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Karatas F, Erdem GU, Sahin S, Aytekin A, Yuce D, Sever AR, Babacan T, Ates O, Ozisik Y, Altundag K. Obesity is an independent prognostic factor of decreased pathological complete response to neoadjuvant chemotherapy in breast cancer patients. Breast 2016; 32:237-244. [PMID: 27318645 DOI: 10.1016/j.breast.2016.05.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 05/25/2016] [Accepted: 05/31/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The relation between higher body mass index (BMI) and pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer (BC) is a controversial issue according to the data of Western and Asian patients. The aim of this study is to evaluate BMI and pCR to NAC and discuss the importance of pCR outcomes in Turkish BC patients as a bridging country between Europe and Asia. PATIENTS AND METHODS Of the 4423 BC patients diagnosed between the years 1994 and 2015 in Hacettepe University Cancer Institute, 295 female patients with stage II and III BC were enrolled in the study. Three different group divisions were done according to patients' BMI as normal or underweight (N/U) patients (BMI <25 kg/m2), overweight (OW) patients (BMI = 25-29.9 kg/m2) and obese (OB) patients (BMI ≥30 kg/m2). BC subtypes were defined as luminal-like (ER/PR-positive and HER2-negative), HER2/luminal (ER/PR-positive and HER2-positive), HER2-type (ER/PR-negative and HER2-positive), and triple-negative (TNBC; ER/PR- and HER2-negative). The analysis of overall survival (OS) and recurrence-free survival (RFS) was performed according to Kaplan-Meier method. The Log-rank test was used to compare the subgroup analysis and logistic regression analysis to determine the independent prognostic factors. RESULTS In this study, a total number of 93 (31.5%) patients were N/U, 107 (36.3%) patients were OW and 95 (32.2%) patients were OB. Among groups, except for the age, no baseline clinicopathological differences were found. In 70 (23.7%) patients, pCR was achieved. pCR rates in N/U, OW and OB were 31.2%, 22.4%, and 17.9% respectively, showing a considerable trend towards significance (P = 0.09 in chi-square test). In the multivariate logistic regression analysis, obesity was an independent adverse prognostic feature on pCR to NAC compared to N/U patients (OR, 0.34; 95% CI, 0.13 to 0.85, P = 0.02). The recurrence rates were slightly increased with the increase of BMI (N/U = 24.7%, OW = 29.0% and OB = 40%; P = 0.06 respectively). Median RFS was significantly higher in N/U group compared to OB patients (150 vs. 76 months respectively, P = 0.03) and was also higher in pCR group compared to non-pCR patients (151 vs. 77 months P = 0.004). Median OS was significantly higher in N/U patients compared to OB patients (N/U = not reached, OW = 211 and OB = 114 months; P = 0.01) and was also higher in pCR group compared to non-pCR patients (not reached vs. 211 months P = 0.04). In Cox regression analysis; pCR, histopathological grade and TNBC were found as independent prognostic factors on OS (HR, 0.29; 95% CI, 0.11 to 0.79, P = 0.015, HR, 2.09; 95% CI, 1.14 to 3.83, P = 0.017, HR, 1.95; 95% CI, 1.01 to 3.77, P = 0.046, respectively). CONCLUSION It was observed that obesity was an important independent prognostic factor which has an adverse effect on pCR. Moreover it causes decreasing RFS and OS in BC patients who had received NAC. The probability of inefficient treatment in obese patients should be considered.
