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    Comparative assessment of three different second-line regimens in chemotherapy resistant / refractory small-cell lung cancer
    (Imprimatur Publications, 2021) Hacibekiroglu, Ilhan; Ozkul, Ozlem; Cakir, Emre; Kostek, Osman; Karatas, Fatih; Esenkaya, Asim; Demirci, Ayse
    Purpose: Small cell lung cancer (SCLC) patients unresponsive or relapsing within 90 days following frontline chemotherapy have poor prognosis and they should be treated with different chemotherapy regimens other than those used in the first-line regimen. Currently there is no globally accepted standard chemotherapeutic regimen for the treatment of these patients. This retrospective study was designed to compare CAV (Cyclophosphamide, Doxorubicin, Vincristine), weekly topotecan and weekly irinotecan regimens and to evaluate the efficacy of the three regimens in patients with chemotherapy resistant/refractory (CRR) SCLC. Methods: A total of 67 CRR-SCLC patients, who were treated with CAV, weekly topotecan and weekly irinotecan were reviewed for weekly irinotecan (27 for 60 mg/m(2) intravenously on days 1, 8 and 15 of a 28-day cycle, 24 for CAV (Cyclophosphamide 750 mg/m(2) on day 1, Doxorubicin 50 mg/m(2) on day 1 and Vincristine 1.4 mg/m(2) on day 1 every 3 weeks), 16 for weekly topotecan (4 mg/m(2) intravenously on days 1, 8 and 15 of a 28-day cycle). Results: The median follow-up time was 12.45 months, there was no difference about disease control rates (DCR) between three chemotherapy regimens (DCR; 25.9% with irinotecan, 29.2% with CAV and 31.3% with topotecan, p=0.92). Objective response rates (ORR) for irinotecan, CAV and topotecan groups were 3,7%, 8,8%, and 0%, respectively (p=0.63). Median progression free survival (PFS) and overall survival (OS) were similar according to irinotecan, CAV, and topotecan (PFS: 1.93 months, 2.30 months and 3.45 months; OS: 2.89 months, 4.79 months and 5.81 months, respectively). The adverse events were generally mild and manageable for both hematological and nonhematological toxicities in all three arms. Conclusions: Weekly irinotecan, CAV and weekly topotecan are similarly effective and safe chemotherapy protocols for the treatment of CRR-SCLC patients.
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    Investigation of the Effect of Tumor Location in Patients with Stage III Colon Cancer Receiving Adjuvant Oxaliplatine-Based Adjuvant Chemotherapy
    (Akad Doktorlar Yayinevi, 2021) Urvay, Semiha; Demir, Hacer; Gokyer, Ali; Hacibekiroglu, Ilhan; Kucukarda, Ahmet; Cakir, Emre; Beypinar, Ismail
    Left-sided (LCC) and right-sided (RCC) colon cancers have different prognostic and predictive features in metastatic colon cancers, however there is insufficent data about tumor location in stage III disease. The aim of this study is to investigate the effect of tumor location on prognosis in patients with stage III colon cancer. From 2006 to 2012, medical records of 215 patients who underwent primary surgery and received adjuvant oxaliplatin based chemotherapy at 5 referral centers were collected, retrospectively. Disease-free survival (DFS) and overall survival were analysed using Kaplan-Meier and log-rank tests, and prognostic facrtors were identified by Cox regression methods. Clinicopathological characteristics of patients were similar between patients with right-and left-sided colon cancers. The 3-year DFS rate was similar (88% vs 78%, p= 0.07) but the RCC was significantly associated with a shorter 3-year OS than LCC (76% vs 87%, p= 0.03). The 3-year median OS was 125.8 months for all patients groups, 92.2 (+/- 5.81) months for the RCCs and 132.2 (+/- 5.52) months for the LCCs (p= 0.037). Multivariate analysis showed that stage (HR:0.32, p= 0.042 for OS) and venous invasion (HR: 0.28, p= 0.002 for OS) were the independent prognostic factors. Although there was no DFS difference between RCCs and LCCs, poorer survival of RCC indicated that the prognosis of RCC worsened after transitioning to the metastatic stage. Tumor location may be a prognostic factor in metastatic colon cancer but not in stage III disase.