Fakülteler / Faculties
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Item Docetaxel, Cisplatin, and Fluorouracil Combination in Neoadjuvant Setting in The Treatment of Locally Advanced Gastric Adenocarcinoma: Phase II NEOTAX Study(2014) Ozdemir, Nuriye; Abali, Huseyin; Vural, Murat; Yalcin, Suayib; Oksuzoglu, Berna; Civelek, Burak; Oguz, Dilek; Bostanci, Birol; Yalcin, Bulent; Zengin, Nurullah; https://orcid.org/0000-0001-5596-0920; 25234436; D-7660-2016This phase II trial aimed to evaluate the efficacy and safety of docetaxel, cisplatin, and fluorouracil (DCF) combination in neoadjuvant setting in patients with locally advanced gastric adenocarcinoma. Fifty-nine patients with resectable or unresectable locally advanced gastric and gastroesophageal cancer were recruited in this multicenter, single-arm, open-label, local clinical phase II study conducted at three centers from Turkey between June 2006 and March 2012. Patients had T3-4 or lymph node-positive disease. After staging with imaging and laparotomy or laparoscopy, they received three cycles of DCF with lenograstim. Imaging studies were repeated after the last two cycles. Patients who underwent surgery were followed up for at least 1 year after the surgery. Toxicity and response were evaluated in accordance with NCI-CTC version3.0 and RECIST 1.0. At baseline, 66.1 % of patients were considered resectable. In 47 patients evaluable, partial response in 16 (34.0 %), stable disease in 27 (57.5 %), and progressive disease in four (8.5 %) were observed. Forty-six patients underwent surgery. In 38 (64.4 %; 95 % confidence interval (CI) 52.2-76.6 %) out of 59 patients, complete resection (R0) was achieved. Median overall and disease-free survival were 19.1 months (95 % CI 13.5-24.7) and 11.6 months (95 % CI 5.9-17.4), respectively. The most frequent grade 3-4 adverse events were neutropenia (52.5 %), febrile neutropenia (11.9 %), leukopenia (39.0 %), and diarrhea (10.5 %). One patient died from an unknown cause. Classical DCF triplet with lenograstim showed a good clinical response with acceptable safety profile in the treatment of locally advanced gastric and gastroesophageal cancer with a significant R0 rate and manageable toxicity.Item Triplet or Doublet Chemotherapy Regimens in Metastatic Gastric Cancer(2022) Yildirim, Serkan; Yilmaz, CengizChemotherapy is the most important treatment option for patients diagnosed at an advanced stage. Chemotherapy both prolongs survival and increases the quality of life. Today, there is still no definite information about whether doublet or triplet chemotherapy should be chosen in empirical therapy. Therefore, we designed our study to evaluate first-line treatment options in metastatic gastric cancer.Our study is retrospective and involves five centers in Turkey. Inclusion criteria were the presence of metastatic gastric adenocarcinoma pathology, not having received treatment for local gastric cancer (surgery, chemotherapy, or radiotherapy), having received chemotherapy (patients with two or more combinations of drugs were included in the study, and patients who received single-drug chemotherapy were not included) for metastatic disease and being HER-2 negative. The survival of the triplet chemotherapy group was significantly longer when compared with the patients who received oxaliplatin-based doublet chemotherapy (11.1 vs. 8.1 months p=0.007). When the patients who received triplet chemotherapy and those who received cisplatin-based doublet chemotherapy were compared, there was no statistically significant difference (11.13 vs. 10.57 months p=0.665).If chemotherapy will be chosen as the first-line treatment in metastatic gastric cancer, choosing triplet chemotherapy regimens if possible, and if doublet chemotherapy will be given for any reason, choosing cisplatin-based regimens may be more appropriate, especially for the patient population in Turkey.Item Concurrent