Araştırma Çıktıları

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    International Association for the Study of Lung Cancer Study of the Impact of Coronavirus Disease 2019 on International Lung Cancer Clinical Trials
    (ELSEVIER SCIENCE INC, 2022-01-01) Smeltzer, Matthew P.; Scagliotti V, Giorgio; Wakelee, Heather A.; Mitsudomi, Tetsuya; Roy, Upal Basu; Clark, Russell C.; Arndt, Renee; Pruett, Clayton D.; Kelly, Karen L.; Ujhazy, Peter; Johnson, Melissa L.; Eralp, Yesim; Barrios, Carlos H.; Barlesi, Fabrice; Hirsch, Fred R.; Bunn, Paul A.; Coronavi, Int Assoc Study Lung Canc; Comm, Clinical Trials Steering
    Introduction: To evaluate the effects of the global coronavirus disease 2019 (COVID-19) pandemic on lung cancer trials, we surveyed investigators and collected aggregate enrollment data for lung cancer trials across the world before and during the pandemic. Methods: A Data Collection Survey collected aggregate monthly enrollment numbers from 294 global lung cancer trials for 2019 to 2020. A 64-question Action Survey evaluated the impact of COVID-19 on clinical trials and identified mitigation strategies implemented. Results: Clinical trial enrollment declined from 2019 to 2020 by 14\% globally. Most reductions in enrollment occurred in April to June where we found significant decreases in individual site enrollment (p = 0.0309). Enrollment was not significantly different in October 2019 to December of 2019 versus 2020 (p = 0.25). The most frequent challenges identified by the Action Survey (N = 172) were fewer eligible patients (63\%), decrease in protocol compliance (56\%), and suspension of trials (54\%). Patient-specific challenges included access to trial site (49\%), ability to travel (54\%), and willingness to visit the site (59\%). The most frequent mitigation strategies included modified monitoring requirements (47\%), telehealth visits (45\%), modified required visits (25\%), mailorder medications (25\%), and laboratory (27\%) and radiology (21\%) tests at nonstudy facilities. Sites that felt the most effective mitigation strategies were telehealth visits (85\%), remote patient-reported symptom collection (85\%), off-site procedures (85\%), and remote consenting (89\%).Conclusions: The COVID-19 pandemic created many challenges for lung cancer clinical trials conduct and enrollment. Mitigation strategies were used and, although the pandemic worsened, trial enrollment improved. A more flexible approach may improve enrollment and access to clinical trials, even beyond the pandemic.(c) 2022 Published by Elsevier Inc. on behalf of International Association for the Study of Lung Cancer.
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    National Multi-Center Observational Retrospective Study to Understand Treatment Patterns and Outcomes for Stage III Non-Small Cell Lung Cancer Patients in Turkey: Turkish Society for Radiation Oncology Study, STONE Trial
    (AKAD DOKTORLAR YAYINEVI, 2022-01-01) Onal, Cem; Demiral, Ayse Nur; Atalar, Banu; Yalman, Deniz; Dagoglu, Nergiz; Hurmuz, Pervin; Erpolat, Petek; Akyurek, Serap; Gul, Sute Karabulut; Berber, Tanju; Guler, Ozan Cem; Umay, Cenk; Sert, Fatma; Karahacioglu, Eray; Birgi, Sumerya Duru; Yaprak, Gokhan; Saglam, Esra Kaytan
    This study investigated treatment patterns and outcomes in patients with inoperable stage III non-small cell lung cancer (NSCLC) treated with radiotherapy (RT) in Turkey. We included 492 patients with stage III NSCLC in this multi-center retrospective study. Pa-tient demographics, clinical characteristics, and clinical treatment patterns from the time of the initial diagnosis to disease progression were recorded. Additionally, the prognostic factors predicting overall survival (OS) and progression-free survival (PFS) were analyzed. For the initial treatment, 429 patients (89.2\%) received chemotherapy and RT, whereas 53 patients (10.8\%) were treated only with RT. The first disease progression occurred in 288 patients (58.4\%) at 9.3 months (median) after the initial treatment, and 64.6\% re-ceived treatment after first progression. The second disease progression occurred in 30 patients, and 20 patients (66.7\%) received treatment. Median OS and PFS were 27.0 months and 13.4 months, respectively. Age (p< 0.001), stage (p= 0.04), poor performance score (PS) (p= 0.03) and RT doses (p= 0.002) were independent predictors for OS and PFS in our multivariate analysis. Additional significant predictors for OS in the multivariate analysis were gender (p= 0.004), treatment period (0.02), and irradiation technique (p= 0.02). Disease progression occurred in nearly 58\% of the patients, and one-third of these patients remained untreated during the disease progression. These findings indicate a need for additional treatment options in patients with unresectable stage III NSCLC with high-risk features, namely older age, stage IIIB disease, poor PS, and lower RT doses.
