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Altinok P, Ergen ŞA, Güzelöz Çapar Z, Canyilmaz E, Akgün Z, Serin M, Akbaş C, Aktan M, Erdiş E, Özmen HK, Özyar E, Çağlar A, Munzuroğlu Ak F, Akyüz MF, Altinok A. Awareness Level of Cervical Cancer Patients Referred to Radiation Oncology Outpatient Clinics-A Multicenter Study. J Low Genit Tract Dis 2024; 28:143-148. [PMID: 38465970 DOI: 10.1097/lgt.0000000000000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE The study aimed to assess the level of knowledge of patients with cervical cancer referred to radiation oncology outpatient clinics in Turkey regarding screening methods and human papillomavirus (HPV) vaccination and increase social awareness based on the findings. METHODS A descriptive cross-sectional survey was conducted from January to June 2022 involving 300 patients in various regions. Data on demographics, cervical cancer screening and HPV vaccination knowledge, and recommendations to relatives were collected through a questionnaire-based interview. Univariate logistic regression analyzed the impact of independent variables on knowledge levels. RESULTS Among the participants, 57% were unaware of cervical cancer screening, and 66% had no knowledge of the HPV vaccine. Higher knowledge levels were associated with higher education, older age at marriage and first birth, and previous gynecological checkups. Lower knowledge levels were observed in patients treated at state institutions, with no formal education, and diagnosed with cervical cancer at age 60 or older. A significant inverse correlation was found between knowledge levels and the stage of cancer at diagnosis, with higher awareness in earlier stages. CONCLUSION The study revealed limited awareness among cervical cancer patients in Turkey regarding screening and HPV vaccination. Lower knowledge levels were associated with specific demographic factors, emphasizing the importance of targeted educational campaigns to reduce the burden of cervical cancer and promote early detection. Efforts to enhance vaccination coverage and encourage early screening can significantly improve outcomes. Comprehensive awareness surveys are essential in guiding policymaking and implementing effective early detection and prevention strategies for cervical cancer.
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Affiliation(s)
- Pelin Altinok
- Radiation Oncology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Şefika Arzu Ergen
- Radiation Oncology, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | | | - Emine Canyilmaz
- Radiation Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Züleyha Akgün
- Radiation Oncology, Memorial Sisli Hospital, Istanbul, Turkey
| | - Meltem Serin
- Radiation Oncology, Acibadem Adana Hospital, Adana, Turkey
| | - Canan Akbaş
- Radiation Oncology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Meryem Aktan
- Radiation Oncology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Eda Erdiş
- Radiation Oncology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | | | - Enis Özyar
- Radiation Oncology, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Ahmetcan Çağlar
- Radiation Oncology, Hatay Training and Research Hospital, Hatay, Turkey
| | | | | | - Ayşe Altinok
- Radiation Oncology, Medikal Park Goztepe Hospital, Istanbul, Turkey
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Duru Birgi S, Özkaya Akagündüz Ö, Dagdelen M, Yazici G, Canyilmaz E, Ceylaner Biçakçi B, Çetinayak HO, Baltalarli PB, Demiröz Abakay C, Kaydihan N, Delikgöz Soykut E, Erdiş E, Akyürek S, Esassolak M, Uzel ÖE, Bakirarar B, Cengiz M. Radiotherapy Results in Locally Advanced Sinonasal Cancer: Turkish Society for Radiation Oncology, Head and Neck Study Group 01-005. Am J Clin Oncol 2024:00000421-990000000-00176. [PMID: 38390915 DOI: 10.1097/coc.0000000000001089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
OBJECTIVE This study aims to examine the treatment outcomes and related factors in locally advanced sinonasal cancer across Turkiye. METHODS Twelve centers participants of the Turkish Society for Radiation Oncology Head and Neck Study Group attended the study. One hundred and ninety-four patients treated with intensity-modulated radiation therapy between 2001 and 2021 were analyzed retrospectively. The survival analysis was performed using the Kaplan-Meier method. Acute and late toxicity were recorded per Common Toxicity Criteria for Adverse Events V4.0. RESULTS The median age was 58 years and 70% were male. The majority of tumors were located in maxillary sinus (59%). Most of the patients (%83) had T3 and T4A disease. Fifty-three percent of patients were in stage 4A. Radiotherapy was administered to 80% of the patients in the adjuvant settings. Median 66 Gy dose was administered in median 31 fractions. Chemotherapy was administered concomitantly with radiotherapy in 45% of the patients mostly with weekly cisplatin. No grade ≥4 acute and late toxicity was observed. The median follow-up was 43 months. The 5-year and 10-year overall survival (OS); locoregional recurrence-free survival (LRFS); distant metastasis-free survival (DMFS), and progression-free survival (PFS) rates were 61% and 47%; 69% and 61%; 72%, and 69%, and 56% and 49%, respectively. In the multivariate analysis, several factors demonstrated significant influence on OS, such as performance status, surgery, and lymph node involvement. Moreover, surgery was the key prognostic factor for LRFS. For DMFS, lymph node involvement and surgical margin were found to be influential factors. In addition, performance status and lymph node involvement were identified as significantly affecting PFS. CONCLUSIONS In our study, the authors obtained promising results with IMRT. Performance status, lymph node involvement, and surgery emerged as the primary factors significantly influencing OS.