Chemoradiotherapy with Vinorelbine plus Split-Dose Cisplatin may be an Option in Inoperable Stage III Non-Small Cell Lung Cancer: A Single-Center Experience(2015) Mertsoylu, Huseyin; Kose, Fatih; Sumbul, Ahmet Taner; Sedef, Ali Murat; Dogan, Ozlem; Besen, Ali Ayberk; Parlak, Cem; Findikcioglu, Alper; Muallaoglu, Sadik; Sezer, Ahmet; Sakalli, Hakan; Ozyilkan, Ozgur; 25731741Background: Concurrent chemoradiotherapy is the current standard treatment for inoperable stage III non-small cell lung cancer (NSCLC). In this study we aimed to investigate the efficacy and toxicity of CCRT with split dose of cisplatin (30 mg/m(2)) and vinorelbine (20 mg/m(2)) in patients with inoperable stage III NSCLC followed in our oncology clinic. Material/Methods: Medical records of 97 patients with inoperable stage III NSCLC treated with concurrent chemoradiotherapy with cisplatin-vinorelbine were retrospectively analyzed. Cisplatin (30 mg/m(2)) and vinorelbine (20 mg/m(2)) were administered on days 1, 8, 22, and 29 during radiotherapy. Two cycles of consolidation chemotherapy were given. All patient data, including pathological, clinical, radiological, biochemical, and hematological data, were assessed retrospectively using our database system. Results: Our study included 97 unresectable stage III NSCLC patients who were treated with CCRT. Median age was 58 years old (range 39-75) and 87 (89.7%) of the patients were men. ECOG performance score was 0-1 in 93 patients (95.9%). Squamous histology, the most common histology, was diagnosed in 46 patients (47.4%). Median follow-up time was 23.8 months. Median progression-free survival (PFS) and median overall survival time (OS) were 10.3 months and 17.8 months, respectively. Objective response rate and clinical benefit rate were 75.3% and 83.5%, respectively. Distant and local relapse rate were 57.1% and 42.9%, respectively. Hematological and non-hematological grade 3-4 toxicities were seen in 13 (13.4%) and 16 (16.5%) patients, respectively. Six (6.1%) patients died due to toxicity. Conclusions: The results of this study suggest that split-dose cisplatin may offer fewer grade III-IV toxicities without sacrificing efficacy and could be an option in patients with inoperable stage III NSCLC during CCRT. Similar to past studies, despite high response rate during CCRT, distant relapse is the major parameter that influences patient survival in long-term in NSCLC.Item Investigation of the Protective Effects of Acetyl L-Carnitine on Cisplatin-Induced Uterus Toxicity(2018) Goktas, Guleser; Seyhan, Sermin; Saribas, Gulistan Sanem; Akcay, Neslihan Coskun; Gurgen, Seren Gulsen; Akyol, Seda Nur; Hirfanoglu, Ibrahim Murat; Erdogan, Deniz; Ozogul, CandanObjective: The aim of the study was to investigate the prophylactic effects of acetyl L-carnitine against to uterus induced by cisplatin. Methods: Twenty-four female Wistar albino rats were divided into four groups: group I (control) was administered with saline; group II was administered with acetyl L-carnitine; group III was administered with cisplatin; group IV was pretreated with acetyl L-carnitine before cisplatin intraperitoneal injection. After 72h of cisplatin injection uterine tissue was removed. Histological and immunohistochemical investigations were performed, respectively. Results: We found that the number of TUNEL and caspases positive cells were increased in the endometrial epithelium, subepithelial connective tissue, endometrial glands and stroma in group III compare to the other groups. Furthermore inflammation and edema were observed in uterus of rats in group III. Conclusion: We can concluded that pretreatment of acetyl L-carnitine administration has protective effect on histological alteration of uterus caused by cisplatin.Item İleri evre küçük hücreli olmayan akciğer kanserli hastalarda cisplatin ve vinorelbine tedavisinin sonuçları(Başkent Üniversitesi Tıp Fakültesi, 2007) Yılmaz, Bahattin; Akçalı, ZaferPlatin