RESUMO
BACKGROUND: Conditioning regimens with high-dose chemotherapy and autologous stem cell transplantation (ASCT) are the mainstays of treatment in lymphoma patients. Although the most frequently used conditioning regimen is the BEAM regimen (Carmustine, Etoposide, Cytarabine, and Melphalan), and alternatives are also used in certain circumstances. The TEAM regimen (carmustine is substituted by the alkylating agent thiotepa) is one of these alternatives; however, data regarding the comparisons of efficacy and safety profiles of these 2 regimens is scarce. This study compared the outcomes of patients who received conditioning regimens with BEAM and TEAM and underwent an ASCT. METHODS: This study was conducted as a retrospective assessment of 294 patient outcomes in terms of efficacy and safety. Adult patients with lymphoma diagnosis who received BEAM or TEAM conditioning regimens and underwent an ASCT between January 1, 2016 and December 31, 2019 were included in the analyses. RESULTS: A total of 294 patients (median age at ASCT: 50 years, males: 60.5%, diffuse large B-cell lymphoma: 35%) were included. Eighty patients (27.2%) received the TEAM regimen, and 214 (72.8%) received the BEAM regimen. Regarding safety profiles, the thrombocyte engraftment time was significantly higher in the TEAM group (P = .003) and fever of unknown etiology was significantly higher in the BEAM group (P = .042). Also, nausea was more in the TEAM group (P = .031). The complete remission rate was 57.5% and 70.3% in the TEAM and BEAM regimens, respectively. The overall mortality rate was 37.3% and not significantly different between the groups (43% and 35% in the TEAM and BEAM groups, P = .22) over a similar median follow-up of 1667 days (P = .28). The 3-year survival rate was 66% and 67% and the 5-year survival rate was 52% and 58% in the TEAM and BEAM regimens, respectively, without significant difference. CONCLUSION: To the best of our knowledge, this is one of the few studies in the literature that compared the TEAM and BEAM as conditioning regimens for ASCT in lymphoma patients. The 2 regimens may provide similar overall survival outcomes and have a comparable safety profile. Although the BEAM regimen may be associated with longer progression-free survival times, the difference may be covered by the similar survival after ASCT.
Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma Difuso de Grandes Células B , Adulto , Masculino , Humanos , Pessoa de Meia-Idade , Carmustina/uso terapêutico , Etoposídeo/uso terapêutico , Estudos Retrospectivos , Transplante Autólogo , Recidiva Local de Neoplasia/tratamento farmacológico , Citarabina , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Melfalan , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Condicionamento Pré-Transplante , Transplante de Células-TroncoRESUMO
BACKGROUND: Surgical procedures applied in the treatment of early breast cancer (EBC) to achieve satisfactory oncological results lie in a wide spectrum. There has been a major shift toward less-invasive treatments during the past decades. We compared the outcomes of oncoplastic breast surgery (OBS), non-oncoplastic breast conserving surgery (NBCS) and mastectomy in the treatment of EBC. METHODS: The records of 412 patients with EBC who underwent OBS, NBCS or mastectomy at our institution between January 2012 and June 2019 were retrospectively analyzed. Postoperative complications, local recurrences (LR) and disease-free survival (DFS) were compared between the groups. EBC patients with unilateral stage-I, IIa and IIb tumors were studied. All patients received adjuvant, targeted and/or endocrine therapy according to the tumor characteristics, followed by radiotherapy (all OBS and NBCS cases, and selected mastectomy patients). RESULTS: Postoperative complications were similar in all groups except for six fat necrosis and partial nipple-areola necrosis in two diabetic patients treated with OBS. Re-excision rate was lower in OBS (6.5%) than NBCS (8%). There was no statistical difference between the groups regarding recurrence (P=1.000) or DFS (P=0.937). CONCLUSION: OBS, NBCS and mastectomy are equally acceptable procedures in EBC in terms of both oncological and surgical aspects.
Assuntos
Neoplasias da Mama , Mamoplastia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Mastectomia Segmentar , Estudos Retrospectivos , Resultado do TratamentoRESUMO
This study investigated the contents of Cu, Zn and Pb in seawater, sediment, different shell sizes of mussel (Mytilus galloprovincialis) and sea snail (Rapana venosa) samples collected from four different provinces of the Eastern Black Sea Region. With the exception of Zn, all the metal concentration values measured in the sea snail were observed to be higher than those of mussels in all stations. While the correlation between mussels and sea snail according to metal concentrations was found to be positive (pË0.05), this relation was not observed between the other parameters, such as the shell sizes, salinity and pH (pË0.05). Although the mean concentration values of Cu, Zn, and Pb for mussel and sea snail are significantly above the tolerable levels, the estimated daily intake values for mussel were below the daily intake recommended.