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Öğe Breast Self-Examination and Breast Cancer Awareness in Medical Students: A Survey Study in a Medical School(Selçuk Üniversitesi, 2023 Şubat) Düzova, Mürsel; Yiğit, Nisa İlayda; Esen, Fatma Zehra; Akman, Nefise Betül; Türkyılmaz, Fatma Nur; Atcı, Ahmet Alper; Sipahi, PerihannurObjective: This study aimed to determine the knowledge, attitudes and behaviors of students in a medical school regarding breast self-exam and also to explore their level of knowledge regarding breast cancer. Methods: The research was carried out in Selcuk University Faculty of Medicine in April 2022, among medical students. The universe of the study consisted of all medical school students and it was conducted with 221 volunteers who accepted the study. Participants were asked questions about breast cancer and breast self-exam. Results: Two-hundred twenty one students participated in the study. The mean age was 20,71±2,108 (range 18-32). Of the 221 participants, 67% (n: 148) were female and 33% (n: 73) were male, and 76.5% (n: 169) were preclinical (1st-2nd-3rd year) students, and 23.5% (n = 52) were clinical (4th5th-6th year) students. 69.2% of the participants reported that they had knowledge about breast cancer. 66.8% (n:147) of the students stated that they did not perform BSE, and when they were asked why they did not perform it, 68.8% (n:93) of them explaiened that did not have enough information. Conclusion: As a result of the survey in which the knowledge, attitude and behavior of medical school students about breast cancer and BSE were evaluated, it was concluded that there is a lack of knowledge about breast cancer. Regarding BSE, it was also determined that the students were not sufficient for both self-application and knowledge. Especially for developing countries, it is a cost-effective and effective screening method that can be useful in the early diagnosis of breast cancer when performed correctly.Öğe Long-Term Survival Outcomes of Early-Stage Grade 1 and 2 Endometrioid Type Endometrial Cancer Patients(Selçuk Üniversitesi, 2023 Nisan) Avcı, Fazıl; Eren, Önder; Bilgi, Ahmet; Başaran, Hamit; Çelik, Murat; Çağlayan, Melek; Çelik, ÇetinAim: Early-stage endometrioid-type endometrial cancer (EC) has a favorable prognosis. The recurrence is still the biggest issue. There are differences in the literature in terms of treatment modalities in the early-stage. The aim of the study is to retrospectively investigate the long-term survival outcomes of early-stage grade 1 and 2 endometrioid-type endometrial cancer patients. Methods: Out of 327 cases, 294 cases in stage 1 and 33 cases in stage 2 were evaluated. Age, stage, tumor size, histologic grade, degree of myometrial invasion, presence of lymphovascular invasion (LVSI), peritoneal cytology positive, presence of recurrence, overall survival (OS), and disease-free survival (DFS) between two groups were evaluated statistically. Results: The mean age of 327 patients was 64.0±10.0 years. Out of 327, 65.7% were ?60 years, and 90% were stage 1, 74.6% were grade 1, 1.8% had positive peritoneal cytology, 8.3% had LVSI and 86% had ?50% myometrial invasion. Recurrence was detected in 6.4% of patients. 40.7% of patients received adjuvant radiotherapy. Only the adjuvant radiotherapy found a significant association between two groups. Only presence of recurrence in terms of OS and DFS durations was a significant parameter in the regression analysis. Conclusion: Development of recurrence in the early-stage endometrioid-type EC is the main prognostic predictor for survival. The early diagnosis and treatment of recurrence have a positive impact on the prognosis.