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    5-fluorouracil-induced manic episode in patients with colon cancer: A case report and literature review
    (2019) Elboga, Gulcin; Aksoy, Perihan Gizem; Kus, Tulay; Karayagmurlu, Elif; Aktas, Gokmen; Sahin, Sengul; Altindag, Abdurrahman
    The combination of 5-fluorouracil (5-FU), irinotecan and bevacizumab (FOLFIRI-beva) is one of the main treatment options for metastatic colon cancer. We present a rare case of irritable mood elevation during FOLFIRI-beva treatment in a man without psychiatric history. A 41-year-old man with colon cancer developed a manic episode after four cycles of chemotherapy. After excluding the other causes, the patient was diagnosed with Medication-induced Bipolar disorder manic episode with mixed features according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Chemotherapy was discontinued, and antipsychotic treatment with haloperidol and biperidone was started. He recovered after 12 days. While adjustment disorders, depression and delirium are more common in cancer patients, mood disorders are rare during chemotherapy. Neuropsychiatric manifestations are uncommon during 5-FU treatment. Clinicians should keep in mind that a neuropsychological condition or mood disorders may be encountered during chemotherapy especially with 5-FU.
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    Effect of diabetes mellitus on prognosis and development of hepatocellular carcinoma in patients with hepatitis C-related cirrhosis
    (2019) Taskaynatan, Halil; Aktas, Gokmen; Vatansever, Sezgin
    Aim: Hepatitis C virus (HCV) infection and diabetes mellitus (DM) negatively affect each other. HCV patients diagnosed with DM have more complications than patients with HCV infection alone. In this study, we aimed to investigate the effect of DM on complication rate, hepatocellular cancer (HCC) development and mortality in HCV RNA (+) cirrhosis patients.Material and Methods: Patients admitted with Hepatitis C-related cirrhosis and followed up for at İzmir Katip Çelebi University Atatürk Training and Research Hospital Gastroenterology and Internal Medicine Clinic for at least six months between 2005and 2014 were retrospectively evaluated.Results: A total of 146 patients with HCV-related cirrhosis were included in the study. Of these patients, 53 (36.3%) had diagnosis of DM. In 108 patients who did not develop hepatocellular carcinoma (HCC), the mean CHILD score at final admission (p=0.024), difference between mean CHILD scores at final and initial admission (p=0.011), and annual rate of increase in CHILD score (p=0.047) was significantly higher in the DM group. There was no significant difference between the DM and non-DM groups according to both overall survival (p=0.115) and time of HCC development (p=0.567).Conclusion: While HCC development and overall survival were similar in both groups, in the subgroup of patients who did not develop HCC, the annual increase in CHILD score and final CHILD score were significantly higher in DM patients.
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    Survival analysis of single agent gemcitabine therapy in patients with metastatic breast cancer
    (2019) Yesil Cinkir, Havva; Aktas, Gokmen
    Aim: Gemcitabine has demonstrated experimental and clinical antitumor activity in various human neoplasms including pancreas, ovary, non-small cell lung and breast tumors. We aimed to investigate the factors affecting progression-free survival (PFS) and overall survival (OS) of patients who received single agent gemcitabine for metastatic breast cancer.Material Methods: Twenty-eight patients with metastatic breast cancer who were treated with gemcitabine in Gaziantep University Medical Faculty Medical Oncology Department between March 2007 and December 2018 were evaluated retrospectively. Gemcitabine 1000 mg / m2 was administered as a single agent treatment on the 1st and 8th days, every 21 days.Results: Twenty-seven (96.4%) of the patients were female and 1 (3.6%) was male. The median age was 52 years(range 35-76). Median PFS was 5 months (95% confidence interval 2,41-7,58) and median OS was 26 months (95% confidence interval 11,73-40,26). The median PFS of the patients with only lung metastasis was 16 months and the other patients were 4 months (Log-rank p = 0.020)Conclusion: Gemcitabine is a very well tolerated agent with sufficient efficacy for patients with metastatic breast cancer who were preferred to use single agent chemotherapy than combination therapies. Patients with only lung metastasis may benefit more from single agent gemcitabine in metastatic breast cancer.Keywords: Metastatic breast cancer; gemcitabine; progression-free survival; overall survival.