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Öğe 5-Fluorouracil-associated bradycardia: case report(Kare Publ, 2010) Kaplan, Muhammet Ali; Cil, Timucin; Isikdogan, Abdurrahman5-Fluorouracil (5-FU) is a synthetic, fluorinated pyrimidine antagonist, which is a cytostatic agent. Cardiotoxicity is a rare but important side effect of 5-FU. The cardiotoxicity incidence of 5-FU is increasing in conjunction with its frequent use in chemotherapy protocols. Ischemic symptoms and signs related to 5-FU are observed during the late phase of the drug administration. Monitoring should be done in all patients having coronary artery disease. There are many treatment options and prophylactic modalities for 5-FU cardiotoxicity. Herein, we present the rare case of a patient with cardiotoxicity during short 5-FU infusion.Öğe Adjuvant Chemoradiation for Gastric Cancer: Multicentric Study of the Anatolian Society of Medical Oncology(H G E Update Medical Publishing S A, 2012) Kucukoner, Mehmet; Isikdogan, Abdurrahman; Arpaci, Erkan; Bilici, Mehmet; Uncu, Dogan; Cetin, Bulent; Dane, FaysalBackground/Aims: The aims of this study were to report the clinical outcomes of adjuvant chemo-radiotherapy after curative resection in 637 patients with gastric cancer. Methodology: The retrospective analysis included 637 patients with resectable gastric cancer and stage IB-IV (MO) from 8 medical centers between 2003 and 2010. The patients were treated with 5FU-leucovorin and radiotherapy according to Schema for INT-0116. Results: Of the 637 patients, the median of overall survival (OS) was 43.7 months and relapse free survival (RFS) was 36.6 months. OS rates were 84%, 45%, 40% while RFS rates were 81%, 45% and 35% at 1, 3 and 5-years, respectively. Hematological and gastro-intestinal toxicities (grade 1-4) were observed in 35% and 36.5% of patients, respectively. In univariate analysis, according to the Lauren classification, tumor grade, T stage, N stage, type of operation (total gastrectomy or subtotal) and surgery resection margin (R0 or R1) were found as prognostic factors on RFS and OS (p<0.05). In multivariate analysis, T stage, N stage and surgical margins were found as effective factors on OS. T stage, N stage and Lauren classification were factors affecting RFS. Conclusions: Adjuvant chemo-radiotherapy after curative resection of gastric cancer was feasible, with acceptable toxicities in the Turkish population.Öğe Adult langerhans cell histiocytosis(Ortadogu Ad Pres & Publ Co, 2007) Cil, Timucin; Goekalp, Deniz; Tuzcu, Alparslan; Isikdogan, Abdurrahman; Bahceci, MithatLangerhans cell histiocytosis is a group of idiopathic disorders characterized by the abnormal proliferation of specialized bone marrow-derived Langerhans cells. There are one to two cases per million population. Most reports are based only on anecdotal experience in adult patients. Surgical excision, radiotherapy and chemotherapy, either alone or in combination are the main treatment options. In this report, we present a rare case of Langerhans cell histiocytosis in a 32 years-old-woman who developed symptomatic diabetes insipidus and multiple bone and cranial metastases during the disease course. This paper discusses controversial treatment modalities.Öğe Aggressive natural killer cell leukemia in a patient with common variable immunodeficiency syndrome(Parthenon Publishing Group, 2006) Ayyildiz, Orhan; Altintas, Abdullah; Isikdogan, Abdurrahman; Tuzcu, Alpaslan[Abstract Not Available]Öğe Association of age with breast cancer clinical and pathological factors: Analysis of Turkish National Breast Cancer Registry.