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İleri Evre Over Kanserli Hastalarda Adjuvan Kemoterapinin Başlama Zamanı ile Yan Etkileri Arasındaki İlişkinin Karşılaştırılması

Yıl 2019, Cilt: 5 Sayı: 3, 532 - 537, 01.01.2019

Öz

Amaç: Platin ve taksan bazlı rejimler, ileri evre epitelyal over kanserinde EOK adjuvan tedavi için birinci basamak tedavidir. Adjuvan kemoterapi KT sonrası sistemik ve periferik önemli yan etkiler izlenmektedir. Biz bu çalışmada, ileri evre EOK’li hastalarda primer sitoredüktif cerrahi sonrası adjuvan kemoterapinin başlama zamanı ile oluşan yan etkileri arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntemler: Çalışmamızda, ileri evre EOK nedeni ile sitoredüksiyon operasyonu yapılmış 117 hastanın verileri retrospektif olarak incelenmiştir. Hastaların 72’sine erken adjuvan KT, 45’ine ise geç adjuvan KT uygulanmıştır. Hastaların yaşı, vücut kütle indeksi, menopoz durumu, sigara içimi, tanı anındaki evresi ve tümörün histolojik tipleri gibi demografik özellikler kaydedilmiştir. KT’nin en sık yan etkileri olan bulantı, kusma, yorgunluk, iştahsızlık, miyalji, uykusuzluk, döküntü, kabızlık ve ishal gibi yan etkiler kaydedilmiştir. Bulgular: Çalışmaya dahil edilen toplam 117 ileri evre epitelyal over kanserli hastanın 72’sine %61,5 erken kemoterapi, 45’ine %38,5 ise geç kemoterapi başlanmıştır. Hastaların yaş, vücut kütle indeksi, menopoz durumu, sigara kullanımı, tanı anındaki evresi ve tümörün histolojik tipleri açısından gruplar arasında istatistiksel olarak fark saptanmamıştır. En sık görülen yan etki yorgunluk olarak bulunmuştur ve erken KT grubunda geç KT grubuna göre daha fazladır ancak istatistiksel anlamlı fark izlenmemiştir sırasıyla, %52,7 ve %48,8 p=0,118 . Her iki grupta oluşan KT yan etkilerine bakılınca kesi yeri enfeksiyonu, bulantı ve kusma, miyalji, uykusuzluk, döküntü, kabızlık ve diyare açısından da her iki grup arasında istatistiksel fark izlenmemiştir p>0,05 . Sonuç: İleri evre over kanserli hastalarda adjuvan KT tedavisinin başlama zamanının erken dönemde oluşabilecek yan etkiler açısından farklılık göstermediği bulunmuştur

