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Öğe Analysis of early and last effects concomittant chemoradiotherapy of 24 patients with locally advanced cervical carcinoma (lacc)(Oxford Univ Press, 2004) Tokatli, Fusun; Uygun, Kazim; Ibis, Kamuran; Bayir, Gulden; Denizli, Bengu; Uzal, Cem[Abstract Not Available]Öğe ANTIEMETIC EFFICACY OF DIAZEPAM IN THE PROPHYLAXIS OF ACUTE AND DELAYED EMESIS INDUCED BY CISPLATIN BASED CHEMOTHERAPY TREATED WITH STANDARD ANTI EMETICS(Kare Publ, 2005) Saip, Pinar; Onat, Haluk; Uygun, Kazim; Demir, Cumhur; Salepci, Taflan; Guney, Nese; Basaran, MertThis study was conducted to evaluate the efficacy of diazepam in managing acute and delayed emesis induced by cisplatin-based chemotherapy. A total of 92 cancer patients who were receiving 60-75 mg/m(2) cisplatin based chemotherapy were treated with granisetron 3 mg/IV plus dexamethasone 16 mg/IV on the first day of the chemotherapy Forty three of these patients also treated with diazepam 5 mg/PO 10-12 and 1 hours before the chemotherapy and 42 of these patients did not received any diazepam prophylaxis. Categorical scales were utilised to document the incidence of vomiting, nausea and loss of appetite. Among the 85 evaluable patients there was no statistically significant difference between the treatment arms in terms of acute and delayed emesis. But more patients achieved acute complete control of vomiting (79% vs 64%) and defined their quality of life as very good and good (70% vs 52%) in the diazepam arm. The protection obtained at the first day significantly influenced the protection during the subsequent days irrespective of the treatment arms. Diazepam does not increase the efficacy of antiemetic treatment but the increase in the patients well being and complete control acute vomiting suggest that it could be added to the standard antiemetic protocols.Öğe Colonic metastasis from carcinoma of the breast that mimicks a primary intestinal cancer(Yonsei Univ Coll Medicine, 2006) Uygun, Kazim; Kocak, Zafer; Altaner, Semsi; Cicin, Irfan; Tokatli, Fusun; Uzal, CemAlthough the lung, liver, or bones are the most common location for distant metastases; in breast cancer patients, metastases to the intestinal tract are very rarely recognized in the clinic. We will present an unusual case of colonic metastasis from a carcinoma of the breast that mimics a primary intestinal cancer, along with a through review of English language medical literature. Despite the fact that isolated gastrointestinal (GI) metastases are very rare and much less common than benign disease processes or second primaries of the intestinal tract in patients with a history of breast cancer, metastatic disease should be given consideration whenever a patient experiences GI symptoms.Öğe The comparison of weekly and 3-weekly cisplatin chemotherapy concurrent with radiotherapy in patients with previously untreated inoperable non-metastatic SCCHN(Oxford Univ Press, 2006) Uygun, Kazim; Karagol, Hakan; Caloglu, Murat; Cicin, Irfan; Caloglu, Vuslat Y.; Uzunoglu, Sernaz; Saip, Pinar[Abstract Not Available]Öğe The comparison of weekly and three-weekly cisplatin chemotherapy concurrent with radiotherapy in patients with previously untreated inoperable non-metastatic squamous cell carcinoma of the head and neck(Springer, 2009) Uygun, Kazim; Bilici, Ahmet; Karagol, Hakan; Caloglu, Murat; Cicin, Irfan; Aksu, Gorkem; Fayda, MerdanSeveral studies have shown that the concurrent administration of chemotherapy (CHT) and radiotherapy (RT) is superior to RT alone in patients with inoperable non-metastatic squamous cell carcinoma of the head and neck (InSCCHN). We compared the efficacy and safety profile of RT and concurrent cisplatin CHT given in two different schedules to patients with previously untreated InSCCHN. Fifty patients with previously untreated InSCCHN admitted to our oncology department were included in the study. Thirty of 50 (60%) patients with a younger age or good performance status (PS) (ECOG 0-1) received cisplatin 100 mg/m(2) on a 21-day schedule (group