ObjectiveCisplatin-paclitaxel and bevacizumab is a frequently used treatment regimen for metastatic or recurrent cervical cancer, and carboplatin-paclitaxel and bevacizumab are also among the recommended regimens. In this study we aimed to evaluate the efficacy of these two regimens for the treatment of metastatic or recurrent cervical cancer.MethodsPatients with metastatic or recurrent cervical cancer treated with cisplatin-paclitaxel and bevacizumab or carboplatin-paclitaxel and bevacizumab were retrospectively evaluated in this study. The clinical and demographic characteristics of patients in each group were evaluated. Median overall survival, progression-free survival, and response rates between the two groups were compared.ResultsA total of 250 patients were included. Overall, the numbers of patients with recurrent disease and metastatic disease were 159 and 91, respectively. The most common histologic subtype was squamous cell carcinoma (83.2%). The median duration of follow-up was 13.6 (range 0.5–86) months. The median progression-free survival was 10.5 (95% CI 9.0 to 11.8) months in the cisplatin-paclitaxel and bevacizumab group (group 1), and 10.8 (95% CI 8.6 to 13.0) months in the carboplatin-paclitaxel and bevacizumab group (group 2) (HR 1.20; 95% CI 0.88 to 1.63; p=0.25). The median overall survival was 19.1 (95% CI 13.0 to 25.1) months in group 1 and 18.3 (95% CI 15.3 to 21.3) months in group 2 (HR 1.28; 95% CI 0.91 to 1.80; p=0.15).ConclusionsThere is no survival difference between cisplatin or carboplatin combined with paclitaxel and bevacizumab in metastatic or recurrent cervical cancer.
245 ÖZET Amaç:Şiddet hayatın her alanında ve dünyanın hemen her bölgesinde görülebilen önemli bir toplum sağlığı sorunudur. Bu çalışma-nın amacı Dicle Üniversitesi Tıp Fakültesi'nde görev yapmakta olan sağlık çalışanlarının aile içi şiddete maruz kalıp kalmadıkla-rını değerlendirmektir. Yöntemler:Çalışmamız bir anket çalışması olup, 2013 yılında Dicle Üniver-sitesi Tıp Fakültesi Hastanelerinde akademik personel, asistan doktor, hemşire, ebe, sağlık teknisyeni ve laborant olan sağ-lık çalışanlarından 371 kişiye gönüllük esasına bağlı olarak uygulandı. Bulgular:Çalışmamıza katılan gönüllüle-rin 203 (%54,7) tanesi erkek olup 168 (%45,3) tanesi kadındı. Olgular yaş aralıklarına göre değer-lendirildiğinde 18-30 yaş aralığın-da 188 olgu, 31-4 yaş aralığında 119 olgu, 41-50 yaş aralığında 37 olgu, 51-60 yaş aralığında 21 olgu ve 61 yaş ve üzerinde ise toplam 6 olgu bulunmakta idi. Olguları-mızın 63'ünün (%17) aile içi şid-dete maruz kaldığını tespit ettik. Çalışmamızda hekimler arasında fiziksel ve psikolojik şiddetin daha fazla olduğu, cinsel ve ekonomik şiddetin ise hemşireler ve diğer sağlık çalışanları içerisinde daha fazla olduğu tespit edilmiştir. Sonuç:Hastalarında şiddet unsuru gör-düğü anda hemen tanımlayacak ve gerekli destekleri sağlayacak olan sağlık çalışanlarının kendileri de şiddete maruz kalabilmektedirler. İnsanların acılarına bir yardım eli uzatması beklenen sağlık çalışanlarının şiddete kendilerinin maruz kalması ça-lışmamız sonucunda elde ettiği-miz üzücü bir sonuçtur. Conclusion:Healthcare staff who would define any fact of violence in the patients and provide the required support may also be exposed to violence. Healthcare staff exposure themselves to violence while they are expected to lend a helping hand is a sad outcome that were obtained as a result of the present study.
Background Vaginal metastasis should be kept in mind when evaluating the staging tests of all cancers, especially endometrial cancer. Case presentation We present four patients with vaginal recurrence who recently applied to our clinic. Three cases were of endometrial cancer and one case of rectal cancer. All patients presented with vaginal bleeding. Conclusion Standard treatment for vaginal metastasis has not yet been established. Therapeutic options for vaginal metastasis—separately or in combination—are surgical resection, radiotherapy, and chemotherapy.
Background The prognostic value of perineural invasion (PNI) in head and neck squamous cell carcinoma (HNSCC) remains controversial. This study investigated the impact of PNI on prognosis in HNSCC. A total of 49 patients with HNSCC who underwent primary surgical treatment were selected for the study. Univariate analysis of the survival curve was performed using the Kaplan-Meier method. Multivariate analysis was carried out by Cox regression. Results PNI was present in 17 of 49 (34.7%) patients. The median follow-up was 18.7 months. The median DFS and OS were 16.6 months and 41.9 months, respectively. Univariate analyses showed that PNI was associated with OS (p: 0.02), but not with DFS (p: 0.50). ENE was associated only with DFS in univariate analysis (p: 0.04), but not OS (yes vs. no; 24.1 vs. 44.6 months, p: 0.21), and in multivariate analysis, ENE lost its significance for DFS (p: 0.12). Also, PNI was the only significant independent adverse prognostic factor for OS in multivariate analysis (p: 0.02). The median OS for patients with and without PNI was 17.1 months and 92.1 months, respectively. Conclusion PNI was an independent factor for poor prognosis in patients with HNSCC. The presence of PNI compared to ENE was associated with a greater risk of death in HNSCC. Therefore, it would be appropriate to consider adjuvant therapy in the presence of PNI alone without other adverse risk features.
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