Öğe Rektal Adenokarsinomlarda Aldehid Dehidrogenaz 1 (ALDH1) ve Gamma Synuclein Ekspresyonunun Prognostik Değeri(Selçuk Üniversitesi, 2020 Aralık) Harmankaya, İsmail; Karabağlı, Pınar; Yavaş, Güler; Çelik, Zeliha Esin; Ata, ÖzlemAmaç: Kolorektal kanserler arasında her evrede sağkalımın en olumsuz olduğu tümörler rektum kanserleridir. Bununla birlikte cerrahi tekniğin optimizasyonu ve neo-adjuvan tedavi yaklaşımı, son yıllarda rektum kanserlerinde 5 yıllık sağ kalım sürelerinin kolon kanserinden daha iyi olmasına neden olmuştur. Erken evre rektum tümörlü hastaların tedavisinde küratif tedavinin köşe taşı cerrahidir. Ancak transmural invazyon ve/veya pozitif perirektal lenf nodu olan hastalarda, hastalığın lokal kontrolü ve kürü açısından olumlu sonuçlar elde edebilmek için cerrahi tedaviye radyoterapi ve kemoterapinin eklenmesi gerekir. Kanser kök hücre belirteci olan ALDH1 ekspresyonunun kemoterapiye rezistansta, tümör progresyonunda ve metastazında anlamlı olduğu yapılan çalışmalarda gösterilmiştir. Ayrıca metastatik ve ileri evre meme over, karaciğer, prostat ve kolon kanserlerinde normal dokudan farklı olarak anormal gamma synuclein ekspresyonu varlığı da gösterilmiştir. Gamma synuclein ekspresyonu meme kanser hücrelerinin proliferasyonu, invazyonu ve metastazıyla ilişkili bulunmuştur. Gereç ve Yöntem: Çalışmamızda rektum rezeksiyon materyallerinden rektal adenokarsinom tanısı alan 55 olguya ait tümöral ve normal mukoza örnekleri incelendi. Prognostik parametreler ile ALDH 1 ve Gamma synuclein antikorlarının ekspresyonları arasındaki ilişki araştırıldı. Bu şekilde çalışmamızda rektum kanserinde gamma- synuclein ve ALDH1 ekspresyonu ile tümör agresivitesi ve prognozu üzerine etkilerini belirlemeyi amaçladık. Bulgular: İmmunohistokimyasal olarak Gamma synucleinin rektum kanseri ve normal mukozasında boyanmadığı görüldü. ALDH 1 ile farklı boyanma paternleri saptanarak bulgular literatür eşliğinde yorumlandı. Sonuç: Çalışmamızda rektum kanseri ve normal mukozal dokuda derece, evre, lenf nodu metastazı, Lenfovasküler invazyon ve Perinöral invazyon ile ALDH1 ekspresyonu arasında istatiksel olarak anlamlı olmayan, boyanma kuvveti açısından ters orantılı bir ilişki saptandı. Gamma synucleinin ise rektum kanserlerinde eksprese olmadığı görülmüştür.Öğe Endometrium Kanserli Hastalarda Preoperatif Tam Kan Sayımının Prognostik Parametreler ve Sağkalımla İlişkisi(Selçuk Üniversitesi, 2018 Mart) Çelik, Zeliha Esin; Yavaş, Güler; Yılmaz, Burcu Sanal; İlhan, Tolgay Tuyan; Yavaş, Çağdaş; Ata, Özlem; Çelik, ÇetinAmaç: Çalışmamızda endometriyum adenokarsinomu tanılı hastalarda preoperatif tam kan sayımı parametrelerinin çeşitli klinikopatolojik prognostik parametrelerle ve sağkalım ile ilişkisi olup olmadığını değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2011-Aralık 2014 tarihleri arasında fakültemizde opere edilen ve endometrial adenokarsinom tanısı alan 144 hasta çalışmaya dahil edilmiştir. Hemogram parametrelerinden absolü beyaz küre sayısı (BK), absolü platelet sayısı (Plt) hematokrit (Hct), hemoglobin (Hb) değerleri yanı sıra absolü nötrofil sayısının absolü lenfosit sayısına bölümü olan NLR, absolü platelet sayısının absolü lenfosit sayısına bölümü olan PLR ve absolü monosit sayısının absolü lenfosit sayısına bölümü olan MLR oranlarının; tümör çapı, tümör derecesi, FIGO evresi, serviks invazyonu, pozitif lenf nodu sayısı, lenf nodunda ekstrakapsüler yayılım, lenfovasküler invazyon (LVİ), myometrial invazyon derinliği gibi prognostik parametreler ve hastalıksız ve genel sağkalım süreleri ile olan ilişkisi istatistiksel metodlarla araştırılmıştır. Bulgular: Derece 3 tümöre sahip hastalarda BK sayısının derece 1 tümörlü hastalara göre anlamlı derecede düşük olduğu görüldü (p=0.04). LVİ olan olgularda PLR (p=0.018) ve MLR (p=0.028) LVİ olmayan hastalara göre daha düşük idi. Düşük evre olgularda (evre I-II) PLR, yüksek evreli olgulara göre (evre II-III) daha düşük tespit edildi (p=0.03). Tedavi öncesi bakılan tam kan parametreleri ile tümör çapı, serviks invazyonu, pozitif lenf nodu sayısı, lenf nodunda ekstrakapsüler yayılım, myometrial invazyon derinliği, hastalıksız sağkalım ve genel sağkalım arasında anlamlı bir ilişki saptanmadı (p>0.05). Sonuç: Endometriyum kanserinde tedavi öncesi tam kan sayımı parametrelerinin bir arada kullanılması, hastalığın prognozu ile ilgili fikir verebilir. Çalışmamızın sonuçlarının daha uzun takip süresine ve daha geniş olgu sayısına sahip çalışmalarla desteklenmesi gereklidir.