A). Other 20 (40%) patients with older age or poor PS (ECOG 2) received cisplatin 40 mg/m(2) on a 7-day schedule (group B). Each of the 50 patients received concurrent conventional dose RT according to primer tumor location. The median follow-up is 12 months for group A and 12.5 months for group B. Twenty-eight (93.3%) patients in group A and 18 (90%) in group B were evaluable for response. The complete response rate was 50% in group A and 40% in group B (P > 0.05). The objective response rate was 92% in group A and 90% in group B (P > 0.05). All grade 3-4 toxic events were seen in 16 (53.3%) of group A patients and 8 (40%) of group B patients (P > 0.05). Comparison between two treatment modalities appears to result in statistically similar response rates and adverse event profile. A randomized phase III trial is required to confirm the safety and efficacy of weekly cisplatin therapy in patients with poor PS and/or older age at diagnosis.Öğe The efficacy of tamoxifen in patients with advanced epithelial ovarian cancer(Humana Press Inc, 2007) Karagol, Hakan; Saip, Pinar; Uygun, Kazim; Caloglu, Murat; Eralp, Yesim; Tas, Faruk; Aydiner, AdnanBackground: Activity of tamoxifen as a salvage therapy in patients with advanced epithelial ovarian cancer was evaluated by a number of studies. In this study, we evaluated efficacy of tamoxifen in our patients with platinum-resistant epithelial ovarian carcinoma. Patients and Methods: A retrospective analysis was conducted of patients who received tamoxifen at a dose 20 mg twice daily for the treatment of advanced epithelial ovarian cancer. Results: Twenty-nine eligible patients were included to the study. There were 1 (3%) complete response, 2 (7%) partial response, 6 (21%) stable disease, and 20 (69%) progressive disease. All patients were progressed after initiation of tamoxifen. Median progression-free survival was 4 mo (95% CI: 2.98-5.02). Disease progression of 19 (65%) patients were shown within the first 6 mo after initiation of tamoxifen. Progression-free survival was between 6 and 12 mo for 7 (24%) patients and >= 12 mo for 3 (10%) patients. The median survival after initiation of tamoxifen was 15 mo (95% CI: 7.2-22.8). No toxicity attributable to tamoxifen was seen in any of the patients. The only independent prognostic factor that had a significant predictive value for progression-free survival was the response to tamoxifen treatment (p = 0.043, hazard ratio: 0.12, 95% CI: 0.01-0.94). Conclusion: Considering minimal side effects and ability to cause objective responses, there is a place for tamoxifen in treatment of patients with platinum-resistant ovarian cancer. A phase III trial is required to confirm the value of the drug in patients presenting these clinical settings.Öğe The efficacy of tamoxifen in patients with advanced epithelial ovarian cancer [Meeting Abstract](Elsevier, 2006) Karagol, Hakan; Saip, Pinar; Uygun, Kazim; Caloglu, Murat; Eralp, Yesim; Tas, Faruk; Aydiner, Adnan[Abstract Not Available]Öğe The efficiency of single agent docetaxel in patients with platinum-refractory non-small cell lung carcinoma(Humana Press Inc, 2008) Uygun, Kazim; Aksu, Gorkem; Cicin, Irfan; Karagol, Hakan; Kocak, Zafer; Fayda, Merdan; Binici, AhmetBackground To evaluate the efficiency of docetaxel as second line chemotherapy in patients with platinum-refractory non-small cell lung carcinoma (NSCLC). Patients and methods Fifty-two patients with locally advanced or metastatic NSCLC who had platinum-refractory disease (progressed through or within 3 months of completion of first line therapy) and an Eastern Cooperative Oncology Group performance (ECOG) status 0-2 were treated with second-line chemotherapy consisting of single agent docetaxel (100 mg/m2, intravenously, on day 1 of a 21-day cycle). The median number of treatment cycles was 4 (2-6). Disease-free (DFS) and overall survival (OS), response rates and toxicity were evaluated. Results The median progression-free survival of patients was 3 months (95% CI: 0.01-5.99) and overall survival was 7.2 months (95% CI: 