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Karatas F, Erdem GU, Sahin S, Aytekin A, Yuce D, Sever AR, Altundag K. Obesity as an independent prognostic factor of decreased pathological complete response to neoadjuvant chemotherapy in breast cancer patients. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ozdogan S, Nurhat RH, Duzkalir AH, Yuce D, Sabuncuoglu H, Gokcil Z, Erdogan E. Vagal Nerve Stimulation Effects on Generalized-Partial Seizures and Medication in Adult Drug- Resistant Epilepsy Patients. Turk Neurosurg 2016; 26:347-51. [PMID: 27161459 DOI: 10.5137/1019-5149.jtn.8534-13.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM The aim of this study was to find out if vagal nerve stimulation (VNS) affect the generalized-partial seizure count and medical treatment in adult drug resistant epilepsy patients. MATERIAL AND METHODS Twenty adult patients who were diagnosed with drug-resistant epilepsy were investigated retrospectively for vagal nerve stimulator implantation between 2001 and 2010 at the Neurosurgery Departments of Ufuk University and Gulhane Military Medical Academy. The effects of vagal nerve stimulation on generalized-partial seizures and medical treatment was scored and if a significant difference was found, a comparison was made by Wilcoxon Signed Ranks test and Pairwise. For all the group analyses, the statistical significant rank was accepted as a p value < 0.05. Bonferroni correction was made when it was needed during pairwise comparisons. RESULTS VNS significantly decreased the scores of generalized-partial seizures. There was no decrease in the doses of antiepileptic drugs and the medical treatment was resumed as before the implantation. The results were correlated with the relevant literature. CONCLUSION VNS is an alternative treatment option for drug resistant epilepsy for patients who are not ideal candidates for surgery or are not healed after epilepsy surgery.
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Birgi SD, Gultekin M, Yuce D, Yildiz F. The Most Important Prognostic Factor Was Response to Treatment in Locally Advanced Cervical Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yuce D, Kucuk Bicer B, Ozvaris S. A Forgotten Issue: Gender Point Of View At Research Related To Cancer Caregivers. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hayran KM, Yuce D, Celik I, Erman M. Need for Proper Training for Assessing Dependency and Exposure of Smoking. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ercan ES, Ardic UA, Ercan E, Yuce D, Durak S. A Promising Preliminary Study of Aripiprazole for Treatment-Resistant Childhood Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol 2015; 25:580-4. [PMID: 26375768 DOI: 10.1089/cap.2014.0128] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a relatively frequent disease in childhood, which is generally treated with selective serotonin reuptake inhibitors (SSRIs) and/or clomipramine and cognitive behavioral therapy (CBT). However, nearly half of the cases are treatment resistant. Aripiprazole was shown to be beneficial in augmentation therapy in treatment-refractory OCD. This study evaluated its effectiveness as a single agent in these cases. METHODS Sixteen children (nine girls, seven boys), who were nonresponders to treatment with at least two types of SSRIs and CBT, were administered 12 weeks of aripiprazole treatment with a mean dose of 4.75 mg/day (range: 2-7.5 mg/day). Treatment outcomes were evaluated by the Childhood Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and the Clinical Global Impressions-Severity and Improvement (CGI-S and CGI-I) scales. RESULTS Children with a mean age of 10.9±2.9 years had severe obsessive compulsive symptoms at baseline, and >80% of them had another comorbid psychiatric disease. Significant improvements in symptoms were achieved after 12 weeks of aripiprazole treatment, which were evaluated by significant decreases in symptom scores in the CY-BOCS, and improvements in CGI-I scores. CONCLUSIONS This very small study of aripiprazole, given to children with OCD resistant to at least 12 weeks treatment with at least two SSRIs and CBT, demonstrated striking improvement in CGI scores (all subsets, p≤0.002) for 13 of 16 children, and halved all CY-BOCS subscores after ∼12 weeks of treatment.
