Evaluation of 2024 Turkish Medical Oncology Board Exam with ChatGPT - Journal of Oncological Sciences

Background: Immune checkpoint inhibitors (ICIs) combined with first-line platinum–etoposide have changed the standard treatment of extensive-stage small-cell lung cancer (ES-SCLC), yet the role of consolidative thoracic radiotherapy (cTRT) in the chemo-immunotherapy era remains unclear. Objectives: To evaluate the association of cTRT after first-line chemo-immunotherapy with survival outcomes and treatment-related toxicity in ES-SCLC. Design: Systematic review and meta-analysis. Data Sources and Methods: We systematically identified studies evaluating cTRT following first-line chemo-immunotherapy in ES-SCLC. Overall survival (OS) and progression-free survival (PFS) were pooled using hazard ratios (HRs), and safety outcomes were pooled using risk differences (RDs), each with 95% confidence intervals (CIs). Results: Seventeen studies (all non-randomized) involving 2,263 patients were included. cTRT was associated with improved OS (HR 0.63, 95% CI 0.56–0.71; p<0.001; I ² =0%) and PFS (HR 0.56, 95% CI 0.46–0.68; p<0.00001). Sensitivity analyses restricted to propensity score–adjusted studies and anti–PD-L1-based regimens showed consistent results. cTRT increased any-grade pneumonitis (RD 0.12, 95% CI 0.03–0.21) and esophagitis (RD 0.22, 95% CI 0.04–0.40), without a significant increase in overall grade ≥3 adverse events (RD 0.02, 95% CI −0.05 to 0.09). Conclusion: In ES-SCLC treated with first-line chemo-immunotherapy, cTRT was associated with improved survival and increased localized thoracic toxicity, particularly any-grade pneumonitis and esophagitis, without a significant increase in overall grade ≥3 adverse events. Pending prospective randomized validation, these results could support the use of cTRT after the disease control with first-line chemo-immunotherapy.

Purpose: The prognostic value of cetuximab-related electrolyte disturbances in metastatic colorectal cancer (CRC) remains unclear. The available reports on the prognostic effect of hypomagnesemia are controversial, while there are no comprehensive analyses regarding hypokalemia. This study aimed to evaluate the impact of hypomagnesemia and hypokalemia on treatment outcomes in patients with RAS/RAF wild-type metastatic CRC receiving first-line cetuximab-based therapy. Patients and Methods: We retrospectively analysed 305 patients treated across seven oncology centers between March 2013 and December 2024. Patients with baseline renal insufficiency or pre-existing electrolyte disturbance were excluded. Serum magnesium and potassium levels were assessed from the initiation of cetuximab until one month after its discontinuation. Results: There was one patient with missing magnesium levels and one patient with missing potassium levels. Three-hundred and four patients were available for the final analyses (n=304). Hypomagnesemia and hypokalemia occurred in 29.9% and 20.7% of the patients, respectively. Neither hypomagnesemia nor hypokalemia was significantly associated with progression-free survival (PFS) (11.9 vs 11.7 months for each; p=0.528 and p=0.327) or overall survival (OS) (25.3 vs 27.9 months; p=0.705 and 22.0 vs 28.8 months; p=0.824, respectively). Hypokalemia was correlated with a higher disease control rate (96.8% vs 87.1%, p= 0.028). In multivariate analyses, only metastatic burden (≥ 2 sites) independently associated with inferior outcomes for both PFS (HR 1.61, 95% CI 1.25– 2.08, p< 0.001) and OS (HR 1.77, 95% CI 1.31– 2.39, p< 0.001). Conclusion: Hypomagnesemia and hypokalemia did not significantly impact survival outcomes despite previous studies indicating otherwise. Moreover, hypokalemia was linked to improved disease control. These results provide incremental evidence regarding the clinical relevance of electrolyte disturbances, particularly hypokalemia, and highlight the need for prospective studies to clarify their prognostic and predictive significance.

