Multicenter Study on Breast Cancer in the Geriatric Population: Insights for Effective Treatment Strategies.

OBJECTIVE: Breast cancer is common among women aged 65 and over. There is a significant lack of evidence regarding the treatment of breast cancer in patients in this age group due to the rare inclusion of these patients in clinical studies. However, it is known that survival in elderly patients with breast cancer is significantly reduced in those not receiving standard therapy. Several factors, including patients' comorbidities, performance status, life expectancy, and tumor pathological and molecular characteristics, can affect the outcomes of treatment. In this study, we aimed to update the knowledge in this field by assessing these factors among the geriatric population in our multicenter dataset. METHODS: This retrospective study analyzed data from 335 breast cancer patients aged 65 and over who received adjuvant radiotherapy at five oncology centers (Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Meram Medical Faculty - Necmettin Erbakan University, Konya, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Umraniye Training and Research Hospital, Istanbul, and Istanbul Oncology Hospital, Istanbul) between May 2010 and September 2022. Demographic, clinical, and pathological data were collected, including age, gender, clinical symptoms, tumor characteristics, treatment approaches, and outcomes. Statistical analyses, including descriptive statistics, Kaplan-Meier analysis, log-rank test, and Cox regression analysis, were performed using IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States), with a significance level of p < 0.05. RESULTS: The tumor characteristics and survival time of 335 breast cancer patients were examined. In the results, performance status, T stage, and perineural invasion were found to be factors affecting the survival of elderly breast cancer patients. In multivariate analysis, it was seen that performance status played an important role as an independent prognostic factor. CONCLUSION: The treatment of breast cancer in the geriatric age group necessitates a personalized approach, taking into account the patient's overall health status, life expectancy, and comorbidities.

Radiotherapy for benign diseases in Turkey: a patterns of care survey of the Turkish Society for Radiation Oncology (TROD 05-002).

PURPOSE: We aimed to investigate the patterns of radiotherapy (RT) care in cases of benign diseases in Turkey. METHODS: A questionnaire survey was sent to all radiation oncology (RO) departments in Turkey. The number of patients treated for benign disease between 2015 and 2020 was requested. A list of benign conditions was given, and information on the number of patients per disease, single and total doses prescribed, weekly fractions, radiation type, energy, and device was requested. RESULTS: Of the 138 RO departments, 29 (21%) responded. The data received concerned 15 (52%) university, 10 (34%) public, and four (14%) private hospitals. A total of 130,846 patients were treated with RT in these departments. Of these patients, 6346 (4.85%) were treated for benign conditions. The most common benign diseases treated with RT were meningioma (35%), plantar fasciitis (19%), schwannoma (16%), arteriovenous malformation (11%), and pituitary adenoma (7%). Most centers performed RT for paraganglioma, heterotopic ossification, vertebral hemangioma, and Graves' ophthalmopathy, but none treated arthrosis. Wide variations were observed across the departments. Radiosurgery for intracranial pathologies was performed intensively in four centers. By contrast, RT for plantar fasciitis was predominantly treated in five centers, one of which had more than 1000 patients. CONCLUSION: The ratio of patients who underwent RT for benign diseases in Turkey among all patients who underwent RT was 4.85%. The common pattern of RT in 72% of patients was radiosurgery for intracranial benign diseases, followed by low-dose RT for plantar fasciitis in 19%.

Assessment of Quality of Life Following Radiotherapy in Patients with Rectum Cancer.

