Lokal İleri ve Metastatik Küçük Hücreli Dışı Akciğer Kanseri Hastalarının Değerlendirilmesi Marmara Üniversitesi Deneyimi

Lokal İleri ve Metastatik Küçük Hücreli Dışı Akciğer Kanseri Hastalarının Değerlendirilmesi Marmara Üniversitesi DeneyimiDr. P. Fulden YUMUK1, Dr. M. Salih İYİKESİCİ1, Dr. Mahmut GÜMÜŞ1, Dr. Mehmet ALİUSTAOĞLU1, Dr. Faysal DANE1, Dr. Gül BAŞARAN1, Dr. Meltem EKENEL1, Dr. Ufuk ABACIOĞLU2, Dr. N. Serdar TURHAL11Marmara Üniversitesi Tıp Fakültesi, Medikal Onkoloji Bilim Dalı, İstanbul2Marmara Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi ABD, İstanbulNisan 1997 ile Şubat 2004 tarihleri arasında onkoloji kliniğimizde tedavi alan 175 KHDAK tanılı hasta retrospektif incelendi. Tüm hastaların performans durumu (PD)≤2'ydi. İlk seçim tedavi olarak 138 hasta cisplatin içeren bir kombinasyon rejimini radyolojik yanıta bağlı olarak 3-6 kür aldı. Torasik radyoterapi evre IIIB hastalarında ilk seçim kemoterapi sonrasında ve semptomatik evre IV hastalarda palyatif amaçla yapıldı. Uygun olan evre IIIA hastalar (%8.6) opere edildi. Medyan yaş 60 ve 132 hasta erkekti. PD %77.5 hastada 0'dı. Sırasıyla 16/39/120 hastanın evreleri IIIA/IIIB/IV'dü. Kırksekiz hastaya lokal radyoterapi yapıldı. Ortanca 11 aylık (1-63 ay) izlemde medyan genel sağkalım (GS) süresi 13±1ay, 1-yıllık GS oranı %51 iken medyan progresyona kadar geçen süre 3ay, 1-yıllık progresyonsuz sağkalım oranı %16'ydı. Kadınların, iyi PD olanların, cerrahi ve primer radyoterapi yapılabilecek hastaların daha uzun GS'ı olduğu görüldü (sırasıyla, p=0.005, p=0.0001, p=0.044 ve p=0.0002). Aynı değişkenler bağımsız prognostik faktörler olarak belirlendi. Kliniğimizin sonuçları dünya literatürü ile uyumludur.Anahtar Kelimeler :&nbsp;Küçük hücreli dışı akciğer kanseri; Antineoplastik kombine kemoterapi protokolleri; Sağkalım analiziOUTCOME OF LOCALLY ADVANCED AND METASTATIC NON-SMALL CELL LUNG CANCER PATIENTS - MARMARA UNIVERSITY EXPERIENCEDr. P. Fulden YUMUK1, Dr. M. Salih İYİKESİCİ1, Dr. Mahmut GÜMÜŞ1, Dr. Mehmet ALİUSTAOĞLU1, Dr. Faysal DANE1, Dr. Gül BAŞARAN1, Dr. Meltem EKENEL1, Dr. Ufuk ABACIOĞLU2, Dr. N. Serdar TURHAL11Marmara Üniversitesi Tıp Fakültesi, Medikal Onkoloji Bilim Dalı, İstanbul2Marmara Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi ABD, İstanbulTreatment outcomes of the 175 advanced and metastatic NSCLC patients who were given chemotherapy since April 1997 were retrospectively evaluated. In 138 patients, a platinum analogue was used in combination with etoposide, vinorelbine, paclitaxel, docetaxel or gemcitabine. The thoracic radiotherapy was given to stage IIIB patients after completion of first line chemotherapy and to symptomatic stage IV patients with palliative intent. Eligible stage IIIA patients (8.6%) were operated. Median age was 60 and 132 patients were male. Performance status was 0 in 77.5% and stage was IIIA/IIIB/IV in 16/39/120 patients. Forty-eight patients received local RT. At a median follow-up of 11 months, median overall survival (OS) was 13 months, 1-year OS ratio was 51%. Women, patients with good performance status, having resectable tumors and who received local radiotherapy lived significantly longer (p=0.005, p=0.0001, p=0.044 and p=0.0002, respectively). The independent factors influencing the OS were identical. Our results are consistent with the world literature.Anahtar Kelimeler :&nbsp;Carcinoma, Non-Small-Cell Lung; Antineoplastic Combined Chemotherapy Protocols; Survival Analysis</p

Vascular endothelial growth factor, hypoxia-inducible factor 1 alpha and CD34 expressions in early-stage gastric tumors: Relationship with pathological factors and prognostic impact on survival

Background: Angiogenesis is one of the key steps in solid tumor growth and metastasis. We planned to investigate the prognostic significance of vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1 alpha (HIF-1 alpha) and CD34 expressions as markers of angiogenesis in gastric cancer. Patients and Methods: We retrospectively reviewed the medical records of 51 gastric cancer patients who had total or subtotal gastrectomy at Marmara University Hospital from 1990 to 2004 and evaluated the expression of VEGF, HIF-1 alpha and CD34 by immunohistochemistry in their archival tumor tissues. We recorded the clinical and pathological characteristics of these patients and analyzed their survival outcome. Results: Thirty out of 51 patients were males. The median age was 63 years (range 34-81). The median follow-up was 17 months. Thirty-six patients had node-positive disease. The majority of patients (n = 43) had T2 and T3 disease. Vascular and lymphatic invasions were present in 57 and 77% of tumors, respectively. VEGF and HIF-1 alpha were positive in 65 and 71% of tumors. The median CD34 staining score was 19 (3-68). VEGF, HIF-1 alpha and CD34 expressions were more frequent in tumors without serosal invasion (p = 0.01, p = 0.01 and p = 0.003, respectively). CD34 expression was significantly more frequent in tumors with VEGF and HIF-1 alpha expression (p = 0.00, p = 0.00). HIF-1 alpha expression was more frequent in tumors with VEGF expression (p = 0.00). The 5year overall survival was 45%. VEGF, HIF-1 alpha, CD34 expressions and other pathological characteristics were found to have no impact on survival. Conclusion: VEGF, HIF-1 alpha and CD34 expressions were more common in tumors without serosal invasion. As a future perspective, biological agents targeting VEGF and HIF-1 alpha might be more effective at earlier stages of gastric cancer. Copyright (c) 2007 S. Karger AG, Basel