PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Survival In Recurrent Ovarian Cancer Patients Before And After The Bevacizumab Era: An Observational Single-Centre Study(2022) Akilli, Huseyin; Rahatli, Samed; Aliyeva, Khayala; Altundag, Ozden; Kuscu, Ulku Esra; Ayhan, Ali; https://orcid.org/0000-0002-5240-8441; https://orcid.org/0000-0003-0197-6622; 35260031; AAX-3230-2020; W-9219-2019A retrospective observational study was carried out in Baskent University School of Medicine, Ankara, Turkey. Recurrent ovarian cancer patients treated between 2007 and 2017 were divided into two groups according to their bevacizumab status. The primary endpoints were overall survival (OS) and safety. Three hundred and ninety-six patients enrolled in this study, 200 (50.5%) received bevacizumab while 196 (49.5%) patients never received bevacizumab. The median follow-up time was 48.2 and 47.6 months, respectively. The 5-year OS was 61% and 46%, respectively (p=.007). In multivariate analysis, only platinum-sensitivity (HR: 3.75, 95% CI: 3.0-5.32; p<.001) was identified as independent prognostic factors. In subgroup analyses according to platinum status, bevacizumab did not affect the 5 year OS in platinum sensitive patients (64% versus 68% p=.28) but increased survival in platinum resistant patients (36% versus 44%, p=.00). The rate of grade III-IV haematologic toxicities was 13.7% in the bevacizumab group and 11% in the other group (p=.6).Impact Statement What is already known on this subject? Bevacizumab increases the progression-free survival in platinum-sensitive and resistant recurrent ovarian cancer patients without changing overall survival. What do the results of this study add? Bevacizumab did not affect OS in platinum sensitive recurrent ovarian cancer patients however improved OS in platinum resistant patients with mild toxicity. What are the implications of these findings for clinical practice and/or further research? This study emphasised the crucial role of bevacizumab in the treatment of recurrent ovarian cancer patients.Item Half-dose bevacizumab experience in relapsed ovarian cancer patients in Turkey due to formal regulations: similar effectiveness with lower rate of hypertension(2020) Kose, Fatih; Alemdaroglu, Songul; Mertsoylu, Huseyin; Besen, Ali Ayberk; Guler, Ozan Cem; Simsek, Seda Yuksel; Erbay, Gurcan; Onal, Cem; Celik, Husnu; 0000-0003-4335-6659; 0000-0002-2742-9021; 0000-0001-6908-3412; 0000-0002-1706-8680; 0000-0002-0156-5973; 0000-0002-7862-0192; 0000-0002-1932-9784; 33099934; AAI-8400-2021; D-5195-2014; AAC-5654-2020; AAK-5370-2021; G-4827-2016; AAK-7016-2021; AAD-6910-2021; M-9530-2014Purpose: Ovarian cancer is the fifth leading cause of cancer related death in women. Platin-based doublet regimens plus bevacizumab is standard treatment in relapse. Due to formal regulation of Turkish Ministry of Health, adjuvant bevacizumab has not been reimbursed and clinicians can use bevacizumab at a dose of 7.5 mg/kg/3wk in platin-resistant and sensitive relapse settings. The primary aim of this study was to evaluate 7.5 mg/kg/3wk bevacizumab dosing in platin-resistant and sensitive relapse ovarian cancer and compare these findings with the current literature. Methods: A total of 106 patients with relapsed ovarian cancer and treated with bevacizumab (bevacizumab is not reimbursed as a part of adjuvant treatment in Turkey) on their first relapse were included. Results: At a median follow-up of 32.1 months (5.3-110.8), 56 (52.8%) patients died. Progression-free survival (PFS) and overall survival (OS) were estimated at 18.8 months (14.4-23.3) vs 29.7 months (24.3-35.1) of the whole group overall survival. We observed that 78.4% of patients treated with primary surgery without neoadjuvant treatment and 59 (57.8%) out