2.2-9.5). One-year overall survival rate was 29%. Disease control (complete response, partial response, or stable disease) was achieved in 25 patients (48%) and overall response rate was 13% (7 patients). There were no complete responses. Seventeen patients (33%) had stable disease and twenty-seven patients (52%) had progressive disease. Age, gender, stage at diagnosis (IIIB vs. IV), performance status at initiation of second-line therapy (0-1 vs. 2) histopathological type (epidermoid vs. others), grade, LDH, albumin, weight loss were evaluated as prognostic factors; however, none of these had a significant affect on survivals. The protocol was well tolerated and there were no toxic deaths. Grade III-IV anemia was present in 8 patients (15%) and thrombopenia in 12 (23%) patients. The most frequent grade 3-4 toxicities were leucopenia (52%) and neutropenia (48%). Febril neutropenia occurred in 14 patients (26%). No patients experienced grade III-IV mucositis and diarrhea. Totally, the need of a dose reduction was about 25% and treatment delay (4-9 days) occurred in 5 patients (10%) and 7 patients (13%), respectively, because of toxicity. Conclusions Second-line chemotherapy with single-agent docetaxel offers a small but significant survival advantage with acceptable toxicity for patients with advanced NSCLC who have platinum-refractory disease.Öğe Efficient and safe application of a FOLFIRI/bevacizumab combination to a patient with locally advanced rectal cancer and severe chronic renal failure(Karger, 2007) Cicin, Irfan; Karagol, Hakan; Uzunoglu, Sernaz; Uygun, Kazim[Abstract Not Available]Öğe Evaluation of prognostic factors and comparison of systemic treatment modalities in patients with recurrent or metastatic endometrial carcinoma(Humana Press Inc, 2006) Karagol, Hakan; Saip, Pinar; Uygun, Kazim; Kucucuk, Seden; Aydiner, Adnan; Topuz, ErkanBackground: Prognostic factors related to survival in patients with inoperable metastatic or recurrent endometrial carcinoma (MREC) have remained unclear due to lack of clinical trials.The management of these patients is also controversial.This study was performed to compare the efficacy and toxicity profiles of two different systemic therapies (chemotherapy vs hormonal therapy) given for the treatment of patients with MREC and to identify the impact of various prognostic factors on the survival. Methods: Between 1992 and 2004, 44 patients with MREC were admitted to our oncology department. Four cases were excluded from this retrospective study because of lack of data in their charts. Age, presence of other systemic diseases (such as diabetes mellitus, hypertension), histological type, tumor grade, staae, disease-free interval, site of recurrence or metastasis, systemic treatment modality, overall response to treatment, and duration of time to progression were evaluated as prognostic factors. Cox regression analysis was per-formed for identification of independent prognostic factors and differences between patients characteristics of two treatment groups were calculated by the chi-square or t test. Results: The median follow-up was 18 mo (range 3-113). The overall response rates for chemotherapy and hormonal therapy group were 42% and 41 %, respectively (p > 0.05). The median time to progression was 4 mo for the chemotherapy group and 5 mo for the hormonal therapy group (p > 0.05). The median survival after metastasis or recurrence was I I mo for the chemotherapy group and 16 mo for the hormonal therapy group (p > 0.05). In the group of chemotherapy, grade 3-4 hematologic and northematologic toxicities were seen in eight and two, patients, respectively. No grade 3-4 toxicities were noted in patients treated with hormonal C therapy. In multivariate analysis, only time to progression (p = 0.001) and grade (p = 0.04) were the independent prognostic factors on survival after metastasis or recurrence. Conclusion: Histological differentiation and duration of time to progression are predictive factors for survival after metastasis or recurrence in the whole group. The efficacy of two different groups of treatment in these patients appears to be similar. But the chemotherapy may have some disadvantageous in terms of toxicity. This study supports a future randomized prospective trial of hormonal therapy vs chemotherapy in patients with MREC.