The Optimal Treatment Modality in Patients with T4N2M0 Non-Small Cell Lung Cancer: The Best Choice May Be Definitive Chemoradiotherapy Followed by Consolidation Chemotherapy.

BACKGROUND: Stage IIIB non-small cell lung cancer (NSCLC) consists of T4N2M0 and TXN3M0 NSCLC. In the present study, we aimed to evaluate the efficacy of different treatment strategies on the survival of patients with radiologically confirmed T4N2M0 NSCLC. METHODS: A total of 145 patients were evaluated in three groups according to the treatment protocol: induction chemotherapy followed by chemoradiotherapy (induction group); chemoradiotherapy (CRT group), and chemoradiotherapy followed by consolidation chemotherapy (consolidation group). The groups were compared regarding survival. RESULTS: The median progression-free survival (PFS) was 10.9, 10.8 and 17.1 months for the induction, CRT and consolidation groups, respectively (p = 0.021). The median overall survival (OS) was 17.6, 13.8 and 25.2 months for the induction, CRT and consolidation groups, respectively (p = 0.001). CONCLUSIONS: The patients with T4N2M0 NSCLC who were treated with chemoradiotherapy followed by consolidation chemotherapy had the best outcome in terms of PFS and OS.

The effect of surgery and hormone therapy on quality of life in breast cancer patients receiving radiotherapy.

Objectives: The aim of this study was to examine the effect of surgery type and hormone therapy on the general quality of life in breast cancer patients receiving radiotherapy. Material and Methods: A total of 109 patients were included in the study. As data collection tools in the research, a form stating the demographic and clinical features was used in the first part, and in the second part, "EORTC QLQ-C30" developed by the European Organization for Research and Treatment of Cancer and "EORTC QLQ-BR23" Turkish quality of life forms specific to breast cancer were used. The patients were asked to fill in the questionnaire forms on the first day, the last day of radiotherapy and three months after the end of the treatment. Results: Mean age of this study was 54.8 ± 12.1 years. In the questionnaires made on the first day, last day and three months after radiotherapy, the highest score according to the EORTC QLQ-C30 scale was in social and cognitive function, and in sexual life on the EORTC QLQ-BR23 scale. According to multiple comparison test and comparing the first day of radiotherapy and three months after radiotherapy, there was a significant difference in patients' physical function average (p= 0.049), future expectation (p= 0.033), sexual life (p= 0.029), sexual satisfaction (p <0.001), and hair loss (p= 0.011), and arm related problems (p <0.001). According to the analysis of variance in repeated measurements, physical function, sexual life, side effects, hair loss, dyspnea, and future expectation were statistically significant according to the type of surgery, and for hormone therapy, sexual life, hair loss, constipation and financial difficulty were found statistically significant. Conclusion: It was observed that other than radiotherapy, hormone therapy and surgical techniques were also effective on the quality of life in patients receiving radiotherapy for breast cancer.

Autophagy-related genes affect the survival of multiple myeloma patients depending on chromosomal abnormality.

Background: Targeting autophagy at gene level may be promising in multiple myeloma (MM) treatment depending on chromosomal abnormality (ABN) status. Objectives: We aimed to investigate the role of ABN on survival of MM patients and to identify prognosis related autophagy-related genes (ARGs) for patients with or without ABN. Methods: Gene intensity values of 222 ARG for 548 MM patients were obtained from the Affymetrix Human Genome U133 Plus 2.0 Array (GPL570) platform containing 54,675 probes (GSE24080). A dataset containing data from 1576 MM patients with 1q21 amplification (GSE4204, GSE4452, GSE4581, and GSE2658) was used for validation. Survival analysis of the patients was analyzed using univariate and multivariate Cox regression method with the help of R3.53 programming language and Kaplan-Meier graphics were created. The Gene Ontology enRIchmentanaLysis and visuaLizAtion (GOrilla) tool was used to define the related biological processes and pathways. Results: The overall survival (OS) and event-free survival (EFS) in all MM patients were strongly influenced by ABN. In the group of patients with ABN, 41 ARGs were found to be important in prognosis, whereas in the group of patients without ABN, 13 ARGs were found to be important in prognosis. CDKN1A, FKBP1B, FOXO3, and NCKAP1 ARGs were commonly significant in both groups and found to be survival triggering. Conclusions: The classification of MM patients according to the absence or presence of ABN is important in the determination of survival status. Detection of survival related ARGs in patients with chromosomal anomalies may be a new therapeutic target in treatment.