Öğe Çocuklarda primer böbrek tümörlerinin klinik özellikleri, tedavi yaklaşımları ve tedavi sonuçları(Selçuk Üniversitesi, 2021) Kara, Buket; Sarıkaya, Mehmet; Ertan, Kübra; Uğraş, Nevzat Serdar; Çiftci, İlhan; Yavaş, Güler; Köksal, YavuzAmaç: Bu çalışmanın amacı, çocuklarda primer malign böbrek tümörlerinin klinik özellikleri, tedavi yaklaşımları ve tedavi sonuçlarının değerlendirilmesidir. Gereç ve Yöntem: 2006 ile 2020 yılları arasında primer malign böbrek tümör tanısı alan ve izlenen çocuk hastaların onkoloji dosyaları geriye yönelik incelendi. Hastaların demografik ve klinik özellikleri ile tedavi yaklaşımları ve izlemleri not edildi. Bulgular: Bu yıllar arasında izlenen 950 malign hastalıklı çocuğun 49’unda(%5,2) primer malign böbrek tümörü vardı. Hastaların yaşı üç gün ile 13 yıl arasında değişiyordu (ortanca, 3 yıl). Erkek kız oranı 25/24’dü. En sık görülen semptom ve bulgu karında kitle idi. İki hastada bilateral hastalık vardı (%4,1). Patolojik tanılar, Wilms tümörü (n = 44, % 89,8), mezoblastik nefroma (n=2, % 4,1), böbreğin clear hücreli sarkomu (n=2, % 4,1) ve böbreğin primer sinovyal sarkomuydu (n=1, %2). Wilms tümörlü hastalardan sadece ikinde diffüz anaplazi vardı. Hastalarımızın risk grupları düşük (n = 4, % 8.3), orta (n = 35, % 72.9) ve yüksek riskli (n = 9, % 18.8) idi. Hastaların takip süreleri iki ay ile 15 yıl (ortanca, 5 yıl) arasında değişiyordu. Primer böbrek tümörlerinde genel ve olaysız sağ kalım oranları sırasıyla % 72,7 ve% 59,7 idi. Wilms tümörlü hastaların genel ve olaysız sağ kalım oranları %79 ve %63’dü. Sonuç: Primer malign böbrek tümörlerinde özellikle de Wilms tümöründe multidisipliner yaklaşımlarla başarı oranları yükselmiştir. Bundan sonra hem tedavi başarısının daha da artırılması hem de tedavi ilişkili yan etkilerin azaltılması üzerinde durulmalıdır.Öğe Beta-Hydroxy-Beta-Methyl-Butyrate, L-glutamine, and L-arginine supplementation improves Radiation-Induce acute intestinal toxicity(Taylor and Francis Ltd, 2019) Yavaş, Çağdaş; Yavaş, Güler; Çelik, Esin; Büyükyörük, Ahmet; Büyükyörük, Cennet; Yüce, Deniz; Ata, ÖzlemWe aimed to evaluate effects of ?-hydroxy-?-methylbutyrate, L-glutamine, and L-arginine (HMB/GLN/ARG) on radiation-induced acute intestinal toxicity. Forty rats were divided into four groups: group (G) 1 was defined as control group, and G2 was radiation therapy (RT) control group. G3 and G4 were HMB/GLN/ARG control and RT plus HMB/GLN/ARG groups, respectively. HMB/GLN/ARG started from day of RT and continued until the animals were sacrificed 10 days after RT. The extent of surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis, crypt distortion, regenerative atypia, vascular dilatation and congestion, and fibrosis were quantified on histological sections of intestinal mucosa. Statistical analyses were performed using the analysis of variance (ANOVA) test. There were significant differences between study groups regarding extent of surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis and crypt distortion, regenerative atypia, vascular dilatation and congestion, and fibrosis (p values were 0.019 for fibrosis, <.001 for the others). Pair-wise comparisons revealed significant differences regarding surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis, vascular dilatation, and congestion between G2 and G4 (p values were <.001,.033, <.001,.007, and <.001, respectively). Fibrosis score was significantly different only between G1 and G2 (p =.015). Immunohistochemical TGF-? score of G2 was significantly higher than G1 and G3 (p values were.006 and.017, respectively). There was no difference between TGF-? staining scores of G2 and G4. Concomitant use of HMB/GLN/ARG appears to ameliorate radiation-induced acute intestinal toxicity; however, this finding should be clarified with further studies. © 2018, © 2018 Taylor & Francis Group, LLC.