Browsing by Author "Afsar, Cigdem Usul"

Now showing 1 - 2 of 2

The Effect of Pretreatment Neutrophil/Leucocyte Ratio on Survival in Patients With Locally Advanced Esophageal Cancer Receiving Chemoradiotherapy
(Carbone Editore, 2017) Karaca, Feryal; Afsar, Cigdem Usul; Almali, Necat; Karabulut, Senem; Karabulut, Mehmet; Keskin, Siddik; Akbulut, Serkan
Introduction: Esophageal cancer (EC) is a highly lethal malignancy. The majority of esophageal cancers are squamous cell or adenocarcinomas. Although the incidence of squamous cell carcinoma (SCC) is decreasing in the United States, the incidence of adenocarcinoma arising out of Barrett's esophagus is rising dramatically, although less so in the last few years. Treatment in locally advanced EC (LA-EC) must be multidisciplinary. There are only few factors which affects the prognosis. Our aim was to investigate the prognostic and predictive roles of pretreatment neutrophil/leucocyte (neu/leu) ratios in LA-EC patients receiving chemoradiotherapy (CRT). Materials and methods: Sixty patients with non-metastatic EC (youngest 31 years old) who applied to our hospital between 2011 and 2015 were included in this study. Neu/leu ratios were calculated before CRT and after CRT. The Kaplan-Meier method was used for estimating the survival function from lifetime data. In addition, Cox regression model was also used to explore the relationship between the survival of a patient and several explanatory variables. Results: There was statistical significance between neu/leu ratio before CRT and OS (p=0.047). One unit increase in neu/leu ratio, increases the probability of being alive 2.725 times (1/0.367). There was statistical significance between neu/leu ratio before CRT and progression-free survival (PFS) (p=0.046). One unit increase in neu/leu ratio, increases the probability of no relapse 3.559 (1/0.281) times. This means that the patients with higher neu/leu ratio before CRT have a lower risk of relapse. Discussion and conclusion: Multimodal therapeutic strategies combining chemotherapy, radiation therapy and surgery have been shown to be feasible and to have a positive impact on outcomes by decreasing the risk of locoregional recurrence and often by increasing overall survival. The overall survival (OS) and disease-free survival (DFS) of patients is too short in patients with LA-EC. Our study shows that patients with LA-EC who had higher pretreatment neu/leu ratios have better OS and PFS.
Retrospective Evaluation of the Pancreatic Cancer Patients Who Received Chemoradiotherapy
(derman Medical Publ, 2015) Karaca, Feryal; Afsar, Cigdem Usul; Oktem, Ozcan; Almali, Necat; Yilmazer, Gokhan; Keskin, Siddik; Tali, Ali Murat
Aim: Pancreatic cancer is a highly lethal malignancy and in locally advanced disease, chemotherapy (CT) or chemoradiotherapy (CRT) are implemented. The aim of this retrospective study was to investigate the general characteristics and survival of our patients receiving CRT. Material and Method: Between the years 2009-2013, 62 pancreatic cancer patients were taken into study who admitted to Van Training and Research Hospital. Eight patients who had whipple operation received radiotherapy (RT) with concurrent CT. Fifty-four patients who were considered to be inoperable underwent CRT. As adjuvant treatment dose, 45 Cy (1,8 Gy/fx/day) radiotherapy was administered to pancreas and regional lymph nodes. In patients who had taken definitive CRT, average 50.4 Cy (1.8 Gy/fx/day) dose was given. Statistical analysis was carried out using SPSS 19 software package; Kaplan-Meier analysis method was used for survival and log-range test for comparisons. Results: Twenty-four patients (38.7%) were female and 38 (61.3%) were wale. Eleven patients (1 7.7%) were at stage IA, 15 (25.8%) were stageI9,13 (20.9%) were stage HA, 8 (12.9%) were stage IIB and 14 (22.5%) were staged as stage HI. Two-year disease free survival (DES): time from the date of biopsy until the date of recurrence was approximately 436 days and the median DFS was found to be 362 days. The average overall survival (OS) time; time from the date of biopsy until the date of death were found to be approximately 854 days, the median survival time was found to be 916 days. Survival due to tumor localization (head, body and tail) showed no significant difference statistically (log-range chi-square=0.366;p=0.833). Discussion: According to our single center experience, our data in pancreatic cancer patients were parallel with international data. In preclinical experiments, effective drug therapies for curative modalities are under investigation for pancreatic cancer patients.