Kaynakça

  • Berek JS. Berek & Novak’s gynecology. Philadelphia: Lippincott Williams & Wilkins. 2012.
  • Webber K, Friedlander M. Chemotherapy for epithelial ovarian, fallopian tube and primary peritoneal cancer. Best Pract Res Clin Obstet Gynaecol 2017; 41:126-38.
  • Omura GA, Bundy BN, Berek JS, Curry S, Delgado G, Mortel R. Randomized trial of cyclophosphamide plus cisplatin with or without doxorubicin in ovarian carcinoma: A Gynecologic Oncology Group study. J Clin Oncol 1989; 7:457-65.
  • Flynn PM, Paul J, Cruickshank DJ, Scottish Gynaecological Cancer Trials G. Does the interval from primary surgery to chemotherapy influence progression-free survival in ovarian cancer? Gynecol Oncol 2002; 86:354-7.
  • Gadducci A, Sartori E, Landoni F, Zola P, Maggino T, Maggioni A, Cosio S, Frassi E, LaPresa MT, Fuso L, Cristofani R. Relationship between time interval from primary surgery to the start of taxane- plus platinum- based chemotherapy and clinical outcome of patients with advanced epithelial ovarian cancer: Results of a multicenter retrospective Italian study. J Clin Oncol 2005; 23:751-8.
  • Paulsen T, Kaern J, Kjaerheim K, Haldorsen T, Trope C. Influence of interval between primary surgery and chemotherapy on short-term survival of patients with advanced ovarian, tubal or peritoneal cancer. Gynecol Oncol 2006; 102:447-52.
  • Wright J, Doan T, McBride R, Jacobson J, Hershman D. Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival. Br J Cancer 2008; 98:1197-203.
  • ElNaggar AC, Hade EM, O’Malley DM, Liang MI, Copeland LJ, Fowler JM, Salani R, Backes FJ, Cohn DE. Time to chemotherapy in ovarian cancer: Compliance with ovarian cancer quality indicators at a National Cancer Institute-designated Comprehensive Cancer Center. Gynecol Oncol 2018; 151:501-5.
  • Gloeckler Ries LA, Reichman ME, Lewis DR, Hankey BF, Edwards BK. Cancer survival and incidence from the Surveillance, Epidemiology, and End Results (SEER) program. Oncologist 2013; 8:541-52.
  • Gunduz N, Fisher B, Saffer EA. Effect of surgical removal on the growth and kinetics of residual tumor. Cancer Res 1979; 39:3861-5.
  • Eggermont AM, Steller EP, Sugarbaker PH. Laparotomy enhances intraperitoneal tumour growth and abrogates the antitumor effects of interleukin-2 and lymphokine- activated killer cells. Surgery 1987; 102(1):71-8.
  • Ono I, Gunji H, Suda K, Iwatsuki K, Kaneko F. Evaluation of cytokines in donor site wound fluids. Scand J Plast Reconstr Surg Hand Surg 1994; 28(4):269-73.
  • Frindel E, Malaise EP, Alpen E, Tubiana M. Kinetics of cell proliferation of an experimental tumour. Cancer Res 1967; 27(6):1122-31.
  • Goldie JH, Coldman AJ. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep 1979; 63:1727-33.
  • Goldie JH, Coldman AJ. The genetic origin of drug resistance in neoplasms: Implications for systemic therapy. Cancer Res 1984; 44:3643-53.
  • Lohrisch C, Paltiel C, Gelmon K, Speers C, Taylor S, Barnett J, Olivotto IA. Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol 2006; 24:4888- 94.
  • Biagi JJ, Raphael MJ, Mackillop WJ, Kong W, King WD, Booth CM. Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer: A systematic review and meta-analysis. Jama 2011; 305(22):2335-42.
  • Mahner S, Eulenburg C, Staehle A, Wegscheider K, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J, du Bois A. Prognostic impact of the time interval between surgery and chemotherapy in advanced ovarian cancer: Analysis of prospective randomised phase III trials. Eur J Cancer 2013; 49(1):142-9.
  • Tewari KS, Java JJ, Eskander RN, Monk BJ, Burger RA. Early initiation of chemotherapy following complete resection of advanced ovarian cancer associated with improved survival: NRG Oncology/Gynecologic Oncology Group study. Ann Oncol 2016; 27:114-21.
  • Hsu HC, Tsai SY, Wu SL, Jeang SR, Ho MY, Liou WS, Chiang AJ, Chang TH. Longitudinal perceptions of the side effects of chemotherapy in patients with gynecological cancer. Support Care Cancer 2017; 25:3457-64.
  • Seretny M, Currie GL, Sena ES, Ramnarine S, Grant R, MacLeod MR, Colvin LA, Fallon M. Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta- analysis. PAIN 2014; 155:2461-70.
  • Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, Itri LM, Johnson DH, Scherr SL, Portenoy RK. Patient, caregiver and oncologist perceptions of cancer-related fatigue: Results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol 1997; 34:4-12.
  • Ruffer JU, Flechtner H, Tralls P, Josting A, Sieber M, Lathan B, Diehl V. Fatigue in long-term survivors of Hodgkin’s lymphoma; A report from the German Hodgkin Lymphoma Study Group (GHSG). Eur J Cancer 2003; 39:2179-86.
  • Shields K, Craig C, Baxter L, Renda L, Pipe J, Monk B, Chase D. Cancer-related fatigue in gynecologic oncology patients undergoing chemotherapy. Gynecol Oncol 2015; 137:596.
  • Paul J, Hesketh N. Chemotherapy induced nausea and vomiting. Engl J Med 2008; 358(23):2482-94.
  • Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA, Danso MA, Dennis K, Dupuis LL, Dusetzina SB, Eng C, Feyer PC, Jordan K, Noonan K, Sparacio D, Somerfield MR, Lyman GH. Antiemetics: American society of clinical oncology clinical practice guideline update. J Clin Oncol 2017; 35(28):3240-61.