(Amer Soc Clinical Oncology, 2015) Benekli, Mustafa; Altundag, Kadri; Dumanli, Esra; Isikdogan, Abdurrahman; Karaoglu, Aziz; Tekin, Salim Basol; Oksuzoglu, Berna[Abstract Not Available]Öğe Atypical skin metastases from early tubular breast carcinoma(Wiley-Blackwell, 2008) Cil, Timucin; Altintas, Abdullah; Pasa, Semir; Isikdogan, Abdurrahman[Abstract Not Available]Öğe Bevacizumab-containing Chemotherapy is Safe in Patients with Unresectable Metastatic Colorectal Cancer and a Synchronous Asymptomatic Primary Tumor(Oxford Univ Press, 2013) Cetin, Bulent; Kaplan, Mehmet Ali; Berk, Veli; Tufan, Gulnihal; Benekli, Mustafa; Isikdogan, Abdurrahman; Ozkan, MetinSurgical resection of asymptomatic primary colorectal cancer in patients presenting with synchronous unresectable metastatic disease is controversial. Concerns and controversies remain over combining cytotoxic chemotherapy with bevacizumab in this patient population. We identified medical records of 99 patients with synchronous metastatic primary colorectal cancer who received chemotherapy with bevacizumab as their initial treatment. The incidence of subsequent use of surgery and surgical outcomes were recorded. Patients were also assessed for overall survival. Patients who received bevacizumab-containing chemotherapy for synchronous metastatic primary colorectal cancer were divided into the non-surgery and surgery groups according to the resection status of their asymptomatic primary tumor. In the non-surgery group, two patients (4.4) underwent additional surgery, while three patients (5.7) required surgery for rectovesical fistula in the surgery group. The median overall survival was 17 months for the non-surgery group (95 CI: 10.623.3 months) and 23 months for the surgery group (95 CI: 21.324.6 months; P 0.322). This study utilizing chemotherapy with bevacizumab did not result in an increased rate of morbidity related to the unresected primary tumor. Survival is not compromised by leaving the primary colon tumor intact.Öğe Biased view against biopsy among cancer patients and its reasons(Drunpp-Sarajevo, 2012) Kucukoner, Mehmet; Inal, Ali; Kaplan, Muhammed Ali; Urakci, Zuhat; Isikdogan, AbdurrahmanObjective: Because the belief that biopsy causes spread of the disease, is a widely accepted opinion among the people in our region. The aim of this study is to assess the view of patients diagnosed with cancer about biopsies and evaluate the factors influencing this. Material and Methods: Three hundred and twenty four patients who presented themselves to the Department of Medical Oncology between October 2009 and March 2010, were included in the study. Data were obtained from patient charts and evaluations of questionnaires. Results: Among those patients with low level of education, the number of people who are thinking that biopsy is harmful, was significantly high (p=0.001). The gender of patients thinking that biopsy was harmful was more female (p=0.065). However, significantly elderly patients (76.8%, n=99) aged over 40 years, considered biopsy as harmful compared to those aged less than 40 years (p=0.078). Significant differences were found in biopsy perception of patients based on their economic status (p=0.023). Conclusions: The education level of the patient should be taken into consideration in diagnosing cancer with biopsy and subsequent transition to treatment steps the consciousness level of the patient should be certainly increased as well.Öğe Biologic subtypes and first relapse pattern in curative surgery performed breast cancer patients: Study of Anatolian Society of Medical Oncology.(Lippincott Williams & Wilkins, 2013) Kaplan, Muhammet Ali; Arslan, Ulku Yalcintas; Isikdogan, Abdurrahman; Oksuzoglu, Berna; Inanc, Mevlude; Akman, Tulay; Inal, Ali[Abstract Not Available]Öğe Biological Subtypes and Distant Relapse Pattern in Breast Cancer Patients After Curative Surgery (Study of Anatolian Society of Medical Oncology)(Karger, 2016) Kaplan, Muhammet A.; Arslan, Ulku Y.; Isikdogan, Abdurrahman; Dane, Faysal; Oksuzoglu, Berna; Inanc, Mevlude; Akman, TulayPurpose: The aim of the study was to investigate the association between the molecular subtypes and patterns of relapse in breast cancer patients who had undergone curative surgery. Methods: We retrospectively evaluated 1,350 breast cancer patients with relapses after curative surgery between 1998 and 2012 from referral centers in Turkey. Patients were divided into 4 biological subtypes according to immunohistochennistry and grade: triple negative, HER2 