Araştırma Çıktıları
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Item Efficacy and safety profile of COVID-19 vaccine in cancer patients: a prospective, multicenter cohort study(FUTURE MEDICINE LTD, 2022-01-01) Yasin, Ayse Irem; Aydin, Sabin Goktas; Sumbul, Bilge; Koral, Lokman; Simsek, Melih; Geredeli, Caglayan; Ozturk, Akin; Perkin, Perihan; Demirtas, Derya; Erdemoglu, Engin; Hacibekiroglu, Ilhan; Cakir, Emre; Tanrikulu, Eda; Coban, Ezgi; Ozcelik, Melike; Celik, Sinemis; Teker, Fatih; Aksoy, Asude; Firat, Sedat T.; Tekin, Omer; Kalkan, Ziya; Turken, Orhan; Oven, Bala B.; Dane, Faysal; Bilici, Ahmet; Isikdogan, Abdurrahman; Seker, Mesut; Turk, Haci M.; Gumus, MahmutAim: To compare the seropositivity rate of cancer patients with non-cancer controls after inactive SARS-CoV-2 vaccination (CoronaVac) and evaluate the factors affecting seropositivity. Method: Spike IgG antibodies against SARS-CoV-2 were measured in blood samples of 776 cancer patients and 715 non-cancer volunteers. An IgG level >= 50 AU/ml is accepted as seropositive. Results: The seropositivity rate was 85.2\% in the patient group and 97.5\% in the control group. The seropositivity rate and antibody levels were significantly lower in the patient group (p < 0.001). Age and chemotherapy were associated with lower seropositivity in cancer patients (p < 0.001). Conclusion: This study highlighted the efficacy and safety of the inactivated vaccine in cancer patients. Clinical Trials Registration: ClinicalTrials.gov) Plain language summary Cancer patients are at high risk for infection with SARS-CoV-2 and of developing the associated disease, COVID-19, which therefore puts them in the priority group for vaccination. This study evaluated the efficacy and safety of CoronaVac, an inactivated virus vaccine, in cancer patients. The immune response rate, defined as seropositivity, was 85.2\% in the cancer patient group and 97.5\% in the control group. The levels of antibodies, which are blood markers of immune response to the vaccine, were also significantly lower in the patient group, especially in those older than 60 years and receiving chemotherapy. These results highlight the importance of determining the effective vaccine type and dose in cancer patients to protect them from COVID-19 without disrupting their cancer treatment.Item Primary hepatic lymphoma: a retrospective, multicenter Rare Cancer Network study(PAGEPRESS PUBL, 2016-01-01) Ugurluer, Gamze; Miller, Robert C.; Li, Yexiong; Thariat, Juliette; Ghadjar, Pirus; Schick, Ulrike; Ozsahin, MahmutPrimary hepatic lymphoma (PHL) is a rare malignancy. We aimed to assess the clinical profile. outcome and prognostic factors in PHL through the Rare Cancer Network (RCN). A retrospective analysis of 41 patients was performed. Median age was 62 years (range. 2386 years) with a male-to-female ratio of 1.9:1.0. Abdominal pain or discomfort was the most common presenting symptom. Regarding B-symptoms, 19.5\% of patients had fever, 17.1\% weight loss, and 9.8\% night sweats. The most common radiological presentation was multiple lesions. Liver function tests were elevated in 56.1\% of patients. The most common histopathological diagnosis was diffuse large B-cell lymphoma (65.9\%). Most of the patients received Chop-like (cyclophosphamide. doxorubicin, vincristine, and prednisone) regimens, 4 patients received radiotherapy (dose range, 30.6-40.0 Gy). Median survival was 163 months, and 5- and 10-year overall survival rates were 77 and 59\%, respectively. The 5- and 10-year disease-free and lymphoma-specific survival rates were 69, 56, 87 and 70\%, respectively. Multivariate analysis revealed that fever. weight loss, and normal hemoglobin level were the independent factors influencing the outcome. In this retrospective multicenter RCN study, patients with PHL had a relatively better prognosis than that reported elsewhere. Multicenter prospective studies are still warranted to establish treatment guidelines, outcome and prognostic factors.Item Current treatment strategies in malignant pleural