Safety and efficacy of transdermal fentanyl in patients with cancer pain: phase IV, Turkish oncology group trial

We have performed a prospective evaluation of the efficacy, safety and convenience of the transdermal therapeutic system - fentanyl (TTS-F) in Turkish cancer patients when it was newly available in Turkey. Ninety-nine patients with historically confirmed malignancy and pain entered the study; the mean age was 55.1 (16-58) years. The study duration was 28 days. Transdermal therapeutic system - fentanyl was used in opioid-naive or pre-treated patients. Most patients reported a decrease in pain severity. Use of rescue medication decreased from day 4 to day 28. The majority of patients rated patch convenience of use as excellent. A total of 22.2% of patients experienced adverse events that were either probably related or very likely to be related to the study drug. The majority of the adverse events mentioned were related to the digestive system. Eighteen serious adverse events were reported by 13 patients. Six events were doubtfully related, and 12 events were not related to the study drug. Four patients died during the trial. None of these deaths was attributed to the study drug. In conclusion, the trial showed that TTS-F is easily managed, effective and will help to enable the appropriate opioid administration to patients who are suffering from cancer pain in Turkey

The relationship between hormone receptor status and c-erbb-2 level with treatment results of 640 breast cancer patients

Amaç: Çalışmada meme kanseri seyrini etkileyebilen hormon reseptör durumu ve c-erbB-2 düzeylerinin tedavi sonuçları üzerine olan etkileri saptanmaya çalışılmıştır. Yöntemler: Küratif amaçla tedavi uygulanan 640 meme kanserli hastada genel ve hastalıksız sağkalım verileri incelenmiştir. Ortalama takip 59,1 ay’dır.Hastalarda SPSS 16.0 versiyonunda Kaplan-Meier yöntemiyle genel ve hastalıksız sağkalım oranları, Log-Rank testi ile prognostik faktörlerin etkileri değerlendirilmiştir. Bulgular: ER (+) ve (-) olgularda sırasıyla beş yıllık genel sağkalım oranları %85,7, %71,2 (p<0,001), hastalıksız sağkalım oranları %79,9, %63,7 (p<0,001); PR (+) ve (-) hastalarda sırasıyla beş yıllık genel sağkalım oranları %85,6, %71,6 (p<0,001), hastalıksız sağkalım oranları %79,6, %64,3 (p<0,001) olarak bulunmuştur. ER ve PR pozitifliğinin genel ve hastalıksız sağkalımı anlamlı derecede arttırdıkları saptanmıştır. C-erbB-2 aşırı salınımında, negatiflere göre sırasıyla beş yıllık genel sağkalımda %76,4, %85,3 (p=0,002), hastalıksız sağkalımda %69,7, %79,1’lik (p=0,012) oranlar elde edilmiştir. En kötü prognostik grubun ER (-), PR (-), c-erbB-2 (+) hastalar olduğu gösterilmiştir. Sonuç: ER, PR ve c-erbB-2 düzeylerinin meme kanserinde büyük önem arz ettiği gösterilmiş ve hasta takiplerinde dikkat edilmesi gereken faktörler olduğu belirtilmiştir.Objective: In this study the relevant factors that effects the treatment outcomes of patients like hormone receptor and c-erbB-2 was established. Methods: The overall and disease-free survival rates were evaluated in 640 breast cancer patients. The mean follow-up was 59,1 months. Overall and disease-free survival rates found by Kaplan-Meier method at SPSS version 16.0. Log-Rank test evaluated the prognostic factors impact. Results: In ER (+) and (-) patients 5 year overall survival rates was 85,7%, 71,2% (p<0,001), disease free survival rates was 79,9%, 63,7% (p<0,001) respectively; in PR (+) and (-) patients 5 year overall survival rates was 85,6%, 71,6% (p<0,001), disease free survival rates was 79,6%, 64,3% (p<0,001) respectively. ER and PR positivity were significantly increased overall and disease-free survival. In c-erbB-2 over-expression 5 year overall survival rates was 76,4%, 85,3% (p=0,002), disease free survival rates was 69,7%, 79,1% (p=0,012) according to (-) patients. The worst prognosis had shown in ER (-), PR (-), c-erbB-2 (+) patients. Conclusion: ER, PR and c-erbB-2 levels have great importance in breast cancer and must be well considered in patients follow-up

Determination of Parameters Affecting the Use of Complementary and Alternative Medicine in Cancer Patients and Detection of Prevalence of Use

This study was conducted to find out the frequency of complementary and alternative medicine (CAM) use that could lead to troubles in patient health and in applied standard therapy protocols when used improperly, which method is used, the reasons for use and from which resources the information about this topic were obtained. A questionnaire consisting of 28 questions was applied to 195 patients with cancer diagnosis by a face-to-face interview. The obtained data were assessed with SPSS 11.5 program. Out of 195 cancer patients, 100 (51.3%) were using CAM and 48.7% (n=95) were not. The most commonly used agent was nettle (72%). This was followed by herbal teas (21%), grape molasses (20%) and black seed (20%). The frequency of CAM use was found higher in those under age 50, in literate people, in those working during the diagnosis stage and having disease at the later stage. While CAM was commonly recommended by friends and relatives of the patients (73%), this ratio was only 5% for health professionals. While 51.3% of all patients were gathering information about CAM, 75% of those actually using CAM gathered information about it. Whilst information was gathered mostly from the relatives of patients and tamperers (47%), it can be gathered from physicians only with a ratio of 10%. Cancer patients use CAM and they gather information mainly from unreliable sources rather than physicians. Although the primary information source should be physicians, the ratio for this was very low (10%). We suggest that physicians should spend more time in gathering correct information and sharing them with their patients for a better guidance

