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Öğe The effect of front-line chemotherapy on overall survival in patients with malignant pleural mesothelioma.(Lippincott Williams & Wilkins, 2013) Elkiran, Emin Tamer; Sevinc, Alper; Harputluoglu, Hakan[Abstract Not Available]Öğe The efficacy and reliability of sequential adjuvant anthracycline-based chemotherapy and weekly paclitaxel regimen in human epidermal growth factor receptor 2 negative breast cancer: A retrospective analysis of a multicentre study(Imprimatur Publications, 2019) Kaplan, Muhammet Ali; Oruc, Zeynep; Gumus, Mahmut; Ozaydm, Sukru; Elkiran, Emin Tamer; Dine, Nur Sener; Sakin, AbdullahPurpose: To analyze the reliability and the effectiveness of chemotherapy and prognostic factors for survival in patients with HER2 (human epidermal growth receptor 2) negative early-stage breast cancer treated with adjuvant sequential anthracycline-based chemotherapy and paclitaxel. Methods: This analysis retrospectively evaluated the medical records of 756 HER2 negative early-stage breast cancel-patients who received adjuvant sequential anthracycline-based chemotherapy and weekly paclitaxel in 15 medical oncology centers in Turkey between 2008-2015. Estrogen receptor (ER), progesterone receptor (PR), HER2, age, tumor size and grade, nodal status, perineural and lymphatic invasion, disease-free survival (DFS) and overall survival (OS) were analyzed. Results: The median patient age was 50 years (22-82). Median follow up period was 46 months (13-82). The rates of recurrence and death detected in this period were 14.8% and 7.4%, respectively.Median OS and PFS were not reached in this period. Five-year DFS and OS rates were 87% and 89%, respectively. Age (OR:0.35, 95%CI 0.12-0.96, p=0.04), PR status (OR:.0.44, 95%CI 0.18-1, p=0.05), lymphatic invasion (OR:.2.6, 95%CI 0.97-7.4, p=0.05) were independent prognostic factors.Most common grade 3-4 toxicides were fatigue (6.7%), neutropenia (1.7%) and nausea (1.3%). Neutropenic fever developed in 1.8% o f the patients and peripheral neuropathy in 16.9%. Dose reduction was necessary for 10%of the patients due to grade 3-4 toxicity, whereas postponement of chemotherapy was neccessary for 7% of the patients. Conclusions: This multicentric retrospective study confirmed that sequential adjuvant therapy with anthracycline-based chemotherapy and paclitaxel for HER2 negative breast cancer is an effective and reliable regimen.Öğe Efficacy of sorafenib in advanced differentiated and medullary thyroid cancer: experience in a Turkish population(Dove Medical Press Ltd, 2015) Benekli, Mustafa; Yalcin, Suayib; Ozkan, Metin; Elkiran, Emin Tamer; Sevinc, Alper; Cabuk, Devrim; Coskun, Hasan SenolBackground: Antivascular endothelial growth factor tyrosine kinase inhibitors have been used recently in the treatment of advanced differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC). Off-label sorafenib is used in Turkey with special permission by the Ministry of Health for this indication. Patients and methods: Patients with advanced DTC and MTC were retrospectively identified from the Turkish Ministry of Health database. Data on these patients were prospectively collected before permission is granted to use sorafenib. Results: Thirty patients with complete data were analyzed: 14 DTC (papillary number [n] = 10; follicular n=4) and 16 MTC. The median age of the patients was 57 years (range: 28-79 years), and there were 18 males and 12 females. All DTC patients were iodine refractory and had received a median three doses of radioactive iodine (range: 1-7 doses). Sorafenib was used for a median of 12 months (range: 1-49 months). The overall response rate was 20%, all partial responses, with no complete response. The overall response rate was 14% in DTC and 25% in MTC patients. The median progression-free survival (PFS) was 17.1 months (95% confidence interval [CI]: 7.3-26.8) and overall survival (OS) was not reached. The 2-year PFS and OS were 39% and 68%, respectively. DTC and MTC patients had similar survival outcomes: median PFS of 21.3 months (95% CI: 5.8-36.7) versus 14.5 months (95% CI: 3.7-25.2), respectively (P=0.36), with the median OS not reached in either group (P=0.17). Tumor marker levels did not have any prognostic or predictive role. The toxicity profile was similar to that of other sorafenib trials. Conclusion: Sorafenib is an effective and well-tolerated treatment in advanced thyroid cancers.