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Öğe Chronic Myeloid Leukemia After Chemoradiotherapy in a Patient with Non-Small Cell Lung Cancer(2017) Demircioğlu, Sinan; Korkmaz, Levent; Yılmaz, Seda; Bektaş, Özlen; Çeneli, Özcan; Artaç, MehmetChronic myeloid leukemia(CML) is a myeloproliferative disease characterized by uncontrolled proliferation of mature and maturing granulocytes. Chronic myeloid leukemia accounts for approximately 15 to 20 percent of leukemias in adults. The incidence is 1-2/10000 per year.1-2 There is only one risk factor, which is ionized radiation.3 There are some publitions in the literature about CML development after chemotherapy and/or radiotherapy. Here we presented a case that CML occured after chemotherapy concurrent with radiotherapy in non-small cell lung cancer patient. Sixty year old man who has diagnosed inoperable lung adenocarcinoma in 2013. Carboplatin concurrent with radiotherapy was administered to him. After 2 years follow-up with no progression of disease, the level of leucocyte was started to increase. White blood cell level was 41700/ul, haemoglobin level was 14.3 g/dl and platelet level was 239000/ul. Peripheral blood smear suggested chronic myeloid leukemia. Bone marrow aspiration and biopsy was performed. The biopsy was supported chronic phase chronic myeloid leukemia. Cytogenetic analysis showed %95 translocation (9;22) in 20 metaphasis. BCR-ABL was detected as 60% IS. Sokal, Hasford and EUTOS risk score was calculated high. Imatinib therapy was started as 400 mg/day. Hematologic response was seen 2 weeks after imatinib treatment. After 3, 6, 12 months, BCR-ABL was detected as 27% IS, 1% IS, and 0.4 IS, respectively. The patient is still being followed as remission for both lung cancer and CML.Öğe Effects of adjuvant therapy on body composition measurements in women with early breast cancer(2019) Eryılmaz, Melek Karakurt; Karaağaç, Mustafa; Araz, Murat; Atabek, Mehmet Emre; Artaç, MehmetAim: This study aimed to determine the effects of adjuvant therapy on body mass index (BMI) and body fat (BF) measurements inwomen with early-stage breast cancer (ESBC).Material and Methods: We prospectively evaluated BMI and BF measurements including trunk fat mass kilograms (kg), trunk fatmass (%) and total body fat (%) on a bioelectric impedance analyzer in 29 women with stages I-III breast cancer. All of the patientsreceived anthracycline-based adjuvant chemotherapy (ACT). Six patients were hormone receptor (HR)-negative. Twenty-threepatients were HR-positive and received adjuvant endocrine therapy (AET) following ACT. Eleven HR-positive postmenopausalpatients were treated with an aromatase inhibitor (AI), and the remaining twelve HR-positive premenopausal patients were treatedwith tamoxifen (TMX). A total of 3 measurements were performed in the beginning of chemotherapy, at 6th, and 12th months.Results: Although the BMI was significantly increased, there was no significant change in the BF during chemotherapy in patientsreceiving only ACT. Both BMI and BF measurements were significantly increased in premenopausal patients receiving TMX afterACT. However, no significant change was observed in BMI and BF measurements in postmenopausal patients receiving AI after ACT.Conclusions: ACT increased both BMI and BF measurements in patients with HR-positive premenopausal ESBC. Treatment withTMX or AI after ACT did not enhance the changes due to chemotherapy on body composition. Therefore, especially patients withHR-positive premenopausal ESBC should be careful not to gain weight during ACT.Öğe Erlotinib Response in a Non-Small Cell Lung Cancer Patient with EGFR Exon 20 Mutation(2016) Korkmaz, Levent; Artaç, Mehmet; Karaagaç, Mustafa; Er, Zehra; Boruban, Melih C; Poyraz, Necdet; Kaya, Buğra; Tavlı, Lema; Ödev, KemalÖğe Evaluating the clinicopathologic characteristics and survival outcome of breast cancer patients with isolated brain metastases after adjuvant treatment or at initial diagnosis(2012) Börüban, Cem; Gulyer, Hüseyin; Altundağ, Kadri; Artaç, Mehmet; Güler, Tunç; Cengiz, MustafaSSS metastazı meme kanserinin geç dönemlerinde ortaya çıkar. Klasik yaklaşım, semptomatik olunca tedavi etmektir. Adjuvan tedavi sonrası veya başlangıçta tanıda, yalnızca beyin metastazı olan hastaların, klinikopatolojik karekteristiklerini inceledik ve sağkalımı değerlendiridik. Yazarlar, retrospektif olarak iki üniversite