İleri evre mide kanserinde, sisplatin ve kapesitabin kombinasyon tedavisinin hastalar üzerindeki klinik etkilerinin retrospektif değerlendirilmesi
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Date
2015
Authors
Bayındır, Murat
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Tüm dünyada mortalitesi yüksek kanser türleri içinde mide kanseri ön sıralarda yer almaktadır. Son yıllarda mide kanseri insidansında öncelikle gelişmiş ülkelerde bir azalma olmasına rağmen halen dünya genelinde kanser mortalitesinde önemli bir yer tutmaktadır. Mide kanserlerinin çoğunluğu tanı anında uzak metastaz göstermektedir. İleri evre mide kanserlerinde cerrahi tedavi yöntemleri başarısız olmakla birlikte ilk tercih kemoterapidir. Mide kanseri için standart bir kemoterapi protokolü yoktur. Bu çalışmada sisplatin-kapesitabin kombine kemoterapi tedavisinin sağ kalım, tedavi yan etkileri gibi parametreler üzerinden hastalar üzerindeki etkisi klinik olarak araştırıldı. Bu çalışmada, lokal ileri (unrezektaabl) veya metastatik mide kanseri nedeniyle Uludağ Üniversitesi Tıp Fakültesi Tıbbi Onkoloji bölümünde sisplatin-kapesitabin tedavisi almış hastalar retrospektif olarak değerlendirildi. Toplam 45 hastaya (15 kadın ve 30 erkek) intravenöz sisplatin 75 mg/m2 (1. gün) ve kapesitabin 2000 mg/m2 (1-14 günler) verildi. Tedavi 3 haftada bir tekrarlandı. Ortalama olarak 3,4 siklus uygulandı. Hastalarda, tedavi sonrası genel sağ kalım, progresyona kadar geçen süre ve çeşitli yan etkiler takip edildi. Çalışma sonunda 5 (%11,1) hastada tam yanıt, 11 (%24,4) hastada parsiyel yanıt olduğu gözlendi. 7 (%15,6) hasta stabil hastalık olarak kabul edildi. Araştırma sonucunda genel sağ süresi 12 ay olarak saptandı. Progresyona kadar geçen süre 7 ay olarak saptandı. Tedaviye bağlı en sık yan etki bulantı kusma oldu ( 33 hasta, %73,3). Hematolojik yan etkilerde anemi %42,2, febril nötropeni %33,3 ve trombositopeni %22,2 olarak saptandı. Bunların dışında %33,3 vakada nefrotoksisite, %26,7 vakada diyare gözlendi. Sonuç olarak tedavi genel olarak iyi tolere edildi. Tedavinin lokal ileri veya metastatik mide kanserinde orta derece etkinliğe sahip olduğu gözlendi.
Gastric cancer is one of the leading cancers with high mortality in worldwide. Although there is a decrease in gastric cancer incidence especially in developed countries; it still has an important place in cancer mortality around worldwide. Most of the gastric cancers have distant metastasis on diagnosis. First treatment choice in advanced level gastric cancers is chemotherapy as surgical treatment methods fail. There is no standart chemotherapy protocol for gastric cancer. In this study, effects of cisplatin-capecitabine combine chemotherapy treatment in terms of parameters such as survival and side effects of treatment on patients were clinically evaluated. In this study, patients received cisplatin-capecitabine treatment in Uludağ University Faculty of Medicine, Department of Medical Oncology due to local advanced (unresectable) or metastatic gastric cancer were retrospectively evaluated. A total of 45 patient (15 women and 30 men) received 75 mg/m2 of cisplatin (1st day) and 2000 mg/m2 of capecitabine (1-14th days) intravenously. Treatment replaced in every three weeks. Averagely 3-4 cyclus administered. Post-treatment survival, time elapsed until progression and various advers effects were followed in patients. In the end of study; 5 (%11,1), 11 (%24,4) and 7 (%15,6) patients were considered as complete response, partial response and stable disease; respectively. General duration of survival was 12 months. Time elapsed until progression was 7 months. Most common advers effect of treatment was nausea-vomiting (33 patients, %73.3). Hematologic side effects were identified as anemia (%42.2), febrile neutropenia (%33,3) and thrombocytopenia (%22,2). In addition, %33,3 of cases experienced nephrotoxicity whereas %26,7 of cases suffered from diarrhea. In conclusion, treatment was generally well-tolerated. It was observed that treatment had intermediate effectiveness on local advanced or metastatic gastric cancers.
Gastric cancer is one of the leading cancers with high mortality in worldwide. Although there is a decrease in gastric cancer incidence especially in developed countries; it still has an important place in cancer mortality around worldwide. Most of the gastric cancers have distant metastasis on diagnosis. First treatment choice in advanced level gastric cancers is chemotherapy as surgical treatment methods fail. There is no standart chemotherapy protocol for gastric cancer. In this study, effects of cisplatin-capecitabine combine chemotherapy treatment in terms of parameters such as survival and side effects of treatment on patients were clinically evaluated. In this study, patients received cisplatin-capecitabine treatment in Uludağ University Faculty of Medicine, Department of Medical Oncology due to local advanced (unresectable) or metastatic gastric cancer were retrospectively evaluated. A total of 45 patient (15 women and 30 men) received 75 mg/m2 of cisplatin (1st day) and 2000 mg/m2 of capecitabine (1-14th days) intravenously. Treatment replaced in every three weeks. Averagely 3-4 cyclus administered. Post-treatment survival, time elapsed until progression and various advers effects were followed in patients. In the end of study; 5 (%11,1), 11 (%24,4) and 7 (%15,6) patients were considered as complete response, partial response and stable disease; respectively. General duration of survival was 12 months. Time elapsed until progression was 7 months. Most common advers effect of treatment was nausea-vomiting (33 patients, %73.3). Hematologic side effects were identified as anemia (%42.2), febrile neutropenia (%33,3) and thrombocytopenia (%22,2). In addition, %33,3 of cases experienced nephrotoxicity whereas %26,7 of cases suffered from diarrhea. In conclusion, treatment was generally well-tolerated. It was observed that treatment had intermediate effectiveness on local advanced or metastatic gastric cancers.
Description
Keywords
Mide kanseri, İleri evre, Sisplatin, Kapasitabin, Gastric cancer, Advanced stage, Cisplatin, Capecitabine
Citation
Bayındır, M. (2015). İleri evre mide kanserinde, sisplatin ve kapesitabin kombinasyon tedavisinin hastalar üzerindeki klinik etkilerinin retrospektif değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.