Yakup ERGÜN, Nuriye YILDIRIM ÖZDEMİR, Ozan YAZICI, Gökhan UÇAR, Yusuf AÇIKGÖZ, Öznur BAL, Doğan UNCU

HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer

Amaç: Trastuzumabın meme kanserinde neoadjuvan tedaviye eklenmesiyle patolojik tam yanıt (PTY) oranını arttırdığı bilinmektedir. Ancak trastuzumabın kullanım sırasıyla ilgili kısıtlı veri bulunmaktadır. HER2 pozitif lokal ileri meme kanserinde neoadjuvan trastuzumab uygulama sırasının PTY üzerine etkisi olup olmadığını incelemeyi amaçladık. Gereç ve Yöntemler: 2010-2018 yılları arasında HER2 pozitif evre 2 ve 3 meme kanseri nedeniyle neoadjuvan trastuzumab kullanan hastaların verileri retrospektif incelenmiş olup antrasiklin bazlı tedavi sonrası trastuzumab alan 30 hasta ve tam tersi sıralama ile tedavi alan 16 hasta çalışmaya alındı. Bulgular: Çalışmaya toplam 46 hasta alınmış olup ortanca takip süresi 31 aydı (aralık; 7–98). Hastaların ortanca yaşı 51 yıldı (19–72). Tüm hastaların %52’si postmenopozal, %67'si hormon reseptör pozitifti. Tüm hastalarda klinik nod pozitifliği olup %54'ü cN1 idi. Hastalar trastuzumab sıralamasına göre grupla ayrıldı. Bazal özellikler açısından gruplar arasında fark yoktu. PTY oranı trastuzumab ile tedaviye başlayanlarda %63 olup diğer grupta %37 idi (p=0.1). Üç yıllık kümülatif hastalıksız sağ kalım oranları ise sırasıyla %100 ve %80 idi (p=0.2). Tek değişkenli analizde evre 2 ve Vücut kitle indeksi (VKİ)

Anahtar Kelimeler:

HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer

Physical Therapy and Balneotherapy in Elderly Patients with Neck, Low Back and Knee Pain, Retrospective Study

Objective: The aim of this study was to investigate the contribution of balneotherapy to physical therapy in elderly people with neck, low back and knee pain. Materials and methods: In this retrospective study, the records of patients who received physical therapy or physical therapy + balneotherapy between 2013 and 2018 were examined. The data of 482 patients withthe exact evaluation parameters were analyzed among 704 elderly patients. Results: Only 196 patients had physical therapy (group 1). 286 patients underwent both physical therapyand balneotherapy (group 2). The treatment was applied to 173 patients from the neck, 338 patients from the low back and 287 patients from the knee. Some patients received treatment from two regions. In the general evaluation, the Pain Visual Analog Scale (VAS) results in 482 patients and the Health Assessment Questionnaire (HAQ) results in 276 patients, VAS results in 173 patients and HAQ results in 120 patients who received treatment from the neck, VAS results in 338 patients and HAQ results in 238 patients who received treatment from the low back and VAS results in 287 patients and HAQ results in 177 patients who received treatment from the knee results were examined. A statistically significant improvement was found in all outcome measures evaluated after treatment (p<0.001). In Group 2, recovery rates were statistically higher than group 1 (in all parameters p<0.001). Conclusion: At the end of this study, physical therapy combined with balneotherapy in elderly patients suffering from neck, low back and knee pain were found to be more effective on pain and quality of life than on physical therapy alone. Balneotherapy applied to the whole body may increase the effectiveness of physical therapy

Keywords:

Balneotherapy, Physical therapy, Elderly Pain,

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