Acute infusion reactions to chemotherapeutic drugs: a single institute experience.

PURPOSE: Treating cancer often involves the use of chemotherapeutic agents. Due to the growing incidence of cancer worldwide and the expanding number of treatment options, it is important to understand the risks of adverse events associated with these treatments. In this study, we monitored the occurrence of acute infusion reactions in an outpatient chemotherapy center from April 2011 to April 2012. METHODS: For patients who developed infusion reactions, the causative drug, the dose and number of treatments received, the onset time of the reaction, the duration of the reaction, blood pressure, pulse, level of oxygen saturation during the reaction, and other symptoms were recorded. The severity of reactions was determined in accordance with NCI toxicity criteria. A reaction was considered as grade 1-2 (mild-moderate) if the patient experienced flushing, rash, fever, tremor, dyspnea, rigor, and mild hypotension. Symptoms such as severe hypotension, bronchospasm, cardiac dysfunction and anaphylaxis, requiring therapeutic intervention, were classified as severe, grade 3-4 reactions. RESULTS: Of the 2213 patients receiving chemotherapy during the study period, 138 (62%) developed an infusion reaction to the treatment. Among 138 patients most commonly treated types of carcinoma included breast (39.2%), lung (17.8%), colorectal (10%), and ovarian (8.5%) cancers. Docetaxel administration resulted in the largest number of infusion reactions, though most reactions were mild to moderate and did not require the cessation of treatment. Patients with mild to moderate reactions (89.2%) were able to continue treatment, while those who developed severe reactions (10.8%) could not continue treatment with the same agent. CONCLUSION: Although severe reactions are rare, the incidence of mild to moderate reactions against taxanes, platinum compounds, and monoclonal antibodies is quite high. Clinical symptoms do not vary widely among the agents, though the onset time of symptoms does vary. While reactions against platinum agents were of type 1 anaphylactic reactions, reactions against taxanes and monoclonal antibodies during the first infusion and in the following minutes suggest the activation of different mechanisms.

Effectiveness of temozolomide treatment used at the same time with radiotherapy and adjuvant temozolomide; concomitant therapy of glioblastoma multiforme: multivariate analysis and other prognostic factors.

AIM: Prognostic factors which affect treatment results of glioblastoma multiforme (GBM; WHO Grade IV) patients has been investigated in many researches. For these patients determination of prognostic factors helps generating multimodal therapy protocols. For this purpose, in the Baskent University Medical School, Neurosurgery Clinic, Adana Medical Research Center, specific characteristics of GBM patients who have surgery retrospectively investigated and factors which affect prognosis has been determined. METHODS: Between January 2005 and January 2009, 59 patients (25 female, 34 male) who have GBM have been evaluated retrospectively. Mean follow-up period was 27.4 (+/-17.3) months. Headache (66.1%) was the most seen symptom. Time of diagnosis was 1-2 months for most of the patients (54.2%). Fifty-nine patients had 67 operations totally. Preoperative Karnofski Performance Scale (KPS) was >or=70 for 43 operations, or=70, for 26 operations KPSor=70 (P=0.0000) , postoperative KPS 2 was >or=70 (P=0.0000), type of tumor resection (P=0.00002), multiple operations (P=0.001), adjuvant RT (P=0.0000) and ConcT with adjuvant TMZ (P=0.0000) were all positive prognostic factors which extend the survival. After multivariate analysis, post operative KPS was >or=70 (P=0.003; OR:0.89; % 95 CI:0.83-0.96), type of resection (P=0.055; OR:0.37; % 95 CI:0.13-0.12) and multiple operations (P=0.042; OR:2.65; % 95 CI:1.03-6.82) were independent prognostic factors. CONCLUSION: When independent prognostic factors were examined ,median survival found out 7.8 months longer fort he patients whose postoperative KPS were >or=70, 5.7 months longer for the patients who had radical resection, 6.6 months longer for the patients who had multiple operations. Although patients who had ConcT with adjuvant TMZ had 1.7 months longer survival compared to patients who had only adjuvant RT, it was not determined as an independent prognostic factor.

Colon adenocarcinoma and solitary tibia metastasis: rare entity.

INTRODUCTION: Colorectal cancer is the third leading cause of cancer-related deaths in the world. Mostly, death occurs with complications of distant metastases. DISCUSSION: Effective systemic chemotherapy regimen and resultant improved survival for patients are associated with an increased incidence of metastases at uncommon sites. Therefore, incidences of osseous metastases are rising at the last decade. Osseous metastases are mostly diffuse, along with visceral metastases. CONCLUSION: Most common osseous metastatic sites are lumbal, sacral vertebrae, and pelvis region, probably because of colonic anatomical proximity to the paravertebral venous plexus. Herein, we report an uncommon case of isolated solitary tibia metastasis in the colorectal cancer patient and management of disease course.