Küçük Hücreli akciğer kanseri (KHAK) kemoterapiye duyarlı ancak kötü prognozu olan bir akciğer kanseri türüdür. Bu çalışmamızda lenfosit/monosit oranının ile birlikte diğer klinik ve laboratuvar parametrelerinin prognostik önemini araştırmayı amaçladık. Araçlar ve Yöntem: Bu çalışmamızda retrospektif olarak Ocak 2014 ile Aralık 2019 tarihleri arasında KHAK tanısı almış ve yaygın evrede olan 146 hastanın tıbbi kayıtları incelendi. Kemoterapi öncesi alınan kan tetkiklerinden lenfosit/monosit oranı (LMO) hesaplandı. Bulgular: Çalışmaya alınan hastalarda medyan genel sağ kalım süresi 8.78 (aralık 1.07-54.80) ay, progresyonsuz sağ kalım süresi (PSK) 5.6 (1.07-44.03) ay olarak bulundu. Tüm hastaların kohort analizinde, LMO düşük grupta medyan PSK 4.5 ay, genel sağ kalım süresi (GSK) 7.5 ay olup, LMO yüksek grupta medyan PSK 6.5 ay, GSK 10.1 ay olarak saptandı. Tek değişkenli analiz ile incelendiğinde LMO yüksek olan hastaların düşük olan hastalara göre genel sağ kalım süreleri de daha uzundu (HR 0.591 %95 CI 0.42-0.83 p=0.003). Çok değişkenli analiz ile incelendiğinde ise LMO yüksekliği sağ kalım için iyi prognostik göstergelerden biri olma özelliğini devam ettiriyordu (HR: 0.54 %95 CI 0.38-0.77. p=0.001) Sonuç: Yüksek LMO, yaygın evre küçük hücreli akciğer kanseri hastalarında uzun PSK ve GSK'yı gösteren bağımsız bir prognostik parametre olabileceği kanıtlandı.

No abstract

No abstract

No abstract

IntroductionBiliary tract tumors constitute 10% to 15% of all tumors involving the hepatobiliary system. They might arise from the intrahepatic biliary tract, or more commonly the extrahepatic biliary tract (1). Surgical resection is the mainstay of treatment for biliary tract tumors, which should aim for uninvolved margins in an attempt to exploit any potential for cure. In the majority of patients, however, the attempts at a potentially curative surgical resection are hindered by the extent of the tumor at the time of diagnosis or the presence of comorbidities (2). In patients with biliary tract tumors, radiation therapy and chemotherapy might be indicated as adjuvant measures for those that have undergone surgical resection with a curative intent or as palliative measures for those that have been deemed inoperable (3). Regarding the medical literature that attempts to evaluate the effectiveness of adjuvant measures in patients with biliary tract tumors, retrospective studies from individual centers are abundant, whereas prospective studies from multiple centers are absent. Therefore, the adjuvant treatment approach for biliary tract tumors is governed by personal tendencies or institutional policies rather than evidence. This study presents the joint experience of three centers in the treatment of patients with biliary tract tumors with radiation therapy. Materials and methodsThe study design was approved by the Institutional Review Board of Kocaeli University. Patient characteristicsThe medical records of 27 patients who had been treated with radiation therapy with the diagnosis of biliary tract tumors (with no evidence of metastatic disease at the time of diagnosis) from July 2007 through June 2013 were Background/aim: This study presents the joint experience of three centers in the treatment of patients with biliary tract tumors with radiation therapy (RT). Materials and methods:The records of 27 patients were retrospectively reviewed. All of the patients who had undergone surgical resection received postoperative adjuvant RT, whereas all of the patients who had not undergone a surgical resection received RT with palliative intent. Twenty patients with adequate performance status were treated with RT and chemotherapy, while the remaining seven patients were treated with RT alone.Results: Follow-up ranged from 1 to 44 months. Local control was not achieved in 10 out of 11 patients who had received RT with palliative intent. Systemic failure was observed in eight patients at 5 to 16 months. Fifteen patients died due to disease-related causes at 1 to 22 months. At 2 years, overall survival was 33% and disease-free survival was 19%. A surgical resection with curative intent predicted improved local failure-free survival and improved disease-free survival. Conclusion:Since local recurrence is still the leading cause of failure following postoperative RT and the outcome following palliative RT is far from satisfactory, the indications, the target volume, and the doses for RT should be reconsidered.