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Affiliation(s)
| | | | - Meltem Dagdelen
- Department of Radiation Oncology, Cerrahpaşa University Faculty of Medicine
| | - Gözde Yazici
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Emine Canyilmaz
- Department of Radiation Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon
| | | | - Hasan O Çetinayak
- Department of Radiation Oncology, Dokuz Eylül University Faculty of Medicine, İzmir
| | - Papatya B Baltalarli
- Department of Radiation Oncology, Pamukkale University Faculty of Medicine, Denizli
| | | | - Nuri Kaydihan
- Department of Radiation Oncology, Memorial Bahçelievler Hospital, İstanbul
| | - Ela Delikgöz Soykut
- Department of Radiation Oncology, Samsun Training and Research Hospital, Samsun
| | - Eda Erdiş
- Department of Radiation Oncology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | | | | | - Ömer E Uzel
- Department of Radiation Oncology, Cerrahpaşa University Faculty of Medicine
| | | | - Mustafa Cengiz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara
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Yılmaz M, Erdiş E, Uçar M, Demir N, Alandağ C, Yücel B. Effects of hormone receptor status on patient clinic and survival in HER2 positive breast cancer. Jpn J Clin Oncol 2024:hyae010. [PMID: 38336481 DOI: 10.1093/jjco/hyae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND In the current study, the effect of hormone receptor (HR) status on clinical and survival in early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer was investigated. METHODS Two hundred ninety-one patients with HER2- positive were examined in two categories as HR-positive and HR-negative. RESULTS Of these, 197 (68%) were HR-positive and 94 (32%) were HR-negative with a mean follow-up period of 68 ± 2.7 months. The groups were found to be similar in terms of age, menopausal status, comorbidity, pathologic type, stage, T stage, N stage, lymphovascular invasion, presence and percentage of intraductal component, multicentricity/focality and extracapsular invasion. Family history (P = 0.038), stage 2 tumor rate (P < 0.001), and perineural invasion (P = 0.005) were significantly higher in the HR-positive group. In the HR-negative group, mean Ki-67 value (P = 0.014), stage 3 tumor rate (P < 0.001), tumor necrosis (P = 0.004) and strong (3+) HER2 staining on immunohistochemical staining (P = 0.003) were higher. The incidence of relapse and metastasis, and the localization of metastasis were similar in both patient groups. The rate of locoregional relapse during the first 2 years was higher in the HR-negative patients than in the HR-positive patients (P = 0.023). Overall survival (OS) and disease-free survival (DFS) did not differ between the groups in univariate analysis. However, HR status was determined as an independent prognostic factor (HR: 2.11, 95% CI: 1.17-3.79; P = 0.012) for OS was not found to be significant for DFS in multivariate analysis. CONCLUSION Both clinicopathologic features and OS outcomes of HR-negative patients were worse than those of HR-positive patients.
