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Öğe The combination of gemcitabine and cisplatin as neoadjuvant chemotherapy for early stage non-small cell lung carcinoma (NSCLC): An interim analysis of a phase II trial.(Amer Soc Clinical Oncology, 2005) Aydiner, A; Kiyik, M; Cikrikcioglu, S; Kosar, F; Gurses, A; Turna, A; Yazar, A; Dilege, S; Goksel, T; Cakan, AÖğe Docetaxel concomitant with radiotherapy in patients with nonsmall cell lung cancer unresponsive to platinum-based induction chemotherapy(Elsevier Ireland Ltd, 2005) Ozkok, S; Yalman, D; Goker, E; Parvizi, M; Cok, G; Goksel, T; Haydaroglu, AÖğe Effect of intratumoral and peritumoral vascular and lymphatic invasions on prognosis of operated non small cell lung cancer patients(Elsevier Ireland Ltd, 2005) Turhan, K; Cagirici, U; Goksel, T; Cakan, A; Samancilar, O; Nart, D; Aktin, BÖğe The European Organization for Research and Treatment of Cancer QLQ-C30: an examination into the cultural validity and reliability of the Turkish version of the EORTC QLQ-C30(Blackwell Publishing Ltd, 2004) Guzelant, A; Goksel, T; Ozkok, S; Tasbakan, S; Aysan, T; Bottomley, AThe Turkish version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire version 2.0 (EORTC QLQ-C30 v.2.0) has started to be used in clinical trials recently. The objective of the study was to evaluate the validity and reliability of the Turkish version of the EORTC QLQ-C30 v.2.0 and the correlation between the Karnofsky Performance Scale (KPS) and the EORTC QLQ-C30. Two hundred and two lung cancer patients were included in the study between January and March 2000. All the subscales met the minimal standards of reliability (Cronbach's alpha greater than or equal to 0.70). Only the role functioning scale differed among the three disease stages of patients (local, locoregional and metastatic). There was no statistically significant difference among therapy types. All interscale correlations were statistically significant (P < 0.01). The strongest correlations were found among the physical functioning, role functioning and fatigue scales. Social functioning was closely related with physical, role, emotional and cognitive functioning. The weakest correlations were between nausea/vomiting and the other scales. Global quality of life (QOL) was substantially correlated with most of the scales except cognitive functioning. The coefficients for the correlation between the items differed between 0.12 and 0.97 and all the subscales were strongly correlated with the scales which they formed. The highest correlation between the EORTC QLQ-C30 and KPS was for physical functioning (r = 0.62, P < 0.05). The Turkish version of the EORTC QLQ-C30 is a valid (by means of interscales validity) and reliable instrument for Turkish lung cancer patients and can be used in clinical studies but needs supporting by the reference data on the QOL of the Turkish population.Öğe High dose rate endobronchial brachytherapy in combination with external beam radiotherapy for stage III non-small cell lung cancer(Elsevier Sci Ireland Ltd, 2001) Anacak, Y; Mogulkoc, N; Ozkok, S; Goksel, T; Haydaroglu, A; Bayindir, UIntroduction: A phase-II study was planned to test the effect of external beam radiotherapy in combination with endobronchial brachytherapy on the local control and survival of stage-III non-small cell lung cancer patients. Materials and methods: Thirty patients with stage-III non-small cell lung cancer have been treated with 60 Gy external beam radiotherapy and 3 x 5 Gy HDR endobronchial brachytherapy to control tumor and to prolong survival. Results: Therapy regimen was found to be very effective for the palliation of major symptoms, palliation rates were 42.8% for cough, 95.2% for hemoptysis, 88.2% for chest pain and 80.0% for dyspnea. There was a 76.7% tumor response (53.3% complete, 23.3% partial) verified by chest CT scans and bronchoscopy. However, median locoregional disease free survival was 9 +/- 4 months (95% Cl: 1-17) and it was only 9.6% at 5 years. Major side effects were radiation bronchitis (70.0%), esophagitis (6.6%) in the acute period and bronchial fibrosis (25%), esophagial fibrosis (12.5%) and fatal hemoptysis (10.5%) in the late period. Median survival was 11 +/- 4 months (95% CI: 4-18),and 5-year actuarial survival was 10%. Locoregional disease free survival (P = 0.008) and the overall survival was longer (P < 0.001) in the patients younger than 60, survival was also improved in the patients with complete response (P = 0.019). There were no major complications during catheterisation; early side effects were quite tolerable but severe late complications were around 10%. Conclusions: It is concluded that endobronchial brachytherapy in combination with external irradiation provides a good rate of response, however does not eradicate locoregional disease and does not prolong survival except for some subgroups such as younger patients. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.Öğe Inter-individual variation in GSTM1 and CYP2A6 genotypes in relation to lung cancer risk among tobacco smokers in Turkey(Wiley-Blackwell Publishing, Inc, 2005) Gumus, NS; Lermioglu, F; Goksel, T; Fujieda, M; Kamataki, T; Topcu, ZÖğe Pattern of lung cancer in Turkey, 1994-1998(Karger, 2002) Akkoclu, A; Atikcan, S; Aysan, T; Bayiz, H; Celik, M; Celik, P; Cetinkaya, E; Cikrikcioglu, S; Cildag, O; Dudurgali, R; Goksel, T; Gonullu, U; Gorguner, M; Guclu, S; Gulhan, M; Halilcolar, H; Hasturk, S; Isik, R; Itil, O; Karadag, M; Kaya, A; Kiyik, M; Kurt, B; Kurutepe, M; Onde, G; Ortakoylu, G; Ozaydin, N; Ozsoz, A; Ozkurt, S; Ozturk, C; Pelit, A; Perim, K; Tasbakan, S; Ulgan, M; Unsal, M; Yavasoglu, G; Yilmaz, U; Yuksel, MBackground: Lung cancer is the most common neoplasm in Turkey, but there is not enough data on the characteristics of this mortal illness in our country. Objectives and Methods: The Turkish Thoracic Society, Lung and Pleural Malignancies Study Group (TTS-LPMSG) conducted a national retrospective hospital-based study to determine the pattern of lung cancer in Turkey. Results: A total of 11,849 lung cancer patients were studied between 1994 and 1998, 90.4% were male and 9.6% were female. The majority of patients were smokers (77.9%) or ex-smokers (10.8%). The mean age at the time of diagnosis was 58.4 years (20-84) and 56.7% of the patients were aged between 46 and 65 years. The most common histological types were squamous cell (45.4%), small cell (SCLC; 20.5%) and adenocarcinoma (20.2%). The majority of patients with non-small-cell lung cancer were diagnosed with metastatic disease (40.4%). Of the patients with SCLC patients, 37.9% had limited stage disease and 62.7% extensive stage disease at diagnosis. Conclusion: The results of the largest data so far collected in Turkey show that the vast majority of patients with lung cancer are male, squamous cell is the most common histological type, and only a small proportion of patients are diagnosed at an early stage. Copyright (C) 2002 S. Karger AG, Basel.Öğe A prospective, multicentre clinical trial comparing cisplatin plus gemcitabine with cisplatin plus etoposide in patients with locally advanced and metastatic non-small cell lung cancer(Blackwell Publishing, 2005) Goksel, T; Hatipoglu, ON; Ozturk, C; Gorguner, M; Kiyik, M; Yilmaz, U; Guzelant, A; Tasbakan, S; Tabakoglu, E; Firat, H; Tutar, U; Cikrikicioglu, S; Akkoclu, A; Soyer, S; Cakir, E; Itil, O; Sanal, SCisplatin-gemcitabine (PG) and cisplatin-etoposide (PE) combinations are active regimens for non-small cell lung cancer (NSCLC). The present study aimed to compare PG with PE in the treatment of patients with stage IIIB and IV NSCLC. We conducted a prospective, multicentre trial. A total of 166 patients were enrolled into the study and received either gemcitabine (1000 mg/m(2)) on days 1, 8 and 15 plus cisplatin (80 mg/m(2)) on day 2 every 4 weeks, or etoposide (100 mg/m(2)) on days 1, 2 and 3 plus cisplatin (80 mg/m(2)) on day 1 every 3 weeks. The overall response rate was superior in the PG group (54.8%vs 39.0%, P = 0.045). There was no significant difference in survival between the two groups, with respective median and 1-year survival of 38 weeks and 33.3% for the PG group, and 34 weeks and 23.2% for the PE group. There was also no statistical difference for time to progression between the two groups. Neutropenia and thrombocytopenia were seen more frequently in the PG group (grade 3 neutropenia, 33.3%vs 15.9%, P = 0.012; grade 3 thrombocytopenia, 27.4%vs 3.7%, P < 0.001 and grade 4 thrombocytopenia, 10.7%vs 1.2%, P = 0.018). PG is an active chemotherapy regimen and has a better response rate than PE in advanced NSCLC, although there was no difference in time to progression and overall survival. A higher incidence of haematological toxicity was seen with PG than with PE.Öğe Quiz case of the month - Posttraumatic intrathoracic splenosis(Springer Verlag, 1998) Katranci, N; Parildar, M; Goksel, T; Savas, R; Alper, HÖğe The role of Tc-99m sestamibi imaging in predicting clinical response to chemotherapy in lung cancer(Japanese Society Nuclear Medicine, 2002) Dirlik, A; Burak, Z; Goksel, T; Erinc, R; Karakus, H; Ozcan, Z; Veral, A; Ozhan, MMultidrug resistance (MDR) is a major problem in lung cancer. Tc-99m methoxyisobutyl isonitrile (MIBI) has been demonstrated to be a non-invasive marker to diagnose MDR1 related P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) expression in various solid tumors. The aim of this study was to evaluate the relationship between the degree of Tc-99m MIBI uptake and its retention on delayed images and the response to chemotherapy in lung cancer. Twenty-three patients (I woman and 22 men, age range 40-67 years) with lung cancer (9 small cell and 14 non-small cell) were examined with Tc-99m MIBI imaging before chemotherapy. After i.v. administration of 740 MBq Tc-99m MIBI, planar and SPECT imaging at 30 minutes and 2 hours was performed. Tumor to normal lung uptake ratio (T/N) and percent retention were measured, Response to chemotherapy was evaluated according to follow-up CT and grouped as complete responders (CR), partial responders (PR) and non-responders (NR). Clinical follow-up and CT evaluation revealed that 12 patients had partial remission, 4 patients had complete remission and 7 patients had no-remission after chemotherapy. Statistically, there was no significant correlation between early (30 min), delayed (2 hr) T/N ratios and percent retention of Tc-99m MIBI with chemotherapeutic response of the lung cancer among the three groups (p > 0.05). Results of the cur-rent study imply that Tc-99m MIBI uptake and the retention index may not correlate with chemotherapy response in lung cancer, so that the accuracy of this method needs to be verified in a larger series with additional investigation at the molecular level.Öğe The role of Tc99m sestamibi imaging in predicting clinical response to chemotherapy in lung cancer(Springer Verlag, 1999) Dirlik, A; Erinc, R; Goksel, T; Argon, M; Karakus, H; Ozhan, M; Burak, ZÖğe Smoking habit among the relatives of patients with serious smoking-related disorders(Karger, 2002) Goksel, T; Ozol, D; Bayindir, U; Guzelant, AObjective: To assess smoking habit and awareness of smoking as a potential cause of disease among relatives of patients with serious smoking-related disorders. Design and Setting:A survey using a face-to-face interview-assisted questionnaire at the Ege University Hospital between October 1998 and March 1999. Subjects: We interviewed 242 relatives of patients with serious smoking-related disorders, of whom 56.6% were female and 43.4% male. The mean age was 41.2 +/- 13.2 years (1575). One relative per patient completed the questionnaire and the chosen relative took care of the patient during his illness and accompanied him during hospital visits. Main Outcome Measures: We assessed the relationship between smoking habit