Zahide YILMAZ, Serhan YILDIRIM, Ülkü Türk BÖRÜ

Sisplatin ve Dosetaksel Kullanan Küçük Hücreli Dışı Akciğer Kanserli Hastalarda İnme Sıklığının Değerlendirmesi

GİRİŞ ve AMAÇ: İnme, beyin damar hastalığını takip ederek ortaya çıkan klinik bir durumu, ani bir nörolojik yetersizliği ifade eder ve hasarın patolojisine göre iskemik ve kanayıcı olarak iki alt gruba ayrılır. Sisplatin ve dosetaksel çeşitli kanserlerin tedavisinde kullanılan bir ilaçtır. Bizim bu çalışmadaki amacımız, sisplatin ile birlikte dosetaksel alan küçük hücre dışı akciğer kanseri hastalarında tedavi esnasında veya sonrasında inme sıklığını araştırmaktı. YÖNTEM ve GEREÇLER: Tıbbi Onkoloji Kliniği’nde küçük hücre dışı akciğer kanseri tanısı olan ve 21 günde bir en az 6 kür sisplatin 75mg/m2 ile birlikte dosetaksel 75mg/m2 tedavisi alan ve 18 yaşından büyük hastalar ileriye dönük olarak 6 ay süre ile takip edildi. Çalışmaya alınan hastaların ne zaman tanı aldığı, metastazı olup olmadığı sorgulandı ve nörolojik muayenesi yapıldı. İlaç tedavisi tamamlandığında hastaların tedavi esnasında ve sonrasında inme geçirip geçirmediği, inme geçirdi ise türü (hemorajik/iskemik) sorgulandı. BULGULAR: İzlem süresinde hastaların 6 (%3) tanesinde iskemik inme gelişti. Bu hastaların 4’ü (%2,3) erkek, 2’si (%7,7) kadındı. 61 (%31) hastada lenf nodu, 25 (%12,7) hastada beyin, 24 (%12,2) hastada kemik, 7 (%3,6) hastada sürrenal, 4 (%2) hastada karaciğer metastazı saptandı. Beyin ve kemik metastazı olması ile iskemik inme arasında ilişki saptanmadı (sırasıyla p=0,075, p=0,169, p=0,112). TARTIŞMA ve SONUÇ: Sisplatin ve dosetaksel alan küçük hücre dışı akciğer kanserli hastalarda kanserin kendisi ya da tedavilerin yan etkisi ile beyin damar hastalıkları neredeyse 10 kata kadar artmaktadır.

Evaluation of Stroke Frequency in Non-Small Cell Lung Cancer Patients Receiving Cisplatin and Docetaxel

INTRODUCTION: Stroke refers to a clinicalcondition following cerebrovascular disease and asudden neurological failure. It's divided into twosubgroups according to damage pathology. Cisplatinand docetaxel are drugs used in various cancertreatments. In this study, we aimed to investigate thefrequency of stroke in non-small cell lung cancerpatients receiving docetaxel with cisplatin during andafter the therapyMETHODS: Patients, over 18 diagnosed with non-smallcell lung cancer and receiving at least six therapies ofdocetaxel(75mg/m2) and cisplatin(75mg/m2) in every 21days, were monitored prospectively in Medical OncologyClinique for 6 months. Patients were questioned whenthey were diagnosed with cancer and if they havemetastases, then the neurological examination wasperformed. When the drug treatment was completed, thepatients were questioned as to whether they experiencedstroke during or after the therapy. If they experiencedstroke, its type (hemorrhagic / ischemic) was examined.RESULTS: During the follow-up period, ischemic strokedeveloped in six (3%) of the patients. Four of thesepatients(2.3%) were male, two (7.7%) were female. Lymphnode metastasis in 61 (31 %) patients, brain metastasis in25 (12.7%), bone metastasis in 24 (12.2%), surrenalmetastasis in 7 (3.6 %) and liver metastasis in 4 patients (2%) were determined. There wasn't correlation betweenbrain and bone metastasis and ischemic stroke (p = 0,075,p = 0,169, p = 0,112, respectively).DISCUSSION and CONCLUSION: Cisplatin anddocetaxel use in patients with non-small cell lung cancerincrease cerebrovascular diseases up to ten folds due to thecancer itself or side effects of treatments.

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