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    Anthracycline-Induced Hepatitis B Reactivation in Solid Organ Cancers: A Multicenter Study
    (Accscience Publishing, 2024) Ugraklı, Muzaffer; Araz, Murat; Koçak, Mehmet Zahid; Ugraklı, Selin; Er, Muhammed Muhiddin; Hendem, Engin; Gürbüz, Ali Fuat
    Objectives: Hepatitis B reactivation is extremely rare in HBsAg-negative/Anti-HBcIgG-positive patients receiving chemotherapy for solid organ cancer in our current practice. In our study, we aimed to investigate the frequency of reactivation and associated risk factors in patients with solid tumors receiving anthracycline-based chemotherapy. Methods: In the study, the records of 3147 patients with solid tumors receiving anthracycline chemotherapy were examined retrospectively. HBsAg negative/Anti-HBcIgG positivity was detected in 196 (6.2%) of the patients. Results: Elevated liver enzymes were found in 45 patients, with the identified causes being adverse effects of chemotherapeutics in 18 (9.1%), liver metastasis in 11 (5.5%), use of antibiotics and analgesics in 7 (3.6%), herbal medications in 7 (3.6%), and Hepatitis B reactivation in 2 (1%) patients. Patients who developed Hepatitis B reactivation had Rheumatoid Arthritis and Systemic Lupus Erythematosus, and were on steroids. Conclusion: In our study, the rates of hepatitis B reactivation after anthracycline chemotherapy in HBsAg negative/ Anti-HBcIgG positive solid tumor patients were found to be lower than those reported in the literature. Our results suggest that prophylactic strategies for hepatitis B reactivation should be repeatedly considered in this group of patients.
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    Comparison of granisetron and palonosetron in triplet anti-emetic prophylaxis in non-small cell lung cancer patients receiving cisplatin-based highly emetogenic chemotherapy
    (Sage Publications Ltd, 2024) Araz, Murat; Beypinar, Ismail; Inci, Fatih; Koral, Lokman; Kocak, Mehmet Zahid; Korkmaz, Mustafa; Demirkiran, Aykut
    Introduction We compared the efficacy of first-generation granisetron and second-generation palonosetron in triplet anti-emetic prophylaxis in patients with non-small cell lung cancer (NSCLC) receiving cisplatin-based high emetogenic chemotherapy (HEC).Methods This prospective, multicenter, non-randomized, observational study was conducted between June 2018 and December 2021. Patients diagnosed with NSCLC who received triplet anti-emetic prophylactic treatment with aprepitant and dexamethasone plus granisetron or palonosetron before the first cycle of chemotherapy were included in the study. At the end of the first week after chemotherapy, the emesis scale was applied to the patients during the outpatient control. The primary endpoint was complete response (CR) and total control (TC).Results One hundred twenty-one patients were included in the study. Sixty-one patients were in the granisetron group and 60 patients were in the palonosetron group. CR was higher with granisetron in the acute phase (70.5% vs. 58.3%, p = 0.16; respectively) and higher with palonosetron in the delayed phase (61.7% vs. 55.7%, p = 0.5; respectively), although not statistically significant. The TC rates were also not significantly different between the groups (54.1% vs.57.6%, p = 0.69).Conclusions There was no significant difference between granisetron and palonosetron in both acute and delayed control of emesis in NSCLC patients receiving cisplatin-based HEC.
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    Comparison of palonosetron and granisetron in triplet antiemetic therapy in nonmetastatic breast cancer patients receiving high emetogenic chemotherapy: a multicenter, prospective, and observational study
    (Springer, 2019) Araz, Murat; Karaagac, Mustafa; Korkmaz, Levent; Koral, Lokman; Inci, Fatih; Beypinar, Ismail; Uysal, Mukremin
    PurposeWe aimed to investigate the efficacy of 0.25mg dose of palonosetron and granisetron in triplet antiemetic prophylaxis in breast cancer patients receiving HEC.MethodsPatients with nonmetastatic breast cancer who received HEC [doxorubicin or epirubicin plus cyclophosphamide (AC/EC)] were enrolled in the study. The prophylactic triplet antiemetic regimens were used according to the doctor's preference during the first cycle of HEC as intravenous dexamethasone and palonosetron 0.25mg or granisetron 3mg on day 1 as well as oral aprepitant (125mg on day 1 and 80mg on days 2 and 3).The primary endpoint was complete response rate (CR) on acute and delayed chemotherapy-induced nausea and vomiting (CINV), separately.ResultsA total of 118 female patients were included in the study. Patients received AC (83%), EC (3%), and dose-dense AC (14%) as adjuvant (88%) or neoadjuvant (12%). The majority of patients received palonosetron (59%) containing antiemetic treatment. The CR rate on acute and delayed vomiting was very high and not statistically different in both of the arms (acute 87% vs. 96%, p=0.089; delayed 90% vs. 92%, p=0.489), respectively. Nevertheless, the CR rate on either acute or delayed nausea was lower than vomiting (acute 51% vs. 51%; delayed 38% vs. 29%, p=0.203; respectively).ConclusionsThis is the second study that compared a 0.25mg dose of palonosetron with first-generation setron in triplet antiemetic prophylaxis in cancer patients receiving HEC. We could not find meaningful statistical differences between two arms, regarding CR rate on acute and delayed CINV.