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.
Gastrointestinal stromal tumors (GISTs) are primarily mesenchymal tumors with specific histological features, located in the gastrointestinal tract and the abdomen. 1 They are identified and diagnosed by the expression of a protooncogene protein called CD117 detected using immunohistochemistry. 2 Atrial myxoma is the most common benign primary tumor of the heart, and atrial myxomas are extremely rare tumors. 3 Normally, interstitial cells of Cajal regulate gastrointestinal peristalsis in the bowel wall. These cells are found in and around the intestinal myenteric plexus in the adult bowel. GISTs are mesenchymal tumors that originate from precursors of Cajal cells. 4 GISTs may be present in all parts of the gastrointestinal tract, but most often in the stomach (50%) and the small intestine (25%). In addition, the tumor can rarely be located in the colorectal (10%), omentum/mesentery (7%), and esophagus (5%). 5 GISTs of 2 cm or less are typically asymptomatic and incidentally detected during surgery, radiology, or endoscopy for any other reason. The most common symptoms are abdominal pain, gastrointestinal bleeding, anemia, abdominal mass, dyspeptic complaints, and dysphagia. 6 Most of the primary cardiac tumors (80%) are benign, and the most common benign heart tumor is atrial myxoma. Although myxomas may develop from all cardiac cavities, they are sporadic tumors and most commonly localized in the left atrium (75%). These tumors, which can be seen in all ages and more frequently in women, may occur with cerebral or peripheral embolism findings, and patients
Background:Aromatase inhibitors (AIs) are used for the adjuvant treatment of early breast cancer. Although generally well-tolerated, they have some adverse effects. Because of AIs are used long term in adjuvant treatment, side effects are also very important. Preclinical and a little clinic data indicate that estrogens exert neurotrophic and neuroprotective actions in the brain. So estrogen appears to play an important role in cognitive function and memory. We know that AIs reduce circulating estrogen to very low levels. For this reason, there has been concern that these agents may have a negative effect on cognitive functions. However, this situation is still unclear. The purpose of our study is to evaluate the relationship between duration of treatment and cognitive functions in patients with breast cancer who use AIs in adjuvant therapy. Methods:Patients diagnosed with breast cancer who use AIs as adjuvant treatment and followed up at the Akdeniz University Medical Oncology Clinic were included. The patients were surveyed for demographic characteristics. Montreal Cognitive Assessment (MoCA) and Standardized Mini-Mental State Examination (SMMT) tests were applied to patients by the same investigator to evaluate their cognitive functions. The total scores of the tests and the orientation, naming, short-time memory, visuospatial functions-executive functions, attention, abstract thinking, language which are the MoCA subscales were evaluated separately. In the Turkish population, the normal range of the MoCA and SMMT tests are 21-30 points and 24-30 points, respectively. Patients were grouped as 0-6, 6-12, 12-24, 24-36, 36 and more months according to the duration of AIs using time. 200 patient’s data were analyzed with SPSS package program. This study was approved by the Akdeniz University Faculty of Medicine Clinical Research Ethnics Committee and was conducted in accordance with declaration of Helsinki. Results:The median follow-up time was 55.5 months. The median duration of AIs treatment was 36.5 months. The mean age of patients was 61.3 years-old. There was no relationship between duration of treatment and MoCA and SMMT scores which indicates cognitive functions (p>0.05). In addition, no statistically relationship was found in the evaluation of MoCA subscales (p>0.05). As expected, the total MoCA and SMMT scores were affected by factors such as age, education level, and employment status. Interestingly, although it was not our main purpose, a causal relationship between the presence of hypertension and cognitive decline was shown in our study (p: 0.004). A statistically strong correlation was found between the MoCA and SMMT scores. So, our data are reliable. The duration of treatment with AIs and MoCA and SMMT scores of the patients were given in Table 1. Conclusions:As a result, despite conflicting results in the literature, we showed with 200 patients that adjuvant treatment with AIs does not affect cognitive functions in post-menopausal hormone receptor-positive breast cancer patients. Table 1: Relationship between the duration of treatment with AIs and MoCA and SMMT scoresDuration of AInMoCA*Mean±SDMoCAMed (min-max)SMMT**Mean±SDSMMTMed (min-max)0-6 m2319,7±5,221 (10-26)25±425 (15-30)6-12 m2420,7±5,421,5 (8-28)24,7±3,624 (16-30)12-24 m1418,2±4,118,5 (13-27)24,3±425 (13-29)24-36 m2920,3±4,920 (11-29)24,1±3,225 (17-30)36 m and more11020,3±4,521 (8-29)25±3,225 (14-30)Total20020.1±4,721 (8-29)24,8±3,425 (13-30)AI: Aromatase inhibitors, m: Mounths, n: Number, MoCA: Montreal Cognitive Assessment, SMMT: Standardized Mini-Mental State Examination, SD: Standart Deviation, Med: Median*p: 0.550 **p:0.533 Citation Format: Rukiye Guler Ilhan, Yusuf Ilhan, Sema Sezgin Goksu, Ali Murat Tatli, Hasan Senol Coskun. The effect of using adjuvant aromatase inhibitors on cognitive functions in postmenopausal women with hormone receptor-positive breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-71.
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