Metastatic Pancreatic Cancer Second-Line Treatment Options: Is the Difference Only in Cost?

INTRODUCTION: Although pancreatic cancer ranks seventh in cancer-related deaths, it is an extremely fatal disease, and more than 330,000 people die from this disease worldwide. Although there are many first-line treatment studies in the literature, there are almost no prospective studies regarding second-line therapy. Therefore, there is no standard approach in the second-line treatment of pancreatic cancer. We decided to conduct this study to investigate second-line treatments with problems such as cost, treatment efficacy, and toxicity. METHODS: Patients older than 18 years old who applied to Ege University Hospital medical oncology department with a diagnosis of metastatic pancreatic cancer, who received first-line chemotherapy due to their illness, and who had progressed afterwards were included in the study. The files of the patients who applied between 2013 and 2017 were examined. RESULTS: Our study's primary endpoint was progression-free survival, and it was found that the median progression-free survival was 3.2 months in the Xelox patients, 3.7 months in the gemcitabine-nab paclitaxel patients, and 3.5 months in the other regimens. When the secondary endpoint was evaluated, overall survival, the median overall survival was 5.9 months in the Xelox patients, 5.3 months in the gemcitabine-nab paclitaxel patients, and 4.8 months in the other regimens. CONCLUSION: As a result, second-line treatments were compared, and no statistically significant difference was found between them. For this reason, the side effects of previously used drugs and the side effects of new drugs to be used, as well as their costs, should be evaluated when choosing a treatment.

Fine needle aspiration biopsy (FNAB) in fibrous and non-fibrous soft oral tissue lesions.

The use of fine needle aspiration biopsy (FNAB) in the diagnosis of many lesions in different parts of the body is quite widespread, while it has been used for oral lesions only very recently. This technique has many advantages including ease of use, cost effectiveness, convenience and accuracy. The present study, investigated the diagnostic value of FNAB in solid oral lesions using, specimens from 90 patients (56 females, 34 males), with ages ranging from 7-70 years which were examined in comparison with their histopathological sections. Cytological specimens were evaluated based on the presence of diagnostic cells. Ninety cases were divided into two major groups those with fibrous and nonfibrous lesions, for the the purposes of histopathological diagnosis. Among all fibrous lesions, cytological diagnosis was possible in 20 cases, whereas 45 out of 49 non-fibrous oral lesions yielded diagnostic cells. In conclusion it was shown that FNAB was not very diagnostic in fibrous lesions. However, in lesions with loose stroma, rich in vessels or inflammatory cells, and in malignant tumors, FNAB was a very successful method which yielded a correct diagnosis.