• Title, Summary, Keyword: Medical oncology

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Clinicopathological Features in Bilateral Breast Cancer

  • Baykara, Meltem;Ozturk, Selcuk Cemil;Buyukberber, Suleyman;Helvaci, Kaan;Ozdemir, Nuriye;Alkis, Necati;Berk, Veli;Koca, Dogan;Coskun, Ugur;Oksuzoglu, Berna;Uncu, Dogan;Arpaci, Erkan;Ustaalioglu, Basak Oven;Demirci, Umut;Kucukoner, Mehmet;Dogu, Gamze Gokoz;Alici, Suleyman;Akman, Tulay;Ozkan, Metin;Aslan, Ulku Yalcintas;Durnali, Ayse Gok;Benekli, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4571-4575
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    • 2012
  • Introduction and Purpose: The frequency of bilateral breast cancer is 1.4-11.0% among all breast cancers. It can present as synchronous (SC) or metachronous (MC). Data regarding clinical course of bilateral breast cancer are scarce. In this study, we therefore evaluated demographic, pathological and clinical characteristics, treatments and responses in bilateral breast cancer cases; making distinctions between metachronous-synchronous and comparing with historic one-sided data for the same parameters. Materials and Methods: One hundred fifty bilateral breast cancer cases from ten different centers between 2000 and 2011 were retrospectively scanned. Age of the cases, family history, menopausal status, pathological features, pathological stages, neoadjuvant, surgery, adjuvant and palliative chemotherapy/radiotherapy were examined in the context of the first and second occurrence and discussed with reference to the literature. Results: Metachronous and synchronous groups showed similar age, menopausal status, tumor type, HER2/neu expression; the family history tumor grade, tumor stage, ER-negativity rate, local and distant metastases rates, surgery, adjuvant chemotherapy application rates were identified as significantly different. Palliative chemotherapy response rate was greater in the metachronous group but median PFS rates did not differ between the groups. Conclusion: Although bilateral breast cancer is not frequent, MC breast cancer is different from SC breast cancer by having more advanced grade, stage, less ER expression, more frequent rates of local relapse and distant metastasis and better response to chemotherapy in case of relapse/metastasis.

Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

  • Berk, Veli;Kaplan, Mehmet Ali;Tonyali, Onder;Buyukberber, Suleyman;Balakan, Ozan;Ozkan, Metin;Demirci, Umut;Ozturk, Turkan;Bilici, Ahmet;Tastekin, Didem;Ozdemir, Nuriye;Unal, Olcun Umit;Oflazoglu, Utku;Turkmen, Esma;Erdogan, Bulent;Uyeturk, Ummugul;Oksuzoglu, Berna;Cinkir, Havva Yesil;Yasar, Nurgul;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7367-7369
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    • 2013
  • Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-${\beta}$) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.

Analysis of Treatment and Delay Times by Disease Site and Delivery Technique at Samsung Medical Center - Proton Therapy Center

  • Jo, Kwanghyun;Ahn, Sung Hwan;Chung, Kwangzoo;Cho, Sungkoo;Shin, Eunhyuk;Hong, Chae-Seon;Park, Seyjoon;Kim, Dae-Hyun;Lee, Boram;Lee, Woo-Jin;Seo, Se-Kwang;Jang, Jun-Young;Choi, Doo Ho;Lim, Do Hoon;Han, Youngyih
    • Progress in Medical Physics
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    • v.27 no.4
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    • pp.258-266
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    • 2016
  • We have treated various disease sites using wobbling and scanning proton therapy techniques since December 2015 at the Samsung Medical Center. In this study, we analyze the treatment time for each disease site in 65 wobbling and 50 scanning patient treatments. Treatment times are longest for liver and lung patients using the respiratory gating technique in the wobbling treatment and for cranio-spinal irradiation in pediatric patients with anesthesia in the scanning treatment. Moreover, we analyze the number of incidents causing treatment delays and the corresponding treatment delay time. The X-ray panel was the main reason for delays in the wobbling treatment; this decreased continually from January to June 2016, related closely to the proficiency of the human operators involved. The main reason for delays in the scanning treatment was interlocks during scanning pattern delivery; this was resolved by proton machine engineers. Through this work, we hope to provide other institutes with useful insight for initial operation of their proton therapy machines.