overexpressing, luminal A and luminal B. Results: The percentages of patients with luminal A, lumina! B, HER2-overexpressing, and triple-negative breast cancer were 32.9% (n = 444), 34.9% (n = 471), 12.0% (n = 162), and 20.2% (n = 273), respectively. The distribution of metastases differed among the subgroups: bone (66.2% and 53.9% in lumina! A and B vs. 38.9% in HER2-overexpressing and 45.1% in triple negative, p < 0.001), liver (40.1% in HER2-overexpressing vs. 24.5% in lumina! A, 33.5% in luminal B, and 27.5% in triple negative, p < 0.001), lung (41.4% in triple negative and 35.2% in HER2-overexpressing vs. 30.2% and 30.6% in luminal A and B, p = 0.008) and brain (25.3% in HER2overexpressing and 23.1% in triple negative vs. 10.1% and 15.1% in lumina! A and B, p < 0.001). Conclusions: Organ -specific metastasis may depend on the molecular subtype of breast cancer. Tailored strategies against distant metastasis concerning the molecular subtypes in breast cancer should be considered. (C) 2016 S. Karger GmbH, Freiburg.Öğe Biological Subtypes and Survival Outcomes in Breast Cancer Patients with Brain Metastases (Study of the Anatolian Society of Medical Oncology)(Karger, 2012) Kaplan, Muhammet Ali; Isikdogan, Abdurrahman; Koca, Dogan; Kucukoner, Mehmet; Gumusay, Ozge; Yildiz, Ramazan; Dayan, AdemBackground: The aim of this study is to determine the relationship between the survival outcomes and biological subtype in breast cancer patients with brain metastases. Methods: We retrospectively evaluated clinical data from 422 breast cancer patients with brain metastases between 2001 and 2011 from referral centers in Turkey. The study population was divided into four biological subtypes according to their hormone receptor status and HER2 expression. Results: Systemic treatment prolonged median overall survival (OS) after brain metastases in the entire group (14 vs. 3.2 months, p < 0.001). It also prolonged median OS after brain metastases in the triple negative (7.5 vs. 1.6 months, p = 0.010) and luminal A (14.3 vs. 7.1 months, p = 0.003) subgroups. The median OS for untreated patients, chemotherapy and/or hormonal therapy receiving patients, and chemotherapy and/or hormonal therapy plus targeted therapy receivers was 2, 5.8, and 17.7 months, respectively (p < 0.001), in the HER2-overexpressing subgroup. In the luminal B subgroup, it was 3.7, 5.3, and 15.4 months, respectively (p = 0.003). Conclusions: The use of systemic therapy improves OS after brain metastases in all biological subgroups. Targeted therapies also improve OS after brain metastases in HER2-positive patients. The combined use of targeted therapies and lapatinib are superior to single use and trastuzumab, respectively, in these patients. Copyright (C) 2012 S. Karger AG, BaselÖğe Biosimilar filgrastim vs filgrastim: a multicenter nationwide observational bioequivalence study in patients with chemotherapy-induced neutropenia(Dove Medical Press Ltd, 2018) Sevinc, Alper; Ozkan, Metin; Ozet, Ahmet; Dane, Faysal; Oksuzoglu, Berna; Isikdogan, Abdurrahman; Ozdemir, FeyyazBackground: We studied the comparative effectiveness of biosimilar filgrastim vs original filgrastim in patients with chemotherapy-induced neutropenia. Patients and methods: This multicenter, observational study was conducted at 14 centers. The study included 337 patients experiencing neutropenia under chemotherapy. Patients were given either filgrastim 30 MIU or 48 MIU (Neupogen (R)) or biosimilar filgrastim 30 MIU (Leucostim (R)). Data regarding age, chemotherapeutic agents used, number of chemotherapy courses, previous diagnosis of neutropenia, neutrophil count of patients after treatment, medications used for the treatment of neutropenia, and duration of neutropenia were collected. Time to absolute neutrophil count (ANC) recovery was the primary efficacy measure. Results: Ambulatory and hospitalized patients comprised 11.3% and 45.1% of the enrolled patients, respectively, and a previous diagnosis of neutropenia was reported in 49.3% of the patients, as well. Neutropenia occurred in 13.7% (n=41), 