Background and Objectives: Despite developments in cervical cancer (CC) treatment, an advanced stage is a poor prognostic factor. Cervical cancer is an immunogenic tumor in which viruses, like HPV, play a role in carcinogenesis. Therefore, systemic inflammatory markers (SIMs) may have prognostic value. Most studies on SIMs focus on the early stage by evaluating pretreatment levels. This study aims to evaluate the prognostic and predictive values of both pretreatment and post-treatment parameters at the advanced stage, as well as treatment efficacy after progression with first-line treatment. Materials and Methods: A total of 133 advanced-stage CC patients with progression on first-line platin–paclitaxel and bevacizumab were evaluated retrospectively. Demographic and histopathological characteristics were recorded along with treatment details. Pre-treatment baseline blood parameters and post-treatment follow-up values were recorded to calculate SIMs as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI). Results: Median values for SIMs were accepted as cut-off values. Post-treatment values demonstrated stronger predictive power, with pre-treatment SIRI and NLR being significant only in univariate analysis, but not in multivariate analysis. High post-treatment SIRI (>2.1) was correlated with shorter overall survival (OS) and considered a poor prognostic factor. High post-treatment SIRI (>2.1), -SII (>746), and -PLR (>197) emerged as independent prognostic factors for progression-free survival (PFS). Their prognostic values were clearer in the whole population and the metachronous metastatic subgroup. Rechallenge of platinum-based chemotherapy was an option for those who had at least 6 months of PFS with first-line platinum-based chemotherapy. Bevacizumab addition to single-agent or combination regimens led to improved ORR as well. Conclusions: Post-treatment SIRI is a promising prognostic factor for OS, while post-treatment SIRI, SII, and PLR may serve as convenient SIMs for PFS. Platinum-based combination chemotherapy reinduction is a feasible second-line treatment strategy, especially with the addition of bevacizumab.
7 March 2024 in Clinical and Translational Oncology
Background/Objectives: In this retrospective study, we aimed to compare the efficacy, survival, and toxicity results of induction (IC) or adjuvant (AC) treatment with chemoradiotherapy (CRT) in locally advanced nasopharyngeal cancer (NPC). Methods: A total of 405 patients from 22 different centres in Turkey, belonging to the Turkish Oncology Group (TOG), was included. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoints were safety and toxicity. Results: The median age of the patients included in the study was 49 (18.2–91.5) years. In total, 298 (73.6%) of the patients were male. Of the 405 patients, 258 (63.7%) received IC and 147 (36.3%) received AC treatment. When OS and PFS analyses were performed in terms of age, gender, T and N stages, pathological features, and treatments received, no effect of any variable on prognosis was observed. For the overall group, the median estimated OS was 137.3 months (the Kaplan–Meier statistical method could not reach the 95% confidence interval [CI]). For the IC group, the median estimated survival was 137.3 months (95% CI: 111.4–163.3), whereas the Kaplan–Meier statistical method could not estimate survival for the AC group. No statistically significant difference was observed between IC and AC groups in terms of OS (p = 0.209) or PFS (p = 0.248). Grade 3–4 side effects were observed in 12% of patients in the IC group and 29.9% of patients in the AC group. Treatment was discontinued due to toxicity in 5 patients (1.9%) in the IC group and 18 patients (12.2%) in the AC group. Conclusion: No difference in OS or PFS was observed between AC and IC treatments. More grade 3–4 side effects were observed in the AC-treated group and early discontinuation rate was higher.
16 September 2025 in Journal of Health Sciences and Medicine
Aims: Solitary fibrous tumors are exceedingly rare neoplasms, for which surgical resection remains the cornerstone of treatment; however, long-term surveillance is imperative due to the significant risk of recurrence. We aimed to evaluate tumor characteristics and treatment responses in this multicenter study. Methods: Sixty-eight adult patients with histologically confirmed solitary fibrous tumor (SFT) diagnosed between 2010 and 2024 from seven cancer centers in Turkiye were included. Clinical and pathological features along with treatment outcomes were assessed. Results: The majority of patients (65/68 pts, 95%) presented with localized disease and underwent primary resection, while 3 patients had metastatic disease at the time of diagnosis. Further analyses were performed only in patients with localized disease. Median follow-up time was 41.7 months. All patients underwent primary surgery; R0 resection was achieved in most patients (66.2%). Five -year DFS and OS were 67% and 87%, respectively. DFS of extrameningeal SFTs was further evaluated according to clinicopathological variables. Low Ki-67 Labeling Index, low mitotic rate, and younger age were found to be associated with longer DFS. Response rates to first-line systemic therapy after recurrence was 27% with chemotherapy and while no objective responses were achieved with pazopanib. Two patients experienced disease control for up to 11 months with pazopanib. This study is limited by the relatively small sample size and the heterogeneity arising from the inclusion of both meningeal and extrameningeal tumors located at different anatomical sites. Conclusion: Localized SFTs usually have favorable prognosis. Patients with extrameningeal SFTs with younger age, low Ki-67 Index and low mitotic rate have longer survival. Once relapsed, repeat surgical resection should be pursued when possible. Response rates to systemic treatment is generally low.