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  • Küçük Resim
    Öğe
    The effect of chloroquine treatment in malignant astrocytomas on prognosis
    (2013) Bulut, Turgay; Ekici, Mehmet Ali; Tucer, Bülent; Başarslan, Seyit Kaan; Kamaşak, Kağan; Kurtsoy, Ali
    Aim: To investigate the adjuvant role of the antimutagenic agent chloroquine in the treatment of patients with malignant astrocytomas (MAs). Materials and methods: Clinical research was conducted at the Neurosurgery Clinic of the Erciyes University School of Medicine, from September 2003 to April 2007, on 37 patients diagnosed with MA after tumor resection subsequent to craniotomy. Chloroquine treatment was started on a daily dose of 150 mg, additional to the patients’ radiotherapy and chemotherapy protocol, and was continued throughout the 43-month surveillance period. A control group was formed of 81 patients with MA after the craniotomy. Results: While the mean survival time of the patients who were treated with chloroquine was found to be 15 months, during the observation period 7 of these patients (18.9%) were alive throughout. In the control group, 20 patients (35.1%) were alive throughout the observation period and their mean survival time was 17 months. There were no statistical differences between the control and chloroquine groups (P > 0.05). Conclusion: The chloroquine treatment was not been found to be effective for the medical treatment of MAs
  • Küçük Resim
    Öğe
    Malign transformation in the low grade astrocytomas and related factors
    (2012) Kaan Kamasak; Ekici, Mehmet Ali; Göçmez, Cüneyt; Tucer, Bülent; Başarslan, Seyit Kaan; Kurtsoy, Ali
    AMAÇ: Düşük dereceli astrositomlarda prognostik faktörlerin retrospektif olarak araştırılması. YÖNTEM ve GEREÇLER: Bu çalışmada, Erciyes Üniversitesi Tıp Fakültesi Nöroşirurji Kliniği’nde Mayıs 1998 ile Aralık 2005 tarihleri arasında kraniyotomi sonrası düşük dereceli astrsositom tanısı almış toplam 67 olgunun prospektif olarak tanımlanan ve prognoz üzerine etkin olabileceği varsayılan prognostik faktörler incelendi. Olguların demografik, nörolojik, radyolojik, cerrahi ve klinik özellikleri ile adjuvan tedavilerinin prognostik kriterler olarak değerlendirmesi ve prognozla olan ilişkileri incelendi. Olguların operasyona alındığı tarihten sonraki kümülatif yaşam süresi, Kaplan-Meier yöntemi kullanılarak belirlendi. Alt gruplara ait hayatta kalış süresi eğrisi, Log Rank testi kullanılarak karşılaştırıldı. Cox regresyon yöntemiyle, olguların hayatta kalışlarına ilişkin çoklu değişkenlerin etkisi analiz edildi. BULGULAR: Subtotal rezeksiyon grubunun 9 hastasında kötücül dönüşüm görüldü, fark istatistiksel olarak anlamlıydı(<0,01). Bir bayan (%3,2) ve 8 erkek (%22,2) hastada kötücül dönüşüm tespit edildi aradaki fark istatistiksel olarak anlamlıydı (P<0,05). Postoperatif radyoterapi verilen 7 hastada kötücül dönüşüm tespit edilirken radyoterapi almayan grupta sadece 2 hastada tespit edildi, gruplar arası karşılaştırmada istatistiksel anlamlı fark ortaya çıktı (P=0,01). SONUÇ: Radyoterapi alan olgularla, almayanlar kıyaslandığında malign dönüşümün radyoterapi alanlarda daha fazla görülmesi ve istatistiksel olarak farklılığın anlamlı olması radyoterapiyle ilgili tedavi planlarını yeniden gözden geçirmemizi gerektirmektedir.
  • Küçük Resim
    Öğe
    Prognostic factors in patients with glioblastoma multiforme (clinical research)
    (2013) Ekici, Mehmet Ali; Bulut, Turgay; Tucer, Bülent; Başarslan, Seyit Kağan; Kurtsoy, Ali
    Aim: To define the independent variables that affect the life spans of patients with glioblastoma multiforme (GBM). Materials and methods: This study was conducted in the neurosurgery clinic of Erciyes University’s Faculty of Medicine, lasting from February 2000 to September 2006. A total of 98 patients were diagnosed with GBM after tumor resections. Patients’ demographic, neurological, radiological, surgical, and clinical features and adjunct therapies were analyzed retrospectively. Results: Of the 98 patients, 36 (36.7%) were female and 62 (65.4%) were male. There were 15 patients (15.3%) still alive. The median survival time (MST) of the gross total resection and subtotal resection groups was 12 and 8 months, respectively. The group with postoperative Karnofsky performance scores (KPS) of &#8805;70 included 56 patients; their survival rate was 19.6% and their MST was 14 months (confidence interval [CI] 95%, 10–18). The postoperative KPS of <70 group included 42 patients; their MST was 4 months (CI 95%, 3–6) and their survival rate was 9.5%. After the radiotherapy, of the 73 patients who underwent chemotherapy, the survival rate was 19.2% and the MST was 14 months (CI 95%, 10–18). The group without chemotherapy had a MST of 2 months (CI 95%, 1–3) and a survival rate of 4%. In a univariate analysis, the MST of age groups I (<45), II (45–59), and III (&#8805;60) were 15 months (CI 95%, 7–23), 10 months (CI 95%, 7–13), and 5 months (CI 95%, 3–7), respectively. The preoperative and postoperative median tumor volume detected was 79 (14–668) and 6 (0–64) mm3, respectively. Conclusion: Multivariate Cox regression analyses showed that prognostic factors are young age, postoperative KPS, chemotherapy, and postoperative tumor volume.