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    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, Oztun
    Posterior 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.
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    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, Oztun
    Posterior 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.
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    Survival and prognostic factors in patients with brain metastasis: Single center experience
    (Zerbinis Medical Publ, 2016) Ekici, Kemal; Temelli, Oztun; Dikilitas, Mustafa; Dursun, Ibrahim Halil; Kaplan, Nihal Bozdag; Kekilli, Ersoy
    Purpose: The purpose of this study was to evaluate the clinical status, prognostic factors and treatment modalities affecting survival in patients with brain metastasis. We aimed to evaluate the whole brain radiation therapy (WBRT) outcomes of patients with brain metastasis in our center. Methods: Clinical data of 315 patients referred to our center between 2004 and 2014 with metastatic brain cancers were collected and analysed for possible relationships between survival time, age, gender, Karnofsky performance status (KPS), recursive partitioning analysis (RPA), primary tumor, number of brain lesions, surgery, radiation therapy scheme, extracranial metastatic status and primary disease control status. Results: The average patient age of onset was 58 years. The primary tumor site was lung (68%), breast (12%), melanoma (4%), colorectal (1.6%), sarcoma (1.3%) and unknown primary disease (4.4%). The rest of the patients had other primary sites. Eighty four (26.6%) patients had single brain metastasis, 71 (22.5%) had 2 or 3 lesions, and 159 (50.4%) patients had more than 3 lesions. Leptomeningeal involvement was seen in combination of paranchymal involvement in 11 (3.5%) patients. Fifty patients had undergone surgical resection. WBRT was delivered to all of the patients. Median overall survival was 6.7 months (95% CI, 5.80-7.74). Median overall survival of patients treated with combination of surgery and WBRT was significantly better compared with those treated with WBRT alone (13.5 vs 5.5 months, p=0.0001). One- and 2- year survival was 17 and 4.7%, respectively. Conclusions: The present study concludes that brain metastasis is common in cancer patients. The best overall survival was obtained by surgery+NBRT in good-condition patients. Treatment should be tailored on an individual basis to all these patients.