Safety and tolerability of first-line bevacizumab in metastatic colorectal cancer.

PURPOSE: To determine the clinical features of bevacizumab-associated toxicities in metastatic colorectal cancer (MCRC) patients. METHODS: The medical records of 60 patients with MCRC who were treated with chemotherapy including bevacizumab in the first-line setting were retrospectively evaluated. RESULTS: Bevacizumab was administered along with irinotecan plus 5-fluorouracil7sol;leucovorin (5-FU/LV) to 44 patients, 57horbar;FU7sol;LV+oxaliplatin to 8 patients, capecitabine+oxaliplatin to 6 patients and 5-FU/LV to 2 patients. The total number of the cycles received was 381 (median 6, range 17horbar;13). The most common bevacizumab-related toxicity was grade 1-2 bleeding (28%) followed by hypertension (17%). Grade 1-2 proteinuria was seen in 8% of the patients (no grade 3-4 proteinuria). Arterial thromboembolic events (ATE) were not observed, however 3 patients (5%) had experienced grade 3-4 venous thromboembolic events. In 3 patients (5%) grade 1-2 wound complications were seen (delayed wound healing in the place of the venous access device in 2, and wound infection in 1). In addition, gastrointestinal perforation (GIP) was seen in 3 (5%) patients. Two of the patients were treated by surgical intervention and one patient died of sepsis. CONCLUSION: Bevacizumab is well tolerated when combined with various chemotherapy regimens. As bevacizumab is becoming widely used in the routine oncology practice, further studies which investigate the mechanism of bevacizumab-associated toxicities are warranted to develop effective management strategies for these adverse events.

Beliefs of Turkish cancer patients on the genesis of cancer: "Why do I have cancer?".

PURPOSE: To determine the beliefs of Turkish cancer patients about the etiology of carcinogenesis. METHODS: The study was carried out at Istanbul Bilim University, European Florence Nightingale Hospital, Department of Medical Oncology. The data were collected during April-June 2008 from 39 women and 23 men. Sociodemographic data form and beliefs on the reasons of carcinogenesis rating scale were used while collecting the data. RESULTS: Of the patients recruited in this study 29 (47%) took it as fate, 28 (45%) as a rightful punishment, 28 (45%) as a result of air pollution and toxins in food, 26 (42%) because of losing a beloved person, 26 (42%) as a result of wrong nutrition, smoking and alcohol consumption. In women the most common belief was fate (n=20, 51%), while in men it was air pollution and toxins in food (n=12, 52%). In primary school graduate patients or patients with no education the most common belief was rightful punishment (n=17, 62%), whereas in university graduate patients it was wrong nutrition, smoking and alcohol consumption (n=12, 63%). CONCLUSION: A considerable proportion of patients behaved in a fatalistic manner. This may cause a risk of taking the responsibility of treatment and control of disease not by the doctor but by other persons. It seems that sex and educational status are important factors in relation with the beliefs of the patients. Meanings attributed to the disease by the patients should be found in order to increase their treatment compliance and be helpful to face off the disease. Patients should also be encouraged to change thoughts that affect treatment process negatively.