Öğe Frequency and risk factors of potential drug interactions in breast cancer patients.(Lippincott Williams & Wilkins, 2014) Acar, Fatma; Dursun, Brahim Hakki; Harputluoglu, Hakan; Yigit, Ali; Kilic, Mehmet Salih; Elkiran, Emin Tamer[Abstract Not Available]Öğe Is eribulin treatment prognostic factor in patients with metastatic breast cancer treated with this drug? Retrospective analysis of a multicentre study(Imprimatur Publications, 2019) Oruc, Zeynep; Kaplan, Muhammet Ali; Geredeli, Caglayan; Sari, Nilgun Yildirim; Ozaslan, Ersin; Aytekin, Aydin; Elkiran, Emin TamerPurpose: This study aimed to analyze prognostic factors for survival and the reliability and the effectiveness of eribulin therapy in metastatic breast cancer (MBC) patients. Methods: A total of 80 patients treated with eribulin in 12 medical oncology centers in Turkey between 2013-2017 were retrospectively evaluated. Sixteen potential prognostic variables were assessed for analysis. Results: The patients had received a median of 5 prior chemotherapy regimens and a median of 3 eribulin cycles for MBC. Median progression-free survival (PFS) was 5.5 months (95% Cl: 4.1-7.8) and median overall survival (OS) was 11 months (95 % Cl: 6-15). Multivariate analysis showed that eribulin treatment line was shown to have independent prognostic significance for PFS. PFS difference was demostrated in patients who received 3 chemotherapy lines for advanced disease compared to those who had more than 3 chemotherapy lines [median PFS; 3 lines: 8.6 months (6.2-11) and >3 lines: 4.6 months (3.7-4.6) p=0.00]. The clinical benefit rate (CBR) was 52.5 and 35% in patients treated with three lines and with >3 previous chemotherapeutic regimens. Most common toxicities were neutropenia (62.5%), fatigue (52.5%), alopecia (50%) and nausea (37.5%). Conclusions: Eribulin treatment line was identified as indepedent prognostic factor for PFS in MBC patients.Öğe Is excision repair cross-complementation Group1 expression a biological marker in nasopharynx carcinoma(Wolters Kluwer Medknow Publications, 2019) Aksoy, Asude; Elkiran, Emin Tamer; Harputluoglu, Hakan; Dagli, Adile Ferda; Isikdogan, Abdurrahman; Urakci, ZuhatObjective: To determine the prognostic value of excision repairs cross-complementation group1 (ERCC1) gene in cases with nasopharyngeal carcinoma (NPC) treated with platinum-containing chemotherapy (PCT). Subjects and Methods: The present study was included 33 cases in local advanced stage with NPC. ERCC1 expression was evaluated by using immunohistochemical staining in biopsy specimens. We evaluated the relationship between the degree of ERCC1 expression and clinicopathological features, response to therapy, survival rates in cases with NPC, retrospectively. Results: ERCC1 expression was not observed in 5 (15.15%) of all cases. Thirteen (39.9%) cases weakly positive (+1, +2) and 15 (45.5%) cases of all them were rather strongly positive (+3). There was no statistically significant difference between the degree of ERCC1 expression and clinicopathological features, response to treatment, survival rates (P 0.05) in cases with NPC. Conclusions: ERCC1 expression has no predictive value for survival in cases locally advanced stage with NPC. Evaluation of ERCC1 expression is not appropriate with a biomarker to detect cases who can benefit from PCT in NPC.Öğe Multicentric study on malignant pleural mesothelioma in Turkey: clinicopathologic and survival characteristics of 282 patients(Humana Press Inc, 2012) Elkiran, Emin Tamer; Kaplan, Mehmet Ali; Sevinc, Alper; Aksoy, Sercan; Demirci, Umut; Seker, Mesut; Harputluoglu, HakanMalignant pleural mesothelioma (MPM) is a relatively rare, but aggressive tumor that causes high mortality. The major risk factor involved in the etiology is environmental and occupational exposure to asbestos. The optimal modality of therapy is controversial. The present study retrospectively evaluated the data pertinent to 282 patients who were examined and treated in 11 different medical oncology centers in Turkey. There were 161 males (57.1 %) and 121 females (42.9 %), with a mean age of 56.38 +/- A 12.07 years. Surgery was used in 74 patients, 21 patients (28.4 %) received only chemotherapy and 28 patients (37.8 %) received chemoradiotherapy after surgery. The median survival in patients who were administered adjuvant therapy after surgery was 24 months, while the median survival in patients who had only surgery was 6 months (p = 0.029). 