An analysis of adjuvant treatment strategies in operated pancreatic cancer patients: An Izmir oncology group study.

BACKGROUND: Adjuvant treatment is necessary in pancreatic cancer patients, but the optimal approach is not clear yet. Our aim was to explore the effectiveness of adjuvant treatment modalities in patients with operated pancreatic cancer. METHODS: There were five groups of patients operated for primary pancreas adenocarcinoma. The first two groups included patients who were treated with only adjuvant chemotherapy or radiotherapy. The patients in third group had received combination chemotherapy and radiotherapy either sequentially or concomitantly. The fourth group was composed of patients who were treated with adjuvant chemotherapy after concurrent chemoradiotherapy, whereas the patients in the fifth group were only observed after surgery without any adjuvant treatment. RESULTS: There were 83 operated pancreatic cancer patients available for analysis. Median age of the patients was 63 years (range, 40-82 years). There were 55 patients who had local disease recurrence (n = 14) or metastasis (n = 41) during or after adjuvant treatment. The median overall survival for all patients was 14 months. When we compared the median survival of patients who had any adjuvant treatment with the patients treated without any adjuvant therapy, we found a significant statistical difference between the groups (32.4 vs 6.5 months; P = 0.000). In addition, survival of each treatment group was also compared with each other but we did not find any significant statistical difference. CONCLUSIONS: Our result suggests that any adjuvant therapy in the treatment of pancreatic cancer patients is important. However, we could not find any superiority between adjuvant treatment modalities.

Fractionated stereotactic radiosurgery for vestibular schwannomas using cyberknife: A single institution experience.

OBJECTIVE: To assess tumour control, hearing preservation status, and complication ratio after fractionated stereotactic radiosurgery/radiotherapy by using CyberKnife device in patients with vestibular schwannomas. METHODS: This retrospective study was conducted at Izmir Ataturk Research and Tranining Hospital, Turkey, and comprised data of vestibular schwannomas patients treated with stereotactic radiosurgery/radiotherapy from March 2010 to December 2013. The patients were subjected to a dose ranging from 12 to 30Gy using CyberKnife system with an average of three fractions. SPSS 17 was used for data analysis. Paired t-test and Pearson's chi-square test were used to compare clinical parameters between groups. P<0.05 was considered significant. RESULTS: Of the 41 patients, 26(63.4%) were women and 15(36.6%) were men. The median follow-up duration after stereotactic radiosurgery/radiotherapy was 25 months (interquartile range: 9-44 months). Radiographic control evaluation ratio was 95.7% with a median follow-up of 3 years (IQR: 18.5 months). Results of 23(56%) patients showed stabile response, 17(42%) regression response and 1(2%) progression response. There were no statistically significant changes between pre- and post-stereotactic radiosurgery/radiotherapy symptoms (p>0.05). One (2.4%) patient reported new onset facial paresis. CONCLUSIONS: Stereotactic radiosurgery/radiotherapy treatment of vestibular schwannomas resulted in a good ratio of tumour control. Hearing preservation status and ratios of toxicity were comparable to published literature.

Evaluation of treatment outcomes of triple-negative breast cancer.

PURPOSE: Breast cancer is the most common cancer in women. Treatment responses are variable depending on tumor morphological characteristics, clinical characteristics, and hormonal receptor levels. In current medical practice, estrogen receptor (ER), progesterone receptor (PGR), and human epidermal growth factor receptor 2 (HER2) levels have been identified as important prognostic factors; they can change prognosis and treatment modalities. In this study, the prognostic factors of patients with triple-negative breast cancer (TNBC) were examined retrospectively. MATERIALS AND METHODS: Some 110 cases with negative prognostic and predictive proteins (ER, PGR, and HER2) were included in this study. Median follow-up was 56 months. Recurrences, overall survival, and prognostic factors were evaluated. RESULTS: We revealed in our triple-negative series that nodal status, tumor size, whole breast radiation doses, and type of surgery are the most useful prognostic markers. CONCLUSION: Triple-negative breast cancers, especially basal-like subtypes, have bad prognoses. They have high histopathological grades and high risk of invasion. This group can make early metastases and expected survival is usually short. We need to focus on new treatment strategy modalities on this group, and pretreatment values of different prognostic markers are well-identified, such as androgen receptors, basal cytokeratin expression, and BRCA gene status.