Öğe Thoracic radiotherapy for extensive-stage small-cell lung cancer: What is the optimal dose and timing(SPRINGER HEIDELBERG, 2019) Yavas, Guler.; Yavas, Cagdas.Small-cell lung cancer (SCLC) is a neuroendocrine tumor that represents about 12-20% of all lung cancers. Most of the SCLC patients present with extensive-stage (ES) disease. Primary therapy for ES-SCLC is 4-6 cycles of platinum-based chemotherapy (CT) followed by prophylactic cranial irradiation (PCI) in selected cases. Although the response rate to CT is approximately 60-70%, median survival times are very limited. The main problem of ES-SCLC patients after CT is intra-thoracic tumor recurrence since 75% of the patients had persisting intra-thoracic disease after CT, and approximately 90% of the patients had intra-thoracic progressive disease within the first year after diagnosis. Such high rate of intra-thoracic disease progression explains the need of local treatment in selected patients. There are three randomized studies and two meta-analyses evaluating the role of thoracic radiotherapy (TRT) in patients with ES-SCLC who responded to CT. Two of the randomized trials and one of the meta-analyses showed survival benefit of TRT. According to the results of relevant studies, the patients who responded to CT and have intra-thoracic residual disease after CT, who had limited metastatic sites (<= 2), and who have good performance status and limited weight loss have more benefit from TRT. We need novel studies evaluating the optimal dose fractionation schedules, optimal timing of RT, impact of time interval between RT and CT, immunotherapy and RT combinations, and number of CT cycles.Öğe The impact of imiquimod on radiation-induced lung injury: Results of an experimental study(BAYRAKOL MEDICAL PUBLISHER, 2019) Calik, Mustafa.; Yavaş, Güler.; Çelik, Zeliha Esin.; Yavaş, Çağdaş.; Calik, Saniye Goknil.; Sargon, Mustafa Fevzi.; Esme, Hidir.Aim: Radiation-induced lung injury (RILI) is a major dose-limiting factor during thoracic irradiation. Imiquimod (Imq) is a heterocyclic amine that has been shown to be effective in diseases related to inflammation and fibrosis. In this study, we aimed to evaluate the impact of Imiquimod on RILI. Material and Method: The study included 60 adult female Wistar-Albino rats (250-300 g). Rats were divided into 6 groups: Group (G) 1: control, G2: radiotherapy (RT) only, G3 and G4: 5 and 10 mg/kg Imq; G5 and G6 RT: plus 5 and 10 mg/kg Imq groups respectively. A single dose of 15 Gray (Gy) RT was given to the lungs. Imq was applied intraperitoneal. Results: The inflammation, fibrosis, and transforming growth factor (TGF)-beta scores of the study groups were significantly different at 6th and 16th week of RT (p < 0.001 for all). At the 6th week of RT, inflammation, fibrosis, and TGF-beta scores did not differ in both RT and non-RT groups. By the 16th week of RT inflammation, fibrosis, and TGF-beta scores were significantly different between G2 and G5, and G2 and G6. Electron microscopy findings supported the results of the light microscopy. Discussion: Although Imq did not improve pneumonitis phase, Imq attenuated radiation-induced lung fibrosis. These findings should be clarified with further preclinical and clinical studies.