106 patients were administered pemetrexed-platinum combination and 35 patients were administered gemcitabine-platinum combination as front-line chemotherapy. Median survival, 1- and 2-year survival rates in patients who received platinum analogues and pemetrexed or gemcitabine combinations were found statistically similar (p = 0.15). The median survival for all patients with MPM in our study was 18 months. The main factors influencing the overall survival were stage of the disease (p = 0.020), performance status (p < 0.001), asbestos exposure (p = 0.030) and mesothelioma histological subtypes (p < 0.001). Results of our study suggest that multi-modality treatment regimens consisting of surgery, radiotherapy and chemotherapy prolong overall survival. Survival rates in patients who received combining platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were found similar.Öğe Outcomes of radiotherapy in early stage glottic laryngeal carcinoma: a single center experience(Medicine Science, 2016) Ekici, Kemal; Temelli, Oztun; Eraslan, Ayse Fatma; Gurocak, Simay; Kaplan Bozdag, Nihal; Elkiran, Emin Tamer; Kekilli, Ersoy; Kizilay, Ahmet[Abstract Not Acailable]Öğe Oxidative stress and antioxidant parameters in neutropenic patients secondary to chemotherapy(Professional Medical Publications, 2016) Dogantekin, Akif; Gurel, Ali; Ustundag, Bilal; Ilhan, Selcuk; Elkiran, Emin TamerObjective: Neutropenia is a serious adverse event that necessitates dosage reduction in patients receiving chemotherapy. In this study, we evaluated the oxidative stress and antioxidant parameters in neutropenic patients after chemotherapy both during the neutropenic period and after successful treatment of neutropenia with filgrastim. Methods: We studied paraoxonase (PON1), arylesterase (ARE), malondialdehyde (MDA), high-density lipoprotein (HDL), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) in addition to routine biochemical and hematologic parameters. SPSS 12.0 was used for statistical evaluation of data (SPSS, Chicago, IL, USA). Results: In our study, PON1, HDL, and LDH levels during the period of active neutropenia were statistically significantly higher than these levels were after resolution of neutropenia (P<0.05); MDA and ALP levels were statistically significantly lower during the period of active neutropenia (P<0.05). Conclusions: Overall, free oxygen radicals (FOR) were increased and antioxidant parameters were decreased with resolution of neutropenia. This is probably due to FOR produced by the increased number of neutrophils rather than tumor burden.Öğe POSTERIOR REVERSIBLE LEUKOENCEPHALOPATHY SYNDROME DEVELOPING SECONDARY TO SUNITINIB THERAPY IN A PATIENT WITH METASTATIC RENAL CELL CARCINOMA(Carbone Editore, 2018) Kaplan, Nihal Bozdag; Harputluoglu, Hakan; Dikilitas, Mustafa; Elkiran, Emin Tamer; Temelli, OztunPosterior reversible encephalopathy syndrome (PRES) is characterized by vasogenic edema occurring generally in parietal and occipital areas of the brain as a result of different etiologic causes and it is diagnosed by means of clinical and radiologic assessment. Sunitinib is an orally administered tyrosine kinase inhibitor used in the treatment of renal cell carcinoma with its antiangiogenic and antitumor effects. Fatigue, nausea-vomiting, diarrhea, hypertension, cardiotoxicity, hypothyroidism, neutropenia, and skin toxicity are among common side effects associated with sunitinib therapy. The current report presents a female patient with metastatic papillary renal cell cancer who developed posterior reversible encephalopathy syndrome as determined by means of clinical and radiologic assessment at 8 months of sunitinib therapy and who completely recovered with antihypertensive, antiepileptic, and antiedema therapy.