Öğe Extrapulmonary small-cell carcinoma compared with small-cell lung carcinoma - A retrospective single-center study(Wiley, 2007) Cicin, Irfan; Karagol, Hakan; Uzunoglu, Sernaz; Uygun, Kazim; Usta, Ufuk; Kocak, Zafer; Caloglu, MuratBACKGROUND. The study was conducted with the aim of reviewing the clinical features, therapy, and natural course of patients with extrapulmonary small-cell carcinoma (EPSCC) and small-cell lung carcinoma (SCLC) to better define current concepts regarding EPSCCs. METHODS. The medical records of patients with proven diagnosis of small-cell carcinoma (SmCQ between January 1999 and May 2006 were retrospectively reviewed. A total of 65 SmCC cases were included in the study (11 [17%] cases of EPSCC and 54 [83%] cases of SCLQ. RESULTS. Progression-free survival of all patients with EPSCC and patients with-extensive EPSCC disease was 7 months (95% confidence interval 10], 0.58-13.42) and 7 months (95% Cl, 4.71-13.29), respectively. Overall survival of all patients with EPSCC and patients with extensive EPSSC disease was 32 months (95% CI, 18.74-45.26) and 28 months (95% Cl, 12.24-43.76), respectively. Progression-free survival and overall survival for all patients with SCLC were 5 months (95% Cl, 2.26-7.74) and 10 months (95% Cl, 5.95-14.05), respectively. Progression-free survival and overall survival for patients with extensive disease were 3 months (95% Cl, 4.71-13.29) and 5 months (95% CI, 3.33-6.67), respectively. Overall survival was significantly better in all patients with EPSCC and in patients with extensive EPSCC disease compared with A patients with SCLC and patients with extensive SCLC disease (P =.014, P -.004, respectively). Early death and brain metastasis were observed in a higher number of patients with SCLC compared with EPSCC) however, these results were not statistically significant (P 33 and P =.076, respectively). Smoking history was significantly less in the FPSCC group (P <.0001). CONCLUSIONS. EPSCC is usually treated similarly to SCLC. However, this study suggests some differences such as etiology, clinic course, survival, frequency of brain metastases, and early death between these entities. These possible differences may influence the choice of therapeutic approach. Cancer 2007; 110: 106&76. (c) 200 7 American Cancer Society.Öğe Factors related with recurrence after complete pathologic response to post- operative chemotherapy in patients with epithelial ovarian cancer(Elsevier, 2006) Karagol, Hakan; Saip, Pinar; Uygun, Kazim; Eralp, Yesim; Topuz, Samet; Berkman, Sinan; Ilhan, Ridvan[Abstract Not Available]Öğe Nasopharyngeal carcinoma with extensive nodular skin metastases: A case report(Sage Publications Ltd, 2006) Caloglu, Murat; Uygun, Kazim; Altaner, Semsi; Uzal, Cem; Kocak, Zafer; Piskin, SuleymanSkin metastasis from nasopharyngeal carcinoma is a rare clinical finding. The most common form of appearance is a few solitary skin nodules. However, massive and extensive nodular dissemination or diffuse dermal lymphatic infiltration is extremely rare. We here present a case of a 40-year-old man with widespread nodular skin metastases from undifferentiated nasopharyngeal carcinoma.