hastanesinden 3600 meme kanserli hastayı değerlendirip, içlerinden sadece ve tek olarak beyin metastazlı olan 31 hastayı çalışmaya aldılar. ER, PR, cerbB2 durumu, T , N evresi , grad, adju van taksan, trastuzumab, hormonal tedaviler, trastuzumab ve palatinin beyin metastazından sonra kullanımı sağ kalımı etkileme di. Cerrahi ve tüm beyin ışınlaması cerbB2 negatif hastlarda, tüm beyin ışınlaması ise cerB2 pozitif hastlarda daha etkili olabilir. (p0.06). Sağ kalım pre ve perimenapozallerde daha iyi olabilir. mOS pre ve perimenapozallerde 17.7 ay postmenapozallerde 10.3 ay bulundu. (p0.06) Lapatinib izole beyin metastazlı hastlarda mOSı etkileyebilir. Bazı prognostic faktörler, hangi tadaviden, hangi hasta gurubunun faydalanacağını öngörmemizi sağlayabilir. Daha çok hasta içeren çalışmalara olan ihtiyaç açıktır.Öğe Metastatik Pankreas Kanserli Hastalarda FOLFİRİNOX Rejiminin Etkinlik ve Tolerabilitesi(2018) Geredeli, Çağlayan; Cihan, Şener; Yaşar, Nurgül; Sakin, Abdullah; Can, Orçun; Artaç, Mehmet; Karaağaç, Mustafa; Koral, LokmanAmaç: Metastatik pankreas kanseri tedavisinde FOLFİ-RİNOX rejiminin kullanımı hem progresyonsuz sağ kalımıhemde genel sağ kalım süresini uzatmıştır. Türk popülasyonundametastatik pankreas kanserli hastalarda birinciseride FOLFİRİNOX rejimi kullanımının etkinlik ve güvenilirliğiniretrospektif olarak araştırmak istedik.Gereç ve Yöntem: Çalışma retrospektif çok merkezli olarakdizayn edilmiştir. 2012-2016 yılları arasında birinci seriFOLFİRİNOX rejimi ile tedavi edilen metastatik pankreaskanserli hastalar dahil edilmiştir.Bulgular: Çalışmaya 44 metastatik pankreas kanserli hastaalındı. Hastalardan 30’u erkek (%68,2), 14’ü kadındı(%31,8). Hastaların yaş ortalaması 58,7 (34-73) yıldı. Mediantakip süremiz 14 ay idi. Hastaların metastaz bölgelerinebakıldığında %72,7 karaciğere, %18,2 akciğere, %18,2peritona, %4,5 lenf nodlarına ve %4,5 kemiklere metastazyapmıştı. Tedaviye yanıt oranlarına bakıldığında %40,9hastada parsiyel yanıt, %13,6 hastada stabil yanıt, %45,4hastada progresyon mevcuttu. Median progresyonsuz sağkalım süresi 8 ay (%95 CI 4-12) olarak bulundu. Mediangenel sağ kalım süresi 14 ay (%95 CI 10.3-17.7), 6 aylıkgenel sağ kalım %76,2, 12 aylık genel sağ kalım %57,5, 24aylık genel sağ kalım %6 olarak bulundu. Toksisite oranlarınabakıldığında grade 3-4 Nöropeni %36,4 (grade 3%27,3, grade 4 %9,1), grade 3-4 trombositopeni %13,6hastada görüldü. Grade 3-4 anemi %14,6 hastada görüldü.Hematolojik dışı yan etkilerden grade 1-2 ishal %68olmasına rağmen grade 3-4 ishal %4,5 oranında görüldü.Grade 1-2 periferik duysal nöropati %72,7 oranında görülürkengrade 3-4 duysal nöropati tespit edilmedi.Sonuç: Metastatik pankreas kanserinde FOLFİRİNOX rejimikullanılarak 12 ayın üzerine çıkan bir genel sağkalımaulaşılmıştır. Fakat grade 3-4 hematolojik yan etki oranı%49’lara kadar çıkmıştır.Öğe Survivin Expression May Affect The Neoadjuvantchemotherapy Response İn Breast Cancer Patients(2017) Er, Zehra; Peştereli, Hatice Elif; Tavlı, Lema; Bozcuk, Hakan; Erdoğan, Gülgün; Esen, Hacı Hasan; Artaç, Mehmet; Korkmaz, Levent; Gündüz, Şeyda; Karaağaç, Mustafa; Demircioğlu, SinanTo investigate whether there is a predictive effect of NF-kappaB, survivin, and Ki-67 expressions on pathological response and disease relapse in breast cancer (BC) patients. Ki-67, survivin and NF-kappaB expressions were analyzed in the pathology specimens of breast biopsy before and after neoadjuvant chemotherapy (NeoCT) in BC patients (n52). Event -free survival (EFS) (defined as recurrence or metastasis free) analyze was performed. The median overall survival was 43.5 months and the median EFS was 51 months (95% CI: 33.3-68.9) in all patients. The expression percentages of NF-kappaB, survivin, and Ki-67 significantly decreased after NeoCT (p>0.001). Survivin expression level before NeoCT was significantly higher in patients who did not respond to NeoCT than both partial-responders and complete-responders (p0.038, p0.010, respectively). Type of NeoCT was the only independent factor on pathological response status (p0.007). Addition of taxanes to NeoCT improved pathological complete response rates about six times. However, no predictor was found to be a prognostic factor for EFS in multivariate analyze. Higher survivin expression level before NeoCT may be associated with poor pathological response to NeoCT. These findings must be tested with prospective clinical trials.