45.5% (n=136), 27.4% (n=82), 11.4% (n=34), and 2.0% (n=6) of the patients during the first, second, third, fourth, and fifth cycles of chemotherapy, respectively. While the mean neutrophil count was 0.53 +/- 0.48 before treatment, a significant increase to 2.44 +/- 0.66 was observed after treatment (p=0.0001). While 90.3% of patients had a neutrophil count,1.49 before treatment, all patients had a neutrophil count >= 1.50 after treatment. Neutropenia resolved within <= 4 days of filgrastim therapy in 60.1%, 56.7%, and 52.6% of the patients receiving biosimilar filgrastim 30 MIU, original filgrastim 30 MIU, and original filgrastim 48 MIU, respectively. However, there was no significant difference between the three arms (p=0.468). Similarly, time to ANC recovery was comparable between the treatment arms (p=0.332). Conclusion: The results indicate that original filgrastim and biosimilar filgrastim have comparable efficacy in treating neutropenia. Biosimilar filgrastim provides a valuable alternative; however, there is need for further studies comparing the two products in different patient subpopulations.Öğe BREAST CARCINOMA METASTASIS TO THE TAIL OF PANCREAS(Aves, 2009) Cil, Timucin; Altintas, Abdullah; Pasa, Semir; Urakci, Zuhat; Isikdogan, AbdurrahmanThe most common distant metastasis of breast cancer are detected in liver, lung, bone and brain. However, atypical organ metastasis is not uncommon. Isolated pancreas metastasis can be seen rarely as well. There have been only seven cases described in the literature. Here, we report extremely a rare case of breast cancer, which metastasizes to the pancreas tail. The patient has diagnosed as breast cancer four years ago, gradual increases in serum levels of CEA and Ca15-3 were detected (129 (0-4,3ng/ml) and 84 U/ml (0-25 U/ml) respectively) in routine follow-up. Although she had no symptoms, contrast-enhanced abdominal computerized tomography (CT) scan revealed a mass of 81mm x 79mm x 68mm, with a necrozis in the tail of the pancreas. No other metastatic sites were detected by gastric endoscopy, lung CT scan or bone scintigraphy. Percutan transabdominal biopsy from tail of pancreas was showed that metastasis of breast carcinoma. We propose that, when an increase is detected in tumor markers, such as CA15-3 or CEA, without any detectable metastasis in common metastatic organs, should be investigated other atypical metastatic areas such as pancreas.Öğe Can LMWH improve the outcome of patients with inoperable stage III non-small cell lung cancer?(Termedia Publishing House Ltd, 2012) Kucukoner, Mehmet; Isikdogan, Abdurrahman; Kaplan, Muhammed Ali; Inal, Ali; Zinciroglu, S.; Cit, Murtaza; Cil, TimucinAim of the study: Lung cancer is the most common malignancy, accounting for one-third of all deaths from cancer. Some studies have shown that low molecular weight heparin (LMWH) significantly prolongs the survival of patients with non-small cell lung cancer (NSCLC). The aim of this study was to determine the effects of treating inoperable stage III NSCLC with LMWH in addition to concurrent chemoradiotherapy. Material and methods: Eighty-two patients with inoperable stage III NSCLC were evaluated at Dicle University's Medical Oncology Department between 2005 and 2010. All patients were treated with concurrent chemoradiotherapy (CRT) with or without LMWH (enoxaparin 4000 IU/day) depending on the patient's risk of thrombosis. The primary objectives were to determine disease-free survival (DES) and overall survival (OS) for patients treated with LMWH. Results: A total of 38 patients in the LMWH negative group and 44 patients in the LMWH positive group were included in the study. The median OS was 11.2 months for the enoxaparin recipients and 12.7 months for the non-enoxaparin group (p = 0.4). The median DES was 9.3 months with CRT alone and 10.0 months with CRT plus enoxaparin (p = 0.9). The one-year OS rates were 47% and 34% for groups treated with CRT and enoxaparin plus CRT, respectively, while the two-year OS rates were 23% and 21%, respectively. No significant difference was noted between the two groups in terms of grade 3-4 hematologic toxicity and mucositis (p = 0.3). Conclusions: This study did not demonstrate improvements in survival for patients with NSCLC treated with enoxaparin. LMWH's positive contribution is still controversial.