mesothelioma with a treatment algorithm(VIA MEDICA, 2019-01-01) Sayan, Mutlay; Eren, Mehmet Fuat; Gupta, Apar; Ohri, Nisha; Kotek, Ayse; Babalioglu, Ibrahim; Kaplan, Sedenay Oskeroglu; Duran, Ozge; Or, Ozlem Derinalp; Cukurcayie, Funda; Kurtul, Neslihan; Bicakci, Beyhan Ceylaner; Kutuk, Tugce; Senyurek, Sukran; Turk, Ali; Jabbour, Salma K.; Atalar, BanuMalignant pleural mesothelioma (MPM) is a rare disease with a poor prognosis. The main therapeutic options for MPM include surgery, chemotherapy, and radiation therapy (RT). Although multimodality therapy has been reported to improve survival, not every medically operable patient is able to undergo all recommended therapy. With improvements in surgical techniques and systemic therapies, as well as advancements in RT, there has been a potential new paradigm in the management of this disease. In this review, we discuss the current literature on MPM management and propose a functional treatment algorithm.Item Treatment results and prognostic factors in primary thyroid lymphoma patients: a Rare Cancer Network study(OXFORD UNIV PRESS, 2011-01-01) Onal, C.; Li, Y. X.; Miller, R. C.; Poortmans, P.; Constantinou, N.; Weber, D. C.; Atasoy, B. M.; Igdem, S.; Ozsahin, M.; Ozyar, E.Background: This study analyzed prognostic factors and treatment outcomes of primary thyroid lymphoma. Patients and Methods: Data were retrospectively collected for 87 patients (53 stage I and 34 stage II) with median age 65 years. Fifty-two patients were treated with single modality (31 with chemotherapy alone and 21 with radiotherapy alone) and 35 with combined modality treatment. Median follow-up was 51 months. Results: Sixty patients had aggressive lymphoma and 27 had indolent lymphoma. The 5- and 10-year overall survival (OS) rates were 74\% and 71\%, respectively, and the disease-free survival (DFS) rates were 68\% and 64\%. Univariate analysis revealed that age, tumor size, stage, lymph node involvement, B symptoms, and treatment modality were prognostic factors for OS, DFS, and local control (LC). Patients with thyroiditis had significantly better LC rates. In multivariate analysis, OS was influenced by age, B symptoms, lymph node involvement, and tumor size, whereas DFS and LC were influenced by B symptoms and tumor size. Compared with single modality treatment, patients treated with combined modality had better 5-year OS, DFS, and LC. Conclusions: Combined modality leads to an excellent prognosis for patients with aggressive lymphoma but does not improve OS and LC in patients with indolent lymphoma.Item GnRH agonist leuprolide acetate does not confer any protection against ovarian damage induced by chemotherapy and radiation in vitro(OXFORD UNIV PRESS, 2015-01-01) Bildik, Gamze; Akin, Nazli; Senbabaoglu, Filiz; Sahin, Gizem Nur; Karahuseyinoglu, Sercin; Ince, Umit; Taskiran, Cagatay; Selek, Ugur; Yakin, Kayhan; Guzel, Yilmaz; Ayhan, Cem; Alper, Ebru; Cetiner, Mustafa; Balaban, Basak; Mandel, Nil Molinas; Esen, Tarik; Iwase, Akira; Urman, Bulent; Oktem, OzgurSTUDY QUESTION: Is there any in vitro evidence for or against ovarian protection by co-administration of a GnRH agonist with chemotherapy in human? SUMMARY ANSWER: The co-administration of GnRH agonist leuprolide acetate with cytotoxic chemotherapy agents does not preserve ovarian reserve in vitro. WHAT IS KNOWN ALREADY: Randomized controlled trials of the co-administration of gonadotrophin-releasing hormone (GnRH) agonists with adjuvant chemotherapy to preserve ovarian function have shown contradictory results. This fact, together with the lack of a proven molecular mechanism of action for ovarian protection with GnRH agonist (GnRHa) places this approach as a fertility preservation strategy under scrutiny. We therefore aimed in this study to provide in vitro evidence for or against the role of GnRHa in the prevention of chemotherapy-induced damage in human ovary. STUDY DESIGN, SETTINGS, SIZE AND DURATION: This translational research study of ex vivo and in vitro models of human ovary and granulosa cells was