Biomedical subjects

Hilmi Kocaoglu

Publications and source records attributed to Hilmi Kocaoglu.

6 recordsLinked to original sources

PubMedDate not supplied

Long-term survival after regional chemotherapy for liver metastases from breast cancer. A case report.

The prognosis of patients with liver metastases from breast cancer has to be regarded as rather unfavorable. A 45-year-old woman with cancer of the left breast and multiple simultaneous liver metastases was initially treated with cyclophosphamide, methotrexate, and 5-fluorouracil. After two treatment cycles a sonogram of the left breast revealed reduction of the tumor size and she underwent a modified radical mastectomy and hepatic artery catheterization. There was no change in the multiple lesions of the liver on abdominal ultrasonography. One week later a regional chemotherapy regimen was given through a hepatic arterial catheter with subcutaneous implanted reservoir. After completion of the seventh course of chemotherapy, ultrasonography revealed that the multiple liver metastases had regressed completely. To date (July 2001) there has been no relapse during the seven-year follow-up period. In conclusion, we suggest that intra-arterial regional chemotherapy may have an important role to play in the management of breast cancer patients with isolated liver metastases.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

An alternative method for preventing extravasation complications in vascular access catheters with reservoirs for subcutaneous infusion: the double injection technique.

Long-term intravascular access catheters with reservoirs are a common requirement for cancer patients. Complications resulting from the use of these devices have been studied in several single-institution investigations, the consensus being that they are safe and have a low complication rate. However, extravasation may occur especially in obese patients due to accidental infusion of the subcutaneous tissue. To prevent this problem we describe an easy method that could be an alternative to the widely used ultrasonography-guided injection method.

Antineoplastic Agents↗

PubMedDate not supplied

Regional chemotherapy-induced cure for pancreatic head carcinoma.

Pancreatic carcinoma has a devastating prognosis. The only hope for cure for many patients is still surgery while the disease is at the early stages. Chemotherapy (systemic/regional) or radiotherapy has been shown to be helpful in the palliation of the disease but not for cure. We reported a pancreatic head carcinoma, which was cured only by regional chemotherapy. To the best of our knowledge this is the first case in the literature.

Adenocarcinoma↗

PubMedDate not supplied

Regional chemotherapy for advanced pancreatic carcinoma.

BACKGROUND/AIMS: Since 1990, 14 patients with advanced pancreatic cancer were treated by regional chemotherapy. Five patients had locally advanced unresectable cancer and 9 had locally advanced disease with liver metastasis. METHODOLOGY: Fourteen patients underwent laparotomy, splenic artery catheterization and received a mean therapy of 3.8 cycles and 3 patients had completed 6 cycles of chemotherapy. Every cycle given monthly consisted of 5-fluorouracil 600 mg/m2 3 days, mitomycin 10 mg/m2 1 day, and cisplatinum 60 mg/m2 1 day. Tumor response was evaluated on the basis of imaging methods, tumor markers and life quality marker pain relief. RESULTS: Four patients had stabilization, 4 had partial response, 5 had progression and 1 had complete response. Median survival was 8 months for the whole group. Palliation for pain was successful and 71.4% of the patients had pain palliation. One patient had complete, 1 patient had partial, 8 patients had stable pain relief. Four patients had poor response to treatment and had progressive pain. Side effects, mainly leukopenia and thrombocytopenia, occurred in 5 patients and responded to medical measures. Mild to moderate nausea and vomiting was common and they responded well to antiemetic treatment. CONCLUSIONS: Although the objective response rate of regional chemotherapy for overall survival is low, in an individual patient it may produce an adequate response and acceptable toxicity so that the patient experiences overall improvement in symptoms, and rarely as in one case in our group may be cured by this method.

Adult↗

PubMedDate not supplied

Intraperitoneal hyperthermic perfusion may induce bacterial translocation.

BACKGROUND/AIMS: Intraperitoneal hyperthermic perfusion (IPHP) has been used widely in oncologic practice. Hyperthermia is known to decrease the interstitial pressure. Also intraperitoneal hyperthermia may alter the intestinal mucosal barrier and the intestinal bacterial flora. These changes may lead to bacterial translocation (BT). To the best of our knowledge, there is no data about the possible role of IPHP on BT. METHODOLOGY: Fifty-one rats were divided into two groups. Group I (n=36) received IPHP by heated isotonic salt solution at a temperature of of 43.0 degrees C and group II (n=15) received intraperitoneal normothermic lavage by isotonic salt solution at 37.0 degrees C. Each group was divided into three subgroups which were sacrificed at 1st (Ia, IIa), 3rd (Ib, IIb) and 7th (Ic, IIc) days. Mesenteric lymph nodes (MLN), spleen and liver were sampled and cecal aspirates were obtained. The presence of viable bacteria in samples was noted. Cecal bacterial population levels (CBPL) were reported as colony forming units (CFU). Groups were compared in terms of BT and CBPL. RESULTS: BT was not detected in the Ia (IPHP, 1st day) and IIa,b,c (all control groups). However, statistically significant BT was observed in group Ib and Ic (83.3% and 66.6%, respectively) in comparison to control group (p<0.01). Also there was positive correlation between CBPL and BT. CONCLUSIONS: Intraperitoneal hyperthermia causes remarkable BT. This may explain septic complications after IPHP. Further studies are necessary to better understand the effects of IPHP on the pathophysiology of BT.

Animals↗

PubMedDate not supplied

Pelvic perfusion for locally recurrent unresectable rectal tumors.

BACKGROUND/AIMS: Pelvic perfusion evolved as a palliative and curative treatment modality for advanced pelvic tumors and literature data support its use in different steps of the disease. METHODOLOGY: 15 patients with recurrent rectal tumor, without any systemic metastases were included in the study. Mean age was 49.7 years, 12 males, 3 females. Mean survival was 18 months. RESULTS: 15 unresectable rectal cancer patients were included in this study. Three (20%) complete response, 6 (40%) partial response, 2 stable disease (13.3%) and 4 (26.7%) progression were seen after pelvic perfusion. Mean survival is 26.54 months after perfusion (median=10). In multivariate analysis response rate to isolated perfusion and tumor size are significant factors effecting survival (p<0.05). The patients who did not receive chemotherapy after detection of pelvic recurrence did better (p=0.0086). Response to isolated pelvic perfusion (IPP) is an important factor for survival of locally advanced rectal tumors in log-rank test (p=0.0001). CONCLUSIONS: Isolated pelvic perfusion is a good alternative for non-resectable pelvic malignancies and should be considered as an important part of the multidisciplinary approach for these tumors.

Adenocarcinoma↗