PURPOSE: The aim of the present study is to investigate the effects of radiotherapy (RT) on quality of life (QoL) and influencing factors. METHODS: Data of 106 patients who completely filled out the three questionnaires were evaluated in this prospective study. Quality of life was evaluated with cancer-specific QLQ-C30 and colorectal cancer module QLQ-CR29 created by European Organization for Research and Treatment of Cancer (EORTC). All statistical analyses were done with SPSS version 22 software. A p level of < 0.05 was accepted as statistically significant. RESULTS: Median age was 61 (27-86). Of the patients, 77 (72.6%) were male and 29 (27.4%) were female. When QLQ-C30 questionnaires were evaluated, it was observed that physical, role, cognitive, and emotional function scores were impaired following RT, however returned to pre-RT levels on control. According to the results of QLQ-CR29 questionnaire, after RT, impairment was observed in urination frequency, urinary incontinence, stool frequency, dysuria, fecal incontinence, embarrassment, and sexual interest in male scales; however, they returned to pre-RT values on control. When evaluated with regard to age, financial difficulty, global health score, mucus in stool, dysuria, dyspareunia, and abdominal pain were observed to be poorer in the young; urination frequency and urinary incontinence were observed to be poorer in the elderly. CONCLUSION: Although both functional and symptom scales were shown to impair, most of them were detected to be temporal and patients could well tolerate radiotherapy. Additional assessment is required for evaluating the late effects of treatments on QoL.

Prognostic importance of expression of mini-chromosome maintenance proteins (MCMs) in patients with nasopharyngeal cancer treated with curative radiotherapy.

OBJECTIVE: The prognostic importance of minichromosome maintenance complex expression in nasopharyngeal cancer is still unknown. We aimed to find whether minichromosome maintenance complex 2-7 expression may potentially be used to predict the prognosis of nasopharyngeal cancer patients treated with definitive radiotherapy. METHODS: Between April 2007 and July 2020, patients with nasopharyngeal cancer treated with radiotherapy were identified. Immunohistochemical analysis was performed on formalin-fixed paraffin-embedded tissues of cases. A single pathologist analyzed the histologic specimens of all patients. RESULTS: Totally, 67 patients were included. The median followup was 75.3 months. Higher tumor (T) stage was correlated with minichromosome maintenance complex 2 overexpression. Minichromosome maintenance complex s expression was also associated with histopathologic subgroups. According to univariate analysis, AJCC stage, histopathological subgroups, tumor response after treatment, minichromosome maintenance complex 2, 3, 5, 6 and 7 expression were the prognostic factors that predict overall survival. According to multivariate analysis minichromosome maintenance complex 7 expression was the only prognostic marker for both progression-free survival and overall survival. CONCLUSION: The overexpression of minichromosome maintenance complex 2, 3, 5, 6 and 7 indicated bad prognosis. Minichromosome maintenance complex 7 was an independent prognostic factor for survival outcomes in nasopharyngeal cancer and may be a potential therapeutic target for treatment.

Prognostic importance of PTEN, EGFR, HER-2, and IGF-1R in gastric cancer patients treated with postoperative chemoradiation

Background/aim: This study aimed to describe the prognostic importance of epidermal growth factor (EGFR), phosphatase and tensin homolog (PTEN), human EGF receptor-2 (HER-2), and insulin-like growth factor 1 receptor (IGF-1R) in gastric cancer patients treated with postoperative chemoradiation therapy. Materials and methods: Sixty-nine patients treated with adjuvant chemoradiation therapy were retrospectively evaluated. Tumor samples were stained immunohistochemically. Results: All patients were treated with 3D conformal radiation therapy with concomitant and adjuvant chemotherapy. Perineural invasion (PNI) (P = 0.042), prechemoradiation therapy albumin levels below 3.5 mg/dL (P = 0.011), and EGFR positivity (P = 0.008) had negative effects on overall survival (OS). The median OS was 26 months for patients with PNI (+), 34.9 months for those with PNI (­), 19.5 months for those with albumin levels below 3.5 mg/dL, and 33.2 months for those with albumin levels above 3.5 mg/dL. IGF-1R (+) (P = 0.035) and history of cigarette smoking (P = 0.033) were observed to have a statistically significantly negative effect on disease-free survival (DFS). The median DFS was 29.2 months for IGF-1R (+) patients, 37.9 months for those with IGF-1R (-), and 26.3 and 40.59 months for smokers and nonsmokers, respectively. Conclusion: IGF-1R and EGFR may be used for patient selection in future prospective studies that evaluate the prognostic importance of these receptors.