Öğe Cancer and thrombotic thrombocytopenic purpura(Ortadogu Ad Pres & Publ Co, 2008) Altintas, Abdullah; Cil, Timucin; Atay, A. Engin; Kaplan, M. Ali; Isikdogan, Abdurrahman; Ayyildiz, OrhanThrombotic thrombocytopenic purpura (TTP) is a rare and fatal disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurologic disorder, renal function deterioration and fever. TTP may be idiopathic or secondary to autoimmune diseases, drugs, cancer and infections. Clinical findings of TTP are also present in cancer patients with disseminated intravascular coagulation and sepsis. TTP must be considered in the differential diagnosis in the case of concurrent microangiopathic hemolytic anemia and thrombocytopenia with or without leukoerythroblastic blood smear in cancer patients. Here we presented two patients who were followed up in our clinic with TTP secondary to metastatic breast cancer.Öğe The case of gastric adenocarcinoma applying with malign Acanthosis Nigricans(Kare Publ, 2015) Oruc, Zeynep; Kaplan, Mehmet Ali; Urakci, Zuhat; Kucukoner, Mehmet; Avci, Yahya; Isikdogan, AbdurrahmanAchantosis Nigricans (AN) is a skin disorder characterised with hyperpigmented hyperkeratotic lesions. It occurs mostly in association with insulin resistance while it may also arise as a symptom of visceral malignancies. In the occurrence of AN considered as associated with malignancy, a detailed examination may be necessary to identify underlying malignancy. 85% of malign AN cases abdominal adenocarcinomas, and especially 60% of those are gastric adenocarcinomas. A 44-year-old male patient applied to our clinic with hyperpigmentation and hyperkeratosis, widespread body pain and weight loss within 3-4 months. Skin symptoms were reviewed as acanthosis nigricans. He had no endocrinological diseases such as DM or obesity. Due to ocurrence of many skin symptoms in accordance with acanthosis nigricans in a rapid growth on our patient, no findings of other AN causes, systemic symptoms such as the age of patient and weight loss, it is considered as malign AN.Öğe Characteristics of Turkish colorectal cancer patients and bevacizumab preference.(Amer Soc Clinical Oncology, 2017) Cicin, Irfan; Gumus, Mahmut; Uncu, Dogan; Ozkan, Metin; Kilickap, Saadettin; Elkiran, Tamer E.; Isikdogan, Abdurrahman[Abstract Not Available]Öğe Childhood, Adolescents, and Young Adults (?25 y) Colorectal Cancer: Study of Anatolian Society of Medical Oncology(Lippincott Williams & Wilkins, 2013) Kaplan, Muhammet A.; Isikdogan, Abdurrahman; Gumus, Mahmut; Arslan, Ulku Y.; Geredeli, Caglayan; Ozdemir, Nuriye; Koca, DoganPurpose: To evaluate the clinicopathologic characteristics and treatment outcomes of young patients with colorectal cancer (CRC). Methods: Between May 2003 and June 2010, 76 patients were found eligible for this retrospective study. Age, sex, presenting symptoms, patients with acute presentation, family history, presence of polyps, histologic features, localization and stage of the tumor, treatment outcomes, time and site of recurrence, sites of metastasis, and survival outcomes were recorded from the patient files. Results: Seventy-six patients (55.3% male) with a median age of 23 years were evaluated. Patients were evaluated in 2 groups as follows: child-adolescent (0 to 19 y, n=20) and young adult (20 to 25 y, n=56). Sex and symptoms (abdominal pain and rectal bleeding) were significantly differed between the groups and acute presentation was close to statistical significance. Overall survival significantly increased in patients undergoing curative surgery (P<0.001). Other parameters affecting the survival was stage of disease (P=0.004). Response to palliative chemotherapy in metastatic patients (P=0.042) and postoperative adjuvant chemotherapy had a statistically significant survival advantage (P=0.028). Conclusions: Diagnosis of CRC should not be excluded solely on the basis of age. CRC features in young-adult patients are more similar to adults compared with that of child-adolescent patients according to the symptoms and presentation. In patients with CRC in this age group, curative surgery, adjuvant chemotherapy, and palliative chemotherapy provide survival advantage.