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OBJECTIVE We investigated the outcomes of radiotherapy (RT) combined with systemic chemotherapy (CHT) including carboplatin and paclitaxel in patients with locally advanced non-small-cell lung cancer. METHODS This retrospective study included 105 patients. Treatment involved concurrent carboplatin and paclitaxel with RT administered weekly followed by two cycles of consolidation carboplatin and paclitaxel administered triweekly. RESULTS Comorbid disease was present in 46 (48.6%) patients. At least four cycles of CHT in the concurrent phase and both cycles of CHT in the consolidation phase were able to be administered to 92.3% and 45.4% of patients, respectively. The most common type of toxicity in the entire treatment protocol was hematological toxicity (34.8%). The objective response rate was 71.4%. Overall, recurrence was found in 71 (67.6%) patients. The most common type of recurrence was distant metastasis, which occurred in 47 (66.2%) patients. The median progression-free survival was 14 months. The 1, 2, and 3-year progression-free survival rates were 59%, 30%, and 26%, respectively. The median overall survival was 27 months. The 1, 2, and 3-year overall survival rates were 81%, 57%, and 34%, respectively. CONCLUSION The survival outcomes in this study closely match those reported in the literature. This is notable because our study included a higher proportion of patients with additional health conditions and fewer concurrent CHT cycles during RT compared to randomized studies. These findings prompt us to consider what the ideal number of concurrent CHT cycles should be when using modern involved-field RT techniques after accurate disease staging. [ABSTRACT FROM AUTHOR]

OBJECTIVE The aim of the study was to evaluate the association between metabolic parameters obtained from pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and molecular subtype, immunohistochemistry, and overall survival (OS) in female breast cancer (BC) patients with invasive ductal carcinoma (IDC). METHODS A total of 179 patients were included in the study, and their primary tumor histopathological features, molecular subtypes, axillary lymph node (ALN) involvement, distant metastasis, and OS were evaluated and compared 18F-FDG PET parameters. Among the PET parameters, maximum standardized uptake value (SUVmax), mean SUV, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the tumor and ALNs were examined. RESULTS Based on molecular subtypes, the metabolic parameters of tumors were at their lowest in the Luminal A group and had the highest values within the triple-negative BC group. The triple-negative BC subtype was associated with a higher Ki67 proliferation index. Tumor SUVmax was higher in patients who were estrogen receptor negative, progesterone receptor (PR) negative, had nuclear grade III, and had distant metastasis (p=0.021, p=0.001, p<0.001, p=0.014, respectively). Patients with distant metastasis, ALN metastasis, and internal mammary lymph node involvement had higher tumor TLG and MTV (respectively, p<0.001, p<0.001, p<0.001). Higher ALN SUVmax values were observed in patients with distant metastasis and those who were PR negative (p=0.016). The ALN TLG value was found to be higher in patients with distant metastases and ALN metastases compared to those without (p<0.001, p=0.049, p=0.025, respectively). CONCLUSION The study indicates that PET/CT is a highly dependable method for detecting ALN involvement. Furthermore, assessing metabolic tumor characteristics using 18F-FDG PET/CT before initiating primary IDC treatment might provide crucial diagnostic and prognostic insights that significantly contribute to managing the disease. [ABSTRACT FROM AUTHOR]

OBJECTIVE Lung cancer (LC) is the leading cause of cancer death worldwide. Multiple studies have shown tumor progression and prognosis to be associated with immune status and nutritional condition. Alterations in blood lipid levels have been demonstrated to be a risk factor for LC. In the present study, we evaluate the effect of blood parameters on brain metastasis in LC. METHODS Patients identified with brain metastases during diagnosis or therapy and who subsequently underwent radiation therapy were included in the study. Patient characteristics, laboratory parameters, pathologic subtype, disease stage, treatment modalities, and outcome following treatment were recorded, and the patients' PFS and OS were calculated. RESULTS Univariate analysis revealed neutrophil, low-density lipoprotein (LDL), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein levels to be significantly different between groups according to brain metastases. In a subgroup analysis based on cancer subtypes, LDL and lymphocyte levels were found to be significantly different in squamous cancer, while LDL was different in the undifferentiated subtype. OS was different in the NLR low and high groups, favoring the NLR low group (p=0.015; OS: 12 vs. 9 months), and the monocyte/lymphocyte ratio was significant in terms of OS favoring the low group with a cutoff value of 0.56 (p=0.002; OS: 13 vs. 9 months). CONCLUSION Our study identified differences in the inflammatory and lipid profiles of LC patients in terms of brain metastases and survival. Other than the literature, LDL levels were different among groups and may be considered a valid subject for future study. [ABSTRACT FROM AUTHOR]