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Eraslan L, Baltaci G, Yuce D, Erbilici A. Effects of Physiotherapy Approaches on Pain and Strength in Lateral Epicondylitis. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478389.58397.bd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Yuce D, Hayran M, Kilickap S, Erman M, Celik I. Health Related Quality of Life in Cancer Patients: Evaluation With A Self-Administered Ipad Application. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A573. [PMID: 27201919 DOI: 10.1016/j.jval.2014.08.1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Hayran M, Yuce D, Huseyin B, Esin E, Kilickap S, Erman M, Celik I. Association of Health Care Cost with Quality of Life for Various Types of Cancers. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A631. [PMID: 27202241 DOI: 10.1016/j.jval.2014.08.2257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Hurmuz P, Kivanc H, Canbolat A, Yavas G, Yuce D, Onder SC, Sargon MF, Yildiz F. Evaluation of the Effect of Changes in Dose Rate on Rat Lung Cells. Technol Cancer Res Treat 2014; 14:343-9. [DOI: 10.1177/1533034614547450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 05/19/2014] [Indexed: 01/20/2023] Open
Abstract
The aim of this study is to evaluate the effect of dose rate (DR) on lung tissue. The rats included in the study were randomly grouped into 3 groups: Group (G) 1 was defined as control group, and in this group rats were sham irradiated. G2 was the group receiving a single dose of 12 Gy in DR of 300 monitor unit (MU)/min. G3 was the group receiving a single dose of 12 Gy in DR of 600 MU/min. Radiotherapy (RT) was applied under general anesthesia with 6-MV photon beams to both lungs. At the 6th and 16th week of the RT, animals from each group were killed for light and electron microscopy evaluation. We evaluated the scores of each group in the 6th and the 16th week and found that in G2, there were significant increases in the perivascular fibrosis ( P = .018), interstitial fibrosis ( P = .002), total inflammation ( P = .040), and total fibrosis ( P = .003) scores. In G3, we found statistically significant increases in perivascular fibrosis ( P = .001), interstitial fibrosis ( P = .002), and total fibrosis scores ( P = .029). There was no significant difference in the total inflammation score in G3 ( P = .225). When we compare G2 and G3 in the 6th week, we found significant increase in the interstitial thickening ( P = .039) and total inflammation ( P = .035) scores in G3. Dose rate per fraction may have an impact on normal tissue toxicity. The prominent effect of increased DR in lung tissue is fibrosis which should be kept in mind, especially in cases where higher doses per fraction are used.
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Erman M, Hayran M, Celik I, Kilickap S, Huseyin B, Yuce D. High Smoking Cessation Rates After National Awareness Campaigns and By Comprehensive Treatment Approach. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu353.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Durak S, Ercan ES, Ardic UA, Yuce D, Ercan E, Ipci M. Effect of methylphenidate on neurocognitive test battery: an evaluation according to the diagnostic and statistical manual of mental disorders, fourth edition, subtypes. J Clin Psychopharmacol 2014; 34:467-74. [PMID: 24875071 DOI: 10.1097/jcp.0000000000000128] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aims of this study were to evaluate the neuropsychological characteristics of the restrictive (R) subtype according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the attention-deficit/hyperactivity disorder (ADHD) combined (CB) type and predominantly inattentive (PI) type subtypes and to evaluate whether methylphenidate (MPH) affects neurocognitive test battery scores according to these subtypes. This study included 360 children and adolescents (277 boys, 83 girls) between 7 and 15 years of age who had been diagnosed with ADHD and compared the neuropsychological characteristics and MPH treatment responses of patients with the R subtype-which has been suggested for inclusion among the ADHD subtypes in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-with those of patients with the PI and CB subtypes. They did not differ from the control subjects in the complex attention domain, which includes Continuous Performance Test, Stroop test, and Shifting Attention Test, which suggests that the R subtype displayed a lower level of deterioration in these domains compared with the PI and CB subtypes. The patients with the CB and PI subtypes did not differ from the control subjects in the Continuous Performance Test correct response domain, whereas those with the R subtype presented a poorer performance than the control subjects. The R subtype requires a more detailed evaluation because it presented similar results in the remaining neuropsychological evaluations and MPH responses.
