Comparison of different cyclin-dependent kinase inhibitors and KI-67 levels on survival and toxicity in breast cancer treatment.

OBJECTIVE: As cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors, which play a crucial role in the cell cycle, palbociclib and ribociclib are two novel drugs that are recently being used in the treatment of breast cancer. Despite targeting the same pathway, these agents have different molecular activities and processes. KI-67 is known to play a significant role in cell proliferation that has been related to prognosis. This study investigated the impact of palbociclib, ribociclib, and KI-67 on toxicity and survival in breast cancer treatment. PATIENTS AND METHODS: The study included 140 breast cancer patients in total. Patients were divided into groups based on the use of different CDK inhibitors and KI-67 values. Mortality, progression, treatment response rates, frequency, and severity of adverse events were assessed retrospectively. RESULTS: The patients in our study had an average age of 53.62±12.71 years, and 62.9% of them were diagnosed at an early stage. 34.3% (n=48) of the patients progressed after receiving treatment, while 19.3% (n=27) of the patients died. The median follow-up time was 576 days, the maximum follow-up time was 1,471 days, and the median time to progression was 301 days (min=28-max=713). Mortality, progression, and treatment response rate between two different CDK inhibitors or KI-67 groups revealed no statistically significant differences. CONCLUSIONS: Our data show a comparison between the effectiveness of palbociclib and ribociclib, and no noticeable difference is found in breast cancer patients' survival, progression, or severity of adverse effects. Likewise, there is no meaningful difference in KI-67 expression subgroups between progression and survival following treatment.

Evaluation of the effect of CPAP treatment on voice in obstructive sleep apnea with objective and subjective voice analyzes.

OBJECTIVE: Obstructive sleep apnea (OSA) is a multifactorial disease that is the most common among sleep-related respiratory disorders. In our study, we aimed to compare the objective and subjective voice analysis results of the patients with CPAP treatment indication after polysomnography performed in the sleep disorders center before the start of CPAP treatment, the 1st month, and the 3rd month after the treatment. PATIENTS AND METHODS: Patients were asked to say the vowels /ɑ:/ for 5 seconds, respectively for voice recording. MPT and S/Z ratios were also recorded. Using the Praat voice analysis program Jitter%, Shimmer%, HNR, f0 values were obtained. VHI-10 questionnaire was applied. The voice analysis results of the patients before and after the treatment were compared. RESULTS: 26 patients were included in the study. Since 8 of these patients did not come to the 3rd month evaluation, the study was completed with the data of 18 patients. In our study, at the end of the 3rd month, no difference was found in terms of the fundamental frequency, Shimmer%, HNR, and S/Z values. There was a statistically significant decrease in Jitter% at the 1st month after treatment and 3rd month after treatment compared to pre-treatment (p=0.05, p=0.018). There was a statistically significant decrease in MPT at the 1st month after treatment and 3rd month after treatment compared to pre-treatment (p<0.001, p<0.001). There was a statistically significant decrease in VHI-10 at the 1st month and 3rd month after treatment compared to pre-treatment. Furthermore, there was statistically significant difference between 3rd month after treatment compared to 1st month after treatment. (p=0.043, p=0.030, p=0.029). CONCLUSIONS: Our study showed that CPAP treatment had both objective and subjective positive effects on voice recovery in the OSA patient group.