The first private-hospital based proton therapy center in Korea; status of the Proton Therapy Center at Samsung Medical Center

  • Chung, Kwangzoo;Han, Youngyih;Kim, Jinsung;Ahn, Sung Hwan;Ju, Sang Gyu;Jung, Sang Hoon;Chung, Yoonsun;Cho, Sungkoo;Jo, Kwanghyun;Shin, Eun Hyuk;Hong, Chae-Seon;Shin, Jung Suk;Park, Seyjoon;Kim, Dae-Hyun;Kim, Hye Young;Lee, Boram;Shibagaki, Gantaro;Nonaka, Hideki;Sasai, Kenzo;Koyabu, Yukio;Choi, Changhoon;Huh, Seung Jae;Ahn, Yong Chan;Pyo, Hong Ryull;Lim, Do Hoon;Park, Hee Chul;Park, Won;Oh, Dong Ryul;Noh, Jae Myung;Yu, Jeong Il;Song, Sanghyuk;Lee, Ji Eun;Lee, Bomi;Choi, Doo Ho
    • Radiation Oncology Journal
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    • v.33 no.4
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    • pp.337-343
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    • 2015
  • Purpose: The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. Materials and Methods: The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and the other treatment room is equipped with a dedicated pencil beam scanning nozzle. The proton beam generator including the cyclotron and the energy selection system can lower the energy of protons down to 70 MeV from the maximum 230 MeV. Results: The multi-purpose nozzle can deliver both wobbling proton beam and active scanning proton beam, and a multi-leaf collimator has been installed in the downstream of the nozzle. The dedicated scanning nozzle can deliver active scanning proton beam with a helium gas filled pipe minimizing unnecessary interactions with the air in the beam path. The equipment was provided by Sumitomo Heavy Industries Ltd., RayStation from RaySearch Laboratories AB is the selected treatment planning system, and data management will be handled by the MOSAIQ system from Elekta AB. Conclusion: The SMC-PTS located in Seoul, Korea, is scheduled to begin treating cancer patients in 2015.

Multicenter Epidemiologic Study on Hepatocellular Carcinoma in Turkey

  • Can, Alper;Dogan, Erkan;Bayoglu, Ibrahim Vedat;Tatli, Ali Murat;Besiroglu, Mehmet;Kocer, Murat;Dulger, Ahmet Cumhur;Uyeturk, Ummugul;Kivrak, Derya;Orakci, Zuat;Bal, Oznur;Kacan, Turgut;Olmez, Sehmus;Turan, Nedim;Ozbay, Mehmet Fatih;Alacacioglu, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2923-2927
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    • 2014
  • Background: Hepatocellular cancer (HCC) is one of the important health problems in Turkey, being very common and highly lethal. The aim of this study was to determine clinical, demographic features and risk factors. Materials and Methods: Nine hundred and sixth-three patients with HCC from 13 cities in Turkey were included in this study. Results: Only 205 (21%) of the 963 patients were women, with a male:female predominance of 4.8:1 and a median age of 61 years. The etiologic risk factors for HCC were hepatitis B in 555 patients (57.6%), 453 (81%) in men, and 102 (19%) in women, again with male predominance, hepatitis C in 159 (16.5%), (14.9% and 22.4%, with a higher incidence in women), and chronic alcohol abuse (more than ten years) in 137 (14.2%) (16.8% and 4.9%, higher in males). The Child-Pugh score paralleled with advanced disease stage amd also a high level of AFP. Conclusions: According to our findings the viral etiology (hepatitis B and hepatitis C infections) in the Turkish population was the most important factor in HCC development, with alcohol abuse as the third risk factor. The Child-Pugh classification and AFP levels were determined to be important prognostic factors in HCC patients.

Staged Improvement in Awareness of Disease for Elderly Cancer Patients in Southern China

  • Li, Xing;Dong, Min;Wen, Jing-Yun;Wei, Li;Ma, Xiao-Kun;Xing, Yan-Fang;Deng, Yun;Chen, Zhan-Hong;Chen, Jie;Ruan, Dan-Yun;Lin, Ze-Xiao;Wang, Tian-Tian;Wu, Dong-Hao;Liu, Xu;Hu, Hai-Tao;Lin, Jia-Yu;Li, Zhuang-Hua;Liu, Yuan-Chao;Xia, Qing;Jia, Chang-Chang;Wu, Xiang-Yuan;Lin, Qu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6311-6316
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    • 2015
  • Background: In mainland China, awareness of disease of elderly cancer patients largely relies on the patients' families. We developed a staged procedure to improve their awareness of disease. Materials and Methods: Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between family and patients, patient awareness of their disease and participation in medical decision-making. After first cycles of treatment, increased information of disease was given to patients with cooperation of the family. Then patient awareness of their disease and participation in medical decision-making was documented. Results: Among the 224 cancer elderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decision-making to their family. Subordinate family members tended to play a passive role in decision-making significantly. Patients participating more in medical decision-making tended to know more about their disease. However, in contrast to the awareness of disease, patient awareness of violation of medical recommendations was reversely associated with their participation in medical decision-making. Improvement in awareness of diagnosis, stages and prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively in medical decision-making. Conclusions: Chinese elderly cancer patient awareness of disease and participation in medical decision-making is limited and relies on their family status. The staged procedure we developed to improve patient awareness of disease proved effective.