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    Approach to Breast Cancer Treatment in Elderly Patients
    (Ortadogu Reklam Tanitim & Yayincilik, 2020) Seber, Selçuk; Çabuk, Devrim; Başaran, Gül
    Old age should be carefully evaluated before the treatment of all kinds of diseases, not only chronologically but also in functional terms. Regardless of the stage of breast cancer, it is known that older patients benefit from standard treatments as much as younger patients to the extent that they are represented in clinical trials, but we also know that toxicity is augmented in this age group. The elderly patient group is a very heterogeneous group within itself, and it is important to separate the healthier, more fit elderly group who will benefit from standard treatments from the group that can only receive standard treatment with some rehabilitation. In addition, it is one of the most important duties of the clinician to identify patients who cannot tolerate both standard and modified treatments before initiation of the cancer treatment. Today, although there are several Comprehensive Geriatric Evaluation tools which are developed for aiding the clinician for making treatment decisions, most of the elderly patients are not properly evaluated in the busy day to day clinical practice. As an alternative,parameters such as patients daily work, social enviorment, prescirbed medicines for other comorbidities, and the potential side effects of the recommended treatment should be carefully reviewed. The validity of the treatment decisions taken at the start of the treatment should be re-evaluated at each visit and if necessary, modifications should be made to maximize benefit with the least toxicity.
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    Fertility Desire and Protection Practices Among Turkish Young Breast Cancer Patients Treated with Chemotherapy
    (2024) Karaoyun, Kubilay; Cavdar, Eyyup; İriağaç, Yakup; Tacar, Seher Yıldız; Avcı, Okan; Seber, Selçuk
    Objectives: This study aims to reflect the oncofertility practice in Turkey as a developing country, by investigating young breast cancer patients' fertilization preservation attitudes and their post-treatment fertility status. Methods: Young breast cancer patients(<42 years) examined for breast cancer follow-up at the medical oncology out- patient clinic were consecutively included in the study. Patients with metastatic, infertile, or no menstrual cycle at the time of diagnosis and women who were less than 3 years from their last chemotherapy cycle were excluded. A ques- tionnaire on the desire for childbearing in the future, the fertility preservation preferences at the time of diagnosis, reproductive history was surveyed with patients. Results: 123 patients were enrolled in the study. 23.5% of the patients reported that they had a desire to give birth in the future at the time of diagnosis. For fertility preservation; 6 patients used embryo or oocyte cryopreservation, and 16 patients used LHRHa during chemotherapy. Nulliparous patients were more likely than others who had at least one child to pursue fertility preservation (p=0.001) and to be interested in having children in the future (p<0.001). Conclusion: This study revealed that oncofertility practices should be encouraged to improve the quality of life of sur- vivors along with cancer treatment in developing countries. Even with fertility preservation, the chances of a successful pregnancy are significantly low. Physicians should offer protection options to all patients regardless of their previous childbearing status, and fertilization counseling should also be discussed during all the post-treatment visits as well as pre-treatment settings.
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    Lorlatinib in ALK- or ROS1-Positive Non-Small Cell Lung Cancer Patients: Experience from an Early Access Program in Turkey
    (Elsevier Science Inc, 2019) Kilickap, S.; Demirci, U.; Buğdaycı, F.; Tural, D.; Korkmaz, T.; Paydas, S.; Cicin, İrfan; Seber, Selçuk
    [No Abstract Available]
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    Prognostic values of various hematological variables as markers of systemic inflammation in metastatic lung cancer
    (Wolters Kluwer Medknow Publications, 2020) Bayir, Duygu; Seber, Selçuk; Yetişyiğit, Tarkan
    Background: Chronic state of inflammation is an important factor in advanced cancer which is used by tumor cells for maintaining survival and growth. Hematological parameters such as neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio (TLR), and lymphocyte/monocyte ratio (LMR) are reliable indicators of systemic inflammation. We aimed to elucidate the effect of hematological parameters and clinical features of patients on the prognosis of advanced-stage non-small cell lung cancer (NSCLC). Methods: We included 102 Stage IV NSCLC patients who presented to the oncology clinic between 2010 and 2016. Pretreatment clinical parameters and NLR, TLR, and LMR were retrieved from the medical records. The cutoff values, calculated with receiver operating curve analysis, for NLR, LMR, and TLR were 2.5, 3, and 183, respectively. All patients were divided into two groups according to cutoff values and analyzed accordingly. Results: Median overall survival and progression-free survival were 10 and 6 months, respectively. In univariate analysis, high NLR, high TLR, and low LMR were found to be significantly associated with survival. Among clinical parameters having eastern cooperative oncology group performance score 0-1, older age (>= 70 years) single metastatic disease was prognostic. In multivariate Cox regression analysis, only the number of metastatic lesions and LMR were found to be independent predictors for survival. Conclusion: Among hematological parameters, only LMR was found to be an independent predictor of survival in patients with advanced-stage NSCLC.
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    Retrospective evaluation of totally implantable venous access port devices: Early and late complications
    (Imprimatur Publications, 2015) Gürkan, Selami; Seber, Selçuk; Gür, Özcan; Yetişyiğit, Tarkan; Donbaloğlu, Mehmet Okan; Özkaramanlı Gür, Demet
    Purpose: The role totally implantable vascular devices (TI-VAD) have an important role in providing care to cancer patients who require continuous or frequent venous access route either for their primary or supportive care treatments. This retrospective study aimed to analyze the efficacy of TIVAD and device-related complications. Methods: A total of 324 consecutive patients (185 male, 139 female, median age 56 years, mean 48 +/- 10.91; min:16, max:87) who were implanted with TIVAD between January 2012 May 2014 were included. We retrospectively assessed all TIVAD complications and focused on early and late complications. Results: A total of 324 devices were implanted successfully without major complications. The overall complication rate was 33.95% (N=110). Of them, 87(26.85%) were early and 23 (7.09%) were late complications. In total, 39 (11.23%) catheters were removed, in 8 (2.30%) patients due to complication and in 31(9.56%) due to the end of treatment. Conclusion: Most of the complications of TIVAD were early without requiring removal. Port catheters for chemotherapy are safe and well tolerated with acceptable complication rates.
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    Review of the current role of targeted therapies as maintenance therapies in first and second line treatment of epithelial ovarian cancer; in the light of completed trials
    (Elsevier Science Inc, 2016) Korkmaz, Taner; Seber, Selçuk; Başaran, Gül
    Late and recurrent stage ovarian cancer has a high mortality and low response rate to therapy beyond first line treatment. Although first line platinum/taxane based regimens have a satisfactory response rate eventually in most cases disease recurrence is common and second-line treatments are not curative. Delaying progression or recurrence is the main goal of current ongoing clinical studies by means of establishing an effective maintenance regimen with acceptable toxicity profile. Clearly, the persistence of dormant and drug-resistant cells after front-line treatments results in the inability to cure the disease. Over the past several years, the idea of prolongation of therapy for ovarian cancer has garnered clinical attention and academic debate. As a result of a greater understanding of the molecular pathways involved in carcinogenesis and tumor growth, a large number of potential therapeutic targets have been identified and drugs to block receptors, ligands or pathways are being developed. Currently, numerous clinical trials with targeted agents have just been completed or are ongoing involving patients achieving a complete or durable response after first-line and beyond the first line chemotherapy in order to evaluate the efficacy of different therapeutic approaches in terms of progression-free survival and overall survival. (C) 2015 Elsevier Ireland Ltd. All rights reserved.