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Tural D, Yuce D, Kilickap S. Mortality in Prostate Cancer and Use of Statins. J Clin Oncol 2014; 32:2274. [DOI: 10.1200/jco.2013.54.3264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kesikli SA, Yuce D, Kilickap S. Dose-dense effect: other contributors. Lancet Oncol 2013; 14:e489. [DOI: 10.1016/s1470-2045(13)70466-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yazici G, Sanlı TY, Cengiz M, Yuce D, Gultekin M, Hurmuz P, Yıldız F, Zorlu F, Akyol F, Gurkaynak M, Ozyigit G. A simple strategy to decrease fatal carotid blowout syndrome after stereotactic body reirradiaton for recurrent head and neck cancers. Radiat Oncol 2013; 8:242. [PMID: 24139288 PMCID: PMC4016484 DOI: 10.1186/1748-717x-8-242] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 10/15/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to compare the therapeutic outcomes and fatal carotid blow out syndrome (CBOS) incidence rates between two different stereotactic body radiotherapy (SBRT) protocols. METHODS The study included 75 patients with inoperable locally recurrent head and neck cancer treated with SBRT in our department between June 2007 and March 2011. The first 43 patients were treated sequentially (group I). Then our SBRT protocol was changed due to the high rate of CBOS, and the following 32 patients were treated every other day in a prospective institutional protocol (group II). RESULTS Median overall survival in group I and group II was 11 months and 23 months, respectively (P = 0.006). We observed 11 cases of CBOS. Only 1 of 7 patients (14%) with CBOS survived in group I, whereas 2 of 4 patients (50%) in group II remain alive. CBOS free median overall survivals were 9 months, and 23 months in group I and group II respectively (P = 0.002). The median radiation dose received by the carotid artery in patients with CBOS was 36.5 Gy (range: 34-42.8 Gy), versus 34.7 Gy (range: 0-44 Gy) in the patients that didn't have CBOS (P = 0.15). CBOS did not occur in any of the patients with a maximum carotid artery radiation dose <34 Gy. CONCLUSIONS Every other day SBRT protocol for re-irradiation of recurrent head and neck cancer is promising in terms of decreasing the incidence of fatal CBOS.
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Kutluk T, Mutlu Hayran K, Kilickap S, Yuce D, Celik I, Erman M, Yalcin S. Increasing performance of a hospital-based cancer registry: Hacettepe University hospitals experience. JOURNAL OF B.U.ON. : OFFICIAL JOURNAL OF THE BALKAN UNION OF ONCOLOGY 2013; 18:1088-1096. [PMID: 24344044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE High-quality hospital-based cancer registry systems are the key elements of a healthy population-based cancer data. The purpose of this study was to present a recent history of establishing a valuable and reliable hospital- based cancer registry in a university hospital in Turkey, and the data gathered by this system in the last 9 years. METHODS This study included the cancer registry records of Hacettepe University Hospitals between 1-Jan-2003, and 31-Dec-2011. The study cohort included data of 39351 cancer patients and the cancer registry system was based on active data acquisition method. RESULTS Most frequent departments of reference were Medical Oncology, Radiation Oncology, General Surgery, Urology, and Pediatrics. The annual number of records gradually increased from 2675 in 2003 to 5152 in 2011. The 5 cancer types most frequency seen in adults were lung (15.5%), prostate (13.5%), stomach (6.6%), bladder (6.2%), and colon (5.8%) in men; and breast (32.7%), ovary (6.4%), uterine corpus (6.2%), uterine cervix (5.6%), and thyroid (5.0%) in women. Childhood cancers were classified according to the International Classification of Childhood Cancers, 3rd Edition (ICCC-3), and the most frequent 5 cancer types in children were tumors of the central nervous system (20.1%), lymphomas (14.6%), leukemia (14.1%), retinoblastoma (9.4%), and tumors of the sympathetic nervous system (7.7%). CONCLUSION Active data acquisition from departments that deal with oncologic patients in a hospital is the precise method for establishing a high-quality cancer registry system that is able to resemble the general population. Hospital- based cancer registry systems also provide highly critical information for planning, monitoring, and measuring the cancer-related services, research, and education.