Comparison of the Relationship Between Initiation Time and Side Effects of Adjuvant Chemotherapy in Patients with Advanced Stage Ovarian Cancer

Yıl 2019, Cilt: 5 Sayı: 3, 532 - 537, 01.01.2019

Öz

Objective: Platinum and taxane-based regimens are the first-line treatment for adjuvant therapy in advanced epithelial ovarian cancer EOC . Significant systemic and peripheral side effects are observed following adjuvant chemotherapy CT . In this study, we aimed to investigate the relationship between the initiation time and the side effects of adjuvant chemotherapy after primary cytoreductive surgery in patients with advanced stage EOC.Material and Methods: In this study, the data of 117 patients who underwent cytoreduction operation due to advanced stage EOC were analyzed retrospectively. Early adjuvant chemotherapy was performed in 72 patients and late adjuvant chemotherapy in 45 patients. Demographic characteristics such as age, body mass index, menopausal status, smoking, stage and histological types of the tumor were recorded. Side effects such as nausea, vomiting, fatigue, loss of appetite, myalgia, insomnia, rash, constipation and diarrhea were recorded.Results: Of the 117 advanced stage epithelial ovarian cancer patients, 72 61.5% received early chemotherapy and 45 38.5% received late chemotherapy. There was no statistically significant difference between the groups in terms of age, body mass index, menopausal status, smoking, stage and histological types of tumor. The most common side effect was fatigue and was more common in the early CT group than in the late CT group, but with no statistically significant difference 52.7% and 48.8%, respectively p=0.118 . There was no statistically significant difference between the two groups in terms of incision site infection, nausea and vomiting, myalgia, insomnia, rash, constipation and diarrhea p>0.05 .Conclusion: The time of initiation of adjuvant chemotherapy in advanced ovarian cancer patients did not make a difference in terms of early side effects

