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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 Breast carcinoma (BC) is the most common cancer in women, and, in particular, some subtypes are established as suitable for immunotherapy strategies targeting immune checkpoints. Programmed cell death-1 (PD-1), as well as cytotoxic T lymphocyte-associated protein-4 (CTLA-4), has an important role in the tumor microenvironment to escape from the immune system. In this study, we examined the relationship of Programmed cell death-1 (PD-L1) expression with survival, recurrence, and other prognostic factors. METHODS This retrospective cohort comprised tissue microarray blocks of 391 cases examined at the same institute between 2000-2012. All cases were completely resected tumors, without neoadjuvant therapy, with more than 5 years of follow-up. Clinical follow-up and all pathologic parameters were recorded. PD-L1 immunohistochemistry (SP263) was applied, then staining details including density, percentage, and patterns were noted for tumor areas and immune cells. PD-L1 expression results were analyzed, and its relationship with prognostic parameters and survival was investigated. RESULTS PD-L1 expression was detected in 90 (24.8%) cases: 55 in only tumor-infiltrating lymphocytes (TILs), 35 in both tumor and TILs. Statistically, there was no significant relationship between PD-L1 expression and survival. However, high histologic grade, high scores in pleomorphism and mitosis, mild stromal reaction, dense immune cell infiltration, perineural invasion, absence of lymph node metastasis, negativity of ER and PR, HER2 expression, and high Ki-67 results had a significant relationship with PD-L1 expression. CONCLUSION Consistent with the literature, our results showed that PD-L1 expression in triple-negative and HER2 overexpressed types and in the presence of TILs is higher than in other breast cancers. [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 This study's objective is to assess the effectiveness of treatment and the prognostic factors that affect survival in 28 patients with epithelial thymic tumors who had adjuvant or definitive radiotherapy (RT) at our facility. METHODS The study comprised 28 patients who received RT at the Radiation Oncology Department of Eskişehir Osmangazi University Faculty of Medicine between 2010 and 2021. Each patient received RT (3DCRT/IMRT/VMAT). RESULTS The median overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) at a median follow-up of 74 months were 76 (3-201), 29, and 57 (0-198) months, respectively. The median RT dose was 50 Gy (44-66). While there was no statistically significant difference between DFS and RT doses (p=0.88), there was a statistically significant difference between PFS and OS and 50 Gy and higher doses (p=0.03 vs. p=0.02). CONCLUSION Post-operative RT has been proven to be beneficial in cases of incomplete resection, even if the role of adjuvant RT in patients with complete resection remains debatable. It is well established that primary unresectable thymic tumors can be treated safely and successfully with neoadjuvant or definitive chemoradiotherapy. [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]

OBJECTIVE Nasopharyngeal cancer (NPC) in childhood is rare. In this study, we retrospectively report the results of adolescent and childhood NPC patients treated with different doses of intensity-modulated radiation therapy (IMRT) and 3D-conformal radiotherapy (RT) (3D-RT). METHODS Between 2007 and 2020, 20 patients were included in our study, 18 of whom received induction chemotherapy before chemoradiotherapy (CRT) (n=16) or RT (n=2). High-risk planning target volumes of 61.2 Gy (complete or good partial response) and 63-70 Gy (partial response) included the primary tumor and metastatic lymph nodes. Survival analyses were made using the Kaplan-Meier method. RESULTS The median follow-up time was 107 months (range: 6-168). The median age was 16 years (range 11-22). All patients had a complete response after CRT. The 5-year local control, disease-free survival, and overall survival were 100%. One patient developed distant metastasis (bone) at 62 months of treatment. There were no grade 4 acute side effects. Acute and late toxicity were observed lower in patients treated by dose reduction with IMRT. CONCLUSION In our study, over 60% of patients were treated with IMRT and dose reduction. Although lower-dose RT was administered, local-regional control was excellent, and the incidence rate of side effects was low. [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 Lung cancer is the leading cause of cancer-related death worldwide. Although the majority of patients have locally advanced or metastatic disease at diagnosis, the incidence of early-stage non-small-cell lung cancer is expected to increase due to the wider use of thoracic CT scans. Primary tumor control and distant metastasis rates in early-stage lung cancer are similar for stereotactic body radiation therapy (SBRT) and surgery. Overall survival (OS) is lower for SBRT compared to surgery. Although some studies provide guidance on which cases will have a good response to SBRT, there is still no standard guideline. SBRT results are not the same in cases at the same stage or with the same metastatic burden. It is thought that there may be other parameters other than stage or tumor burden that affect the response. It is aimed to predict the response to SBRT with artificial intelligence in early-stage lung cancer, recurrent lung cancer, and lung metastases. METHODS Between September 2016 and April 2021, 137 cases and 148 lesions in which SBRT was applied by Eşkişehir Osmangazi University Faculty of Medicine Radiation Oncology Department were evaluated. To create a balanced data set, Synthetic Minority Oversampling Technique technique was used and 200 lesions were evaluated. Logistic Regression (LR), multilayer perceptron Classifier, Extreme Gradient Boosting, Support Vector Classifier, Random Forest Classifier, and Gaussian Naive Bayes algorithms were used. The data sets are divided into 85% training and 15% prediction sets. Models were created using the training set and validated using the prediction set. RESULTS Complete response was obtained in 41 tumors out of 148 tumors. The median OS after SBRT is 18 (2-61) months, and progression-free survival is 16 (0-61) months. Important variables are tumor diameter, NLR, presence of biopsy at diagnosis, tumor location and type, diagnosis, and histopathology. LR algorithm was determined as the best estimating algorithm with 80% accuracy (Confidence Interval, CI: 0.65-0.94, ROC AUC: 0.60), 66% sensitive and 90% specificity. CONCLUSION In order to use the current algorithm in clinical practice, it is necessary to increase the diversity of data and the number of patients by sharing data between centers. [ABSTRACT FROM AUTHOR]

