Publications by authors named "Mehmet Fuat Eren"

9 Publications

  • Page 1 of 1

New horizons from novel therapies in malignant pleural mesothelioma.

Adv Respir Med 2020 ;88(4):343-351

Department of Radiation Oncology, Acıbadem Maslak Hospital, Istanbul, Turkey.

Malignant pleural mesothelioma (MPM) is a relatively rare, but highly lethal cancer of the pleural mesothelial cells. Its pathoge-nesis is integrally linked to asbestos exposure. In spite of recent developments providing a more detailed understanding of the pathogenesis, the outcomes continue to be poor. To date, trimodality therapy involving surgery coupled with chemotherapy and/or radiotherapy remains the standard of therapy. The development of resistance of the tumor cells to radiation and several che-motherapeutic agents poses even greater challenges in the management of this cancer. Ionizing radiation damages cancer cell DNA and aids in therapeutic response, but it also activates cell survival signaling pathways that helps the tumor cells to overcome radiation-induced cytotoxicity. A careful evaluation of the biology involved in mesothelioma with an emphasis on the workings of pro-survival signaling pathways might offer some guidance for treatment options. This review focuses on the existing treatment options for MPM, novel treatment approaches based on recent studies combining the use of inhibitors which target different pro-survival pathways, and radiotherapy to optimize treatment.
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June 2021

The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis.

Medicina (Kaunas) 2020 Jul 13;56(7). Epub 2020 Jul 13.

Department of Radiation Oncology, Medicine Faculty, Acibadem University, 34457 Istanbul, Turkey.

Everolimus (EVE) is a mammalian target of the rapamycin (mTOR) inhibitor that is widely used in cancer patients. Pulmonary toxicity, usually manifesting as interstitial pneumonitis, is a serious adverse effect of this drug. Radiation therapy, which is often administered in conjunction with chemotherapy for synergistic effects, also causes pulmonary fibrosis. In view of pulmonary damage development in these two forms of cancer treatment, we have examined the effect of EVE administration individually, in combination with radiation given in varying sequences, and its relation to the extent of pulmonary damage. We performed an experimental study in albino rats, which were randomized into five groups: (1) control group, (2) EVE alone, (3) EVE 22 h after radiation, (4) EVE 2 h after irradiation, and (5) only radiation. Sixteen weeks after thoracic irradiation, rat lung tissue samples were examined under light microscopy, and the extent of pulmonary damage was estimated. After this, we calculated median fibrosis scores in each group. The highest fibrosis score was noted in Group 4. Among the five groups, the control group had a significantly lower median fibrosis score compared to the others. When the median fibrosis score of the group that received concurrent EVE with radiation therapy (RT) (Group 4) was compared with that of the control group, the difference was statistically significant ( = 0.0022). However, no significant differences were achieved among the study groups that received EVE only or RT only, whether concurrently or sequentially ( > 0.05). EVE is an effective treatment option for the management of several malignancies and is often combined with other therapies, such as radiation, for a more efficient response. However, an increased risk of pulmonary fibrosis should also be anticipated when these two modalities are combined, as they both can cause pulmonary damage, especially when administered concurrently.
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July 2020

Current treatment strategies in malignant pleural mesothelioma with a treatment algorithm.

Adv Respir Med 2019 ;87(5):289-297

Department of Radiation Oncology, Mehmet Ali Aydınlar Acıbadem University, School of Medicine, Istanbul, Turkey.

Malignant pleural mesothelioma (MPM) is arare disease with apoor prognosis. The main therapeutic options for MPM include surgery, chemotherapy, and radiation therapy (RT). Although multimodality therapy has been reported to improve survival, not every medically operable patient is able to undergo all recommended therapy. With improvements in surgical techniques and systemic therapies, as well as advancements in RT, there has been apotential new paradigm in the management of this disease. In this review, we discuss the current literature on MPM management and propose afunctional treatment algorithm.
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April 2020

A Case of Multifocal Skin Metastases from Lung Cancer Presenting with Vasculitic-type Cutaneous Nodule.

Indian J Dermatol 2015 Mar-Apr;60(2):213

Department of Medical Oncology, Okmeydanı Education and Research Hospital, Kayseri, Turkey.

