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Objective Rectal toxicity is one of the primary dose-limiting side effects of prostate cancer radiotherapy, and consequential impairment on quality of life in these patients with long survival is an important problem. In this study, we aimed to evaluate the possibility of predicting rectal toxicity with artificial intelligence model which was including certain dosimetric parameters. Materials and methods One hundred and thirty-seven patients with a diagnosis of prostate cancer who received curative radiotherapy for prostate +/− pelvic lymphatics were included in the study. The association of the clinical data and dosimetric data between early and late rectal toxicity reported during follow-up was evaluated. The sample size was increased to 274 patients by synthetic data generation method. To determine suitable models, 15 models were studied with machine learning algorithms using Python 2.3, Pycaret library. Random forest classifier was used with to detect active variables. Results The area under the curve and accuracy were found to be 0.89–0.97 and 95%–99%, respectively, with machine learning algorithms. The sensitivity values for acute and toxicity were found to be 0.95 and 0.99, respectively. Conclusion Early or late rectal toxicity can be predicted with a high probability via dosimetric and physical data and machine learning algorithms of patients who underwent prostate +/− pelvic radiotherapy. The fact that rectal toxicity can be predicted before treatment, which may result in limiting the dose and duration of treatment, makes us think that artificial intelligence can enter our daily practice in a short time in this sense. [ABSTRACT FROM AUTHOR]

Background: Curative thoracic radiotherapy (CTRT) with concurrent chemotherapy has been considered as standard treatment approach for stage-III non-small cell lung cancer (NSCLC). The hematological and esophageal toxicities that have been encountered during CTRT would affect the immunonutritional status of the patients. The aim of this study is to evaluate the prognostic value of the change in pre- and post-treatment prognostic nutritional index (PNI) in stage-III NSCLC patients. Methods: Eighty seven consecutive stage III NSCLC patients' data were collected. Pre-radiotherapy (RT) and post-RT PNI values were calculated and the impact of prognostic value of PNI change on overall survival (OS) was evaluated by univariate and multivariate Cox regression analyses. A cutoff value of PNI change was obtained by receiver operator characteristic (ROC) curve analysis. Results: The cutoff value was found to be a 22% decrease in PNI by ROC curve analysis in terms of effect on OS. The median OS of low and high PNI decrease groups were 22.5 and 16.5 months respectively (P = 0,001). In univariate and multivariate analyses PNI decrease of = 22% was found to be an independent poor prognostic factor for OS (P = 0.012) and hazard ratio (95% confidence interval)= 2.05 (1.16-3.62). Conclusion: The PNI change would be a convenient parameter to assess the immunonutritional status of the patient at the end of CTRT. A decrease of more than 22% of PNI value may predict poor prognosis. [ABSTRACT FROM AUTHOR]

Objective: Treatment side effects lead to a negative impact on the quality of life in breast cancer survivors. Exercise is reported to improve the physical and psychological status of these patients. We aimed to investigate the effect of exercise during radiotherapy on physical and psychological status in breast cancer patients. Material and Method: A randomized controlled study was set in outpatient rehabilitation clinic. Histologically proven stage I-III breast cancer patients referred for adjuvant radiotherapy were randomly assigned to a supervised aerobic and strengthening exercise program or usual medical care without exercise training. The primary outcome parameters were Rosenberg Self Esteem Scale (RSES), Short Form-36 (SF_36) Quality of life, Coping Strategies Questionnaire (COPE Inventory), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI). End points were assessed 1 week prior to and 1 week following 6 weeks of exercise training. Results: In the repeated measured analysis, BAI and FSS scores decreased, general health (GH) and energy/fatigue (E) scores of SF-36 increased in the exercise group (p=0.045, Cohen d=0.757 for BAI, p=0.02, Cohen d=0.863, p=0.010, Cohen d =1.02 for GH, p=0.032, Cohen d=0.801 for E), while the use of problem-based coping score decreased in the control group (p=0.049, Cohen d=0.641). No significant differences were found in scores for BDI and RSES (p>0.05). Conclusion: In conclusion, supervised comined exercise training during adjuvant radiotherapy improved anxiety, fatigue, energy, general health perceptions and prevented decreasing in using effective coping strategies. [ABSTRACT FROM AUTHOR]

Breast fibrosis (BF) is one of the most reported late toxicities following whole breast radiotherapy (WBRT). This study aims to find out biomarkers that can be used in individual risk assessment of BF. The correlation of surgical and dosimetric parameters with BF was also analyzed. Two hundred twenty-three invasive breast carcinoma patients who underwent breast conserving surgery and adjuvant WBRT +/- regional nodal irradiation were included in the study. Age, lumpectomy size, microscopic tumor size, systemic treatment status, the time from surgery to WBRT were the clinicopathological features evaluated. The volume of the whole breast and boost volume and their ratio, the maximum and mean dose of the breast, the dose of 95% of breast volume, the percent of the breast volume that had 50Gy and more (V50), V55, and V60 were the parameters evaluated. Neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte, systemic immune-inflammation index, hemoglobin, and C-reactive protein (CRP) levels before WBRT, the ratio of hemoglobin and CRP levels before and after WBRT were the biomarkers that investigated for prediction of BF. The median follow-up time was 22.5 (6-85.29) months. Grade 1 fibrosis was observed in 107 (47%), and grade 2 fibrosis in 7 (3.1%) patients. In the grade 1-2 fibrosis group lymphatics irradiation rate was higher (51.8% vs 35.8%, p= 0.016) and the treated breast in this group were mostly left-sided (left side percentages: 38.5% vs 56.1%; p= 0.008). CRP-Ratio was the only parameter that had statistically significant ROC curve (Area under the curve: 0.412, p= 0.024). The CRP-Ratio value of 0.544 was found to have the best sensitivity (35.65%) and specificity (84.25%). [ABSTRACT FROM AUTHOR]