262he development of a second malignant neoplasm was about 10-40% in patients with head and neck squamous cell carcinoma (HNSCC). Metachronous second cancers most frequently involve the esophagus and lung, whereas synchronous second cancers are more common in head Second Primary Tumors in Patients with Head and Neck Cancer: A Retrospective Study from a Single Center A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Patients with squamous cell carcinoma of the head and neck are at risk for developing a second primary cancer. The aim of this study was to determine incidence and localization of second primary tumors. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Three hundred twenty-four patients with head and neck cancer diagnosed between 2000 -2010 were analyzed for the presence of a second malignancy. The data used in this study were obtained retrospectively from a database. R Re es su ul lt ts s: : A total of 324 patients were enrolled in this study, there were 248 males and 76 females ranging between the ages of 18 and 84 years, with a median age of 53 years. Ten patients (3.08%) had metachronous, three patients (0.93%) had synchronous cancers. In our study, 7.12% of the older population (>60 years) had second primary tumors, and 2.46% of the younger population (≤ 60 years) had second primary cancers. There were no statistical differences between two groups (p=0.07). Overall survival of patients with metachronous second primary cancers at 1 and 3 years were 87.5% and 62.5% respectively while these rates were 95.2% and 88.3% respectively in the ones without second primary cancers. C Co on nc cl lu us si io on n: : In our study, 4% of patients had second primary tumors. Screening programs were considered beneficial in high risk patients with head and neck cancers who smoke and use alcohol in order to detect second primary cancers.K Ke ey y W Wo or rd ds s: : Carcinoma, squamous cell of head and neck; neoplasms, second primary Ö ÖZ ZE ET T A Am ma aç ç: : Baş boyun skuamöz hücreli kanser hastaları, ikinci primer gelişimi açısından risklidir. Bu çalışmanın amacı, baş boyun kanserli hastalarda ikinci primer kanser insidansı ve lokalizasyonu araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmaya 2000 ile 2010 yılları arasında, Gazi Üniversitesi Hastanesi'nde baş boyun kanseri tanısı alan 324 hasta dahil edildi. Çalışmada retrospektif veri tabanı oluşturularak analiz yapıldı. B Bu ul lg gu ul la ar r: : Hastaların 248'i erkek, 76'sı kadındı. Ortanca yaş 53 yıl (18-84 yıl) olarak saptandı. Hastaların 10'unda (%3,08) metakron, 3'ünde (%0,83) senkron ikinci primer vardı. Yaşlı hastaların (> 60 yaş) %7,12'sinde, 60 yaş ve daha genç hastaların %2,46'sında ikinci primer kanser geliştiği gözlendi. Bu iki grup arasında istatistiksel fark yoktu (p=0,07). Ortanca sağkalım ikinci primer gelişen grupta 1 yıllık %87,5, 3 yıllık %62,5 iken, gelişmeyen grupta %95,2 ve %88,3 olarak bulundu. S So on nu uç ç: : Bu çalışmada %4 oranında ikinci primer kanser gözlendi. Sigara ve alkol kullanan...

e19107 Background: In this study, the efficacy and safety of pemetrexed chemotherapy was evaluated retrospectively in patients who were non-responders to or who have demonstrated progression after the first and/or second line treatments in local advanced and metastatic NSCLC. Methods: 175 patients (139 males, 36 females) were assessed in years 2008 – 2012. Patients were given pemetrexed 500 mg/m2, and the ones receiving combined treatment were given pemetrexed 500 mg/m2 and cisplatin 75 mg/m2 once in every 21 days. Supplementary steroid and vitamin treatment were administered to all patients. Age, gender, performance status (PS), stage, single agent or combined administration of treatment, progression-free survival (PFS) and overall (OS) were investigated. Patients were assessed in terms of treatment efficacy and toxicity. Results: Median follow-up period was 6 months (1 - 25), and median age was 55 years (28 - 83). In 82% of patients, PS was 0 – 1. 73% of patients were at stage 4. 71% of the patients received single agent pemetrexed, and 14% received platinum - pemetrexed combination treatment. 93% of patients received pemetrexed treatment as second line. Median 3 cycles of treatment (1 – 12) were administered. In side effect assessment, while side effects (grade 1 – 4) were observed in 62% of the patients, the most frequently observed side effects were anemia (18%) and nausea-vomiting (15%). Febrile neutropenia was detected in 6 patients (3.4%).In assessment of the response, the disease control ratio was 50% (21% partial response, 29% stable disease). 1- and OS rates were respectively 14% and 41%. Median OS was 10 months (SE:1, 95% CI: 7-12) and median PFS was 3 months (SE:1, 95% CI: 2-4). In multivariate analysis, PS of 0 – 1 and response to treatment were found as factors with prognostic significance (p=0.047, p=0.014, respectively). Conclusions: It is observed that chemotherapy regimen containing pemetrexed in NSCLC treatment is a treatment approach, which provides an efficient disease control with a manageable side effect profile, in patients especially with good performance status and with no platinum resistance, who can receive treatment in combination form.