Although cutaneous metastasis occurs usually at the terminal stage of the disease, it may be rarely concurrent with the diagnosis and may also present as the first sign of the illness. A 55-year-old male patient presented with vasculitic-type cutaneous nodular lesions and a necrotic distal phalangeal lesion developed over the last month. He was a tradesman and smoked 40 packets year. On physical examination, he was found to have multiple cutaneous lesions on the skin of the face, limbs, neck, scalp, dorsal side, fingers, subungual side, right leg, and feet. A skin lesion punch biopsy was performed and squamous cell carcinoma metastasis was detected. He was diagnosed as having squamous cell lung cancer with bronchoscopic biopsy. Although it is very rare, cutaneous metastases that is concurrent with the diagnosis of lung cancer may be the first sign of the disease. In patients with suspicious skin lesions, the patient's age, smoking history, and other symptoms should be evaluated and a biopsy should be performed.
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March 2015

The impact of radiotherapy on quality of life for cancer patients: a longitudinal study.

Support Care Cancer 2014 Sep 12;22(9):2479-87. Epub 2014 Apr 12.

Cumhuriyet University, Sivas, Turkey,

Purpose: The aim of this study was to assess for changes in quality of life (QOL) among cancer patients who undergo radiotherapy (RT) and to identify factors that influence QOL in this group.

Materials And Methods: Three hundred sixty-seven cancer patients who received curative RT were investigated using the EORTC QLQ-C30 questionnaire at the start of RT, end of RT, and 1 and 6 months post-RT.

Results: The patients were 49 % women, 51 % men, and median age at diagnosis was 57 years (range, 16-86 years). Compared to pre-RT, at the end of RT, the global health status score (p < 0.001), nausea/vomiting (p < 0.001), and apetite loss scores (p < 0.001) were significantly poorer. Compared to the end of RT, at 1 and 6 months post-RT, global health status, all functional, and all symptom scores were significantly improved (p < 0.001). Patient sex influenced scores for pain (p = 0.036), appetite loss (p = 0.027), and financial difficulty (p = 0.003). Performance status influenced scores for global health status (p = 0.006), physical functioning (p < 0.001), cognitive functioning (p = 0.001), and role functioning (p = 0.021). Comorbidity influenced fatigue score (p < 0.001). Cancer stage influenced scores for physical functioning (p = 0.001), role functioning (p = 0.010), and fatigue (p < 0.001). Treatment modality (chemoRT vs. RT alone) influenced scores for physical functioning (p = 0.016), fatigue (p < 0.001), nausea/vomiting (p = 0.009), and appetite loss (p < 0.001); and RT field influenced scores for nausea/vomiting (p = 0.001), appetite loss (p = 0.003), and diarrhea (p = 0.037). Radiotherapy dose functioning (p < 0.001), cognitive functioning (p < 0.001), social functioning (p < 0.001), fatigue (p < 0.001), and pain (<60 vs ≥60 Gy) had an effect on scores for physical functioning (p < 0.001), role functioning (p < 0.001), emotional (p < 0.001), insomnia (p < 0.001), constipation (p < 0.001).

Conclusion: While RT negatively affects cancer patients' QOL, restoration tends to be rapid and patients report significant improvement by 1 month post-RT. Various patient- and disease-specific factors and RT modality affect QOL in this patient group. We advocate measuring cancer patients' QOL regularly as part of routine patient management.
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September 2014

Could the neutrophil to lymphocyte ratio be a poor prognostic factor for non small cell lung cancers?

Asian Pac J Cancer Prev 2014 ;15(5):2089-94

Department of Medical Oncology, Cumhuriyet University, Sivas, Turkey E-mail :

Background: Although many prognostic factors have been identified for lung cancers, new ones are needed to determine the course of the disease. Recently, a high neutrophil to lymphocyte ratio (NLR) prior to surgery or treatment has been shown to be an indicator of prognosis for cancer. The aim of this study was to investigate the value of NLR as a prognostic factor and the correlation between NLR and other probable clinical prognostic factors in non small cell lung cancer patients prior to treatment.