OBJECTIVE There are few agents used in soft-tissue sarcoma treatment. We compared the efficacy of therapies, aiming to identify the best therapy sequence, and reveal the factors affecting the risk of progression or death. METHODS Fifty-five patients were included in the study. Data such as age, gender, tumor primary site, histological type, tumor grade, the Ki67 percentage score, treatments, radiotherapy, and metastasectomy history, the dates of diagnosis, metastasis, progression, and death were retrospectively evaluated. Progression-free survival (PFS) and overall survival (OS) for therapies, and the risk factors for the progression or death were analyzed. RESULTS In the first-line, gemcitabine-docetaxel provided longer PFS than the doxorubicin-ifosfamide combination (7.4 months vs. 4.8 months, p=0.035), although this did not result in OS difference. In the secondline, the efficacy of trabectedin and pazopanib were similar, whereas trabectedin showed less activity in liposarcomas. In the third-line and beyond, trabectedin, pazopanib and eribulin showed similar PFS and OS. The only factor that affected the risk of death was metastasectomy (HR for death: 0.35, 95% CI: 0.18-0.66, p=0.001). CONCLUSION We found that agents used in soft-tissue sarcoma have similar efficacy, which is not affected by the previous therapies. However, it should be noted that soft-tissue sarcomas include many histological types, and to choose the optimal drug, the histological type must be one of the major factors considered. Furthermore, all patients should be evaluated for possible metastasectomy, which came out as the only factor reducing the risk of death in our study. [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]

The discovery of synergistic effects between radiation and immunotherapy in pre-clinical studies has encouraged researchers to conduct clinical trials testing the effects of combined therapy in patients. The first step in conducting any clinical trial is to define the hypothesis and core objectives. The challenge while developing trials analyzing combinations of immunotherapy and radiation therapy (RT) is to select an appropriate hypothesis that can be tested in the future research, as well as raising new questions for investigation. Here, we review some of the concerns and challenges for designing clinical trials of RT combined with immunotherapy. [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 Survival rates have dramatically improved in Wilms' tumor (WT) with multimodal treatment. Herein, we aimed to compare the efficacy of 9-10.8 Gy flank irradiation or whole abdominal irradiation (WAI) in patients with WT treated in a single tertiary treatment center. METHODS This study includes 42 patients with a unilateral or bilateral WT with a local Stage III disease who received a low-dose (10.8 Gy) or lower-dose (9 Gy) flank radiotherapy (RT) or whole abdominal irradiation between 1998 and 2018. Patients had undergone either upfront surgery followed by adjuvant chemotherapy (CXT) or neoadjuvant CXT followed by surgery. Patients with lung metastasis without a complete response to CXT also received whole lung irradiation (WLI) of 9-12 Gy. RESULTS The disease was staged as III in 22, IV in 12, and V in nine patients, respectively. After a median follow-up of 75 months, the 2-and 5-year overall survival, locoregional relapse-free survival, and distant metastasisfree survival rate was 92% and 79%, 87% and 76%, and 75% and 69%, respectively. None of these survival rates were significantly different among 9 Gy and 10.8 Gy doses. Among patients receiving WLI, the lung relapse rate was also similar between <12 Gy and 12 Gy of irradiation. Late toxicity was observed in 4 (10%) patients as scoliosis, cardiac dysfunction, renal injury with hypertension, and short stature in each. CONCLUSION De-escalated RT of 9 Gy to the flank or abdomen does not compromise oncologic outcomes in patients with a local Stage III WT. [ABSTRACT FROM AUTHOR]

