Metastatik evre böbrek hücreli kanser hastalarının klinik ve demografik özelliklerinin birinci seri tedavilere yanıtının değerlendirilmesi
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Böbrek Hücreli Karsinom (BHK) önemli bir mortalite ve morbidite nedenidir. Tüm kanserlerin %2-3'lük kısmını oluşturmaktadır. Üriner sistem kaynaklı tümörlere bağlı ölümlerde BHK %40'ın üzerinde ölüm oranı ile mortalitesi en yüksek ürolojik kanserdir. Erkeklerde kadınlara göre yaklaşık %50 daha sık görülmektedir. Tanı anında %20-30, takiplerinde ise %20-40 oranında metastaz saptanan BHK hastalarında ülkemizde ilk basamak tedavisi interferon alfa olarak uygulanmaktadır. Genellikle interferon alfa altında progresyon gözlenen hastalarda, tirozin kinaz inhibitörleri (TKİ), vasküler endotelyal growth faktör (VEGF) yolu inhibitörleri, mTOR inhibitörleri ve anti-PD1 monoklonal antikorları gibi hedefe yönelik tedavilerin daha etkin olduğu gösterilmiştir. Fakat ülkemizde halen 1. basamak tedavide TKI, VEGF reseptör inhibitörlerinin anti PD-1 monoklonal antikoru olan nivolumabın ödemesi devlet tarafından yapılmamaktadır. Bu çalışmadaki amacımız Trakya Üniversitesi Tıbbi Onkoloji Bilim Dalı'nda metastatik BHK tanısı ile izlenen, pazopanib veya sunitinib almış hastaların klinik, demografik ve patolojik özelliklerini gözden geçirmek, GS-PSK sürelerini değerlendirmek, prevelansını saptamak, literatür bulguları ile karşılaştırmak ve BHK'lara yaklaşımımızı değerlendirmek ve iyileştirmekti. Çalışmaya Trakya Üniversitesi Tıp Fakültesi Hastanesinde 2005 ile 2018 yılları arasında metastatik BHK tanısı almış 63 hasta dahil edildi. Hastaların verilerine patoloji raporlarından ve hasta dosya kayıtlarından ulaşıldı. Sağkalım hesapları Kaplan-Meier yöntemi ile yapıldı. Parametrik olmayan değişkenlerin birbiri ile ilişkileri Ki-kare test ile araştırıldı. Parametrik değişkenlerin gruplar arası karşılaştırması student testi ile yapıldı. Sonuç olarak, metastatik BHK'da, sunitinib ve pazopanip tedavisi için literatüre benzer sağkalım sonuçlarına rastlandı. Yüksek ECOG skorunun, berrak hücreli dışı sitolojinin, karaciğer metastazı varlığının daha kısa GS ve PSK ile ilişkili olduğunu saptadık.
Renal Cell Carcinoma (RCC) is an important cause of mortality and morbidity. It accounts for 2-3% of all cancers. RCC is the urologic cancer with the highest mortality rate with a mortality rate of over 40%. It is approximately 50% more common in men than in women. Interferon alpha is the first line treatment in our country in patients with RCC who have 20-30% metastasis at the time of diagnosis and 20-40% during follow-up. n patients with progression usually under interferon alpha, tyrosine kinase inhibitors (TKI), vascular endothelial growth factor(VEGF) pathway inhibitors, mTOR inhibitors and anti-PD1 monoclonal antibodies have been shown to be more effective. However, in our country, the payment of nivolumab, the anti-PD-1 monoclonal antibody of TKI, VEGF receptor inhibitors, is not made by the state. In this study our aims were; to review the demographic ande pathological features of patients followed with the diagnosis of metastatic RCC at Trakya University Faculty of Medicine Department of Medical Oncology and treated with pazopanib and sunitib, to asses the os-es analysis, to determine the prevelance, to compare with the findings from the literatüre and to re-evaluate and improve our approach to RCC. Sixty-three patients diagnosed with metastatic RCC between 2005 and 2018 in Trakya University Medical Faculty Hospital were included in the study. Data of the patients were obtained from pathology reports and patient file records. Survival calculations were performed by Kaplan-Meier method. The relationship between nonparametric variables was investigated by Chi-square test. The comparison of the parametric variables between the groups was made by student test. As a result, literature similar survival results were found for mRCC sunitinib and pazopanip treatment. High ECOG score, non-clear cell cytology, liver metastasis was associated with shorter OS and PFS.
Renal Cell Carcinoma (RCC) is an important cause of mortality and morbidity. It accounts for 2-3% of all cancers. RCC is the urologic cancer with the highest mortality rate with a mortality rate of over 40%. It is approximately 50% more common in men than in women. Interferon alpha is the first line treatment in our country in patients with RCC who have 20-30% metastasis at the time of diagnosis and 20-40% during follow-up. n patients with progression usually under interferon alpha, tyrosine kinase inhibitors (TKI), vascular endothelial growth factor(VEGF) pathway inhibitors, mTOR inhibitors and anti-PD1 monoclonal antibodies have been shown to be more effective. However, in our country, the payment of nivolumab, the anti-PD-1 monoclonal antibody of TKI, VEGF receptor inhibitors, is not made by the state. In this study our aims were; to review the demographic ande pathological features of patients followed with the diagnosis of metastatic RCC at Trakya University Faculty of Medicine Department of Medical Oncology and treated with pazopanib and sunitib, to asses the os-es analysis, to determine the prevelance, to compare with the findings from the literatüre and to re-evaluate and improve our approach to RCC. Sixty-three patients diagnosed with metastatic RCC between 2005 and 2018 in Trakya University Medical Faculty Hospital were included in the study. Data of the patients were obtained from pathology reports and patient file records. Survival calculations were performed by Kaplan-Meier method. The relationship between nonparametric variables was investigated by Chi-square test. The comparison of the parametric variables between the groups was made by student test. As a result, literature similar survival results were found for mRCC sunitinib and pazopanip treatment. High ECOG score, non-clear cell cytology, liver metastasis was associated with shorter OS and PFS.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Onkoloji, Oncology
