü, Beslenme ve Diyetetik Ana Bilim DalıBu araştırma ile kanser tanılı bireylerin gıda güvenliği bilincinin gıda güvenliğine yönelik bilgi, tutum ve uygulamaları ele alınarak değerlendirilmesi amaçlanmıştır. Sağlık Bakanlığı-Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji ve Radyasyon Onkolojisi polikliniklerinde takipli kanser tanısı almış ortalama yaşı 58±13,8 yıl olan 200 gönüllünün katılımı ile gerçekleştirilmiştir. Çalışmaya 138 kadın (%69), 62 erkek (%31) katılım sağlamıştır. Katılımcılara uygulanan anket formunda katılımcıların sosyo-demografik özelliklerinin yanı sıra gıda güvenliği kavramını duyma ve hakkında bilgi edinme durumu, maddi durumun beslenme tercihlerini etkileme durumu, yemek hazırlamaya dahil olma durumları ve dışarıda yemek yeme sıklıkları, gıda güvenliği bilgisi, gıda güvenliğine dair tutumları ve uygulamalarını değerlendirmeye yönelik sorular bulunmaktadır. Analizler MedCalc® Statistical Software version 22.009 Programı kullanılarak yapılmıştır. Çalışmada katılımcıların %74'ünün daha önce gıda güvenliğine dair bilgi edinmediği saptanmıştır. Katılımcıların gıda güvenliği uygulamaları ile gıda güvenliği bilgisi arasında orta düzeyde ve istatistiksel olarak anlamlı korelasyon bulunmuştur (p<0,005). Çapraz bulaşma (p<0,05), sıcaklık kontrolü (p<0,05), gıda güvenliği uygulamaları (p<0,005) ve gıda güvenliği bilgi (p<0,05) skorları cinsiyete göre istatistiksel anlamlı farklılık göstermiştir. Çalışma sonuçları kanser tanılı bireylerin gıda güvenliği uygulamalarına yönelik daha ileri ve detaylı araştırmaların yapılması gerektiğini vurgulamaktadır. Anahtar Kelimeler: Anket, Gıda Güvenliği, Gıda Güvenliği Bilgisi, Kanser, Onkoloji HastalarıThis research aims to evaluate the food safety awareness of individuals diagnosed with cancer by considering their knowledge, attitudes and practices towards food safety. The study involved 200 volunteers, with an average age of 58±13.8, who had been diagnosed with cancer and were receiving care at the Medical Oncology and Radiation Oncology outpatient clinics at the Ministry of Health-Marmara University Pendik Training and Research Hospital. Of the participants, 138 were women (69%), and 62 were men (31%). The questionnaire form applied to the participants included questions aimed at assessing the participants' socio-demographic characteristics, as well as their knowledge of the concept of food safety and their knowledge about it, the extent to which financial circumstances affect nutritional preferences, their involvement in meal preparation and frequency of eating out, food safety knowledge, and their attitudes and practices regarding food safety. Data analysis was performed using the MedCalc® Statistical Software version 22.009 Program. The study revealed that 74% of the participants had not received prior education on food safety. A moderate and statistically significant correlation was found between participants' food safety practices and food safety knowledge (p<0.005). Cross-contamination (p<0.05), temperature control (p<0.05), food safety practices (p<0.005) and food safety knowledge (p<0.05) scores showed statistically significant differences according to gender. The study results emphasize the need for further and more detailed research on the food safety practices of individuals diagnosed with cancer. Keywords: Questionnaire, Food Safety, Food Safety Knowledge, Cancer, Oncology Patient
Evaluation of nutritional status with phase angle in patients with head-neck and brain tumor taking radiotherapy and comprasion with current screening tests
No full textLisansüstü Programlar Enstitüsü, Beslenme ve Diyetetik Ana Bilim DalıKanser hastalarının malnütrisyon riskinin hızlı ve erken dönemde belirlenmesi ve malnütrisyon tedavisinin yapılması; onkolojik tedavilerin toksisitesini azaltmada, hastaların yaşam kalitelerini artırmada ve hastane maliyetlerini azaltmada oldukça önemlidir. Bu çalışma; baş-boyun kanseri ve beyin tümörü tanılı hastaların malnütrisyon riskinin kullanımı kolay, non-invaziv ve tekrarlanabilir bir yöntem olan BİA'dan elde edilen faz açısı ile belirlenmesi ve bunun mevcut beslenme durumu tarama ve değerlendirme araçları ile kıyaslanması amacıyla gerçekleştirilmiştir. Çalışma Ekim 2019 ve Şubat 2020 tarihleri arasında, Marmara Üniversitesi