Öğe The impact of spironolactone on the lung injury induced by concomitant trastuzumab and thoracic radiotherapy(IJRR-IRANIAN JOURNAL RADIATION RES, 2019) Yavaş, Güler; Yavaş, Çağdaş; Çelik, Esin; Şen, E.; Ata, O.; Afşar, Rengin ElsürerBackground: To evaluate impact of spironolactone (S) on pulmonary toxicity of concomitant use of thoracic radiotherapy (RT) and trastuzumab (T). Materials and Methods: Eighty rats were divided into eight groups: group (G) 1 was control group; G2, G3 and G4 were RT, S and T groups; G5, G6, G7 and G8 were RT+T, T+S, RT+S and RT+T+S groups respectively. Rats were sacrificed at 6 hour, 21 and 100 day after RT and lung samples were retrieved. Results: By 100th days of RT inflammation score, lung fibrosis score and TGF- expression were significantly different within study groups (p values were 0.002, 0.001 and 0.043 respectively). Inflammation score of G8 was significantly lower than inflammation scores of G2 and G5 (p values: G2-G8=0.004, and G5-G8=0.022). Inflammation score of G2 was significantly higher than G7 (p=0.028). There were significant differences regarding to fibrosis scores between G2-G8 (p=0.015), G2-G7 (p=0.017) and G5-G8 (p=0.011). TGF-beta expression was higher in both G2 and G5 when compared to G8 (p = 0.038). Conclusion: Our results suggested that S is an effective treatment option for improving radiation-induced pulmonary fibrosis. These findings should be clarified with further preclinical and clinical studies.Öğe Targeted therapy combined with thoracic radiotherapy for non-small cell lung cancer(SPRINGER HEIDELBERG, 2019) Yavas, Guler.; Yavas, Cagdas.IntroductionIn recent years, there has been undoubted progress in the evaluation and development of targeted agents for non-small cell lung cancer (NSCLC). At the same time, remarkable progress in radiation therapy (RT) has been developed largely due to our ability to more effectively focus and deliver radiation to the tumor target volume. Both developments brought the idea of combining the radiation with molecularly targeted agents in order to improve outcomes in NSCLC patients who have limited survival times with standard chemoradiotherapy.MethodsWe identified patients with gastric cancer treated with post-operative radiation at our institution between 2002 and 2016. Acute and late toxicities were evaluated per RTOG/EORTC Radiation Toxicity Grading Scale. Statistical analysis was performed using Chi-square tests, t tests, log-rank, and logistic regression.ResultsCetuximab has no survival benefit, and it seems to be toxic in this patient population. Bevacizumab has severe toxicity including tracheoesophageal fistulae formation in addition to its ineffectiveness. It is difficult to have an opinion about TKIs when combined with RT since most of the studies were conducted on unselected patients. For oligometastatic/oligoprogressive NSCLC patients, it seems to be reasonable to use a combined regimen since combined regimen resulted in superior survival time; however, the patients should be followed up closely with respect to the toxicity. In patients with brain metastases, the use of concomitant RT + TKIs increased survival with acceptable toxicity levels.ConclusionsIn this review, we summarize the recent literature about the use of molecularly targeted agents with concurrent RT in NSCLC patients.Öğe Dose rate definition in brachytherapy(KARE PUBL, 2019) Yavaş, Güler.Brachytherapy (BRT) is defined as treatment from a short distance. The word is derived from the word "brachy" that means "short" in Greek. Treatment in BRT is performed by placing the radioactive source in or near the tumor tissue. According to the report 38 of the International Commission on Radiation Units and Measurements (ICRU 38), BRI is divided into three types according to the activity of the radioactive source. Low-dose rate (LDR) implants deliver dose at the rate of 0.4-2 Gy/h, requiring treatment times of 24-144 11. LDR BRT has extensive experience with well-known efficacy and side effects. Medium-dose rate (MDR) BRT, defined as the 2-12 Gy/h range, is rarely used. High-dose rate (HDR) BRT uses dose rates in excess of 0.2 Gy/min (12 Gy/h). Although not defined in ICRU 38, there is also a very-low dose (ultra LDR: ultra-low