Sürdürülebilir Kalkınma Amaçları

• 3

• MakaleAçık Erişim2025/r/gumushane/10705
  Real-world comparison of doxorubicin-ifosfamide versus gemcitabine-docetaxel regimens in metastatic uterine leiomyosarcoma: a multicenter retrospective study

  Tunbekici, Salih; Sahin, Gokhan; Yuksel, Haydar Cagatay; Acar, Caner; Akin, Imge; Aslanhan, Hasan; Isci, Mert; Kabaoglu, Ceren; Bal, Hamit; Sakin, Abdullah

  BackgroundUterine leiomyosarcoma is a rare and aggressive malignancy with limited responsiveness to standard therapies. We conducted a real-world, multicenter study to compare the clinical efficacy and safety of two commonly used first-line chemotherapy regimens-doxorubicin-ifosfamide and gemcitabine-docetaxel-in patients with metastatic uterine leiomyosarcoma.MethodsThis retrospective cohort included 271 patients with advanced or metastatic uterine leiomyosarcoma treated between 2010 and 2023 across 30 centers in Turkey. Patients received either doxorubicin-ifosfamide (n = 142) or gemcitabine-docetaxel (n = 129) as first-line therapy. The primary endpoint was overall survival; secondary endpoints included progression-free survival, objective response rate, disease control rate, and safety. Adverse events were graded according to the Common Terminology Criteria for Adverse Events version 5.0, while survival outcomes were estimated using the Kaplan-Meier method and further analyzed with Cox proportional hazards models.ResultsMedian overall survival was 19.7 months with doxorubicin-ifosfamide and 20.2 months with gemcitabine-docetaxel (P = .26). Median progression-free survival was 5.5 months with doxorubicin-ifosfamide and 7.0 months with gemcitabine-docetaxel (P = .62). The objective response rate was numerically higher with gemcitabine-docetaxel (35% vs. 26%), although not statistically significant (P = .11). Grade 3-4 neutropenia (16% vs. 12%) and febrile neutropenia (7% vs. 6%) were more frequent with doxorubicin-ifosfamide.ConclusionsIn this largest-to-date real-world cohort of metastatic uterine leiomyosarcoma, doxorubicin-ifosfamide and gemcitabine-docetaxel demonstrated comparable survival outcomes. Gemcitabine-docetaxel, however, was associated with a more favorable hematologic safety profile. These findings support the clinical utility of both regimens while underscoring the need for prospective, biomarker-driven studies to refine treatment selection and improve personalization in this rare malignancy.

  • 
  İncele
• MakaleAçık Erişim2025/r/gumushane/16369
  EZH2 expression in colorectal carcinoma: an evaluation of clinicopathological and prognostic value

  Cagatay, Diren Vuslat; Balci, Mecdi Gurhan; Issin, Gizem; Demir, Fatih

  BackgroundEnhancer of zeste homolog 2 (EZH2), the catalytic subunit of Polycomb Repressive Complex 2, catalyzes trimethylation of histone H3 lysine 27 and has been implicated in tumor progression.AimOur study aims to assess the relationship between EZH2 expression and clinicopathologic data, and survival in colorectal carcinomas (CRC).Materials and methodsEZH2 immunohistochemistry was performed on tumor blocks from 124 CRC patients. Based on H-scores, cases were stratified into low- and high-expression groups. EZH2 status was correlated with demographic, clinical, and pathologic features, and overall survival was analyzed with the Kaplan-Meier method and log-rank test.ResultsA total of 124 cases of CRC; 12 (9.7%) cases were classified as low EZH2 expression, and 112 (90.3%) cases were classified as high EZH2 expression. A significant association was found between EZH2 expression and microsatellite stability. High EZH2 expression was significantly enriched in microsatellite-stable tumors (p = 0.007) and in left-sided lesions (p = 0.049). No significant associations were detected with sex, stage, grade, lymph-node status, or vascular invasion. Kaplan-Meier analysis revealed no difference in overall survival between low- and high-EZH2 groups (log-rank p = 0.47; hazard ratio = 1.13, 95% CI 0.45-2.85). EZH2 staining was uniformly strong in normal mucosa and adenomas, mirroring the high expression observed in most CRCs.ConclusionsEZH2 is highly expressed across the normal-adenoma-carcinoma sequence and, in our cohort, was not linked to overall survival or to most clinicopathologic parameters in CRC. The lower expression observed in a subset of MSI-H tumors warrants further investigation; present evidence remains insufficient to establish EZH2 as an independent prognostic biomarker.

  • 
  İncele
• MakaleAçık Erişim2023/r/gumushane/12713
  Mobile care app development process: using the ADDIE model to manage symptoms after breast cancer surgery (step 1)

  Aydin, Aydanur; Gürsoy, Ayla; Karal, Hasan

  The use of mobile applications is widespread in patient monitoring or education today. This study aims to describe the design and development process of a mobile app that supports patient self-care after breast cancer surgery. We used the ADDIE model to develop and test the mobile app. ADDIE (Analysis, Design, Development, Implementation, Evaluation) is a systematic approach based on a standard instructional design model for creating training materials. The model consists of five phases, each with its own set of steps. Once the steps within each phase are completed, the model progresses to the next phase, ultimately resulting in a “usable” product. Different team collaborations were established within each phase, and support was obtained from multiple experts during the design process. Thanks to this model, the information that patients need was transformed into a technological product. This article, which explains the stages of the product design process for mobile applications, provides information that may be helpful to researchers working on similar products.

  • 
  İncele