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    Staging with PET-CT in Patients with Locally Advanced Non Small Cell Lung Cancer is Superior to Conventional Staging Methods in Terms of Survival
    (ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2013-01-01) Mutlu, Hasan; Buyukcelik, Abdullah; Erden, Abdulsamet; Aslan, Tuncay; Akca, Zeki; Kaya, Eser; Kibar, Mustafa; Seyrek, Ertugrul; Yavuz, Sinan; Calikusu, Zuleyha
    Background: Of patients with non small cell lung cancer (NSCLC), around one third are locally advanced at the time of diagnosis. Because only a proprotion of stage III patients can be cured by surgery, in order to improve the outcomes, sequential or concurrent chemoradiation, or concurrent chemoradiation with induction or consolidation is offered to the patients with locally advanced NSCLC. Today, PET combined with computerized tomography (PET-CT) is accepted as the most sensitive technique for detecting mediastinal lymph node and extracranial metastases from NSCLC. We aimed to compare PET-CT and conventional staging procedures for decisions regarding curative treatment of locally advanced NSCLC. Materials and Methods: A total of 168 consecutive patients were included from Acibadem Kayseri Hospital, Acibadem Adana Hospital and Kayseri Research and Training Hospital in this study. Results: While the median PFS was 13.0 +/- 1.9 months in the PET-CT group, it was only 6.0 +/- 0.9 in the others (p<0.001). The median OS values were 20.5 +/- 15.6 and 11.5 +/- 1.5 months, respectively (p<0.001). Discussion: As a result, we found that staging with PET CT has better results in terms of survival staging. This superiority leads to survival advantage in patients with locally advanced NSCLC.
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    Does Sunlight Exposure Improve Survival in Patients with Non-small Cell Lung Cancer?
    (ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2013-01-01) Mutlu, Hasan; Buyukcelik, Abdullah; Aksahin, Arzu; Kibar, Mustafa; Cihan, Yasemin Benderli; Kaya, Eser; Seyrek, Ertugrul; Yavuz, Sinan; Erden, Abdulsamet; Calikusu, Zuleyha; Aslan, Tuncay; Akca, Zeki
    Background: Some epidemiological studies reported that sunlight exposure and highvitamin D levels may decrease the morbidity and mortality related to cancer. We aimed to evaluate whether sunlight exposure has an impact on survival in patients with non small cell lung cancer. Materials and Methods: A total of 546 patients with NSCLC from two different regions (Kayseri and Adana) differing according to sunlight exposure were analysed retrospectively. Results: The median overall survival (OS) rates were 11. 6 (CI: 9.50-13.6) and 15.6 months (CI: 12.4-18.8) for Kayseri and Adana, respectively, in all patients (p=0.880). Conclusions: There were no differences between groups in terms of OS. While there is strong evidence regarding inverse relationship between cancer incidence and sunlight exposure, it is still controversial whether sunlight exposure is a good prognostic factor for survival in patients with lung cancer.
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    Detection of reactive oxygen metabolites in malignant and adjacent normal tissues of patients with lung cancer
    (BMC, 2013-01-01) Okur, Hacer Kuzu; Yuksel, Meral; Lacin, Tunc; Baysungur, Volkan; Okur, Erdal
    Background: Different types of reactive oxygen metabolites (ROMs) are known to be involved in carcinogenesis. Several studies have emphasized the formation of ROMs in ischemic tissues and in cases of inflammation. The increased amounts of ROMs in tumor tissues can either be because of their causative effects or because they are produced by the tumor itself. Our study aimed to investigate and compare the levels of ROMs in tumor tissue and adjacent lung parenchyma obtained from patients with lung cancer. Methods: Fifteen patients (all male, mean age 63.6 +/- 9 years) with non-small cell lung cancer were enrolled in the study. All patients were smokers. Of the patients with lung cancer, twelve had epidermoid carcinoma and three had adenocarcinoma. During anatomical resection of the lung, tumor tissue and macroscopically adjacent healthy lung parenchyma (control) that was 5 cm away from the tumor were obtained. The tissues were freshly frozen and stored at -20 degrees C. The generation of ROMs was monitored using luminol- and lucigenin-enhanced chemiluminescence (CL) techniques. Results: Both luminol (specific for. OH, H2O2, and HOCl-) and lucigenin (selective for O-2(center dot)) CL measurements were significantly higher in tumor tissues than in control tissues (P < 0.001). Luminol and lucigenin CL measurements were 1.93 +/- 0.71 and 2.5 +/- 0.84 times brighter, respectively, in tumor tissues than in the adjacent parenchyma (P = 0.07). Conclusion: In patients with lung cancer, all ROM levels were increased in tumor tissues when compared with the adjacent lung tissue. Because the increase in lucigenin concentration, which is due to tissue ischemia, is higher than the increase in luminol, which is directly related to the presence and severity of inflammation, ischemia may be more important than inflammation for tumor development in patients with lung cancer.