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Objective: Extragonadal germ cell tumours have a more unfavourable prognosis than gonadal germ cell tumours. We aimed to evaluate the survival analysis, response rates, and factors affecting responses to high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) in patients with relapsed/refractory extragonadal germ cell tumours. Methods: This study included patients diagnosed with extragonadal germ cell tumours who underwent HDCT + ASCT between November 2016 and January 2023 at Gülhane Training and Research Hospital. Clinical characteristics and follow-up data from patient records and the hospital's electronic system were retrospectively analysed. Patients under 18 years of age and those without medical records were excluded. Patient characteristics, post-HDCT progression-free survival (PFS), overall survival (OS) data, and factors affecting survival were examined. The relationship between clinical factors and OS/PFS was analysed. Results: Twenty-five patients were included in this study. Complete response (CR) was observed in seven patients (28%), partial response (PR) was observed in nine patients (36%), stable disease (SD) was observed in one patient, and progressive disease (PD) was observed in eight patients (32%) after HDCT + ASCT. The median follow-up period was 25.4 months. The median PFS and OS after HDCT + ASCT were calculated as 6.1 months and 12.2 months, respectively. Conclusions: Salvage HDCT + ASCT is an option in the treatment of extragonadal germ cell tumours, offering the potential for prolonged survival and curing. [ABSTRACT FROM AUTHOR]

The effects of harvesting periods and cultivars on the nutritional values of forage crops are very important. In the present study, the effects of harvesting periods and varieties on the nutritional values of Italian ryegrass were investigated. The trial was conducted in the Randomized Complete Block Design with four replications under the environmental conditions of Central Anatolia in the growing season of 2015. Seven Italian ryegrass varieties were harvested at two different harvest times in the study (earing and dough forming period) and feed values were determined. As a result of the study, the crude protein content of Italian ryegrass was found to be 9.4 - 21.0%, crude ash was 0.22% - 0.48%, crude fat 0.11% - 0.26%, ADF 30.45 - 36.26%, NDF 49.99% - 57.11%, ADL 7.72 - 10.11%, TDN 49.31% - 53.55%, ME 1.68 - 1.86 Mcal/kg, NEL 0.99 - 1.12 Mcal/kg, NEM 0.87 - 1.04 Mcal/kg, and NEG 0.31 - 0.48 Mcal/kg compared to the beginning of earing and dough formation period. According to the statistical analysis results, the differences between variety averages, growth period averages, and cutting averages were found to be significant in terms of the analyzed characteristics (crude protein, crude fat, crude ash, ADF, NDF, ADL, TDN, ME, NEL, NEM, and NEG). According to the results of the present study, it is recommended to cut at the beginning of the heading to obtain quality grass in Italian ryegrass farming. It is also very important to choose the appropriate Italian ryegrass variety for each region. [ABSTRACT FROM AUTHOR]

Introduction: The optimal management of relapsed/refractory germ cell tumors remains unsettled. In this study, we aimed to evaluate the efficacy of high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) as salvage therapy in patients who progressed after at least one line of cisplatin-based chemotherapy. Methods: We retrospectively reported the results of 133 patients who underwent HDCT and ASCT as salvage therapy from 2016 to 2021. Patients received 3 cycles of paclitaxel, ifosfomide and cisplatin (TIP) regimen as induction and 1 cycle of carboplatin 700 mg/m2 on days 1–3 plus etoposide 750 mg/m2 on days 1–3, followed by ASCT. Demographic and clinicopathological features of patients, the International Germ Cell Cancer Collaborative Group (IGCCCG) risk group at diagnosis, serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCG) levels before HDCT, treatment-related complications and survival outcomes were recorded. Results: The median age of the patients was 31 (range 18–62). The median follow-up was 31.1 months (95% CI, 28.9–33.3 months). During the median follow-up period, 74 of the 133 patients were still alive, and 63 of these were in complete remission. The median progression-free survival (PFS) was 25.8 months (95% CI, 8.1–43.4 months). The 2-year PFS rate was 50.3% and the 2-year overall survival (OS) rate was 60.8%. Variables that remained statistically significant in multivariable analysis and were associated with poor prognosis were mediastinal primary tumor location, presence of brain metastases, and higher AFP and HCG levels at baseline. Conclusion: One course of HDCT and ASCT after induction with TIP is an effective and feasible treatment option for salvage treatment of relapsed/refractory germ cell tumors, with cure rates of up to 60%. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate treatment responses, survival analysis and treatment-related mortality characteristics of patients with malignant somatic transformation (MST). Materials and Methods: In this retrospective cross-sectional study, patients with relapsed and refractory MST who had previously received multiple-line chemotherapy were evaluated. Clinical features and follow-up data of relapsed/refractory MST patients were recorded from the patients’ registration database at the hospital. Age, clinical stage at initial diagnosis, serum tumour marker levels, visceral metastasis status, previous treatment protocols and follow-up times were recorded. This study aims to demonstrate demographic and disease-related characteristics, best response to systemic therapy, and overall survival (OS) results. Results: The study included 14 patients. Mean age at diagnosis was 29.6 years for the whole group. The most-common sarcoma subtype was Ewing sarcoma (44.4% in the sarcoma group). In half the patients, the best response to systemic treatment was determined as a complete response. Median OS for the sarcoma group was 19.72 months [interquartile range (IQR) 29.18 months], and in the adenocarcinoma group, it was determined as 136.24 months (IQR 131.92 months) (p=0.006). The median OS for the whole group was 28.12 months (IQR 99 months). No significant difference in survival was found between synchronous and relapsed cases [median (IQR) 24.09 (91.23) months vs 43.54 (113.51) months, p=0.606]. Conclusions: Germ cell tumour patients with MST should be treated according to the somatic component. Poor responses to cisplatin-based chemotherapy have been found in this cohort. Patients with sarcomatous components were found to have significantly shorter OS. [ABSTRACT FROM AUTHOR]

Objectives: To aim to show the survival outcomes of ifosfamide, carboplatin and etoposide (ICE) therapy and the characteristics of treatment-related hematological side effects in patients with relapsed/refractory bone sarcomas (BSs) and soft tissue sarcomas (STSs). Methods: Patients who were treated at the Department of Medical Oncology, Gulhane School of Medicine between January 2017 and June 2021 were included. Post-ICE progression-free survival (PFS), overall survival (OS) rates and treatment-related hematological side effects were determined. Results: Fifty-six adult patients were included (thirty-four of them BSs). PFS was determined as 6.7 ± 4.4 months and 7.1±3.6 months for STSs and BSs, respectively. OS was 11.4±5.6 monhts and 12.6±7.1 for STSs and BSs, respectively. PFS and OS were not found to be better between groups (p=0.84 and p=0.517, respectively). The median OS and PFS after ICE protocol in patients with two or less systemic chemotherapy lines were significantly higher than those who received three or more lines (7.85±1.66 vs 3.74 ±2.89, p=0.001 and 13.80±8.45 vs 6.73, p=0.001). Conclusion: In addition to its contribution for all patients, ICE may contribute to longer survival, especially in patients receiving ≤2 lines of systemic chemotherapy [ABSTRACT FROM AUTHOR]