Öğe Cisplatin plus docetaxel combination in the first-line treatment of metastatic non-small cell lung cancer(Sage Publications Ltd, 2010) Kaya, Ali Osman; Buyukberber, Suleyman; Dane, Faysal; Isikdogan, Abdurrahman; Ustaalioglu, Basak Oven; Coskun, Ugur; Yumuk, Perran FuldenAims. To evaluate activity and toxicity of cisplatin plus docetaxel combination in the first-line treatment of chemotherapy-naive patients with metastatic non-small cell lung cancer. Patients and methods. Between October 2004 and July 2008, 186 patients with metastatic non-small cell lung cancer treated with first-line cisplatin plus docetaxel were retrospectively evaluated in 7 centers. The chemotherapy schedule consisted of cisplatin, 75 mg/m(2) iv infusion, and docetaxel, 75 mg/m(2) iv infusion on day 1, every 3 weeks. Results. Median age was 56 years (range, 28-75). Eighteen patients (9.7%) were females and 168 (90.3%) were males, with a median ECOG performance status of 1 (range, 0-2). A total of 833 cycles of chemotherapy was administered (median, 4 cycles; range, 1-6). Two patients (1.1%) achieved clinical complete response, 77 patients (41.4%) partial response, and 66 patients (35.5%) stable disease. Median time to disease progression was 6 months (95% CI, 5.54-6.46). Median overall survival was 14.6 months (95% CI, 11.47-17.73). One- and 2-year overall survival was 55.2% and 19.7%, respectively. The most common grade 3-4 hematological toxicities were neutropenia (n = 32, 17.2%) and anemia (n = 4, 2.2%). Conclusions. The cisplatin plus docetaxel combination was effective and safe in the first-line treatment of patients with metastatic non-small cell lung cancer. Free full text available at www.tumorionline.itÖğe Cisplatin-Based Therapy for the Treatment of Elderly Patients with Non-Small-Cell Lung Cancer: a Retrospective Analysis of a Single Institution(Asian Pacific Organization Cancer Prevention, 2012) Inal, Ali; Kaplan, M. Ali; Kucukoner, Mehmet; Urakci, Zuhat; Karakus, Abdullah; Isikdogan, AbdurrahmanBackground: In spite of the fact that platinum-based doublets are considered the standard therapy for patients with advanced non-small-cell lung cancer (NSCLC), no elderly-specific platinum based prospective phase III regimen has been explored. The aim of this retrospective singlecenter study was to evaluate the efficacy and side effects of cisplatin-based therapy specifically for the elderly. Methods: Patients receiving platinum-based treatment were divided into three groups. In the first group (GC), Gemcitabine was administrated at 1000 mg/m(2) on days 1, 8 and cisplatin was added at 75 mg/m(2) on day 1. In the second group (DC), 75 mg/m(2) docetaxel and cisplatin were administered on day 1. The third group (PC) received 175 mg of paclitaxel and 75 mg of cisplatin on day 1. These treatments were repeated every three weeks. Result: GC arm had 36, the DC arm 42 and the PC arm 29 patients. Grade III-IV thrombocytopenia was higher in the GC arm (21.2% received GC, 2.8% received DC, and 3.8% received PC), while sensory neuropathy was lower in patients with GC arm (3.0%, 22.2%, and 23.1% received GC, DC and PC, respectively). There were no statistically significant difference in the response rates among the three groups (p>0.05). The median Progression-free survival (PFS) was 5.0 months and the median Overall survival (OS) in each group was 7.1, 7.4 and 7.1 months, respectively (p>0.05). Conclusion: The response rate, median PFS and OS were similar among the three treatment arms. Grade III-IV thrombocytopenia was higher in the GC arm, while the GC regimen was more favorable than the other cisplatin-based treatmetns with regard to sensory neuropathy.