The best radiotherapeutic approach for brain metastasis (BM) is highly controversial. Compared to Whole-brain radiotherapy, the stereotactic radiotherapy (SRT) technique allows for focused ablative doses to target lesions. We aim to present our clinical experience with SRT as a treatment option for radioresistant BM in melanoma and renal cell carcinoma (RCC). METHODS We identified 46 BM from radioresistant histologies (26 melanoma and 20 RCC) treated with SRT in our clinic between 2010 and 2020 in 29 patients (18 melanoma and 11 RCC). The robotic linear acceleratorbased CyberKnife system was used to administer SRT. RESULTS SRT was performed in a median of 2 fractions, and the median dose was 20 Gy. The median follow-up was 8 months. Median overall survival after SRT was 8 months, and 1- and 2-year survival rates were 37.9 and 14.2%, respectively. Median local progression-free survival (LPFS) was not reached, and 1- and 2-year LPFS were both 83.4%. Median distant brain progression-free survival (DBPFS) was 14 months, and 1- and 2-year DBPFS rates were 54.2 and 23.2%, respectively. Radionecrosis occurred in 2 metastases (4.3%). CONCLUSION SRT is a valuable treatment option for RCC and melanoma brain metastases with reasonable local and distant brain control and limited toxicity. [ABSTRACT FROM AUTHOR]

OBJECTIVE This study aimed to determine whether lymphopenia and neutrophil-to-lymphocyte ratio (NLR) could be prognostic factors of overall survival (OS), disease-free survival (DFS), or distant metastasis-free survival (DMFS) in patients with head-and-neck cancer (HNC) undergoing radical radiotherapy or chemoradiotherapy. METHODS Eighty-four patients' medical records with HNC who underwent radical radiotherapy/concurrent chemoradiotherapy were retrospectively included in the study. Blood tests were analyzed at the treatment's beginning, middle, and end. The degree of lymphopenia was categorized according to the Common Terminology Criteria for Adverse Events. The OS, DFS, and DMFS were calculated with the Kaplan-Meier method. In addition, univariate and multivariate Cox regression analyses were used to investigate the relationship between lymphopenia and survival. RESULTS The median follow-up time of patients was 20 months (range, 3-103). Forty-five deaths and a median 1-year OS of 76% were found. There was no difference in OS (median 27 months vs. 32 months, p=0.674) and DFS (30 months vs. 31 months, p=0.350) between patients who developed and did not develop lymphopenia during radiotherapy. However, survival was significantly worse in patients with G3 lymphopenia than in G1-2 patients (median 21 months vs. 49 months, p=0.033). When patients with an NLR of =4.9 and <4.9 were compared, no difference in OS (p=0.156) and DFS (p=0.830) was observed between these two groups. However, DMFS (43.1 months vs. 66.6 months, respectively, p=0.052) was worse in patients with high NLR (=4.9). CONCLUSION Treatment-related G3 lymphopenia and high NLR rate are poor prognostic factors in patients with HNC. [ABSTRACT FROM AUTHOR]

OBJECTIVE In our study, we aimed to determine the clinicopathological and prognostic factors and their effects on overall survival (OS) and disease-free survival (DFS) in patients who underwent curative resection for gastric cancer and did not have lymph node metastasis. METHODS A total of 138 patients followed for lymph node-negative gastric cancer between 2001 and 2016 were included in the study. The effects of clinicopathological and prognostic factors such as age, sex, tumor localization, tumor differentiation, tumor TNM stage, type of surgery, lymphovascular invasion, perineural invasion, presence of Helicobacter pylori, tumor size, histopathologic subtype of the tumor, complete blood count, tumor markers, and adjuvant treatments on OS and DFS were analyzed. RESULTS In the current study, Eastern Cooperative Oncology Group (ECOG) performance score before adjuvant treatment (hazard ratio [HR]=2.320; p<0.001), largest tumor diameter (HR=1.198; p=0.029), post-operative carbohydrate antigen 19-9 (CA19-9) level (HR=1.104; p=0.047), and post-operative carcinoembryonic antigen (CEA) level (HR=1.183; p=0.043) were found to be independent predictors of recurrence rate. In addition, ECOG score before adjuvant treatment (HR=2.585; p<0.001), post-operative CEA level (HR=1.128; p=0.005), and post-operative CA 19-9 level (HR=1.080; p=0.006) were independent predictors of mortality risk in OS analysis. CONCLUSION Some clinicopathological and prognostic factors, such as ECOG score, largest tumor diameter, post-operative CA 19-9 level and post-operative CEA level, could assist us to predict recurrence and mortality in node-negative gastric cancer patients who underwent curative resection. More comprehensive studies are required to be carried out in this context. [ABSTRACT FROM AUTHOR]

