Purpose: We aimed to identify the prognostic and predictive values of post-treatment prognostic nutritional index (PNI) and PNI dynamics in nasopharyngeal cancer patients (NPC) in this study.Methods: 107 non-metastatic NPC patients were included. PNI was calculated by using the following formula: [10 x serum albumin value (gr/dL)] + [0.005 x total lymphocyte count (per mm3)]. ROC analysis was used for determining prognostic PNI values and univariate and multivariate statistical analyses for prognostic characterization of PNI.Results: The statistically signi cant cut-off values for pre-and post-treatment PNI were 50.65 and 44.75, respectively. Of the pre-treatment PNI analysis, PNI≤50.65 group had shorter loco-regional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS). Furthermore, for post-treatment PNI analysis, PNI≤44.75 group had shorter LRRFS and OS. In univariate analysis, only pretreatment PNI was associated with LRRFS and DMFS, while pre-and post-treatment PNI were both associated with OS. In multivariate analysis, both PNI were independent prognostic markers for OS. In the combined analysis, pre-and post-treatment PNI, differences between the groups were statistically signi cant, and the PNI dynamics was an independent prognostic indicator for OS.Conclusion: PNI is a useful, independent prognostic marker for non-metastatic NPC patients. It is used for either pre-or post-treatment patients. Furthermore, changes in pre-treatment PNI value after curative treatment is a signi cant indicator for OS.
Background: We present two cases of secondary pneumothorax after immunotherapy in two different clinics. Case summary: A 25-year old female patient with metastatic osteosarcoma, treated with atezolizumab. Grade 2 pneumonitis developed twice in the first year. Treatment was continued after recovery and areas of pneumonitis and pneumothorax were observed on computed tomography. No other reason could be found to cause pneumothorax. Pneumothorax resorbed spontaneously during follow-up. A 36-year old female patient treated with nivolumab for metastatic renal cell carcinoma (RCC), areas of pneumonitis and pneumothorax were only found as the cause of dyspnea. After treatment, remission was achieved on computed tomography findings. Pneumothorax was detected for the second time during continued therapy, and immunotherapy stopped permanently. Conclusion: These cases, indicate that immunotherapy can cause secondary immune-related pneumothorax based on immune pneumonitis.
In December 2019, several cases of severe pneumonia were identified in Wuhan City, the capital of Hubei province. Upon further investigation, the pathogen causing these symptoms was identified and named as SARS-CoV-2 and the disease was given the name COVID-19 by the World Health Organization. Being able to spread rapidly through respiratory droplets and capable of asymptomatic transmission, COVID-19 became a health concern of a global scale in a matter of months. The most common signs and symptoms of COVID-19 patients at hospital admission are fever, dry cough, and dyspnea. Most people experience the disease with mild symptoms but in more severe cases these can develop into pneumonia and acute respiratory distress syndrome. In this review, we aim to summarize the current information over COVID-19 and its causative agent SARS-CoV-2.
Objective: To evaluate clinical and demographic characteristics and the results of cytotoxic treatments of KRASG12C, KRASother, and next-generation sequencing (NGS) panel negative patients. Methods: NGS data of 1264 patients with non-small cell lung cancer were retrospectively evaluated. Among these patients, the mutation distributions of 1081 patients with metastatic lung adenocarcinoma were analyzed. A total of 150 patients with negative NGS panel or mutant KRAS followed up in our clinic were included. Clinical features, overall survival, first-line chemotherapy responses, and progression-free survival of NGS panel negative, KRASG12C, and KRASother groups were compared. Results: In 1081 patients who underwent NGS from tumor tissue with the diagnosis of metastatic lung adenocarcinoma, 296 (27%) NGS panel negative and 276 (26%) KRAS mutant patients were detected. Among these patients, 150 patients whose data were available were 71 (47.3%) NGS panel negative, 54 (36%) KRASother, and 25 (16.7%) KRASG12C. Clinical features, brain metastasis, and first-line chemotherapy response were similar among groups. Bone metastases were detected more often in the NGS panel negative group ( p = 0.03). The median follow-up was 8.4 months. Overall, 107 deaths had occurred at the time of analysis. There was no difference in overall survival ( p = 0.56) or progression-free survival ( p = 0.71) among NGS panel negative, KRASother, and KRASG12C patients. Conclusion: There is no difference in overall survival, first-line chemotherapy response, or progression-free survival among patients with NGS panel negative, KRASG12C, or KRASother metastatic lung adenocarcinoma. Bone metastases were observed more frequently in the NGS panel negative group.
Despite significant developments made in early diagnosis and treatment, the incidence of lung cancer remains high both in Turkey and worldwide, and it is one of the leading causes of cancer-related deaths. 1 When we evaluate Turkey, according to the age-standardized cancer rate in males, lung cancer occupies first place with 57.7%, and in females, it is at fifth place with 9.8%. 80% of lung cancer cases are nonsmall cell lung cancer (NSCLC), most of them are diagnosed at an advanced stage, and only 19% of patients can live for five years or longer. 2 The dominant histological subtype in NSCLC is adenocarcinoma both in the world and in Turkey (47.1%).
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