The efficiency of the acupressure in prevention of the chemotherapy-induced nausea and vomiting

Genç, Aslı (Arel Author)This experimental study was planned to assess the efficiency of the acupressure in prevention of the chemotherapy-induced nausea and vomiting (CINV). This single-blinded randomized trial was performed at Istanbul University Institute of Oncology between October 2010 and January 2011. The patients, diagnosed with breast, gynecological, or lung cancer treated by doxorubicin-based- or cisplatin-based treatment were included in the study. Taking the consent of the patients, they were divided into experimental (n = 67) and control groups (n = 53) in line with the randomization list prepared before. The patient description form, Rhodes Index of Nausea, Vomiting, and Retching (INVR), and Functional Assessment of Cancer Therapy-General were used in data collection. Non-parametric tests were applied. The patients in the experimental and control groups were identical in terms of sociodemographic features and their conditions. Most of the patients were married (84 %), and some were primary school graduates (41.7 %) and had mid-level income (54.2 %). In nausea-vomiting-retching, experiences of the patients before using a placebo and a real acupressure were identical and similar changes had been observed during 5 days after the treatment. It has been determined that there was no difference between the groups statistically. A similar result has been observed when the impact of acupressure on the subgroups of sociodemographic features and condition were examined, and it has been concluded that real acupressure application cannot increase the quality of life. It has been determined that CINV is directly related to the treatment, and acupressure wristband was not an effective approach in preventing CINV

NEOADJUVANT CHEMOTHERAPY AND RADIOTHERAPY IN LOCALLY ADVANCED UNDIFFERENTIATED NASOPHARYNGEAL CARCINOMA

Twenty one patients with nonmetastatic locally advanced undifferentiated nasopharyngeal carcinoma were treated with chemotherapy and radiotherapy. According to TNM staging 8 patients had T4 and 16 patients (80%) had N2 or N3 disease.Two courses of Cisplatinum (P) and 5 Fluorouracil (F) chemotherapy were given before and also after radiation therapy. P was given 20 mg/m2, for 5 days as 30 minutes infusion and F was given 600 mg/m2, for 5 days as 24 hours continous infusion. Co-60 radiotherapy was given as 46 Gy to the primary lesions and upper cervical region, 50 Gy to the lower cervical region, 50 Gy to the lower cervical and bilateral supraclavicular regions

Outcomes and prognostic factors in patients with HER2-positive metastatic breast cancer with brain metastasis

Background:Breast cancer is the most common malignancy in females. Brain metastasis is a poor prognostic factor in breast cancer. Brain metastasis can develop in about half of the HER2- positive metastatic breast cancer patients. The study was aimed to determine outcomes and prognostic factors in HER2 positive metastatic breast cancer patients who had brain metastasis.Methods:We evaluated the HER2-positive metastatic breast cancer patients with brain metastasis between 2008 and 2018. Data of the patients were recorded retrospectively. Kaplan Meier and Cox regression analysis were used for survival analysis and prognostic factors.Results:Eighty-three patients were included in the study. The median age was 49 (range, 25-76). Thirty-two (38.6%) patients had de-novo metastatic disease at diagnosis. The most common histopathological type was invasive ductal carcinoma (88.4%). The estrogen receptor and progesterone receptor positivity ratios were 42.2% and 28.9%, respectively. At the beginning of brain metastasis, the median number of extra-cranial metastasis was 2 (range, 0-4). The most common extra-cranial metastasis sites were bone (63.9%), liver (41%), and lung (34.9%), respectively. Twenty-eight patients (41.8%) had solitary brain metastasis. The median size of brain metastasis was 16 mm (range, 5-63) at diagnosis. All patients had treated with trastuzumab-based chemotherapy, 29 patients (34.9%) TDM-1, and 73 patients (88%) lapatinib+capesitabine combination. Seventeen patients (20.5%) had undergone craniotomy, and 82 patients (98.8%) received brain radiotherapy. The patients also received hormonotherapy (41%) and bisphosphonates (56.6%). At a median follow-up of 36 months (range 5.9-177.7) from beginning metastasis, the median overall survival was 34.9 months (95% CI, range 24.6-45.2). In multivariate analysis, age at diagnosis (p = 0.005), presence of five and over brain metastasis (p = 0.016), the number of chemotherapy used with trastuzumab (p = 0.017), and receiving three different HER2-targetted therapy (p = 0.032) were statistically significant for overall survival. However, size of brain metastasis (p = 0.091), lung metastasis (p = 0.428), liver metastasis (p = 0.338), bone metastasis (p = 0.132), and hormone positivity of tumor (p = 0.238) were not.Conclusions:Real-life outcomes of HER2-positive breast cancer patients with brain metastases were presented in this study. We showed that age at diagnosis, number of brain metastasis, number of chemotherapy received with trastuzumab, and had received three different HER2 targetted therapy was prognostic factors for overall survival