of the 102 patients with debulking surgery relapsed. A significant number of patients (81%) treated with primary surgery without neoadjuvant treatment and 59 (76.6 %) had secondary debulking surgery at relapse. In relapse, 38 patients were treated with single agent liposomal doxorubicin (LPD) plus bevacizumab. On the other hand, 68 patients were treated with carboplatin and LPD plus bevacizumab. Multivariate analysis failed to show any clinicopathological characteristics with significant effect on PFS. However, cytoreductive surgery at relapse showed significant effect on OS. Bevacizumab-related toxicities were detected in 23 (21.7%) patients; hypertension, pulmonary embolism, perforation, and other toxicities (nephrotic syndrome in 2, osteonecrosis in 2, cerebrovascular and cardiac ischemia in 3 patients) were seen in 12 (11.3%), 3 (2.8%), 1 (0.9%) and 7 (6.6%) patients, respectively. Conclusions: In conclusion, our findings showed that 7.5 mg/ kg/3week dosing of bevacizumab in relapsed ovarian cancer could have similar effectiveness compared to standard 15 mg/ kg/3week dosing. Increase of OS and PFS in patients treated with primary and secondary debulking surgery with no-visible disease was more pronounced. No new safety information was observed but lower rate of grade 3 or above hypertension with similar rate of severe vascular and intestinal complications were detected.Item Comparison of intravitreal bevacizumab and triamcinolone acetonide theraphies for diffuse diabetic macular edema(2015) Aksoy, Sibel; Yilmaz, Gursel; Akkoyun, Imren; Yazici, Ayse Canan; 26086006AIM: To compare therapeutic effects of intravitreal triamcinolone acetonide (IVTA) versus intravitreal bevacizumab (IVB) injections for bilateral diffuse diabetic macular edema (DDME). METHODS: Forty eyes of 20 patients with bilateral DDME participated in this study. For each patient, 4 mg/0.1 mL IVTA was injected to one eye and 2.5 mg/0.1 mL IVB was injected to the other eye. The effects of injection for diabetic macular edema (DME) were evaluated using best -corrected visual acuity (BCVA), central macular thickness (CMT) by optical coherence tomography (OCT) and intraocular pressure (IOP) by applanation tonometer. Patients underwent eye examinations, including BCVA, CMT, and IOP at pre-injection, 1, 4, 8, 12 and 24wk after injection. During the follow -up, second injections were performed to eyes which have CMT greater than 400 pm at 12wk for salvage therapy. RESULTS: BCVA (logarithm of the minimum angle of resolution) at pre -injection, 1, 4, 8, 12 and 24wk after injection was 0.71 +/- 0.19, 0.62 +/- 0.23, 0.63 +/- 0.12, 0.63 +/- 0.13, 0.63 +/- 0.14 and 0.61 +/- 0.24 in the IVTA group and 0.68 +/- 0.25, 0.61 +/- 0.22, 0.60 +/- 0.24, 0.62 +/- 0.25, 0.65 +/- 0.26 and 0.59 +/- 0.25 in the IVB group, respectively. CMT (mu m) at pre-injection, 1, 4, 8, 12 and 24wk after injection was 544 +/- 125, 383 +/- 96, 335 +/- 87, 323 +/- 87, 333 +/- 92, 335 +/- 61 in the IVTA group and 514 +/- 100, 431 +/- 86, 428 +/- 107, 442 +/- 106, 478 +/- 112, 430 +/- 88 in the IVB group respectively. Reduction ratios of mean CMT were 29% at 1wk, 38% at 4wk, 40% at 8wk, 38% at 12wk, and 38% at 24wk in the IVTA group. Second IVTA injections were performed to the 6 eyes (30%) at 12wk. Reduction ratios of mean CMT were 16% at 1wk, 17% at 4wk, 14% at 8wk, 7% at 12wk, and 16% at 24wk in the IVB group. Second IVB injections were performed to the 15 eyes (75%) at 12wk. CONCLUSION: This study showed earlier and more frequent macular edema recurrences in the eyes treated with bevacizumab compared with the ones treated with triamcinolone acetonide. Triamcinolone acetonide was found to provide more efficient and long-standing effect in terms of reducing CMT compared with the bevacizumab.