Temozolomide in combination with fotemustine in patients with metastatic melanoma

Purpose Temozolomide and fotemustine are both active drugs for treating metastatic melanoma. The present study was designed to assess the efficacy and safety of combination therapy with temozolomide + fotemustine in patients with metastatic melanoma

Factors Associated with Late Toxicity in Nasopharyngeal Carcinoma Patients Treated with Radio-Chemotherapy

Objective: To quantify late toxicity in patients treated with intensive chemotherapy (ChT) and radiotherapy (RT) for nasopharyngeal carcinoma (NPC) and to investigate factors associated with it. Material and Methods: We retrospectively reviewed the treatment outcome in terms of moderate-severe late toxicity (MSLT) in 44 NPC patients diagnosed between 2001 and 2007. All the patients were treated with conformal RT and cisplatin containing ChT. Twenty-eight (63.6%) patients among 44 received only multidrug neoadjuvant ChT, while the remaining 16 (36.4%) patients received additional concomitant cisplatin during RT. MSLT was evaluated according to RTOG/EORTC scoring system and defined as grade 3-5 late toxicity. The median follow-up of these 44 patients was 38 months (range, 12-84 months). Statistical analyses were performed with Kaplan-Meier method and a multiple Cox's regression model. Results: The hazard probability of developing MSLT at 5 years was 49%. In univariate analyses; gender, age, histopathology, T stage, N stage and ChT schema did not have significant impact on treatment outcome in terms of MSLT. Total radiation dose to the neck, which appeared to have a paradoxical effect on late toxicity in univariate analysis turned to be insignificant in multivariate analysis. Treatment response was found to be the only prognostic factor in multiple Cox's regression analysis, which had an impact on MSLT in NPC patients. Probability of MSLT among the 12 NPC patients with less than complete response to the treatment was higher than 32 patients with complete response to the treatment (85.7% and 35.2% at 5 years, respectively; p=0.0254). Conclusion: Late toxicity in NPC patients is treatment related. Poor tumour control can be a triggering factor for development of late toxicity. Long lasting residual disease following treatment is an interesting phenomenon in NPC patients, which appears to be related with MSLT and has to be further investigated in prospective studies

Descriptive Characteristics of Cancer Patients in Istanbul University Institute of Oncology

Objective: The present study was conducted to determine the profile and preferences of the recently diagnosed cancer patients at the Istanbul University (I.U.) Oncology Institute. Material and Methods: The hospital's patient registration system and a questionnaire were used to collect data on 9306 patients. Patients who presented to the I.U. Oncology Institute from 2001 to 2003 were investigated for sex, age, social security, education levels and distances traveled to the I.U. Oncology Institute. Results: Male/female ratio was 1.01 in 2001, 1.05 in 2002 and 1.11 in 2003, respectively. The five most frequent cancer types were breast (36.7%), gastrointestinal tract (15.2%), genital system (14.9%), respiratory (6.6%) and lymphoid system (5.6%) cancers for females, and the respiratory system (31.7%), gastrointestinal system (20.6%), genital system (10.7%), lymphoid system (6.6%) and oral cavity (5.4%) for males. Smokers were 68.5% for males and 27.0% for females. Overall, 79.8% of cancer patients were living in Istanbul, 20% were coming from different cities in Turkey and 0.2% was foreigners. The mean distance traveled by the patients to the institute was 325 km (111-2400 km) for outsiders and 11 km (1-68 km) for residents in Istanbul; 90.3% of the patients accessed from the Marmara region followed by the Black Sea region. Conclusion: Cancer control depends on defining the number of cancer cases, the most common cancer types and the geographic spread of cancer through Turkey

Statistical Interpretation of CA125 and Bcl-2 in Serum of Patients With Late Stage Ovarian Cancer

Objectives: The present study was conducted to investigate the sensitivity, specificity, predictive values and accuracy of serum CA 125 and Bcl-2 levels and their combination in advanced epithelial ovarian cancer patients

Malignant melanoma in Turkey: A single institution's experience on 475 cases

Background: This study was performed to determine the characteristics and the clinical outcomes of patients with cutaneous melanoma in Turkey

Intermediate dose interferon alpha in adjuvant treatment for high-risk melanoma - A single institution's experience

Interferon is widely used as the most effective agent in the adjuvant therapy of patients with melanoma. However, little is known about the effect of intermediate dose interferon (IDI) in adjuvant therapy. We conducted this study to determine whether intermediate doses of interferon-alpha 2 could be beneficial for these patients. A series of 84 melanoma patients with high-risk relapse potential (stage II-III) after excisional biopsy were enrolled for adjuvant therapy with IDIs, either IFN-alpha 2a, 9 MU or IFN alpha 2b, 10 MU per day, subcutaneously, for 1 yr consisted of an induction period (5d/wk for 4 wk) followed by 48 wk of same dose administered three times per week. The median follow-up was 25.9 mo with range 4-90.4 mo. Thirty-three (39%) patients had progressed; 18 (55%) of them while on treatment. The median (range) time of the failure occurrence was 9.1 mo (1.7-47.3 mo). Distribution of failure site was identical and the majority of the recurrences were found as single metastasis. For distant metastasis-free interval, mean (+/- SE) value was 28.8 +/- 3.6 mo: 1- and 2-yr survival rates were 87.8 +/- 5.7% and 61.6 +/- 9.3%, respectively. Twenty-two deaths were observed. Five-year survival rates of progression-free survival and overall survival were 50% and 60%, respectively. Generally, the treatment was found well-tolerated; drug-induced dose reduction or treatment discontinuation due to toxicity was minimal. Severe toxicity was rare. In conclusion, the small number of patients and the short follow-up does not permit any conclusion. However, the preliminary data seem to show that treatment with IDI was usually well tolerated with low toxicity of the patients during the adjuvant therapy