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    The clinical and pathological features of 133 colorectal cancer patients with brain metastasis: a multicenter retrospective analysis of the Gastrointestinal Tumors Working Committee of the Turkish Oncology Group (TOG)
    (Humana Press Inc, 2014) Tanriverdi, Ozgur; Kaytan-Saglam, Esra; Ulger, Sukran; Bayoglu, Ibrahim Vedat; Turker, Ibrahim; Ozturk-Topcu, Turkan; Cokmert, Suna; Turhal, Serdar; Oktay, Esin; Karabulut, Bulent; Kilic, Diclehan; Kucukzeybek, Yuksel; Oksuzoglu, Berna; Meydan, Nezih; Kaya, Vildan; Akman, Tulay; Ibis, Kamuran; Saynak, Mert; Sen, Cenk Ahmet; Uysal-Sonmez, Ozlem; Pilanci, Kezban Nur; Demir, Gokhan; Saglam, Sezer; Kocar, Muharrem; Menekse, Serkan; Goksel, Gamze; Yapar-Taskoylu, Burcu; Yaren, Arzu; Uyeturk, Ummugul; Avci, Nilufer; Denizli, Bengu; Ilis-Temiz, Esra
    Brain metastasis in colorectal cancer is highly rare. In the present study, we aimed to determine the frequency of brain metastasis in colorectal cancer patients and to establish prognostic characteristics of colorectal cancer patients with brain metastasis. In this cross-sectional study, the medical files of colorectal cancer patients with brain metastases who were definitely diagnosed by histopathologically were retrospectively reviewed. Brain metastasis was detected in 2.7 % (n = 133) of 4,864 colorectal cancer patients. The majority of cases were male (53 %), older than 65 years (59 %), with rectum cancer (56 %), a poorly differentiated tumor (70 %); had adenocarcinoma histology (97 %), and metachronous metastasis (86 %); received chemotherapy at least once for metastatic disease before brain metastasis developed (72 %), had progression with lung metastasis before (51 %), and 26 % (n = 31) of patients with extracranial disease at time the diagnosis of brain metastasis had both lung and bone metastases. The mean follow-up duration was 51 months (range 5-92), and the mean survival was 25.8 months (95 % CI 20.4-29.3). Overall survival rates were 81 % in the first year, 42.3 % in the third year, and 15.7 % in the fifth year. In multiple variable analysis, the most important independent risk factor for overall survival was determined as the presence of lung metastasis (HR 1.43, 95 % CI 1.27-4.14; P = 0.012). Brain metastasis develops late in the period of colorectal cancer and prognosis in these patients is poor. However, early screening of brain metastases in patients with lung metastasis may improve survival outcomes with new treatment modalities.
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    Second-Line Capecitabine and Oxaliplatin Combination for Gemcitabine-Resistant Advanced Pancreatic Cancer
    (Asian Pacific Organization Cancer Prevention, 2014) Bayoglu, Ibrahim Vedat; Varol, Umut; Yildiz, Ibrahim; Muslu, Ugur; Alacacioglu, Ahmet; Kucukzeybek, Yuksel; Akyol, Murat; Demir, Lutfiye; Dirican, Ahmet; Cokmert, Suna; Yildiz, Yasar; Karabulut, Bulent; Uslu, Ruchan; Tarhan, Mustafa Oktay
    Background: The role of second-line therapy in metastatic pancreatic cancer is not clear. In this study, we aimed to explore the second-line efficiency of capecitabine and oxaliplatin (XELOX) in patients with advanced pancreatic cancer who have received gemcitabine-based first-line therapy. Materials and Methods: We retrospectively evaluated 47 patients with locally advanced or metastatic pancreatic cancer previously treated with gemcitabine-based first-line regimens. Treatment consisted of oxaliplatin 130 mg/m(2) and capecitabine 1000 mg/m2 twice daily with a 3 week interval, until unacceptable toxicity or disease progression. Results: Median number of cycles was 4 (range, 2-10). The overall disease control rate was 38.3%. The median overall survival and progression-free survival from the start of second-line therapy were 23 weeks (95% CI: 16.6-29.5 weeks) and 12 weeks (95% CI: 9.8-14.4 weeks), respectively. The most common grade 3-4 toxicities were nausea, vomiting and hematologic side effects. Conclusions: Our result suggests that the combination of capecitabine and oxaliplatin was tolerated with manageable toxicity and showed encouraging activity as second-line treatment of advanced or metastatic pancreatic cancer patients with ECOG performance status 0-2.
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    Sunitinib for Patients with Metastatic Non-clear Cell Renal Cell Carcinoma: A Multicenter Retrospective Turkish Oncology Group Trial
    (Int Inst Anticancer Research, 2014) Yildiz, Ibrahim; Ekenel, Meltem; Akman, Tulay; Kocar, Muharrem; Uysal, Mukremin; Kanitez, Metin; Varol, Umut; Bayoglu, Ibrahim Vedat; Tural, Deniz; Kaplan, Mehmet Ali; Avci, Nilufer; Surmeli, Zeki; Dede, Isa; Ulas, Arife; Yazici, Ozan; Basaran, Mert
    Aim: This study aimed to assess the clinical efficacy and toxicity of sunitinib, a targeted-agent, for non-clear cell renal cell carcinoma. Patients and Methods: Sixty-three patients with complete clinical data from 13 oncology Centers were retrospectively evaluated. Outcomes analyzed were objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and adverse events. Results: The median age of all patients, 38 men (60.3%) and 25 women (39.7%), was 63 years (range=25-82 years). Histological subtypes included 46 (88%) cases of papillary RCC, 10 of chromophobe, and 7 unclassified cases. Median treatment duration was seven months (range=2-86 months). At the time of this analysis, 52 patients had discontinued treatment, 33 of whom had died. Treatment discontinuation was due to disease progression in 43 patients, and toxicity in nine. Dose interruption was necessary in 22 (34.9%) patients, and dose reduction in 27 (42.9%). The objective response rate and disease control rate were 11.1% and 63.5%, respectively. The median PFS and OS were 7.6 months (95% confidence interval (CI)=5.5-9.7 months) and 22.0 months (95% CI=13.4-30.6 months), respectively, with 1-year rates of 64.7% and 33.7%, respectively. Conclusion: Clinical outcome of the metastatic non-clear cell RCC patients with sunitinib treatment seemed to be worse than the historical data of clear cell RCC patients, in terms of PFS, OS and objective response. New and more effective targeted-therapies and better understanding of the underlying molecular processes are necessary to improve survival outcome for these patients.