Determination Of Parameters Affecting The Use Of Complementary And Alternative Medicine In Cancer Patients And Detection Of Prevalence Of Use

This study was conducted to find out the frequency of complementary and alternative medicine (CAM) use that could lead to troubles in patient health and in applied standard therapy protocols when used improperly, which method is used, the reasons for use and from which resources the information about this topic were obtained. A questionnaire consisting of 28 questions was applied to 195 patients with cancer diagnosis by a face-to-face interview. The obtained data were assessed with SPSS 11.5 program. Out of 195 cancer patients, 100 (51.3%) were using CAM and 48.7% (n=95) were not. The most commonly used agent was nettle (72%). This was followed by herbal teas (21%), grape molasses (20%) and black seed (20%). The frequency of CAM use was found higher in those under age 50, in literate people, in those working during the diagnosis stage and having disease at the later stage. While CAM was commonly recommended by friends and relatives of the patients (73%), this ratio was only 5% for health professionals. While 51.3% of all patients were gathering information about CAM, 75% of those actually using CAM gathered information about it. Whilst information was gathered mostly from the relatives of patients and tamperers (47%), it can be gathered from physicians only with a ratio of 10%. Cancer patients use CAM and they gather information mainly from unreliable sources rather than physicians. Although the primary information source should be physicians, the ratio for this was very low (10%). We suggest that physicians should spend more time in gathering correct information and sharing them with their patients for a better guidance

Clinical and prognostic features of plasmacytomas: A multicenter study of Turkish Oncology Group-Sarcoma Working Party

To identify the outcomes of prognostic factors of solitary plasmacytoma mainly treated with local radiotherapy (FIT). The data were collected from 80 patients with solitary plasmacytoma (SP). Forty patients (50.0%) received radiotherapy (FIT) alone while 38 of them (47.5%) were treated with surgery (S) and FIT. The median radiation dose was 46 Gy (range 30-64). The median follow up was 2.41 years (range 0.33-12.33). Ten-year overall survival (OS) and local relapse-free survival (LRFS) were 73% and 94%, respectively. The median progression-free survival (PFS) and multiple myeloma-free survival (MMFS) were 3.5 years and 4.8 years, respectively. On multivariate analyses, the favorable factors were radiotherapy dose of >= 50 Gy and RT + S for PFS and younger age for MMFS. For the patients with medullary plasmacytoma, the favorable factor was younger age for MMFS. RT at >= 50 Gy and RT + S may be favorable prognostic factors on PFS. Younger patients, especially with head-neck lesion and without pre-RT macroscopic tumor, seem to have the best outcome when treated with RT +/- S. Progression to MM remains as the main problem especially for older patients

Influenza Vaccination Knowledge, Vaccination Status and Associated Factors Among Intern Doctors of a Medical School

Introduction: Seasonal influenza vaccination is recommended for healthcare workers as they are considered to be in the risk group for contracting influenza. Final year medical students (intern doctors) are a special group because they are healthcare providers and at the beginning of their professional lives. It was aimed to determine the knowledge of intern doctors at a state university about the seasonal influenza vaccine, their vaccination status and the associated factors, given that it will affect their behavior towards themselves and in consulting their patients in future years. Materials and Methods: This descriptive study was conducted in March 2020 at a state university medical school. Intern doctors completed a standardized data collection form consisting of a total of 57 questions prepared for this study under supervision. The incidence of seasonal influenza vaccination in the last three years and factors associated with vaccination behavior were determined. Certain questions about seasonal influenza vaccination were asked. Results: Of the 254 students who participated in the study, 30 (11.8%) reported having received seasonal influenza vaccine in the last season and 86 (33.9%) in the last three years. Having received influenza vaccine in the last three years was 4.28 (95% CI= 1.53-11.90) times higher among those who had the intention to receive influenza vaccine if it was provided free of charge and on time compared to their counterparts. In the same model, excluding “intention”, receiving education about influenza infection and vaccination (OR= 1.84; 95% CI= 1.03-3.27), and being the people surrounding who had received influenza vaccination (OR= 3.06; 95% CI= 1.60-5.84) were positively associated with the students’ influenza vaccination status. In this model, those perceiving their own risk of influenza infection as “high” and/or “more severe than that in others” were 5.23 (95% CI= 1.11-24.45) times more likely to be vaccinated for influenza over the last three years. Responses to eight of the 12 statements questioning knowledge were more than 70% correct. At least one of every three participants approved that influenza vaccination might lead to influenza. This was the most prominent misinformation regarding influenza vaccination. Conclusion: Influenza vaccination is also low among intern doctors at the beginning of their professional life. It is recommended that education about influenza infection and influenza vaccine, influenza vaccination of surrounding people, especially leaders like faculty members, and the provision of free and timely influenza vaccine are recommended to increase influenza vaccination among intern doctors