RESUMEN
BACKGROUND: The prognosis of primary glioblastoma (GBM) is poor. Approximately 2/3 of primary brain tumor diagnoses are GBM, of which 95% are primary lesions. In this study, we aimed to evaluate whether more sunlight exposure has an effect on survival of patients with primary GBM. MATERIALS AND METHODS: A total of 111 patients with primary GBM were enrolled from Kayseri in inner Anatolia which has a cold climate (n: 40) and Mersin in Mediterranean region with a warm climate and more sunlight exposure (n: 71). The patients with primary GBM were divided into two groups as Kayseri and Mersin and compared for progression free survival (PFS) and overall survival (OS). RESULTS: The PFS values were 7.0 and 4.7 months for Kayseri and Mersin groups, respectively (p=0.10) and the respective OS values were 13.3 and 9.4 months (p=0.13). We did not found any significant difference regarding age, sex, comorbidity, smoking, surgery, resurgery, adjuvant chemoradiotherapy and palliative chemotherapy between the groups. CONCLUSIONS: We found that more sunlight exposure had no impact on prognosis of patients with primary GBM, adding inconsistency to the literature about the relationship between sunlight and GBM.
Asunto(s)
Neoplasias Encefálicas/mortalidad , Glioblastoma/mortalidad , Luz Solar , Antineoplásicos/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/cirugía , Quimioradioterapia Adyuvante , Supervivencia sin Enfermedad , Exposición a Riesgos Ambientales , Femenino , Geografía , Glioblastoma/tratamiento farmacológico , Glioblastoma/cirugía , Humanos , Masculino , Persona de Mediana Edad , Turquía , Vitamina DRESUMEN
PURPOSE: To compare standard radiotherapy field (SRTF) with whole abdomen irradiation (WAI), used in conjunction with adjuvant chemotherapy following curative surgery in patients with gastric cancer. METHODS AND MATERIAL: Ninety patients were included in the study and divided into two treatment arms. In the first treatment arm, SRTF, including 45 Gy radiation to the primary tumor and regional lymph nodes, was performed in 45 patients. In the second treatment arm, a total of 45.2 Gy RT was delivered; 20 Gy to the whole abdomen followed by 25.2 Gy RT to the tumor and regional lymph nodes, in 45 patients. An intravenous bolus dose of 250 mg/m(2)/week 5-fluorouracil (5-FU) was administered concomitantly with RT in both treatment arms. Patients who completed concomitant chemoradiotherapy, received adjuvant treatment, including 4 cycles of 5-FU (425 mg/m(2)) and folinic acid (20 mg/m(2)) in 4 week intervals. RESULTS: Median age was 56 years (range: 22-81), 89% of the patients (n = 80) had serosal involvement, 78% (n = 70) were node positive. The rate of hematological (40% vs. 16%, p = 0.010) and gastrointestinal toxicities (80% vs. 53%, p = 0.010) were higher, and performance loss (60% vs. 29%, p = 0.003) was greater in the second treatment arm. Number of patients who experienced Grade 3 and Grade 4 gastrointestinal toxicities (especially diarrhea) were higher in the second treatment arm (4% vs. 16%, p = 0.049). The median follow-up was 19 months (range: 7-96). The median 5-year survival was 29% and 17%, locoregional control was 30% and 25%, and disease-free survival was 27% and 16% in the first and second treatment arms, respectively. There was no significant difference between the treatment groups in terms of survival, locoregional control and disease-free survival rates (p > 0.05). CONCLUSION: Whole abdomen irradiation was not found to be superior to standard field radiotherapy used in conjunction with adjuvant chemotherapy in gastric cancer.