Pendik Eğitim Araştırma Hastanesi Radyasyon Onkolojisi Kliniği tedavi ünitelerinde tedavi ve takip hastası olan 61'i (%61) erkek, 39'u (%39) kadın olmak üzere toplamda 100 yetişkin hasta (<18 yaş) ile yürütülmüştür. Çalışmaya katılan hastaların 37'si (%37) baş-boyun kanserli, 63'ü (%63) beyin tümörlüdür. Çalışmada veri toplama araçları olarak; hasta bilgi formu, SGA, NRS-2002, MNA, Nutriscore kullanılmış ve bu beslenme durumu tarama ve değerlendirme testleri baz alınarak ROC eğrisi analizi ile faz açısı kesim noktası değeri 5,72o olarak belirlenmiştir. Ayrıca hasta dosyalarından biyokimyasal parametrelerinden NLR, PLR ve SII hesaplanmış, faz açısı ile kıyaslaması yapılmıştır. Faz açısı kesim noktası ile SGA ve MNA skorları arasında istatistiksel olarak anlamlı bir ilişki bulunurken; NRS-2002 ve Nutriscore skorları arasında bir ilişki saptanamamıştır (p<0,05). Faz açısı kesim noktası ile BİA parametrelerinden vücut suyu, FFM, BCM, ECM/BCM, hücre payı ve beslenme indeksi arasında istatistiksel olarak anlamlı bir ilişki saptanmıştır (p<0,05). Faz açısı kesim noktası ile NLR ve SII arasında istatistiksel olarak anlamlı bir ilişki saptanırken; PLR ile bu ilişki bulunamamıştır (p<0,05). Bu sonuçlara göre faz açısının baş-boyun kanserli ve beyin tümörlü hastalarda malnütrisyon riskinin belirlenmesinde mevcut tarama ve değerlendirme testlerine ek olarak basit, hızlı ve tekrarlanabilir bir yöntem olduğu görülmektedir. Bu sonuçlarla birlikte, toplumlarda vücut kompozisyonu açısından farklılıklar olabileceği bilindiğinden, BİA cihazlarıyla ölçüm yapılan, daha geniş hasta ve sağlıklı popülasyonları içeren çalışmalar gerçekleştirerek standart bir faz açısı referans değeri belirlenmesinin önemli olduğu kanısına varılmıştır.Determining the malnutrition risk of cancer patients in the rapid and early period and performing malnutrition treatment; It is very important in reducing the toxicity of oncological treatments, increasing the quality of life of patients and reducing hospital costs. The aim of this study was to determine the malnutrition risk of patients with head and neck cancer and brain tumor using the phase angle obtained from BIA, which is an easy-to-use, non-invasive and reproducible method, and to compare this with current nutritional status screening and assessment tools. The study was conducted in a total of 100 adult patients (<18 age), 61 (61%) male and 39 (39%) female, who were treated and controlled patients in Marmara University Pendik Training and Research Hospital Radiation Oncology Clinic treatment units between October 2019 and February 2020. Of the patients participating in the study, 37 (37%) had head and neck cancer, and 63 (63%) had brain tumors. As data collection tools in the study; patient information form, SGA, NRS-2002, MNA, Nutriscore were used and based on these nutritional status screening and assessment tests, the phase angle cutoff value was determined as 5.72o by ROC curve analysis. In addition, the biochemical parameters NLR, PLR and SII were calculated from the patient files and compared with the phase angle. While there was a statistically significant relationship between the phase angle cutoff point and SGA and MNA scores; no correlation was found between NRS-2002 and Nutriscore scores (p<0.05). A statistically significant correlation was found between the phase angle cutoff point and BIA parameters body water, FFM, BCM, ECM/BCM, cell fraction and nutrition index (p<0.05). While a statistically significant relationship was found between the phase angle cutoff point and NLR and SII; this relationship with PLR was not found (p<0.05). According to these results, it is seen that the phase angle is a simple, fast and reproducible method in addition to the existing screening and assessment tests in determining the risk of malnutrition in patients with head and neck cancer and brain tumor. With these results, since it is known that there may be differences in body composition in populations, it was concluded that it is important to determine a standard phase angle reference value by carrying out studies involving larger patient and healthy populations with BIA devices
The role of the dietitian in the solution of the nutritional problems of oncology patients from the point of patient’s view: an awareness study