Öğe PROGNOSTIC FACTORS AND TREATMENT RESULTS IN LARYGEAL CARCINOMA: DEPARTMENT OF RADIATION ONCOLOGY OF TRAKYA UNIVERSITY MEDICAL SCHOLL EXPERIENCE(Kare Publ, 2005) Caloglu, Murat; Yurut Caloglu, Vuslat; Uzal, Cem; Karagol, Hakan; Tokatli, Fusun; Uygun, KazimPurpose: To review the Department of Radiation Oncology of Trakya University Medical School experience in the treatment of laryngeal carcinoma and to evaluate the different factors affecting locoregional control. Methods and Material: We reviewed the records of 78 consecutive patients were treated for laryngeal carcinoma between July 1999 and November 2004. There were 74 men and 4 women, with a median age of 58 years (range, 34-80 years). Forty-two patients had T4 lesions, and 20 had T3 lesions; 32 had NO, 15 had N1, 27 had N2, and 2 had Nx disease. Surgery was the primary treatment modality in 34 patients. Twenty-six patients had RT alone, or chemotherapy combined with RT. Eighteen patients applied with locoregional or distant recurrent disease and they were given salvage or palliative treatment. x2 statistics were employed to identify significant factors for LRC. Results: The median follow-up was 18 months (range, 4-54 months). Twelve patients relapsed, of which 9 (26.5 %) locoregional failures among 34 patients of postoperative radiotherapy group. Significant prognostic factors for locoregional recurrence on univariate analysis were performance status, and surgical margin. Nine of 26 (34.6 %) patients relapsed and all of them had locoregional failures in primary radiotherapy group. Significant prognostic factors for these patients were primary tumor site, overall stage, T stage, and N stage. Conclusion: Radiotherapy is effective in the treatment of laryngeal carcinoma. The identification of prognostic factors for locoregional recurrence could help to determine more effective treatment strategies.Öğe Second line chemotherapy in non-small-cell lung carcinoma: A single-institution experience(Oxford Univ Press, 2006) Uygun, Kazim; Cicin, Irfan; Karagol, Hakan; Uzunoglu, Sernaz; Saip, Pinar[Abstract Not Available]Öğe Subacute motor neuronopathy associated with hepatocellular carcinoma(Springer, 2007) Turgut, Nilda; Karagoel, Hakan; Celik, Yahya; Uygun, Kazim; Reyhani, Aylin[Abstract Not Available]Öğe Trastuzumab beyond progression in metastatic breast cancer(Oxford Univ Press, 2006) Yanmaz, Mustafa T.; Ozguroglu, Mustafa; Ozturk, Betul; Uygun, Kazim; Basaran, Gul; Turna, Hande; Yildiz, Ozcan[Abstract Not Available]Öğe The treatment results of patients with extrapulmoner and pulmoner small cell cancer(Oxford Univ Press, 2006) Uygun, Kazim; Cicin, Irfan; Karagol, Hakan; Uzunoglu, Sernaz; Kocak, Zafer; Caloglu, Murat; Saip, Pinar[Abstract Not Available]Öğe Trimodality treatment in patients with superior sulcus tumors: hopes and realities(Sage Publications Ltd, 2011) Kocak, Zafer; Saynak, Mert; Uygun, Kazim; Yoruk, Yener; Ozen, Alaattin; Sut, Necdet; Altiay, GundenizAims and background. In late 2001 at our institution, we started offering induction radiochemotherapy as a treatment option for superior sulcus tumors. Our aim was to evaluate treatment choices and outcome in this patient group treated over the past 7 years at our institution. Methods. The records of 34 patients were retrospectively reviewed and 33 were assessable for the analysis. Results. Twenty of 28 patients with MO disease had operable disease. The induction radiochemotherapy for superior sulcus tumors was possible in about two-thirds (14/20) of the cases with operable disease, with only one-third (5/14) of these having undergone surgery. The most common reason for not proceeding to surgery following induction radiochemotherapy was patient refusal (n = 5). The median follow-up of all 33 patients was 17 months. In curatively treated patients with (n = 11) or without surgery (n = 15), the median overall survival time was 26 months (range, 10-26) and 26 months (range, 7-71), respectively (P = 0.534). Local-regional and/or distant failure developed in 20 of 26 patients treated curatively. In patients treated with the trimodality regimen (n = 5), no local-regional failure was observed, and distant failure occurred in one case. Conclusions. The trimodality treatment was possible in 25% of cases with operable disease due to the high rate of patient refusal to proceed to surgery following induction radiochemotherapy. No difference in survival was observed between patients treated with surgery and those treated with radiochemotherapy only because of a limited follow-up. So, the benefit of additional surgery is not clear, and a longer follow-up is needed before final conclusions can be drawn.