OBJECTIVE The objective of this study was to extensively analyze failure patterns of patients who received single or multi-fraction stereotactic radiosurgery (SRS) to the surgical cavity and to identify prognostic factors for recurrence and survival metrics. METHODS Patients with brain metastases who underwent surgical resection and then had SRS to the surgical cavity, between 2010 and 2021, at our department were identified. Local failure (LF), distant failure (DF), leptomeningeal disease (LMD), overall survival (OS), and salvage whole brain radiotherapy (WBRT) rates were calculated. Patient or treatment-related variables were evaluated for association with LF, DF, LMD, and OS. RESULTS Fifty-three patients with total of 54 operated metastases were identified. The median follow-up period was 13 months. Cumulative incidence rates of LF, LMD, and DF were 15%, 11%, and 37% at 1 year, respectively. Salvage WBRT was employed in 13 (26%) patients. DF was less frequent in patients with breast cancer primary compared to patients with other primaries (p=0.048, Hazard ratio [HR]:0.28) on univariate analysis. One-year OS rate was 54%. Median survival was 17 months. Eastern cooperative oncology group (ECOG) 0 performance status (p=0.0113; HR:0.328), being without active extracranial metastasis at the time of brain SRS (p=0.0035; HR:0.321), and metachronous brain metastases (p=0.0191; HR:0.399) were determined as statistically significant prognostic factors of survival on multivariate analysis. CONCLUSION SRS to surgical cavity seems optimal treatment modality especially for the patients with one of the following factors including ECOG 0 performance status, not having an active extracranial metastasis at the time of SRS, and metachronous brain metastases. [ABSTRACT FROM AUTHOR]

OBJECTIVE The objective of the study was to evaluate the outcomes of central neurocytoma treatments. METHODS Between 2003 and 2019, 23 post-operative patients with central neurocytoma were included in the study. According to the World Health Organization (WHO) 2021 classification, 14 patients were classified as atypical neurocytoma. Gross total resection was performed in 12 patients whereas subtotal resection (STR) was performed in ten patients and eight patients had residual disease. In total, 13 patients received radiotherapy (RT), nine of whom were irradiated postoperatively, and four patients were irradiated after relapse. Recurrence and progression-free survival (PFS) of each subgroup were presented. RESULTS The median follow-up was 59 months (15-262 months). The 5-year overall survival (OS) was 89.3% and PFS was 83.4%. During follow-up in total three patients died; two patients had disease progressionrelated death, and one patient died because of his comorbidities. Comparing the outcome of RT group and the observation group; there was no recurrence in the radiotherapy group, but three recurrences or progression were detected in the observation arm. There was no statistical significance (p=0.257) due to the low number of patients in this subgroup. Patients with extraventricular tumors received postoperative radiotherapy; however, patients had recurrences and died due to disease progression. Furthermore, there was no statistical significance (p=1.00) when the operation type was evaluated. In terms of histopathology, recurrence or progression was observed in two patients with typical CN and one patient with atypical histology, which was not statistically significant (p=0.247). CONCLUSION All treatment modalities were applied in our cohort, but due to the small number of patients, the significance of any modality could not be demonstrated. However, the prognosis of the patients with extraventricular pathology was very poor and two patients died due to the disease. [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]

OBJECTIVE Astragalus membranaceus root extract (AMe) has been shown to have immunomodulatory effects on macrophages and Th1 type immune responses. Our goal was to determine whether AMe improves the overall survival (OS) of patients with metastatic non-small cell lung cancer (NSCLC). METHODS The medical charts of metastatic NSCLC were retrospectively reviewed. Histological subtype, performance status, age, gender, smoking status, comorbidities, chemotherapeutics, and erlotinib that were part of any type of treatment were recorded. RESULTS The median age of the patients was 61. The median follow-up period was longer for Group A (AMe users) than Group C (control group) (18 vs. 11 months, p<0.001). At the time of analysis, 83.8% of the patients had died. Univariate analysis showed that OS was significantly longer in Group A than Group C (21±4.2 vs. 11±0.9 months, p=0.004). In addition to AMe usage, female gender, smoking status, presence of hypertension, and erlotinib usage also had significant impacts on OS (p<0.05 for all variables). The multivariate analysis showed that only AMe (hazard ratio [HR]: 0.46, 95% CI: 0.27-0.76, p=0.003) and erlotinib (HR: 0.45, 95% CI: 0.22-0.89, p=0.02) usage were correlated with significantly longer OS. CONCLUSION Taking AMe during systemic anti-cancer treatment may significantly prolong OS of patients with meta- static NSCLC. [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]