dose rate (ULDR)) BRT of 0.01-0.3 Gy/h. Pulse dose rate (PDR) BRT is a new BRT concept that is also not defined in ICRU 38. PDR BRT combines physical advantages of LDR BRT technology with the radiobiological advantages of LDR BRT. Each dose rate in the clinic has its advantages and disadvantages. It is difficult to compare the efficacy of dose rates in the clinic because of the lack of prospective randomized studies comparing the defined dose rates with each other. In this review, we aimed to explain the advantages, disadvantages, and common clinical sites of use of different dose rates.Öğe Aggressive treatment for urothelial cancer-complete urinary tract extirpation: operative feasibility in two cases(AVES, 2019) Akand, Murat.; Kılıç, Özcan.; Harmankaya, İsmail.; Karabağlı, Pınar.; Yavaş, Çağdaş.; Ata, Özlem.Bladder cancer (BC), the most common malignancy of the urinary tract, accounts for 90-95% of all urothelial carcinomas (UCs), while upper urinary tract UC (UUTUC) accounts for only 5-10%. Radical nephroureterectomy with excision of bladder cuff, and radical cystectomy with pelvic lymph node dissection and a urinary diversion (UD) are the gold standard treatments for UUTUC and muscle-invasive bladder cancer (MIBC), respectively. These two treatments can be performed simultaneously when a bilateral or unilateral UUTUC is present with a MIBC, and are called complete urinary tract extirpation (CUTE) and hemi-CUTE, respectively. This complex surgery can help the patient by avoiding multi-staged surgeries, repeated anesthesia, and delay in completion of treatment. Herein, we report the first cases of a hemi-CUTE and CUTE in our department and share our experience with this aggressive and complex surgical treatment.Öğe Gastrointestinal stromal tümörlerde tümör yanıtı değerlendirilmesinde boyut ve sayı herşey demek değildir(2018) Şen, Erdem; Öner, İrem; Yılmaz, Farise; Ata, ÖzlemGastrointestinal stromal tümörler gastrointestinal sistemin en yaygın görülen mezenkimal tümörleridir. Kontrastlı bilgisayarlı tomografi, tedaviye yanıtı değerlendirmede en yaygın kullanılan yöntemdir. Hedefli tedaviler tümör yapısında bazı değişikliklere neden olabilir. Lezyon vaskülaritesinde azalma, kavitasyon ve intratümöral kanama, imatinib tedavisi sonrası hastalarda herhangi bir boyut azalması olmadan bile görülebilen bazı değişikliklerdir. Çelişkili olarak, kistik değişiklik ve intratümöral kanama nedeniyle bazı durumlarda geçici bir boyut artışı görülebilir. Gastrointestinal stromal tümörlerde Choi ve arkadaşları tarafından alternatif tümör yanıt kriterleri geliştirilmiştir. Choi ve arkadaşları Yanıtın değerlendirilmesinde sadece tümör boyutunun değil tümör yoğunluğunun da önemli olduğunu gösterdiler. Bu çalışmada biz gastrointestinal stromal tümör tanısı alan, imatinib ile tedavi edilen 67 yaşında erkek hastayı sunduk. 3 aylık imatinib tedavisinden sonra, yanıt değerlendirilmesinde karaciğer lezyonları progresyon olarak rapor edilmişti.Öğe Efficacy of Feiba for Acute Bleeding and Surgical Haemostasis in Haemophilia a Patients with Inhibitors: a Multicentre Registry in Turkey(2012) Zülfikar, B.; Aydoğan, G.; Şalcıoğlu, Z.; Öner, A. F.; Kavaklı, K.; Gürsel, T.; Zülfikar, H.Long used in established industrialized nations to treat patients with haemophilia and inhibitors, factor eight inhibitor bypassing activity (FEIBA) has, in recent years, been introduced into more geographically diverse settings. Data are needed on how successfully FEIBA therapy has been implemented in new regions. To determine the efficacy and safety of FEIBA for the treatment of acute bleeding and surgical haemostasis in a newly industrialized country. A multicentre registry of haemophilia A patients with inhibitors receiving FEIBA treatment was established in Turkey. With a standardized case report form, data were collected retrospectively on: patient demographics; characteristics of acute