Materials And Methods: Data of patients who were diagnosed with non-small cell lung cancer in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristics were recorded. NLR was calculated before the application of any treatment.

Results: A total of 299 patients, 270 (90%) males and 29 (10%) females, were included in the study. Age (p<0.001) stage (p<0.001), Eastern Cooperative Oncology Group performance status (p<0.001), weight loss (p<0.001), anemia (p<0.001), histopatology (p<0.001), NLR ≥ 3 (p=0.048), NLR ≥ 4 (p=0.025) and NLR ≥ 5 (p=0.018) were found to be the prognostic factors. Age, anemia, Eastern Cooperative Oncology Group performance status, the stage, NLR (≥ 5) were an independent prognostic factors. There was a positive correlation between NLR and the Eastern Cooperative Oncology Group performance status (0.23, p=0.001), the C reactive protein levels (r=0.36, p<0.001).

Conclusions: Prior to treatment high NLR was found as an independent poor prognosis factor. Besides, NLR correlated with Eastern Cooperative Oncology Group performance status and the C reactive protein levels.
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December 2014

Survival analysis and prognostic factors for neuroendocrine tumors in Turkey.

Asian Pac J Cancer Prev 2014 Jan;14(11):6687-92

Radiation Oncology Department, Cumhuriyet University School of Medicine, Sivas, Turkey E-mail :

Background: This study aimed to determine the demographical distribution, survival and prognostic factors for neuroendocrine tumors monitored in our clinic.

Materials And Methods: Data for 52 patients who were admitted to Cumhuriyet University Medical Faculty Training Research and Practice Hospital Oncology Center between 2006 and 2012 and were diagnosed and treated for neuroendocrine tumors were investigated.

Results: Of the total, 30 (58%) were females and 22 (42%) were males. The localization of the disease was gastroenteropancreatic in 29 (56%) patients and other sites in 23 (44%). The most frequently involved organ in the gastroenteropancreatic system was the stomach (n=10, 19%) and the most frequently involved organ in other regions was the lungs (n=10, 19%). No correlation was found between immunohistochemical staining for proteins such as chromogranin A, synaptophysin, and NSE and the grade of the tumor. The patients were followed-up at a median of 24 months (1-90 months). The three-year overall survival rate was 71%: 100% in stage I, 88% in stage II, 80% in stage III, and 40% in stage IV. The three-year survival rate was 78% in tumors localized in the gastroenteropancreatic region, and 54% in tumors localized in other organs. In the univariate analysis, gender, age, performance status of the patients, grade, localization, surgical treatment, and neutrophil/ lymphocyte ratio (≤ 5 versus >5) affected the prognosis of the patients.

Conclusions: Most of the tumors were localized in the gastroenteropancreatic region, and the three-year survival rate in tumors localized in this region was better than the tumors localized in other sites. Surgical treatment was a positive independent prognostic factor, whereas Grade 3 and a neutrophil/lymphocyte ratio of >5 were negative independent prognostic factors.
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January 2014

Lack of impact of age on acute side effects and tolerance of curative radiation therapy.

Asian Pac J Cancer Prev 2013 ;14(2):969-75

Cumhuriyet University School of Medicine, Sivas, Turkey.

Aim: The aim of this study was to determine the impact of age on the occurrence, severity, and timing of acute side effects related to radiotherapy.

Materials And Methods: We analysed the data of 423 patients.

Results: Of the patients, 295 (70%) were under the age of 65 (group 1) and 128 (30%) were over the age of 65 (group 2). The frequencies of radiotherapy-induced side effects were 89% in group 1 and 87% in group 2 (p=0.286). The mean times to occurrence were 2.5±0.1 weeks in group 1 and 2.2±0.1 weeks in group 2 (p=0.013). Treatment was ended in 2% of patients in group 1 and 6% of those in group 2 (p=0.062). Treatment interruption was identified in 18% of patients in group 1 and 23% in group 2 (p=0.142). Changes in performance status were greater in older patients (p=0.013). There were no significant differences according to the frequency or severity of side effects, except skin and genitourinary complications, between the groups.

Conclusions: Early normal tissue reactions were not higher in older versus younger patients, though there was a tendency towards an earlier appearance.
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July 2014