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Esin E, Yuce D, Kilickap S, Erman M. Aromatase Inhibitors and Safety: Clinical or Statistical Significance? J Clin Oncol 2013; 31:3439. [DOI: 10.1200/jco.2013.49.2884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Petekkaya I, Sahin U, Gezgen G, Solak M, Yuce D, Dizdar O, Arslan C, Ayyildiz V, Altundag K. Association of breast cancer subtypes and body mass index. TUMORI JOURNAL 2013; 99:129-33. [PMID: 23748802 DOI: 10.1177/030089161309900201] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS AND BACKGROUND Breast cancer is a heterogeneous disease with various pathological and molecular subtypes. This study aims to determine the association between BMI and the distribution of breast cancer subtypes defined by estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2/neu) expression in pre- and postmenopausal breast cancers. METHODS AND STUDY DESIGN A total of 1847 female breast cancer patients were involved. After the exclusion of 457 patients due to missing subtype information (n = 400) or benign histology (n = 57), 1390 were included in the analyses. The histological type of the tumor, ER and PR expression, HER2/neu with immunohistochemistry and HER2/neu gene evaluation with interphase fluorescence in situ hybridization (if necessary), age, body weight, height and menopausal status at diagnosis were investigated retrospectively. The patients were stratified as having a normal body weight if BMI was ≤24.9 kg/m², as being overweight if BMI was between 25.0 and 29.9 kg/m², and as being obese if BMI was ≥30.0 kg/m². RESULTS Median BMI was 28.7 kg/m² (17.6-55.6) in the postmenopausal and 25.6 kg/m² (16.4-51.1) in the premenopausal group (P <0.001). BMI at diagnosis did not differ significantly between the molecular subtypes (P = 0.12). Distribution of BMI strata was similar between the molecular subtypes both in pre- and postmenopausal breast cancer (P = 0.24 and P = 0.99, respectively). Premenopausal women with a BMI of ≥25.0 kg/m² showed a tendency towards ER- tumors when compared to premenopausal women with a BMI of <25.0 kg/m² (P = 0.009). CONCLUSIONS The risk of specific breast cancer subtypes may not be associated with BMI in pre- and postmenopausal breast cancer. However, obesity might be related to an increased risk of premenopausal hormone receptor-negative breast cancer. Further studies are needed for clarification of the probable mechanisms in the pathogenesis of premenopausal hormone receptor-negative breast cancer.
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Yalcin S, Kertmen N, Yuce D, Yildiz F, Hamaloglu E. The impact of adjuvant delayed radiotheraphy (RT) on survival in patients with resected periampullary adenocarcinomas. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e15168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15168 Background: Postoperative prognosis for ampullary carcinoma (AC) is superior to that of pancreatic cancer (PC), the former exhibiting higher complete surgical resection, lower recurrence and longer survival rates (1). Despite all the major recent advances in surgery, chemotherapy (CT) and RT, PC is still one of the most lethal malignancies, overall survival (OS) rates being as low as 5% at 5 years (2). This study was intended to evaluate survival in patients with resected periampullary cancer treated with adjuvant Gemcitabine (Gem) and cisplatin (Cis) with or without delayed RT (with Gem). Methods: This retrospective study involved 91 patients diagnosed and treated with periampullary cancer. Patients with adenocarcinoma of periampullary region with gross total tumor resection and lymph node dissection (R0 and R1 resections only) were included. Of 59 patients with PC, 38 received Gem and Cis for 3 cycles (3 months) before CRT. When delivered after Gem /RT, Gem and Cis were usually given for another 1-3 cycles. Twenty-seven patients received Gem and Cis alone over 6 cycles. Of 32 patients with non-pancreatic periampullary 23 received CT+CRT and 9 patients received CT alone. Results: Patients with non-pancreatic periampullary cancer had better OS (p:0.017) and disease free survival (DFS) ( p<0.001 ) compared to patients with PC. Median OS of patients with PC was 21 months. Both OS and DFS were superior in the RT arm compared to nonRT arm (p: 0.043 and p <0.001). In non-pancreatic periampullary cancer patients OS was 31 months in RT group and 51 months in non-RT group (p: 0.709). DFS was 29 months and 49.8 months respectively, p:0.504). Conclusions: The prognosis of PC was worse than non–pancreatic periampullary tumor. In PC adjuvant delayed RT improved patient outcome. Although OS and DFS were better in patients receiving CT alone, the difference was not statistically significant in non–pancreatic periampullary tumors.