bleeding episodes and surgical interventions; FEIBA regimen; and treatment outcomes. Thirty-seven patients received a total of 112 FEIBA treatment courses, 90 for acute bleeding and 22 for surgical haemostasis. The median FEIBA dose per infusion for acute bleeding was 50IUkg -1, and for surgery was 100IUkg -1. For both acute joint and muscle/soft tissue bleeding and in surgery, haemostasis was attained in a median of two FEIBA infusions. FEIBA was judged effective in 92% of treatment courses for acute bleeding, with a 95% confidence interval (CI) of 85-97%. Rates of haemostatic efficacy did not differ significantly between anatomical sites of acute bleeding. The haemostatic efficacy rate of FEIBA in surgery was 86% (CI, 65-97%). No thromboembolic complications or other adverse events occurred during any treatment course. FEIBA has been successfully integrated into clinical practice in Turkey, with rates of haemostatic efficacy comparable to those reported in countries with a longer history of FEIBA usage.Öğe Lapatinib Plus Capecitabine for Brain Metastases in Patients With Human Epidermal Growth Factor Receptor 2-Positive Advanced Breast Cancer: A Review of the Anatolian Society of Medical Oncology (ASMO) Experience(Karger, 2012) Çetin, Bülent; Benekli, Mustafa; Öksüzoğlu, Berna; Koral, Lokman; Ulaş, Arife; Dane, Faysal; Türker, İbrahim; Kaplan, Mehmet A.; Koca, Doğan; Boruban, Cem; Yılmaz, Burçak; Sevinç, Alper; Berk, Veli; Işıkdoğan, Abdurrahman; Uncu, Doğan; Harputluoğlu, Hakan; Coşkun, Uğur; Büyükberber, SüleymanBackground: We investigated the clinical outcome of patients with brain metastases (BMs) from human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (MBC) treated with lapatinib and capecitabine (LC). Patients and Methods: A total of 203 patients with HER2+ MBC, who had progressed after trastuzumab-containing chemotherapy, were retrospectively evaluated in 11 centers between September 2009 and May 2011. 85 patients who had developed BMs before the initiation of treatment with LC were included. All patients had received prior cranial radiotherapy. All patients were treated with the combination of lapatinib (1,250 mg/day continuously) and capecitabine (2,000 mg/m(2) on days 1-14 of a 21-day cycle). Results: The median follow-up was 10.5 months (range 1-38 months). An overall response rate of 27.1% was achieved, including complete response in 2 (2.4%) and partial response in 21 (24.7%) patients. Median progression-free survival was 7 months (95% confidence interval (CI) 5-9), with a median overall survival of 13 months (95% Cl 9-17). The most common side effects were hand-foot syndrome (58.8%), nausea (55.3%), fatigue (48.9%), anorexia (45.9%), rash (36.5%), and diarrhea (35.4%). Grade 3-4 toxicities were hand-foot syndrome (9.4%), diarrhea (8.3%), fatigue (5.9%), and rash (4.7%). There were no symptomatic cardiac events. Conclusion: LC combination therapy was effective and well-tolerated in patients with HER2+ MBC with BMs, who had progressive disease after trastuzumab-containing therapy.Öğe Baş-boyun tümörlerinde reirradyasyondaki güncel gelişmeler(2012) Yavaş, Güler; Yavaş, ÇağdaşBaş-boyun kanserlerinin tedavisindeki ilerlemelere rağmen %15-50 hastada nüks hastalık gelişmektedir. Tedavi sonrasında takipler- de bu hastalarda ikinci primer hastalık geliştirme riski de yüksektir. Bu risk hayat boyu %14-20'dir. Daha önce radyoterapi uygulan- mış bölgede lokal nüksü gelişen ya da radyoterapi alanı içerisinde ikinci primer tümörü gelişen hastalarda tedavi seçenekleri kısıtlıdır. Sınırlı hacimde tümörü olan hastalarda tercih edilen tedavi şekli kurtarma cerrahisidir. Ancak kurtarma cerrahisi için uygun olmayan ya da cerrahi sonu kötü prognostik faktörleri bulunan hastalarda reirradyasyon alternatif bir tedavi seçeneğidirÖğe A Case of Superior Vena Cava Syndrome Caused by Colon Cancer Treated With Bevacizumab Combination Chemotherapy(2009) Yavaş, O.; Eren, O.; Artaç, M.; Börüban, C.; Genç, M.Metastasis of colon cancer to the mediastinal lymph nodes is extremely rare. Herein we report a case of superior vena cava syndrome caused by mediastinal lymph node metastasis of colon cancer and treated by radiotherapy and bevacizumab with chemotherapy.