Öğe Posterıor reversıble leukoencephalopathy syndrome developıng secondary tosunıtınıb therapy ın a patıent wıth metastatıc renal cell carcınoma(Carbone edıtore, vıa quıntıno sella, 68, palermo, 90139, ıtaly, 2018) Kaplan, Nihal Bozdag; Harputluoglu, Hakan; Dikilitas, Mustafa; Elkiran, Emin Tamer; Temelli, OztunPosterior reversible encephalopathy syndrome (PRES) is characterized by vasogenic edema occurring generally in parietal and occipital areas of the brain as a result of different etiologic causes and it is diagnosed by means of clinical and radiologic assessment. Sunitinib is an orally administered tyrosine kinase inhibitor used in the treatment of renal cell carcinoma with its antiangiogenic and antitumor effects. Fatigue, nausea-vomiting, diarrhea, hypertension, cardiotoxicity, hypothyroidism, neutropenia, and skin toxicity are among common side effects associated with sunitinib therapy. The current report presents a female patient with metastatic papillary renal cell cancer who developed posterior reversible encephalopathy syndrome as determined by means of clinical and radiologic assessment at 8 months of sunitinib therapy and who completely recovered with antihypertensive, antiepileptic, and antiedema therapy.Öğe Prognostic factors of patients who received chemotherapy after cranial irradiation for non-small cell lung cancer with brain metastases: A retrospective analysis of multicenter study (Anatolian Society of Medical Oncology)(Medknow Publications & Media Pvt Ltd, 2018) Inal, Ali; Kodaz, Hilmi; Odabas, Hatice; Duran, Ayse Ocak; Seker, Mehmet Metin; Inanc, Mevlide; Elkiran, Emin TamerPurpose: Almost half of all patients diagnosed with non-small cell lung cancer (NSCLC) have distant metastases at presentation. One-third of patients with NSCLC will have brain metastases. Without effective treatment, the median survival is only 1 month. However, it is difficult to treat brain metastases with systemic chemotherapy since the agents have difficulty crossing the blood-brain barrier. Therefore, it is important to estimate the patient's survival prognosis. The aim of this study was to analyze prognostic factors for survival in Turkish patients who received chemotherapy after cranial irradiation for NSCLC with brain metastases. Methods: We retrospectively reviewed 698 patients with brain metastases resulting from NSCLC. Ten potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with overall survival (OS). Results: Among the 10 variables for univariate analysis, six were identified to have prognostic significance; these included sex, smoking history, histology, number of brain metastases, extracranial metastases, and neurosurgical resection. Multivariate analysis by the Cox proportional hazard model showed that a smoking history, extracranial metastases, and neurosurgical resection were independent negative prognostic factors for OS. Conclusion: Smoking history, extracranial metastases, and neurosurgical resection were considered independent negative prognostic factors for OS. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for more appropriate treatment options.Öğe Prognostic factors of patients who received chemotherapy after cranial irradiation for non-small celllung cancer with brain metastases: A retrospective analysis of multicenter study (anatolian society ofmedical oncology)(Medknow publıcatıons & medıa pvt ltd, b-9, kanara busıness centre, off lınk rd, ghaktopar-e, mumbaı, 400075, ındıa, 2018) Elkiran, Emin TamerPurpose: Almost half of all patients diagnosed with non-small cell lung cancer (NSCLC) have distant metastases at presentation. One-third of patients with NSCLC will have brain metastases. Without effective treatment, the median survival is only 1 month. However, it is difficult to treat brain metastases with systemic chemotherapy since the agents have difficulty crossing the blood-brain barrier. Therefore, it is important to estimate the patient's survival prognosis. The aim of this study was to analyze prognostic factors for survival in Turkish patients who received chemotherapy after cranial irradiation for NSCLC with brain metastases. Methods: We retrospectively reviewed 698 patients with brain metastases resulting from NSCLC. Ten potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with overall survival (OS). Results: Among the 10 variables for univariate analysis, six were identified to have prognostic significance; these included sex, smoking history, histology, number of brain metastases, extracranial metastases, and neurosurgical resection. Multivariate analysis by the Cox proportional hazard model showed that a smoking history, extracranial metastases, and neurosurgical resection were independent negative prognostic factors for OS. Conclusion: Smoking history, extracranial metastases, and neurosurgical resection were considered independent negative prognostic factors for OS. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for more appropriate treatment options.