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Hayran M, Kilickap S, Elkiran T, Akbulut H, Abali H, Yuce D, Kilic D, Turhal S. Smoking Habits of Relatives of Patients with Cancer: Cancer Diagnosis in the Family is an Important Teachable Moment for Smoking Cessation. Asian Pac J Cancer Prev 2013; 14:475-9. [DOI: 10.7314/apjcp.2013.14.1.475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yavas C, Yavas G, Acar H, Toy H, Yuce D, Akyurek S, Ata O. Amelioration of radiation-induced acute inflammation and mucosal atrophy by beta-hydroxy-beta-methylbutyrate, L-glutamıne, and L-argınıne: results of an experimental study. Support Care Cancer 2012; 21:883-8. [PMID: 22993027 DOI: 10.1007/s00520-012-1601-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 09/10/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to evaluate the effects of β-hydroxy-β-methylbutyrate, L-glutamine, and L-arginine (HMB/Glu/Arg) on radiation-induced acute inflammation and mucosal atrophy in the oral mucosa. METHODS Twenty-eight rats were divided into four groups. group (G) 1 was defined as control group, and G2 was the radiation therapy (RT) group. G3 and G4 were HMB/Glu/Arg control and 17 Gy RT plus HMB/Glu/Arg groups, respectively. A single dose of 17 Gy RT was given to the head and neck area, and the active supplement consisting of 5.2 g of HMB, 29.6 g arginine, and 29.6 g of glutamine which was equivalent to 60 kg adult dose was calculated for each rat and administrated orally. HMB/Glu/Arg started from the day of RT and continued until the animals were sacrificed 7 days after the RT. The extent of acute inflammation and mucosal atrophy for each rat was quantified with image analysis of histological sections of the oral mucosa. RESULTS There were significant differences in terms of epithelial thickness, subepithelial edema, inflammation, and congestion between all groups (p values were <0.001, 0.003, <0.001, and 0.001 for each parameter, respectively). Using HMB/Glu/Arg alone led to hypertrophic changes in the epithelial layer. Moreover, when used with RT, HMB/Glu/Arg reversed radiation-induced epithelial atrophy (p, 0.006) and decreased radiation-induced inflammation at a significant level (p, 0.007). CONCLUSION Concomitant use of HMB/Glu/Arg appears to ameliorate the radiation-induced acute inflammation and mucosal atrophy which represent the early phase of acute oral mucositis; however, this finding should be clarified with further clinical studies.
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Hayran M, Kilickap S, Elkiran T, Akbulut H, Abali H, Yuce D, Kilic D, Turhal S. Smoking habits of relatives of patients (pts) with cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.9050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9050 Background: We aimed to determine the rate and habitual patterns of smoking, intentions of cessation, dependence levels and sociodemographic characteristics of relatives of cancer patients. Methods: The smoking habits of relatives of cancer pts were evaluated with a questionnaire and Fagerstrom test (FT) of nicotine dependence. FT and a questionnaire form were filled in by the volunteers. The quit rate of the relatives of the cancer pts was compared with the rates declared in the literature. Results: A total of 560 subjects who have relatives of pts with cancer. The median age of those with lower and higher Fagerstrom scores (FS) were 40 years and 42 years, respectively (p<0.001). We found no association between FS and sociodemographic variables, such as the subject's medical status, gender, living in the same house, educational status, family income, closeness and time spent with the cancer pts. Only 2% of the subjects started smoking after cancer was diagnosed in their relative and almost 20% of subjects had quit smoking within the year. Spontaneous quit rates of these subgroup of smokers (20%) was significantly higher than reported self-quit rates (max. ~10%) in the literature (p<0.001). Conclusions: The FS is known to be helpful in determining who would benefit from a cigarette smoking cessation program. We also show here that the cancer diagnosis in a smoker's family motivates this individual to quit smoking and may create a time window for any involved health staff to intervene for help. This study was designed by the Turkish Oncology Group, Epidemiology and Prevention Subgroup. [Table: see text]