OBJECTIVE It is known that cancer patients are more prone to infections than the general population. We aimed to describe the risk factors affecting the survival of cancer patients infected with COVID-19 and clinical findings compared with a large COVID-19 patient population without cancer diagnosis. METHODS The clinical data of 61 cancer and 558 non-patients with COVID-19 infection who applied to the emergency room were compared retrospectively. Risk factors affecting overall survival in cancer patients were analyzed. RESULTS Gender and mean age were comparable in both groups. In the entire cohort, cancer diagnosis was found to be an independent poor prognostic factor (hazard ratio [HR] = 3.09, p<0.001) among other comorbidities. In univariate analysis; lung cancer, activated partial thromboplastin time >32 seconds, INR >1.1, N-terminal-pro-B-type natriuretic peptide (NT-proBNP) >400 pg/ml, C-reactive protein >100 mg/L, and procalcitonin >0.23 ng/mL were determined as prognostic risk factors. Lung cancer (HR=5.277, p=0.012) and NT-proBNP >400 pg/ml (HR=0.139, p=0.021) were determined as independent prognostic risk factors in multivariate analysis. CONCLUSION Cancer patients with COVID-19 infection have poor survival outcomes. Lung cancer diagnosis and elevated NT-proBNP levels were identified as the most crucial prognostic risk factors in cancer patients infected with COVID-19. [ABSTRACT FROM AUTHOR]

OBJECTIVE This study aimed to predict the overall survival (OS), survival time, and time to progression in cases diagnosed with Stage III lung cancer. METHODS The sample consisted of 585 patients that underwent radiotherapy and chemotherapy with the diagnosis of Stage III lung cancer. OS prediction was undertaken in 324 cases, survival time prediction in 241 that died due to lung cancer, and prediction of time to progression in 223 that showed progression during follow-up. Twenty-seven variables were evaluated, and logistic regression, multilayer perceptron classifier (MLP), extreme gradient boosting, support vector clustering, random forest classifier (RFC), Gaussian Naive Bayes, and light gradient boosting machine algorithms were used to construct prediction models. RESULTS In OS prediction, over a median 21-month follow-up, 255 of 324 cases died and the median OS was 20 (2-101) months. The best predictive algorithms belonged to logistic regression for OS (accuracy rate: 70%, confidence interval [CI]: 0.60-0.82, area under curve [AUC]: 0.76), MLP classifier for 12- and 20-month survival times (67%, CI: 0.54-0.81, AUC: 0.64 and 71%, CI: 0.59-0.84, AUC: 0.61, respectively), and RFC for time to progression (76%, CI: 0.66-0.86, AUC: 0.78). CONCLUSION Considering high treatment costs, potential serious toxicity, the harm of early progression, and low survival in cases of ineffective treatment, machine learning-based predictive systems are promising. Personalizing prognosis and treatment using these algorithms can improve oncological results. [ABSTRACT FROM AUTHOR]

OBJECTIVES In this study, it was aimed to clarify the features of patients with rare ovarian cancers (ROC) and to determine the prognostic factors associated with survival. METHODS A total of 48 patients with ROC, seen between 2003 and 2011, were analyzed retrospectively. RESULTS There were 12 (25%) germ-cell tumors (GCT), 25 (52.1%) sex cord-stromal tumors (SCT) and 11 (29.1%) "other" ROC patients. Significant differences were detected with respect to age, tumor localization, initial symptom(s) at diagnosis, surgery type, tumor size, and tumor grade. GCTs were commonly localized in the left and/or bilateral ovaries, while SCT and the other ROCs were frequently localized in the right ovary (p=0.02). Staging at primary surgery was high in the other ROCs compared with GCTs and SCTs (p=0.02). Patients with GCT were younger in age (p=0.006) and had larger (p=0.03) and well-differentiated (p=0.01) tumors than those with SCTs or the other ROCs. Survivals were similar among groups. CONCLUSION ROCs should be evaluated separately from epithelial ovarian cancers because of their different biological features and different natural history. [ABSTRACT FROM AUTHOR]