Bevacizumab is a monoclonal antibody which targets the vascular endothelial growth factor molecule. It is indicated for the treatment of recurrent and metastatic colorectal cancer. A 66-year-old ...woman was operated with left hemicolectomy who had a tumor in the left colon causing a total obstruction. Her tumor stage was IV (T3N1M1). 5-Fluorouracil, folinic acid,irinotecan and bevacizumab chemotherapy was started to the patient at the forty day of the colon operation. The patient was hospitalized after first administration of the 5th chemotherapy cycle because of febrile neutropenia. Abdominal pain began although the neutrophil count was within the normal ranges. The patient was operated with the diagnosis of acute abdomen. A one centimeter sized perforation was seen at the ilial loop which was 80 cm proximal to the ileocaecal valve. The patient died 8 days after the operation. Although bevacizumab is generally a well-tolerated agent, one must pay attention.
OBJECTIVES Sarcomatoid differentiation has been reported in 8% of whole renal cell carcinoma (RCC) and is associated with bad prognosis, increased risk of metastasis. METHODS Patients with RCC ...between April 2008 and July 2011 were analyzed, retrospectively. RESULTS There were 209 RCC patients. Rate of sarcomatoid differentiation was 3.3% (n = 7). Median age was 53 (min 45-max 69). Patients were men. Histological subtype was clear cell carcinoma in 3 patients (42.9%) and chromophobic in 1 patient (14.3%). Five of the patients (71.4%) were stage 4, one of them (14.3%) was stage 3, and 1 of them (14.3%) stage 2. Interferon treatment was administered to 2 patients (28.6%) and antracyline based chemotherapy to 2 patients (28.6%) as systemic therapies. In median 1 month follow-up (min:1-max:78) 4 of 7 patients (57.5%) were dead. CONCLUSION In the early stages of RCC, main treatment modality is surgery. Gemcitabine-adriamycin, are used for sarcomatoid differentiated RCC patients despite low response rates. Key words: Renal cell carcinoma; poor prognosis; sarcomatoid differentiation. AMAC Bobrek hucreli kanserlerin (BHK) yaklasik %8'inde sarkomatoid farklilasma bulunmaktadir. Bu farklilasma kotu prognozu ve artmis metastaz riskini gostermektedir. GEREC VE YONTEM Nisan 2008 ile Eylul 2011 tarihleri arasinda BHK'li hastalar arasindan sarkomatoid farklilasma gosterenler calismaya alindi. BULGULAR BHK'li 209 hasta degerlendirildi. Ortanca yasi 53 yil olan (min 45-maks 69), sarkomatoid farklilasma gosteren 7 erkek BHK'li (%3.3) hasta saptandi. En sik gorulen hucre tipinin 3 (%42.9) hastada berrak hucre, 1 (%14.3) hastada kromofob hucre oldugu saptandi. Tani aninda, 5 hasta (%71.4) evre IV, 1 hasta (%14.3) evre III ve 1 hasta (%14.3) II olarak degerlendirilmisti. Sistemik tedavi olarak 2 (%28.6) hastaya interferon tedavisi ve 2 (%28.6) hastaya kemoterapi (antrasiklin icerikli) tedavisi baslanildigi bulundu. Ortanca 1 aylik (min: 1-maks: 78) izlem suresi icinde 7 hastadan 4'u (%57.5) oldu. SONUC BHK'nin erken evrelerinde tedavi cerrahidir. Gemsitabin + adriyamisin ise sadece sarkomatoid farklilasma gosteren BHK'de dusuk yanit oranlarina ragmen kullanilabilmektedir. Anahtar sozcukler: Bobrek hucreli karsinom; kotu prognoz; sarkomatoid farklilasma.
Sarcomatoid differentiation has been reported in 8% of whole renal cell carcinoma (RCC) and is associated with bad prognosis, increased risk of metastasis. There were 209 RCC patients. Rate of ...sarcomatoid differentiation was 3.3% (n = 7). Median age was 53 (min 45-max 69). Patients were men. Histological subtype was clear cell carcinoma in 3 patients (42.9%) and chromophobic in 1 patient (14.3%). Five of the patients (71.4%) were stage 4, one of them (14.3%) was stage 3, and 1 of them (14.3%) stage 2. Interferon treatment was administered to 2 patients (28.6%) and antracyline based chemotherapy to 2 patients (28.6%) as systemic therapies. In median 1 month follow-up (min:1-max:78) 4 of 7 patients (57.5%) were dead. In the early stages of RCC, main treatment modality is surgery. Gemcitabine-adriamycin, are used for sarcomatoid differentiated RCC patients despite low response rates.
Chemotherapy-induced febrile neutropenia (FN) with solid tumors causes mortality and morbidity at a significant rate. The purpose of this study was to compare the effects of filgastrim and ...lenograstim started with the first dose of antibiotics in hospitalized patients diagnosed with FN.
Between February 2009 and May 2012, 151 patients diagnosed with FN were evaluated, retrospectively. In those considered appropriate for hospitalization, convenient antibiotic therapy with granulocyte colony stimulating factors was started within first 30 minutes by completing necessary examinations in accordance with FEN guide recommendations.
In this study, 175 febrile neutropenia attacks in 151 patients were examined. Seventy three of the patients were male and 78 were female. The average age was 53.6 and 53.6, respectively. The most common solid tumor was breast carcinoma in 38 (25%) . One hundred and five FN patients (58%) were those who received granulocyte colony stimulating factors as primary prophylaxis.
While studies comparing both drugs generally involve treatments started for prophylaxis, this study compared the treatment given during the febrile neutropenia attack. Compared to lenograstim, filgastrim shortens the duration of hospitalization during febrile neutropenia attack by facilitating faster recovery with solid tumors.
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