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Affiliation(s)
- Mukaddes Yılmaz
- Cumhuriyet University Faculty of Medicine, Department of Medical Oncology, Sivas
| | - Eda Erdiş
- Cumhuriyet University Faculty of Medicine, Department of Radiation Oncology, Sivas
| | - Mahmut Uçar
- Cumhuriyet University Faculty of Medicine, Department of Medical Oncology, Sivas
| | - Necla Demir
- Department of Medical Oncology, Acıbadem Hospital, Kayseri
| | - Celal Alandağ
- Department of Medical Oncology, Medicana Hospital, Department of Medical Oncology, Medicana Hospital, Sivas, Turkey
| | - Birsen Yücel
- Cumhuriyet University Faculty of Medicine, Department of Radiation Oncology, Sivas
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Yılmaz M, Erdiş E, Uçar M, Yücel B. "Evaluation of quality of life in patients with gastric adenocarcinoma receiving chemoradiotherapy: a cross-sectional study". Support Care Cancer 2023; 31:600. [PMID: 37770678 DOI: 10.1007/s00520-023-08036-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 09/02/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE The aim of this study was to evaluate quality of life (QoL) in patients with gastric adenocarcinoma receiving adjuvant chemoradiotherapy (CRT). METHODS The European Organization for Cancer Research and Treatment Quality of Life Questionnaire-Core 30 (QLQ-C30) and site-specific module for gastric cancer (QLQ-STO22) were administered at four time points to 156 patients admitted to Cumhuriyet University Oncology Center between 2011 and 2018. RESULTS The patient group comprised 76% men and 24% women with a median age of 61 years (range, 18-88). During CRT, 12 patients (8%) discontinued treatment, 25 (16%) lost weight, and 42 (27%) had reduced performance. There was significant worsening in QLQ-C30 global health status and all functional and symptom scale scores at CRT completion. These changes were also clinically significant except for physical functioning scores and were supported by minimal clinically important difference measurements. In the QLQ-STO22, all symptoms except dry mouth and hair loss were negatively affected at CRT completion. In general, scores were improved at 1 month after CRT and almost all scores reached baseline level by 6 months. Certain scores were more adversely affected in women (global health status, physical functioning, role functioning, fatigue, pain, and insomnia), those who lost weight during CRT (emotional functioning), and those with CRT interruption (emotional functioning and anxiety). CONCLUSION Although CRT reduces QoL in patients with gastric cancer, the effects tend to resolve within 6 months after completing treatment. Female sex, weight loss, and CRT interruption negatively affected some QoL scores.
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Affiliation(s)
- Mukaddes Yılmaz
- Department of Medical Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
| | - Eda Erdiş
- Department of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Mahmut Uçar
- Department of Medical Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Birsen Yücel
- Department of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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Yücel B, Erdiş E, Bahar S, Akkaş Atasever E, Celasun MG, Altuntaş EE. Factors Affecting Permanent Sensorineural Hearing Loss and Bone Conduction in Patients After Receiving Radiotherapy to the Head and Neck Region. Turk Arch Otorhinolaryngol 2022; 60:212-219. [PMID: 37456600 PMCID: PMC10339269 DOI: 10.4274/tao.2022.2022-6-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/27/2022] [Indexed: 07/18/2023] Open
Abstract
Objective This study aimed to investigate the factors affecting permanent sensorineural hearing loss (SNHL) and causing changes in bone conduction (BC) thresholds over time in patients after receiving radiotherapy (RT) or chemoradiotherapy (CRT) to the head and neck region. Methods A total of 63 patients with irradiated HNC that were admitted to the Radiation Oncology Department between 2011 and 2018 were included in the study. All patients were assessed with pure tone audiometry at eight different time points (first before RT and last five years after completion of RT). A chi-square test was used to analyze the variables that affected permanent SNHL occurrence. Repeated measure analysis of variance was conducted to investigate the factors affecting change in the BC threshold at pure-tone average (0.5-2 kHz) and the air conduction (AC) threshold at 4 and 6 kHz frequencies over time. Results Median follow-up was 52 months (range, 12-110 months). SNHL was found in 18 (14%) of the 126 ears. According to the receiver operating characteristic analysis, the cut-off values of cochlear Dmean and Dmax radiation doses were 40 Gy [p=0.017, area under the curve (AUC): 0.676] and 45 Gy (p=0.008, AUC: 0.695). Dmean (≤40 Gy vs. >40 Gy) and Dmax (≤45 Gy vs. >45 Gy) cochlear doses and age (≤40 vs. >40 years) were determined as factors affecting SNHL in the chi-square test. Repeated measures showed that BC thresholds between 0.5-2 kHz and AC thresholds at 4 and 6 kHz increased over time. Age (≤40 vs. >40 years), treatment of head and neck cancer (RT vs. CRT), cisplatin use, and Dmean (≤40 Gy vs. >40 Gy) and Dmax cochlear dose (≤45 Gy vs. >45 Gy) were important factors affecting the course of BC threshold over time. Conclusion Dmean and Dmax cochlear doses and age were found to be associated with permanent SNHL. Conduction thresholds worsened over time at all frequencies, and this trend was affected by cochlear doses, age, CRT, and cisplatin use.
