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    Efficacy and Safety of Erlotinib in Previously Treated Advanced Non-Small Cell Lung Cancer
    (Akad Doktorlar Yayinevi, 2013) Karaca, Halit; Geredeli, Caglayan; Kaplan, M. Ali; Demirci, Umut; Alici, Suleyman; Artac, Mehmet; Isikdogan, Abdurrahman
    Erlotinib is a potent inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, with single-agent antitumor activity which improves symptom control and quality of life compared with placebo in non-small-cell-lung cancer (NSCLC) patients. We aimed to determine the efficacy and safety of the second, third or fourth-line erlotinib in advanced NSCLC patients in Turkish population. Eighty patients (33 males and 47 females) were retrospectively evaluated. All patients had received a platinum-based regimen as the first-line metastatic therapy. Most of the patients (62.5%) had received erlotinib as the second-line treatment. None of the patients had EGFR mutation studied. One patient achieved a complete response, 10 patients partial response and 21 stable diseases. The overall response rate was 14% and disease control rate was 40%. The median progression-free survival (PFS) and overall survival (OS) were 12 months and 18 months, respectively. Although, there was no survival difference between male and female patients, the median PFS of females was significantly better than male patients (p=0.03). There was no significant difference in disease control rate in terms of age, smoking status, erlotinib line, performance status (PS), stage and skin rash. The most common adverse events were skin rash (56%), diarrhea (9%) and anorexia (8%). Sixteen patients (20%) developed grade 3 toxicities. Grade 4 toxicity or treatment related interstitial lung disease were not observed. Erlotinib showed an acceptable response rate, survival time and toxicity after disease progression with chemotherapy. It's an alternative therapy as a second or third-line therapy in patients with NSCLC. Prospective studies are needed to evaluate the efficiency of the treatment in Turkish population.
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    Salvage Treatment Experience in Advanced Synovial Sarcoma: a Multicenter Retrospective Analysis of the Anatolian Society of Medical Oncology
    (Asian Pacific Organization Cancer Prevention, 2013) Yetisyigit, Tarkan; Arpaci, Erkan; Seber, Erdogan Selcuk; Kucukoner, Mehmet; Kos, Fatma Tugba; Sonmez, Ozlem Uysal; Alici, Suleyman
    Background: We aimed to evaluate prognostic factors and response rates to various treatment approaches to patients with synovial sarcoma in an advanced setting. Materials and Methods: We retrospectively reviewed the medical records of 55 patients (18 pts; 32.7% women) diagnosed with synovial sarcomas. Twenty had metastatic disease at the time of diagnosis while the remainder of the study group consisted of patients who developed metastatic or inoperable locally advanced disease during follow up. Results: The median follow up time was 15 months (range: 1-53). Regarding outcomes for the 55 patients, 3 and 5 year overall survival rates were 26% and 14%, respectively. In univariate analyses among demographic factors female gender was associated with a better outcome (p=0.030). Patients with early progressing disease (<2 years) had a worse prognosis when compared to patient group with late relapse, but this difference did not reach statistical significance (p=0.056). According to multivariate Cox regression analysis patients who had undergone metastasectomy had a significant survival advantage (p=0.044). The overall response rate to different salvage chemotherapy regimens given as second line treatment was around 42.9-53.9% for all regimes. There were no statistically significant differences between chemotherapy regimens given in either second or third line settings in terms of overall survival. Conclusions: We observed no major differences in terms of response rate and survival between different salvage chemotherapy regimens. Although metastatic disease still carries a poor prognosis, metastasectomy was found to be associated with improved survival
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    Weekly Topotecan for Recurrent Small Cell Lung Cancer - a Retrospective Anatolian Medical Oncology Group Study
    (Asian Pacific Organization Cancer Prevention, 2012) Altinbas, Mustafa; Kalender, Mehmet Emin; Oven, Basak; Sevinc, Alper; Karaca, Halit; Kaplan, M. Ali; Alici, Suleyman
    Aim: To evaluate efficacy and tolerability of topotecan treatment for recurrent small cell lung carcinoma. Patients and Methods: A total of 62 patients were evaluated retrospectively. Statistical analysis was performed using GraphPad Instat (version 3.05). Results: DFifty five of patients (89%) were male and 7 (11%) were female. Median age was 56.7 +/- 9.3 (34-75). Forty eight of patients (80%) were extensive stage (ES) at the time of diagnosis. Fifty of the patients (80.6 Medical Oncology Clinic) were given median 5.36 cycles of cisplatin-etoposide (2-8 cycles). Time to recurrence was 15.6 +/- 6.13 weeks in patients with limited stage (LS) and 6.3 +/- 3.82 weeks in extensive stage (ES) (p<0.0001). Overall survival was 14.0 +/- 6.08 months in ES and 17.9 +/- 6.88 months in LS. The difference between two groups was statistically meaningful (p=0.0447). The overall survival of the patients was 14.8 +/- 6.43 months (4.5-40 months). In terms of survival, there was no difference between males and females (p=0.1171). In 17 (27%) patients who were refractory to topotecan or in whom progression occurred other chemotherapies were used. Conclusion: Small cell lung cancer is chemosensitive, but recurrences occur in short time. Other chemotherapy regimens are used in progression. Topotecan is one of them. Patients who were young and in whom recurrences occur late had given better response to topotecan. Because of the retrospective nature of the study, we couldn't reach the records exactly and consequently, rate and duration of response couldn't be calculated. In recurrent SCLC topotecan is one of the treatment choices. But both hematological and non hematological side effects should be taken into consideration.