içeren ikili kemoterapiler, ileri evre küçük hücreli olmayan akciğer kanserinde (KHOAK) birinci basamakta önerilen tedavi seçeneğidir. Biz bu çalışmada retrospektif olarak Cisplatin ve Vinorelbine (CV) tedavisinin, ileri evre akciğer kanserinde etkinliğini, sağkalım üzerine etkisini, yan etkilerini ve tolere edilebilirliğini araştırdık. Çalışmaya Evre IIIB veya IV olan KHOAK tanısı almış, daha önce kemoterapi almayan 56 hasta dahil edildi. Vinorelbine (V) 25 mg/m2 dozunda 1. ve 8. günlerde, 15 dk iv infüzyon şeklinde verildi. Cisplatin (C), 1. günde, gerekli hidrasyon sağlandıktan sonra, 75 mg/m2 dozunda, % 0,9 SF içinde 2 saatlik infüzyonla verildi. Kürler 21 günde bir tekrarlandı. Ortanca 3,5 kür (0,5 – 6) tedavi verildi. Hastaların 28’i (% 50) evre III B, 28’i (% 50) evre IV olarak tesbit edildi. 5 hastada (% 8,9) radyolojik tam yanıt (CR), 17 hastada kısmi yanıt (PR) elde edildi. Toplam yanıt oranı % 39,3 idi. Hastalık ilerlemesine kadar geçen süre (TTP) ortanca 11,9 ay (% 95 CI: 8,2 – 15,6) saptandı. Toplam sağkalım (OS) ortanca 13,6 ay ( %95 CI: 9,2 – 18,0 ay) saptandı. Tüm hastalar için 1 yıllık sağkalım oranı % 50 (28 hasta), 2 yıllık sağkalım oranı % 10,7 (6 hasta) tesbit edildi. Grade 3-4 anemi 4 hastada (% 7,2), grade 3-4 granülositopeni 13 hastada (% 23,2) gelişmiştir. Hiçbir hastada grade 3-4 trombositopeni gelişmedi. Hematolojik olmayan toksisitelerden, 8 hastada (% 14,2) grade 3-4 bulantıkusma, 1 hastada (%1,7) grade 3 böbrek toksisitesi, 1 hastada (%1,8) grade 3 flebit gelişti. Enfeksiyon nedeniyle kaybedilen 2 hasta da grade 5 toksisite olarak kabul edildi. Sonuç olarak kendi uygulamamızda CV tedavisi literatür ile uyumlu etkinlik ve cevap oranlarına ve toksisite olarak güvenli bir profile sahiptir. Ayrıca diğer tedavi seçeneklerine göre de düşük maliyet avantajı sağlamaktadır. Using platinum-based doublets are recommended as first-line chemotherapy in advanced non-small cell lung cancer (NSCLC). Here, we assessed the efficiency, influence on survival, adverse reactions, and tolerability of Cisplatin and Vinorelbine (CV) doublet treatment in advanced lung cancer in a retrospective manner. A total of 56 patients who were diagnosed with Stage IIIB or IV NSCLC and did not receive chemotherapy were recruited for the study. Vinorelbine (V) was administered intravenously in 15 minutes at a dose of 25 mg/m2 on the 1st and 8th days. Cisplatin (C) was given as 2-hour intravenous infusion in 0,9 % saline at a dose of 75 mg/m2 on the 1st day following adequate hydration and prior to V. The courses were repeated once in 21 days. Median 3,5 (0,5 - 6) treatment courses were given. Among the patients, 28 (50 %) were detected as stage III B, 28 (50 %) stage IV. Radiological complete response (CR) was achieved in 5 patients (8,9 %) and partial response (PR) in 17 patients. Total response rate was 39,3 %. Median time to progression (TTP) was detected as 11,9 months (% 95 CI: 8,2 – 15,6). Median overall survival (OS) was found as 13,6 months (%95 CI: 9,2 – 18,0). One-year survival rate for all patients was established as 50% (28 patients) and 2-year survival rate as 10,7 % (6 patients). Grade 3-4 anemia developed in 4 patients (7,2 %), grade 3-4 granulocytopenia in 13 patients (23,2 %). Grade 3-4 thrombocytopenia developed in none of the patients. Among the nonhematologic toxicities, grade 3-4 nausea-vomiting developed in 8 patients (14,2 %), grade 3 nephrotoxicity in 1 patient (1,7 %), and grade 3 phlebitis in 1 patient (1,8 %). Two of the patients (3,5 %) died due to grade 5 infection. The cost of one course is about 39 % of the Cisplatin + Gemcitabine treatment and 23 % of the Cisplatin + Docetaxel treatment. In conclusion, the CV treatment that we have administered has efficiency and response rates as consistent with those in the literature and is reliable regarding toxicity. The cost is low with respect to other treatment alternatives as well.