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Affiliation(s)
- Birsen Yücel
- Department of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Eda Erdiş
- Department of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Seher Bahar
- Department of Radiation Oncology, University of Health Sciences Turkey, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
| | - Ebru Akkaş Atasever
- Department of Radiation Oncology, University of Health Sciences Turkey, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Mustafa Gürol Celasun
- Department of Radiation Oncology, University of Health Sciences Turkey, Kütahya Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Emine Elif Altuntaş
- Department of Otorhinolaryngology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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Hasbek Z, Ozer H, Erturk SA, Erdiş E, Yucel B, Çiftçi E, Çakmakcilar A. Relationships between hypoxia induced factor-1α and 18F-FDG PET/CT parameters in colorectal cancer. Rev Esp Med Nucl Imagen Mol 2019; 38:355-361. [PMID: 31672495 DOI: 10.1016/j.remn.2019.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/28/2019] [Accepted: 05/02/2019] [Indexed: 10/25/2022]
Abstract
AIM The hypoxia-inducible factor 1 (HIF-1) has a critical role in oxygen homeostasis and it is a transcriptional activator of angiogenesis, erythropoiesis, iron and glucose metabolism. Glucose metabolism rate is increased in some tumours via HIF-1α. Our aim is to evaluate the relationship between hypoxia in colorectal cancer, PET parameters, necrotic tissue size and pathologic prognostic factors via using HIF-1α. MATERIALS/METHODS 70 patients (28 female/42 male; median age: 63 years) who were diagnosed with colorectal cancer via biopsy were staged with preoperative PET/CT and operated subsequently. Immunohistochemical evaluation scoring was done according to nuclear HIF-1α expression, staining density and intensity. Metabolic tumour volume (MTV), total lesion glycolysis (TLG) and tumour volume (TV) were calculated by using volume of an ellipsoid formula via CT images, and percentage of tumour necrosis (%TmNcr) that was calculated by the difference between TV and recorded MTV. RESULTS There was a moderately meaningful positive correlation between tumour SUVmax and TV and %TmNcr (r=0.403, p=0.001 and r=0.500, p=0.0001, respectively). There were no statistically significant relationships between HIF-1α expression levels and tumour SUVmax, TLG, MTV, TV, %TmNcr, tumour stage, lymphovascular invasion, perineural invasion and extracapsular/capsular lymph node involvement. On the other hand, strong nuclear immunohistochemical staining was seen in tumour cells adjacent to invasive border, inflammatory cells. Although not statistically significant, moderate or strong nuclear staining were seen in 64.9% of metastatic patients. CONCLUSION Although the presence of a positive correlation between tumour SUVmax and %TmNcr shows that there are hypoxic cells in cancer tissue with high FDG uptake, the relationship between the presence of HIF-1α and enhanced glucose metabolism and pathological prognostic factors of tumour was not shown. Strong nuclear immunohistochemical staining in tumour cells adjacent to invasive border and inflammatory cells leads us to believe that HIF-1α plays a role in the invasion area of tumour microenvironment.
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Affiliation(s)
- Z Hasbek
- Cumhuriyet University, School of Medicine, Department of Nuclear Medicine, Sivas, Turquía.
| | - H Ozer
- Cumhuriyet University, School of Medicine, Department of Pathology, Sivas, Turquía
| | - S A Erturk
- Cumhuriyet University, School of Medicine, Department of Nuclear Medicine, Sivas, Turquía
| | - E Erdiş
- Cumhuriyet University, School of Medicine, Department of Radiation Oncology, Sivas, Turquía
| | - B Yucel
- Cumhuriyet University, School of Medicine, Department of Radiation Oncology, Sivas, Turquía
| | - E Çiftçi
- Sakarya University, School of Medicine, Research and Training Hospital, Department of Nuclear Medicine, Sakarya, Turquía
| | - A Çakmakcilar
- Cumhuriyet University, School of Medicine, Department of Nuclear Medicine, Sivas, Turquía
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Kaymak-Cihan M, Erdiş E, Bozkurt S, Ünver-Korğalı E. Pediatric primary anaplastic ganglioglioma with malignant neuronal component. Turk J Pediatr 2018; 60:102-106. [PMID: 30102489 DOI: 10.24953/turkjped.2018.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Kaymak-Cihan M, Erdiş E, Bozkurt S, Ünver-Korğalı E. Pediatric primary anaplastic ganglioglioma with malignant neuronal component. Turk J Pediatr 2018; 60: 102-106. Gangliogliomas (GGs) represent approximately 0.4%-1.0% of all brain tumors. Anaplastic gangliogliomas (AGGs) form 5-10% of all GGs. They are a mixed neuronal-glial tumor of central nervous system and composed by two cell lines; neuronal (ganglionic) and glial cells. Anaplastic component of AGGs is usually glial cells. Malignant neuronal component is a rare condition. Here we report an 8-year-old male patient who was diagnosed with primary AGG with malignant neuronal component and was treated with surgery, adjuvant radiotherapy and chemotherapy.
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Affiliation(s)
- Meriç Kaymak-Cihan
- Departments of Pediatric Hematology and Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Eda Erdiş
- Departments of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Süheyla Bozkurt
- Department of Pathology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Elif Ünver-Korğalı
- Departments of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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