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Yavas C, Zorlu F, Ozyigit G, Gurkaynak M, Yavas G, Yuce D, Cengiz M, Yildiz F, Akyol F. Health-related quality of life in high-grade glioma patients: a prospective single-center study. Support Care Cancer 2011; 20:2315-25. [PMID: 22160582 DOI: 10.1007/s00520-011-1340-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 11/29/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE In this single center study, we aimed to assess quality of life and cognitive and emotional distress in patients treated for high-grade glioma. METHODS AND MATERIALS A hundred and eighteen patients with high-grade glioma were prospectively enrolled. We assessed HRQoL at baseline (after surgery before radiotherapy), at the end of radiotherapy and during follow-up (every 3 months for the first 2 years and every 6 months between 2 and 5 years) using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC-C30), Brain Cancer Module-20 (BN-20), Minimental State Examination (MMSE) and Hospital Anxiety and Depression Scale (HADS). Baseline scores, and first 18-month follow-up period scores were included to statistical analysis. RESULTS Sixty-five (55%) patients had progressive tumor. Global score, physical, role and emotional function, insomnia (p for each <0.001) and appetite loss (p: 0.008) scores of EORTC-C30 significantly related to disease progression. According to BN-20 seizure and leg weakness (p < 0.001), drowsiness and bladder control (p: 0.002), motor dysfunction (p: 0.001), future uncertainty (p: 0.04), visual disorder (p: 0.008) and communication deficit (p: 0.006) symptoms significantly related to disease progression. There were significant decrements in orientation, attention and calculation and language scores (p values were 0.017, 0.005 and 0.003, respectively) of MMSE. The baseline and follow-up anxiety and depression scores did not differ significantly. CONCLUSION We conclude that there were many changes in patients with high-grade glioma during the course of the disease and most of them were related to disease progression.
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Yavas C, Zorlu F, Ozyigit G, Gurkaynak M, Yavas G, Yuce D, Cengiz M, Yildiz F, Akyol F. Prospective assessment of health-related quality of life in patients with low-grade glioma: a single-center experience. Support Care Cancer 2011; 20:1859-68. [PMID: 21979904 DOI: 10.1007/s00520-011-1288-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 09/26/2011] [Indexed: 11/28/2022]
Abstract
PURPOSE The assessment of Health-Related Quality of Life (HRQoL) in cancer patients has become increasingly important during the past decades. The aim of this study was to evaluate the HRQoL in patients treated for low-grade glioma (LGG). METHODS AND MATERIALS Forty-three adult patients with LGG were evaluated prospectively between September 2006 and December 2010. We assessed HRQoL at baseline (after surgery before radiotherapy), at the end of radiotherapy and during follow-up (every 3 months for the first 2 years and every 6 months between 2 and 5 years), using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC-C30), Brain Cancer Module-20 (BN-20), Mini Mental State Examination (MMSE) and Hospital Anxiety and Depression Scale (HADS). RESULTS We demonstrated changes in global score (p = 0.004), and future uncertainty (p < 0.001), communication deficit (p = 0.007), headache (p < 0.001), drowsiness (p = 0.002) and hair loss (p < 0.001), and recall score (p = 0.0029) during follow-up. All complaints of LGG patients showed improvement, except for the hair loss. Although the baseline cognitive function scores was not significantly different, the third-year cognitive function scores of patients who used antiepileptic drugs had lower when compared to patients who did not use (p < 0.001). The baseline and follow-up anxiety and depression scores did not differ significantly. CONCLUSION Our results suggested that there were improvement in HRQoL in LGG patients during follow-up and antiepileptic drugs had negative effect on cognitive functions.
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