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Öğe Biatrial Cardiac Metastases in a Patient with Uterine Cervix Malignant Melanoma(Hindawi Ltd, 2015) Geredeli, Caglayan; Boruban, Melih Cem; Poyraz, Necdet; Artac, Mehmet; Aribas, Alpay; Koral, LokmanPrimary malignant melanomas of uterine cervix are quite rarely seen neoplasms, and long-life prognosis of patients with this disease is poor. Immunohistochemical methods and exclusion of other primary melanoma sites are used to confirm the diagnosis. As with other melanomas, cervix malignant melanomas may also cause cardiac metastases. Cardiac metastases are among rarely seen but more commonly encountered cases, compared to primary cardiac tumors. Here, we present a case of biatrial cardiac metastases in a 73-year-old patient with uterine cervix malignant melanomas. The patient underwent echocardiography, cardiac magnetic resonance imaging, and computed tomography. Our report shows the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but for a better anatomic definition and tissue characterization. Although the cases of malignant melanomas leading to multiple cardiac metastasis were reported in literature, the metastatic concurrence of malignant melanomas in both right and left atriums is quite rarely encountered as metastatic malignant melanomas. Also, another intriguing point in our case is that the primary lesion of our case was stemmed from uterine cervix, but not skin.Öğe Comparison of palonosetron and granisetron in triplet antiemetic therapy in nonmetastatic breast cancer patients receiving high emetogenic chemotherapy: a multicenter, prospective, and observational study(Springer, 2019) Araz, Murat; Karaagac, Mustafa; Korkmaz, Levent; Koral, Lokman; Inci, Fatih; Beypinar, Ismail; Uysal, MukreminPurposeWe aimed to investigate the efficacy of 0.25mg dose of palonosetron and granisetron in triplet antiemetic prophylaxis in breast cancer patients receiving HEC.MethodsPatients with nonmetastatic breast cancer who received HEC [doxorubicin or epirubicin plus cyclophosphamide (AC/EC)] were enrolled in the study. The prophylactic triplet antiemetic regimens were used according to the doctor's preference during the first cycle of HEC as intravenous dexamethasone and palonosetron 0.25mg or granisetron 3mg on day 1 as well as oral aprepitant (125mg on day 1 and 80mg on days 2 and 3).The primary endpoint was complete response rate (CR) on acute and delayed chemotherapy-induced nausea and vomiting (CINV), separately.ResultsA total of 118 female patients were included in the study. Patients received AC (83%), EC (3%), and dose-dense AC (14%) as adjuvant (88%) or neoadjuvant (12%). The majority of patients received palonosetron (59%) containing antiemetic treatment. The CR rate on acute and delayed vomiting was very high and not statistically different in both of the arms (acute 87% vs. 96%, p=0.089; delayed 90% vs. 92%, p=0.489), respectively. Nevertheless, the CR rate on either acute or delayed nausea was lower than vomiting (acute 51% vs. 51%; delayed 38% vs. 29%, p=0.203; respectively).ConclusionsThis is the second study that compared a 0.25mg dose of palonosetron with first-generation setron in triplet antiemetic prophylaxis in cancer patients receiving HEC. We could not find meaningful statistical differences between two arms, regarding CR rate on acute and delayed CINV.Öğe Complete response and long-term remission to anti-HER2 combined therapy in a patient with breast cancer presented with bone marrow metastases(Sage Publications Ltd, 2014) Artac, Mehmet; Koral, Lokman; Toy, Hatice; Guler, Tunc; Boruban, Melih C.; Altundag, KadriPresentation with bone marrow metastasis at diagnosis is a rare event in breast carcinoma. Here, we report a rare presentation of metastatic breast cancer patient with bone marrow metastases, who was successfully treated with trastuzumab combined chemotherapy. The regimens initially applied for bone marrow metastasis were docetaxel/adriamycin, gemcitabine/vinorelbine, epirubicin/cyclophosphamide, capecitabine, docetaxel, gemcitabine, and paclitaxel. But, the best response to these regimens was not satisfactory. Our patient was completely treated with etoposide-cisplatin and trastuzumab combination. She is still on remission after five years of metastatic breast cancer diagnosis using letrozole and trastuzumab without complication. Physicians should be careful in treating bone marrow metastases in breast cancer, since patients can show improved marrow function after chemotherapy and long-lasting survival is possible.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 The prognostic significance of the 18F-fluorodeoxyglucose positron emission tomography/computed tomography in early-stage nonsmall cell lung cancer(Wolters Kluwer Medknow Publications, 2020) Geredeli, Caglayan; Artac, Mehmet; Kocak, Ismail; Koral, Lokman; Sakin, Abdullah; Altinok, Tamer; Kaya, BugraContext: The prognostic criteria for early-stage nonsmall cell lung cancer (NSCLC) wait to be explored. Aim: In this study, our aim was to evaluate the prognostic significance of the positron emission tomography/computed tomography (PET/CT) maximum standardized uptake value (SUVmax) value of the primary tumor in patients with a diagnosis of early-stage NSCLC who received surgical treatment. Settings and Design: This was a multicenter retrospective design. Materials and Methods: Patients who had been diagnosed with early-stage NSCLC and who underwent surgery for the condition were included in this study. The preoperative fluorodeoxyglucose (18F-FDG) PET/CT results of the patients were retrospectively accessed from their medical files. The disease-free survival (DFS) rates of patients who had SUVmax values above and below the determined cutoff value were compared. Statistical Analysis Used: SPSS version 22 and Kaplan-Meier method were used for statistical analysis. Results: A total of 92 patients were included in the study. The median age of the patients was 60 years (range: 36-79). The determined cutoff SUVmax value of the primary tumor was 13.6. A comparison of the DFS rates of the patients with an SUVmax value above and below 13.6 revealed a significant difference in patients with Stage I (22.9 months vs. 50.3 months; P = 0.02) and Stage II (28 months vs. 40.4 months; P = 0.04), Stage I + II (43.5 months vs. 26.1 months; P = 0,02), and Stage IIIA (14.7 months vs. 13.6 months; P = 0.92) NSCLC. Conclusions: We found that in early-stage NSCLC patients, the SUVmax value of the primary mass in 18F FDG PET/CT was a prognostic indicator for the DFS rates.