conducted in a university hospital between 2013 and 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS: Ovarian cortical pieces (n = 15, age 14-37) and mitotic non-luteinized (COV434 and HGrC1) and non-mitotic luteinized human granulosa cells (HLGC) expressing GnRH receptor were used for the experiments. The samples were treated with cyclophosphamide, cisplatin, paclitaxel, 5-FU, or TAC combination regimen (docetaxel, adriamycin and cyclophosphamide) with and without GnRHa leuprolide acetate for 24 h. DNA damage, apoptosis, follicle reserve, hormone markers of ovarian function and reserve (estradiol (E2), progesterone (P) and anti-mullerian hormone (AMH)) and the expression of anti-apoptotic genes (bcl-2, bcl-xL, bcl-2L2, Mcl-1, BIRC-2 and XIAP) were compared among control, chemotherapy and chemotherapy + GnRHa groups. MAIN RESULTS AND THE ROLE OF CHANCE: The greatest magnitude of cytotoxicity was observed in the samples treated with cyclophosphamide, cisplatin and TAC regimen. Exposure to these drugs resulted in DNA damage, apoptosis and massive follicle loss along with a concurrent decline in the steroidogenic activity of the samples. GnRHa co-administered with chemotherapy agents stimulated its receptors and raised intracellular cAMP levels. But it neither activated anti-apoptotic pathways nor prevented follicle loss, DNA damage and apoptosis induced by these drugs. LIMITATIONS, REASONS FOR CAUTION: Our findings do not conclusively rule out the possibility that GnRHa may offer protection, if any, through some other mechanisms in vivo. WIDER IMPLICATIONS OF THE FINDINGS: GnRH agonist treatment with chemotherapy does not prevent or ameliorate ovarian damage and follicle loss in vitro. These data can be useful when consulting a young patient who may wish to receive GnRH treatment with chemotherapy to protect her ovaries from chemotherapy-induced damage.Item New horizons from novel therapies in malignant pleural mesothelioma(VIA MEDICA, 2020-01-01) Sayan, Mutlay; Mamidanna, Swati; Eren, Mehmet Fuat; Daliparty, Vasudev; Mustafayev, Teuta Zoto; Nelson, Carl; Ohri, Nisha; Jabbour, Salma K.; Mert, Aslihan Guven; Atalar, BanuMalignant pleural mesothelioma (MPM) is a relatively rare, but highly lethal cancer of the pleural mesothelial cells. Its pathogenesis is integrally linked to asbestos exposure. In spite of recent developments providing a more detailed understanding of the pathogenesis, the outcomes continue to be poor. To date, trimodality therapy involving surgery coupled with chemotherapy and/or radiotherapy remains the standard of therapy. The development of resistance of the tumor cells to radiation and several chemotherapeutic agents poses even greater challenges in the management of this cancer. Ionizing radiation damages cancer cell DNA and aids in therapeutic response, but it also activates cell survival signaling pathways that helps the tumor cells to overcome radiation-induced cytotoxicity. A careful evaluation of the biology involved in mesothelioma with an emphasis on the workings of pro-survival signaling pathways might offer some guidance for treatment options. This review focuses on the existing treatment options for MPM, novel treatment approaches based on recent studies combining the use of inhibitors which target different pro-survival pathways, and radiotherapy to optimize treatment.Item Clinical Outcome and Characteristics of Turkish Breast Cancer Patients who had SARS-Cov-2 Infection(KARE PUBL, 2022-01-01) Isiklar, Aysun; Zengin, Rehile; Balci, Veysel; Sesin Kocagoz, Ayse; Basaran, GulOBJECTIVE COVID-19 pandemic has placed an unprecedented burden on health-care system. Patients with cancer are reported to have a higher risk of infection and a more complicated COVID-19 course. Breast cancer (BC) is the most common cancer in women in Turkey. We report clinical outcomes and characteristics of patients with COVID-19 who were on treatment for BC at our center. METHODS We reviewed medical records of BC patients who had COVID-19 between July 2020 and 2021 at our center. We recorded pathological, clinical, treatment characteristics, and the clinical outcome of COVID-19 infection. RESULTS A total 82 BC patients had COVID-19 between July 2020 and 2021. All patients were female, with a median age of 49 (43-64 years). 