Browsing by Author "Asoglu, Oktar"

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    Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series
    (BMC, 2022-01-01) Asoglu, Oktar; Bulut, Alisina; Aliyev, Vusal; Piozzi, Guglielmo Niccolo; Guven, Koray; Bakir, Baris; Goksel, Suha
    Aim To report long-term oncological outcomes and organ preservation rate with a chemoradiotherapy-consolidation chemotherapy (CRT-CNCT) treatment for locally advanced rectal cancer (LARC). Method Retrospective analysis of prospectively maintained database was performed. Oncological outcomes of mid-low LARC patients (n=60) were analyzed after a follow-up of 63 (50-83) months. Patients with clinical complete response (cCR) were treated with the watch-and-wait (WW) protocol. Patients who could not achieve cCR were treated with total mesorectal excision (TME) or local excision (LE). Results Thirty-nine (65\%) patients who achieved cCR were treated with the WW protocol. TME was performed in 15 (25\%) patients and LE was performed in 6 (10\%) patients. During the follow-up period, 10 (25.6\%) patients in the WW group had regrowth (RG) and 3 (7.7\%) had distant metastasis (DM). Five-year overall survival (OS) and disease-free survival (DFS) were 90.1\% and 71.6\%, respectively, in the WW group. Five-year OS and DFS were 94.9\% (95\% CI: 88-100\%) and 80\% (95\% CI: 55.2-100\%), respectively, in the RG group. For all patients (n=60), 5-year TME-free DFS was 57.3\% (95\% CI: 44.3-70.2\%) and organ preservation-adapted DFS was 77.5\% (95\% CI: 66.4-88.4\%). For the WW group (n=39), 5-year TME-free DFS was 77.5\% (95\% CI: 63.2-91.8\%) and organ preservation-adapted DFS was 85.0\% (95\% CI: 72.3-97.8\%). Conclusion CRT-CNCT provides cCR as high as 2/3 of LARC patients. Regrowths, developed during follow-up, can be successfully salvaged without causing oncological disadvantage if strict surveillance is performed.
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    Neoadjuvant hyperfractionated accelerated radiotherapy plus concomitant 5-fluorouracil infusion in locally advanced rectal cancer: A phase. study
    (BAISHIDENG PUBLISHING GROUP INC, 2018-01-01) Gural, Zeynep; Saglam, Sezer; Yucel, Serap; Kaytan-Saglam, Esra; Asoglu, Oktar; Ordu, Cetin; Acun, Hediye; Sharifov, Rasul; Onder, Semen; Kizir, Ahmet; Oral, Ethem N.
    AIM To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy (HART) and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer. METHODS A total of 30 patients with histopathologically confirmed T2-3/N0+ infraperitoneal adenocarcinoma of rectum cancer patients received preoperative 42 Gy/1.5 Gy/18 days/bid radiotherapy and continuous infusion of 5-fluorouracil (325 mg/m(2)). All patients were operated 4-8 wk after neoadjuvant concomitant therapy. RESULTS In the early phase of treatment, 6 patients had grade III- IV gastrointestinal toxicity, 2 patients had grade III-IV hematologic toxicity, and 1 patient had grade V toxicity due to postoperative sepsis during chemotherapy. Only 1 patient had radiotherapy-related late side effects, i.e., grade IV tenesmus. Complete pathological response was achieved in 6 patients (21\%), while near-complete pathological response was obtained in 9 (31\%). After a median follow-up period of 60 mo, the local tumor control rate was 96.6\%. In 13 patients, distant metastasis occurred. Disease-free survival rates at 2 and 5 years were 63.3\% and 53\%, and corresponding overall survival rates were 70\% and 53.1\%, respectively. CONCLUSION Although it has excellent local control and complete pathological response rates, neoadjuvant HART concurrent chemotherapy appears to not be a feasible treatment regimen in locally advanced rectal cancer, having high perioperative complication and intolerable side effects. Effects of reduced 5-fluorouracil dose or omission of chemotherapy with the aim of reducing toxicity may be examined in further studies.
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    The impact of total neo-adjuvant treatment on nonoperative management in patients with locally advanced rectal cancer: The evaluation of 66 cases in a single center (vol 46, pg 402, 2019)
    (ELSEVIER SCI LTD, 2020-01-01) Asoglu, Oktar; Tokmak, Handan; Bakir, Baris; Demir, Gokhan; Ozyar, Enis; Atalar, Banu; Goksel, Suha; Koza, Burak; Mert, Aslihan Guven; Demir, Atakan; Guven, Koray