and the perception of smoking as a potential cause of illness by the relatives. Statistical analysis was performed by chi(2) test. Results:The prevalence of smoking among relatives was 37.6% [49.5% males (n = 105) and 28.5% females (n = 137), p = 0.0003] and an additional 20.2% were ex-smokers. Of the relatives, 86.4% knew that the diseases were directly related to smoking, and 37.8% of these people were smokers and 21.5% ex-smokers. Only 7.2% reported that they had quit smoking after being influenced by the diseases of the patients. The decision to quit was statistically unrelated to the awareness of smoking as the cause of disease. Of all the relatives, 69.2% had tried to quit at least once, 86.8% considered quitting, and 89.0% considered using professional help for smoking cessation. Conclusion: The findings show that even though this group of smokers is aware of the harmful effects of smoking they cannot successfully quit smoking; however, the majority reconsider quitting and receiving professional help. Copyright (C) 2002 S, Karger AG, Basel.Öğe Symptomatic and edoscopic response in primary lung cancer patients following endobronchial brachytherapy: An evaluation of 166 cases(Elsevier Ireland Ltd, 2005) Celik, OK; Goksel, T; Mogulkoc, N; Anacak, Y; Cok, G; Haydaroglu, A; Ozkok, SÖğe Tc-99m MIBI SPECT in prediction of prognosis in patients with small cell lung cancer(Japanese Society Nuclear Medicine, 2006) Akgun, A; Cok, G; Karapolat, I; Goksel, T; Burak, ZPurpose: The purpose of this study was to evaluate whether the degree of technetium-99m methoxyisobutylisonitrile (MIBI) uptake and its retention in delayed imaging in small cell lung cancer (SCLC) was correlated with the response to multiagent chemotherapy and to investigate if there was a relationship between the survival time of patients with SCLC and Tc-99m MIBI SPECT tumor uptake parameters at the time of diagnosis. Methods: Between 1998 and by December 2004, 40 patients with SCLC were studied with Tc-99m MIBI SPECT at the time of diagnosis. The patients were classified by a follow-up CT as good responders (complete or partial remission) and poor responders (stable disease or progressive disease). Following i.v. administration of 740 MBq Tc-99m MIBI, SPECT imaging at 30 minutes (early) and 2 hours (delayed) was performed. Regions of interests were placed over the tumors and contralateral normal lung tissue on one transverse section. The uptake ratio of the lesion to that in the contralateral normal lung was obtained from early images (early ratio; ER) as well as delayed images (delayed ratio; DR). The retention index (RI%) was measured as: RI% = [(DR - ER)/ER] x 100. Tc-99m MIBI tumor uptake parameters were compared with chemotherapeutic response and survival time. Results: Of 40 patients, 29 patients were good responders (72.5%) and 11 patients were poor responders (27.5%). RI% of Tc-99m MIBI SPECT in the group of good response was significantly higher than in that with poor response (p < 0.05). On the other hand, there was no significant difference between the two groups with respect to ER or DR values. Four of 40 patients were still alive with disease (10%). The patient survival time varied from 1 to 70 months (mean survival time = 12.9 +/- 13.4 months). There was no significant difference between the survival time of patients with respect to ER or DR of Tc-99m MIBI SPECT imaging. When median RI% was accepted as a cut-off value (-3.85%), patients with higher RI% values had a longer survival time (12 months) when compared with those with low RI% (8 months), p < 0.05. Conclusion: Our results suggest that Tc-99m MIBI SPECT could accurately predict the chemotherapy response in patients with SCLC. RI% of Tc-99m MIBI SPECT is recommended to differentiate patients with a poor response to chemotherapy and good responders, and RI% of Tc-99m MIBI SPECT appears as the only parameter that may be useful in predicting the survival of patients with SCLC.