Full text linkÖZET: Onkoloji hastalarının beslenme sorunlarının erken tespit edilmesi ve bu sorunlara hızlı çözümler üretilmesi tedavinin ilerleyişi açısından oldukça önemlidir. Bu çalışma onkoloji hastalarının tedavi süreci ve sonrasında beslenme ihtiyaçlarının sorgulanmasında, aldıkları beslenme eğitiminin yeterliliğinin incelenmesinde, beslenme eğitimindeki eksikliklere çözüm yolları üretilmesinde diyetisyen etkisini saptamayı amaçlayan ilaç dışı klinik, tek merkezli bir anket çalışmasıdır. Çalışma, Kasım-Aralık 2020 tarihleri arasında Marmara Üniversitesi Pendik Eğitim Araştırma Hastanesi Tıbbi Onkoloji, Radyasyon Onkolojisi, Hematoloji Kliniği ve Kemoterapi Servisi tedavi ünitelerinde kanser tanısı almış, tedavi bekleyen, tedavisi devam eden ya da tedavisi bitmiş ve takip altında olan 84’ü kadın (%51,9) ve 78’i erkek (%48,1) olmak üzere toplam 162 yetişkin (?18 yaş) kanser tanılı hastayla yürütülmüştür. Araştırmada veri toplama aracı olarak 30 soruluk bir anket formu kullanılmıştır. Sürekli değişkenleri tanımlamak için deskriptif istatistikler kullanılmıştır. Normal dağılıma uygun olan parametreler için ortalama+standart sapma, normal dağılıma uygun olmayan parametreler için medyan (minimummaksimum) değerleri verilmiştir. İstatistiksel anlamlılık düzeyi 0,05 olarak belirlenmiştir. Analizler MedCalc Statistical Software version 12.7.7 Programı kullanılarak gerçekleştirilmiştir. Çalışma sonucunda çalışmaya katılan hastaların %74,7’sine beslenme hakkında bilgilendirme yapıldığı gözlenmiştir. Ancak bu bilgilendirmenin içeriği kişiye özgü olmaktan uzaktır ve genel beslenme bilgilerini içermektedir. Çalışmaya katılan 162 kişinin %32,7’sinin (n = 53) çoğunluk yüzdeyle beslenme eğitimini eğitim hemşiresinden aldığı gözlenmiştir. Hastaların %25,9’lük dilimi (n = 42) beslenme eğitimini diyetisyenden almıştır. Hastaların %16’sı ise beslenme eğitimini, tedavilerini planlayan doktor tarafından almıştır. Çalışmaya katılan hastaların %70,4’ü (n = 114) hastalık sürecinde beslenme eğitimi almayı beklemediklerini belirtmiştir. Çalışma sonuçları yapılacak diğer çalışmalara ışık olabilecek niteliktedir. Farklı gruplarla yapılacak çalışmalara ihtiyaç vardıABSTRACT: Early detection of nutritional problems of oncology patients and rapid solutions to these problems are very important for the progress of treatment. This study is a nondrug clinical, single-center survey study aiming to determine the effect of dietitian in questioning the nutritional needs of oncology patients during and after the treatment, examining the adequacy of the nutrition education they receive, and producing solutions to the deficiencies in nutrition education. The study was conducted in Marmara University Pendik Training and Research Hospital Medical Oncology, Radiation Oncology, Hematology Clinic and Chemotherapy Service treatment units between November-December 2020. It was conducted with a total of 162 adult (?18 years old) cancer patients, of which 84 (%51,9) were female and 78 (%48,1) were male. A questionnaire with 30 questions was used as a data collection tool in the research. Descriptive statistics were used to describe continuous variables. Mean+standard deviation values are given for parameters suitable for normal distribution, and median (minimum-maximum) values are given for parameters not suitable for normal distribution. Statistical significance level was determined as 0,05. Analyzes were performed using MedCalc Statistical Software version 12.7.7. As a result of the study, it was observed that %74,7 of the patients participating in the study were informed about nutrition. However, the content of this information is far from being personal and includes general nutritional information. It was observed that %32,7 (n = 53) of the 162 people who participated in the study received nutrition education from the training nurse with the majority percentage. %25,9 of the patients (n = 42) received nutrition education from a dietitian. %16 of the patients received nutrition education by the doctor who planned their treatment. %70,4 (n = 114) of the patients participating in the study stated that they did not expect to receive nutrition education during the disease process. The results of the stud
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