[Effect of propolis against radiation-induced oral mucositis in rats]. / Siçanlarda radyasyona bagli oral mukozitte propolisin etkisi.

OBJECTIVES: This study aims to investigate whether propolis has a protective role in oral mucosal damage induced by radiotherapy applied to head-neck region, using quantitative, biochemical and histopathological approaches. MATERIALS AND METHODS: Forty eight Wistar-Albino adult female rats at eight weeks of age and weighing 213±27 grams were included in this study and randomly divided into six groups: Group 1: control, group 2: only irradiated rats, group 3: irradiated rats with propolis administration at 50 mg/kg/day, group 4: irradiated rats with propolis administration at 100 mg/kg/day, group 5: only propolis administration at 50 mg/kg/day, group 6: only propolis administration at 100 mg/kg/day. The first dose of propolis was administered before 30 minutes irradiation and the other doses after irradiation once daily for seven days by topical application. Radiotherapy was applied to the total cranium by single fraction at a dose of 18 Gy. The mucositis degrees and body weights of the animals were measured throughout the experiment. On the 7th day of study, blood samples were taken from the rats under ketamine anesthesia and then the rats were sacrificed and tongue tissues samples were taken. Complete blood count and biochemical and antioxidant activities were analysed in the blood samples. The tongue samples were microscopically examined. RESULTS: Radiotherapy group had a decrease in body weight and neutrophil count, and an increase in oral mucositis as compared with the control group (p<0.001). Moreover, an increase in plasma malondialdehyde concentrations (p<0.001) and significant decreases in catalase and superoxide dismutase activities (p<0.001) were observed in irradiation-alone group when compared to the control group. Propolis administered irradiated rat groups showed a dose-dependent normalization in quantitative, biochemical and histopathological parameters when compared with the irradiation-alone group. CONCLUSION: The results showed that propolis is effective in reducing the severity of oral mucositis induced by head-and-neck irradiation.

Is Height of Prognostic Significance in Breast Cancer Cases?

Objective: The objective of this study was to investigate the correlation of height with prognosis and other prognostic factors in Turkish breast cancer cases. Materials and Methods: We retrospectively reviewed a total of 393 women aged between 26 and 88 years, diagnosed with stage 1-3 invasive ductal breast cancer, treated and followed-up in Kayseri Education and Research Hospital. Findings: The mean age at admission was 55.7 years; 77.6% were aged under 65, 56.7% were postmenopausal, 97.4% had undergone modified radical mastectomy, 47.3% were AJCC stage II, 36.8% N0, 46.0% grade II, 95.4% had received chemotherapy, 81.1% radiotherapy and 71.5% hormonotherapy. Height was under 151 cm in 20.8 %, 151-160 cm in 57.3 % and over 161 in 21.9 %. Follow-up duration differed between 0.3 and 195.3 months. Mean overal survival (OS) was 125.0 (65.6-184.3) months and progression free survival was 91.5 (37.7-145.2) months, with a tendency for better survival in taller individuals but no signficant variation between height groups. The 5 and 10-year OS rates were 74.5% and 56.4%, and PFS rates were 64.5% and 49.2%. Regarding association of height with other prognostic factors, a significant correlation was found between height and AJCC stage (p= 0.011) and estrogen status (ER) (p= 0.043). Conclusion: In conclusion, overal survival was found to be longer in patients with a height between 151 and 160 cm than those under 151 cm and over 161 cm. The reason for not obtaining significant results might be a relatively small number of patients and lack of the evaluation of clinical and pathologic characteristics together with anthropometric measurements in the patient population. Further studies are warranted to clarify any association.