Klinik Araştırma Türleri Ayşegül SAKİN Geleneksel Çin Tıbbı Kubilay KARABOYUN Ginseng Jamshid HAMDARD Zerdeçal Ekstresi (Kurkumin/Turmeric) Saadet SİM YILDIRIM Kara Kohoş Otu (Cimicifuga Racemosa) Merve ÖZKAN Ekinezya (Echinacea Purpurea) Abdussamet ÇELEBİ Gingko Biloba Mert ERCİYESTEPE Flavonoidler Aslı GEÇGEL Yeşil Çay (Camellia Sinensis) Berkan KARABUĞA Ada Çayı (Salvıa Offıcınalıs) Seval ORMAN Essiac Çayı Shamkhal SAFAROV Çörek Otu (Nigella Sativa) Özden DEMİR Deve Dikeni (Silybum Marianum) Gamze SERİN ÖZEL Isırgan Otu (Urtica Dioica) Gülhan DİNÇ Andız (Inula Viscoza) Azer GÖKMEN Garcinol (Garcinia Cambogia) Serkan GÜLCÜ Nar kabuğu (Punica Granatum) Orçun CAN Kişniş (Coriandrum Sativum) Nurbanu İNCİ Biberiye (Rosmorinus Officinalis) Pınar ÇOBAN EŞDUR Zencefil (Zingber Officinale) Nadiye SEVER Nane (Mentha Piperita) Okan AYDIN Papatya (Chammomilla Recutita) Buket ŞAHİN ÇELİK Zeytinyağı (Virgin Olive Oil) Hayriye TANİN DEMİRCİ Kekik (Thymus/ Thyme/ Thymus Vulgaris) Ahmet Emin ÖZTÜRK Ökse Otu (Mistletoe) Hacı ARAK Keçiboynuzu (Ceratonia Siliqua) Murad GULIYEV Hurma (Phoenix Dactylifera) Akif DOĞAN İncir (Ficus Carica) Erkam KOCAASLAN Sarımsak (Allium Sativum) ve Soğan (Allium Cepa) Ahmet AYDIN Sabin GÖKTAŞ AYDIN Kava Kava (Piper Methysticum) Yıldız GARİP BİLEN Meyan kökü (Glyctrrhiza Uralensis) Altay ALİYEV Sarı Kantaron (Hypericum Perforatum) Mustafa ERSOY Kedi Otu (Valeriana Officinalis) Mürsel SALİ Geven Otu (Astragalus) Harun MUĞLU Aloe Vera Emir Gökhan KAHRAMAN Kenevir (Cannabis) Alperen Akansel ÇAĞLAR Graviola Meyvesi ve Yaprağı (Annona Muricata Leaf) Seda SALİ Reişi Mantarı (Reishi Shiitake Maitake) Alper COŞKUN Likopen (Solanum Lycopersicum) Oğuzcan ÖZKAN Modifiye Narenciye Pektini (Pectin) Sümeyra DERİN Bayır Turbu (Armoracia Rusticana) Yasin SEZGİN Akgünlük (Boswellia Serrata) Esra Şazimet KARS Balık Yağı / Omega Yağları Nargiz MAJİDOVA Melatonin Aykut TURHAN Köpekbalığı Kıkırdağı Ömer GENÇ Hidrazin Doğan BAYRAM Koenzim Q10 Ekin KONCA KARABUĞA Resveratrol İbrahim BİLEN Timus Ekstresi Mehmet Cem FİDAN Bal ve Propolis Eyüp ÇOBAN Mineral Takviyesi Ömer Faruk ELÇİÇEK Kefir ve Kanser Melek ÖZDEMİR Alfa Lipoik Asit Hülya ODABAŞI BÜKÜN Glutatyon Fatma Pınar AÇAR Mavi Akrep Zehiri (Rhopalurus Junceus) Muslih ÜRÜN Spirulina Özge YALICI Chlorella Şermin DİNÇ SONUŞEN C Vitamini (Askorbik Asit) Murat GÜNALTILI Vitamin D Yunus Emre ALTINTAŞ A Vitamini ve Karotenler Tanju KAPAĞAN Vitamin E Güner AKGÜNER B6 Vitamini (Pridoksin) Erdem SÜNGER B12 Vitamini (Kobalamin) Goncagul AKDAG Folik Asit Selen KANTARCI KARATAŞ Multivitamin Kompleksleri Ezgi TÜRKOĞLU Ketojenik Diyet Ömer Faruk KUZU Akdeniz Diyeti Osman Bilge KAYA Aralıklı Oruç Ülviye OFLAS Vegan Beslenme Oğuzcan KINIKOĞLU Akupunktur Tedavisi Gülin Alkan ŞEN Yoga/Meditasyon Mehmet Nezir RAMAZANOĞLU Hypnotherapy Zeynep ALTUNDAĞ DERİN Aromatherapy Pınar PEKER Ayurveda Salih TÜNBEKİCİ Hacamat (Cupping Therapy) Mahmut KARA Ozon Tedavisi Murat ALAN üm Vücut Hipertermi (Whole Body Hyperthermia) Şaban SEÇMELER