Öğe Kolorektal Kanserli Hastalarda Sitokrom P450 (CYP2C9 ve CYP2C19) Genetik Polimorfizm Sıklığı(2009) Büyükdoğan, Murat; Boruban, M. Cem; Artaç, Mehmet; Demirel, SennurÖzellikle gelişmiş ülkelerin önemli sağlık sorunlarından biri olan kolorektal kanserler, genetik ve çevresel faktörlerin katkılarıyla gelişen multifaktöriyel bir hastalıktır. Bu vaka kontrol çalışmasında kolorektal karsinoma ile CYP2C2 alt gurubunun bir üyesi olan endojen ve eksojen maddelerin karsinojenlerin ve ilaçların metabolizmasında önemli rol alan CYP2C9 ve CYP2C19 gen polimorfizmini ve aynı zamanda sigara, alkol, ailede kanser hikayesi, asbestoz maruziyeti gibi risk faktörlerini araştırdık. Çalışmaya ailesinde kanser hikayesi olmayan 85 sağlıklı gönüllü ile Meram Tıp Fakültesi Tıbbi Onkoloji ve Genel Cerrahi kliniklerine başvuran klinik ve histopatolojik olarak çoğunluğu adenokarsinom olan kolorektal kanserli 85 hasta alındı. CYP2C9 ve CYP2C19 genlerinin heterozigot ve mutant genotiplerini belirlemek için CYP2C9*2, CYP2C9*3 ve CYP2C19*2, CYP2C19*3 mutasyon saptama kitleri Light Cycler Real Time Polymerase Chain Reaction ile kullanıldı. Sonuçlar vaka ve kontrol guruplarında istatistiksel olarak karşılaştırıldı ve hesaplanan odds oranları kullanıldı. Kolorektal karsinomdaki risk faktörleri ve CYP2C9*2, CYP2C9*3 ve CYP2C19*2, CYP2C19*3 genlerinin polimorfik genotip sıklıklarının araştırıldığı bu vaka kontrol çalışmasında; kolorektal kanserli hastalar ve kontrol gurubu arasında anlamlı fark saptanamadı. (p > 0.05). Kolorektal kanserli hastalarda beyaz toprağa maruz kalanların oranı anlamlı oranda (p < 0.05) yüksek bulundu ve beyaz toprağın kolorektal kanser için bir risk faktörü olabileceği düşünüldü.Öğe Radyoterapi sonrası beyin hasarı ve tedavi yaklaşımları(2006) Genç, Mine; Ergun, Ufuk; Selek, UğurRadyasyona bağlı nörotoksisite nadir ama ciddi bir komplikasyondur. Esas hedef hücreler endotel ve glial hücreler olmakla birlikte günümüzde radyasyona bağlı nörotoksisitenin santral sinir sistemi içindeki parankimal ve vasküler endotelyal hücreler arasındaki kompleks dinamik etkileşimlerden kaynaklandığı düşünülmektedir. Görüntüleme tekniklerindeki gelişmelere rağmen radyasyon nekrozunun tanısı hala zor olup, kesin tanı histopatolojik incelemeyi gerektirir. Hastaların bir kısmı radyasyon nekrozunun cerrahi rezeksiyonundan yararlanır. Kortikosteroidler hem profilaksi hem de tedavide kullanılır. Radyasyona bağlı nörotoksisitenin önlenmesi ve tedavisinde etkili olabilecek büyüme faktörleri, kök hücreler gibi birçok ajan üzerinde araştırmalar devam etmektedir.Öğe Analysis of cancer cases in Konya(2005) Genç M.; Avunduk M.C.This study has been carried out to estimate the number of cancer patients and the distribution of cancer types in Konya for planning of the prevention activities and radiotherapy equipment more cost effectively. The cancer cases were analysed by reviewing the records of all pathology centres in the province of Konya to estimate the incidence and histological distribution of tumors and 1523 cancer cases were found to be diagnosed in a period of one year. Overall cancer incidence was higher in males than in females (Age Standardised incidence rates of 121.1 and 94.7 per 100.000, respectively). Non-melanoma skin cancer was the most common cancer for both gender. While bladder, lung, colorectal and stomach cancers were the most frequent cancers in men; breast, colorectal, stomach cancers were the leading tumors in women. These estimates in the present study reflect the current burden of cancer in the period of instructing a new radiotherapy department in Konya.
