Evre IV Küçük Hücreli Dışı Akciğer Kanserli Olgularda Prognostik Faktörlerin İncelenmesi

Amaç: Çalışmamızda, ileri evre küçük hücreli dışı akciğer karsinomlu hastalarda tedavi öncesi prognostik faktörlerin sağkalım üzerine etkilerini değerlendirmeyi amaçladık. Hastalar ve Yöntem: Şubat 2004 - Aralık 2006 tarihleri arasında kliniğimize baş- vurmuş evre IV küçük hücreli dışı, kemoterapi almış olan 73 hasta retrospektif olarak değerlendirildi. Bulgular: Performansı sıfır, 65 yaşından daha genç hastaların yaşam süreleri di- ğerlerine göre anlamlı olarak uzun bulunurken, histopatolojik alt grup, sigara içimi, kilo kaybı ve cinsiyet farkının yaşam süresi üzerinde anlamlı bir etkisi yoktu (p>0.05). Metastaz varlığı ile sağkalım süresi karşılaştırıldığında, istatistiksel olarak anlamlı bir fark saptanmamıştır. LDH seviyesi yüksek olanların yaşam süresinin daha kısa olduğu görüldü. Sonuç: 65 yaştan genç olmak, performansın iyi olması, normal LDH düzeyi ileri evre küçük hücreli dışı akciğer kanserli olguların uzun yaşam süresinde önemli rol oynar

Predicting Teeth Extraction after Concurrent Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer Patients Using the Novel GLUCAR Index

To evaluate the value of the newly created GLUCAR index in predicting tooth extraction rates after concurrent chemoradiotherapy (C-CRT) in locally advanced nasopharyngeal carcinomas (LA-NPCs). Methods: A total of 187 LA-NPC patients who received C-CRT were retrospectively analyzed. The GLUCAR index was defined as ′GLUCAR = (Fasting Glucose × CRP/Albumin Ratio) by utilizing measures of glucose, C-reactive protein (CRP), and albumin obtained on the first day of C-CRT. Results: The optimal GLUCAR cutoff was 31.8 (area under the curve: 78.1%; sensitivity: 70.5%; specificity: 70.7%, Youden: 0.412), dividing the study cohort into two groups: GLUCAR ˂ 1.8 (N = 78) and GLUCAR ≥ 31.8 (N = 109) groups. A comparison between the two groups found that the tooth extraction rate was significantly higher in the group with a GLUCAR ≥ 31.8 (84.4% vs. 47.4% for GLUCAR ˂ 31.8; odds ratio (OR):1.82; p p = 0.008), mandibular V55.2 Gy group ≥ 40.5% (80.3 vs. 63.5 for p = 0.004, OR; 1.30), and being diabetic (71.8% vs. 57.9% for nondiabetics; OR: 1.23; p = 0.007) appeared as the additional factors significantly associated with higher tooth extraction rates. All four characteristics remained independent predictors of higher tooth extraction rates after C-CRT in the multivariate analysis (p Conclusions: The GLUCAR index, first introduced here, may serve as a robust new biomarker for predicting post-C-CRT tooth extraction rates and stratifying patients according to their tooth loss risk after treatment

Cetuximab-induced rash is associated with overall survival in patients with recurrent/metastatic squamous cell carcinoma of head and neck

Purpose In this study, we looked for whether treatment-induced rash predicts treatment efficacy in patients with recurrent/metastatic HNSCC treated with Cetuximab and chemotherapy. Methods Patients who were treated with platinum-based chemotherapy and cetuximab for the first line treatment of recurrent/metastatic HNSCC were recruited. Presence of rash, hypomagnesemia, hypopotassemia, anemia, neutropenia, thrombocytopenia during treatment and treatment response, date of progression, date of last visit and death were recorded. Results A total of 138 patients' data were available for analysis. Any grade of rash was detected in 57 (44.5%) of the patients. The incidence of rash was significantly higher in patients with objective response than in patients with disease progression (%56.8 vs %14.3, p < 0.001). Progression free survival was 7.06 months (4.98-9.15) in patients treated with cetuximab and chemotherapy as first line treatment. In the multivariate analysis; rash was significantly correlated with longer PFS (HR 2.136; 95% CI 1.067-4.278; p = 0.032). Progression free survival was 9.65 months in patients who experienced rash, and 6.02 months in patients without rash, (p = 0.019, log-rank test). Overall survival was 11.24 months (9.65-12.82). In multivariate analysis, the survival of patients with rash was significantly longer than patients without rash (HR 1.954; 95% CI 1.162-3.285; p = 0.012). Overall survival was 15.08 months in patients who experienced rash, and 8.61 months in patients without rash (p = 0.05, log-rank test). Conclusion Cetuximab-induced rash is associated with better ORR and longer PFS and OS in patients with recurrent/metastatic HNSCC treated with Cetuximab and platinum-based chemotherapy