85\% of all patients had early and 14.6\% of them had advanced stage BC. COVID-19 had a mild clinical course in 73\%, hospitalization was required in 27\% of patients. Twenty-five patients who required hospitalization were discharged and three patients died due to COVID-19. All of the patients who died from COVID-19 had metastatic BC (p=0.002). Metastatic disease (p=0.002) and chemotherapy within 7 days of COVID-19 diagnosis (p=0.024) have been associated with increased mortality. CONCLUSION Majority of BC patients with COVID-19 have a mild course, patients with risk factors that increase mortality should be followed more carefully.Item A New Era in Metastatic Prostate Cancer: ``The Combination of Chemotherapy and Hormonal Treatment as Initial Treatment''(GALENOS YAYINCILIK, 2016-01-01) Tinay, Ilker; Turkeri, LeventIn recent years, studies have been reported about the combination of androgen deprivation therapy (ADT) and different chemotherapy modalities as the initial therapy in newly-diagnosed patients with hormone-sensitive metastatic prostate cancer and recently, possible effects of docataxel chemotherapy in combination with ADT was evaluated in the 2 multi-institutional randomized trials from North America (CHAARTED) and Europe (GETUG-AFU-15). We reviewed the data for the current use of chemo-hormonal therapy as the initial treatment modality in castration-sensitive metastatic prostate cancer. New findings of CHAARTED trial showed that combination of ADT with docetaxel chemotherapy conferred a significant median over-all survival benefit over ADT alone and patients with high-volume disease derived a 17-month gain in median over-all survival. However in GETUG trial, while no over-all survival benefit was observed between two groups however combination therapy was associated with an improvement in biochemical and clinical progression-free survivals. The combination of docetaxel-based chemotherapy with ADT as the initial treatment seems as a promising treatment alternative in patients with hormone-sensitive metastatic prostate cancer, especially in patients with ``high-volume{''} disease.Item Acute Effects of Video Game-based Exercises in Patients Receiving Chemotherapy After Breast Cancer Surgery - A Pilot Study(KARE PUBL, 2022-01-01) Feyzioglu, Ozlem; Ozturk, Ozgul; Dincer, Selvi; Akan, ArzuOBJECTIVE Virtual reality programs, which have developed rapidly with the advancement of technology, have led to the development of alternative treatment methods preferred in rehabilitation. This study aimed to investigate the acute effects of a video game-based exercise program applied after breast cancer surgery on the upper extremity functionality, pain severity, and the level of fatigue. METHODS Fifteen female patients aged between 30 and 60 years (50.13 +/- 8.79) who completed their 12th week after breast cancer surgery and were received adjuvant chemotherapy treatment were randomly included in this pre-test and post-test study. The patients were performed a 30-min video game-based exercise program. The muscle strength, range of motion (ROM), pain and fatigue level assessments were performed before and after the video game-based exercises. The level of exercise pleasure was determined with the modified visual analog scale. RESULTS Shoulder flexion, abduction, and external rotation ROM significantly increased after video game-based exercise program. No difference was detected for shoulder abduction muscle strength (p>0.05) and pain level significantly increased (p<0.05). The average exercise pleasure level is 4.5/5 and the average fatigue level was 11.13/20. CONCLUSION Video game-based exercises provided improvement in ROM of the shoulder joint without causing fatigue. Studies with different treatment durations are needed to minimize the increase in pain level.