Kaynakça

  • Berek JS. Berek & Novak’s gynecology. Philadelphia: Lippincott Williams & Wilkins. 2012.
  • Webber K, Friedlander M. Chemotherapy for epithelial ovarian, fallopian tube and primary peritoneal cancer. Best Pract Res Clin Obstet Gynaecol 2017; 41:126-38.
  • Omura GA, Bundy BN, Berek JS, Curry S, Delgado G, Mortel R. Randomized trial of cyclophosphamide plus cisplatin with or without doxorubicin in ovarian carcinoma: A Gynecologic Oncology Group study. J Clin Oncol 1989; 7:457-65.
  • Flynn PM, Paul J, Cruickshank DJ, Scottish Gynaecological Cancer Trials G. Does the interval from primary surgery to chemotherapy influence progression-free survival in ovarian cancer? Gynecol Oncol 2002; 86:354-7.
  • Gadducci A, Sartori E, Landoni F, Zola P, Maggino T, Maggioni A, Cosio S, Frassi E, LaPresa MT, Fuso L, Cristofani R. Relationship between time interval from primary surgery to the start of taxane- plus platinum- based chemotherapy and clinical outcome of patients with advanced epithelial ovarian cancer: Results of a multicenter retrospective Italian study. J Clin Oncol 2005; 23:751-8.
  • Paulsen T, Kaern J, Kjaerheim K, Haldorsen T, Trope C. Influence of interval between primary surgery and chemotherapy on short-term survival of patients with advanced ovarian, tubal or peritoneal cancer. Gynecol Oncol 2006; 102:447-52.
  • Wright J, Doan T, McBride R, Jacobson J, Hershman D. Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival. Br J Cancer 2008; 98:1197-203.
  • ElNaggar AC, Hade EM, O’Malley DM, Liang MI, Copeland LJ, Fowler JM, Salani R, Backes FJ, Cohn DE. Time to chemotherapy in ovarian cancer: Compliance with ovarian cancer quality indicators at a National Cancer Institute-designated Comprehensive Cancer Center. Gynecol Oncol 2018; 151:501-5.
  • Gloeckler Ries LA, Reichman ME, Lewis DR, Hankey BF, Edwards BK. Cancer survival and incidence from the Surveillance, Epidemiology, and End Results (SEER) program. Oncologist 2013; 8:541-52.
  • Gunduz N, Fisher B, Saffer EA. Effect of surgical removal on the growth and kinetics of residual tumor. Cancer Res 1979; 39:3861-5.
  • Eggermont AM, Steller EP, Sugarbaker PH. Laparotomy enhances intraperitoneal tumour growth and abrogates the antitumor effects of interleukin-2 and lymphokine- activated killer cells. Surgery 1987; 102(1):71-8.
  • Ono I, Gunji H, Suda K, Iwatsuki K, Kaneko F. Evaluation of cytokines in donor site wound fluids. Scand J Plast Reconstr Surg Hand Surg 1994; 28(4):269-73.
  • Frindel E, Malaise EP, Alpen E, Tubiana M. Kinetics of cell proliferation of an experimental tumour. Cancer Res 1967; 27(6):1122-31.
  • Goldie JH, Coldman AJ. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep 1979; 63:1727-33.
  • Goldie JH, Coldman AJ. The genetic origin of drug resistance in neoplasms: Implications for systemic therapy. Cancer Res 1984; 44:3643-53.
  • Lohrisch C, Paltiel C, Gelmon K, Speers C, Taylor S, Barnett J, Olivotto IA. Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol 2006; 24:4888- 94.
  • Biagi JJ, Raphael MJ, Mackillop WJ, Kong W, King WD, Booth CM. Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer: A systematic review and meta-analysis. Jama 2011; 305(22):2335-42.
  • Mahner S, Eulenburg C, Staehle A, Wegscheider K, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J, du Bois A. Prognostic impact of the time interval between surgery and chemotherapy in advanced ovarian cancer: Analysis of prospective randomised phase III trials. Eur J Cancer 2013; 49(1):142-9.
  • Tewari KS, Java JJ, Eskander RN, Monk BJ, Burger RA. Early initiation of chemotherapy following complete resection of advanced ovarian cancer associated with improved survival: NRG Oncology/Gynecologic Oncology Group study. Ann Oncol 2016; 27:114-21.
  • Hsu HC, Tsai SY, Wu SL, Jeang SR, Ho MY, Liou WS, Chiang AJ, Chang TH. Longitudinal perceptions of the side effects of chemotherapy in patients with gynecological cancer. Support Care Cancer 2017; 25:3457-64.
  • Seretny M, Currie GL, Sena ES, Ramnarine S, Grant R, MacLeod MR, Colvin LA, Fallon M. Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta- analysis. PAIN 2014; 155:2461-70.
  • Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, Itri LM, Johnson DH, Scherr SL, Portenoy RK. Patient, caregiver and oncologist perceptions of cancer-related fatigue: Results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol 1997; 34:4-12.
  • Ruffer JU, Flechtner H, Tralls P, Josting A, Sieber M, Lathan B, Diehl V. Fatigue in long-term survivors of Hodgkin’s lymphoma; A report from the German Hodgkin Lymphoma Study Group (GHSG). Eur J Cancer 2003; 39:2179-86.
  • Shields K, Craig C, Baxter L, Renda L, Pipe J, Monk B, Chase D. Cancer-related fatigue in gynecologic oncology patients undergoing chemotherapy. Gynecol Oncol 2015; 137:596.
  • Paul J, Hesketh N. Chemotherapy induced nausea and vomiting. Engl J Med 2008; 358(23):2482-94.
  • Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA, Danso MA, Dennis K, Dupuis LL, Dusetzina SB, Eng C, Feyer PC, Jordan K, Noonan K, Sparacio D, Somerfield MR, Lyman GH. Antiemetics: American society of clinical oncology clinical practice guideline update. J Clin Oncol 2017; 35(28):3240-61.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Yakup Yalçın Bu kişi benim

Mustafa Karaca Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 5 Sayı: 3

Kaynak Göster

Vancouver Yalçın Y, Karaca M. İleri Evre Over Kanserli Hastalarda Adjuvan Kemoterapinin Başlama Zamanı ile Yan Etkileri Arasındaki İlişkinin Karşılaştırılması. Akd Tıp D. 2019;5(3):532-7.