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Objective: The prognostic nutritional index (PNI) reflects the immunological response and nutritional status. We evaluated the effect of immunonutrition on PNI in patients with brain tumors receiving chemoradiotherapy and immunonutritional support. Methods: Demographic, laboratory and clinical data were collected retrospectively from 30 consecutive brain tumor patients who received brain chemoradiotherapy between 2019 and 2022 in our clinic and who were given immunonutrition support during their treatment. The cut-off PNI value before adjuvant therapy was calculated in patients who received immunonutrition support in the postoperative period and compared with the PNI values after adjuvant therapy. Results: While glioblastoma patients constitute the majority (60%) of all patients diagnosed as pathological, different histopathological brain tumors were also included in the study (meningioma, oligodendroglioma). The mean albümin value before adjuvant treatment was 4.04 g/dL, while the mean albümin value after adjuvant treatment increased to 4.16 g/dL (p=0,057). The optimal cut-off value for PNI was found to be 45.5 by ROC analysis. PNI was calculated as 49.38 ± 6.03 SD before adjuvant treatment and 49.40 ± 6.12 SD after adjuvant treatment (p>0.05). Retrospective analysis was conducted on over 30 HGG patients who did not receive immunonutritional supplementation containing Arg/gln/HMB (Arginine/glutamine/Beta-Hydroxy Beta-Methylbutyrate). Interestingly, the analysis revealed that the average PNI was 45.15 before adjuvant therapy and decreased to 42.26 after adjuvant therapy, indicating a statistically significant decline in PNI among those without immunonutritional supplementation. This finding suggests a potential beneficial impact of immunonutritional supplementation on PNI. Conclusions: Immunonutrition support has positive effects on PNI and albumin levels in brain tumor patients who will undergo postoperative radiotherapy/chemoradiotherapy. It can be thought that low PNI, which may be an indicator of hematological and nutritional toxicity predicted by brain chemoradiotherapy, can be prevented by immunonutrition support. [ABSTRACT FROM AUTHOR]

OBJECTIVE This is the first study to determine whether there is a relationship between penile bulb radiation dose and urinary incontinence. METHODS This study comprises 131 patients with localized, locally advanced, and pelvic oligometastatic prostate cancer treated at our institution. All patients were treated with IMRT between February 2016 and August 2020. Urinary incontinence after the treatment was assessed retrospectively using a standardized follow-up program based on data available at our center. The urinary incontinence was scored using the CTCAE version 5.0 scoring system. In univariate analysis, the Mann-Whitney test was used to detect any association between penile bulb V50 doses and membranous urethral length on urinary incontinence. RESULTS Urinary incontinence after the treatment was reported in 17 of 131 patients. The average penile bulb V50 values of patients with incontinence were 28.66 gy and 26.8 in patients who did not have urinary incontinence. The mean membranous urethral length was 3.01cm in patients with incontinence and 3.34cm in patients without incontinence. Although these parameters have minimal difference in patients with and without incontinence, they are not statistically significant (p>0.05 all). CONCLUSION Radiation-induced urinary incontinence was not associated with the radiation dose of the penile bulb and membranous urethral length. However, further studies are essential. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of the study was to assess nutritional status among radiation oncology outpatients. METHODS: A total of 394 consecutive oncology outpatients who were screened for nutritional status through nutritional risk screening (NRS) 2002 during their admission to 12 radiation oncology centers across Turkey in October 2018 were included in this cross-sectional screening study. Data on cancer type, time of diagnosis (former and newly diagnosed), and NRS 2002 scores were recorded. Patients with NRS 2002 scores =3 were considered to be at risk of malnutrition necessitating the provision of nutritional intervention. NRS 2002 scores were evaluated in the overall study population as well as according to cancer types and time of diagnosis. RESULTS: NRS 2002 assessment (scores ≤3) revealed 133 (33.8%) patients to be at risk for malnutrition. The highest rates for malnutrition risk were noted for patients with lung cancer (43.8%), head-and-neck cancer (43.5%), and gastrointestinal tumors (42.7%). Poor nutritional status was evident in 36.0% and 25.3% of newly diagnosed and former cancer patients, respectively (p=0.067). CONCLUSION: This screening study revealed malnutrition risk and need for nutritional intervention in 33.8% of cancer patients, including 36.0% of newly diagnosed patients. A need for nutritional intervention was evident in two out of every five patients with newly diagnosed cancer, emphasizing the importance of screening for nutritional risk in every cancer patient at the time of initial diagnosis given the role of appropriate multimodal nutritional intervention before anti-cancer therapy in the long-term success. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The discovery of PD-L1 receptors triggered a great interest in immunotherapeutics for the management of locally advanced non-small-cell lung cancer (NSCLC). The efficacy of immunotherapeutics for overall survival (OS) in locally advanced NSCLC has been proven in several clinical trials. However, no data exist for the relationship between radiotherapy (RT) response and programmed death-ligand (PD-L1) receptor positivity in the literature. In this regard, we aimed to investigate the predictor value of PD-L1 receptors for RT response. METHODS: Eighty patients who were diagnosed as having locally advanced NSCLC were selected from among patients in whom PD-L1 status was assessed in the Gazi University pathology laboratory. The relationship between PD-L1 and progression-free survival (PFS), OS, metastasis-free survival (MFS), RT response, and RT doses was evaluated using Kaplan-Meier and Cox regression analysis. Chi-square and t-tests were used for descriptive statistics. RESULTS: The median follow-up was 16.1 months. The mean age was 61.1 years. PD-L1 positivity was detected in 34 patients. One year and 2-year OS and PFS ratios were found as 87%, 54% and 65%, 30%, respectively. The median OS and PFS were 26.8 and 15.1 months, respectively. There was no statistically significant difference between PD-L1 receptor status and OS and PFS (p=0.736 and p=0.372, respectively). In the PD-L1 positive subgroup analysis for OS, doses higher than 60 Gy (n=28, mean dose 64.6±1.53) were found superior to the 60 Gy dose (n=6) (p=0.034). The median MFS was 33 months. CONCLUSION: PD-L1 status did not seem to be a predictor for RT response. However, despite the low number of patients in the 60 Gy group, our study showed that dose-escalation could improve survival in PD-L1 positive locally advanced NSCLC. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to determine: (1) the prevalence of complementary and alternative medicine (CAM) use (2) the characteristics of CAM users, (3) patients' source of information about CAM, (4) patients' perceived attitude of their physician regarding CAM use, and (5) the association between CAM use and Hospital Anxiety and Depression Scale (HADS). METHODS: This descriptive-cross section study was conducted between June 2007 and December 2007. Three-hundred and six patients were asked to complete a questionnaire about the use of CAM along with HADS. RESULTS: The prevalence of CAM use among cancer patients treated with radiotherapy was 35%. The patients with severe anxiety score were more likely to use CAM than the others. The younger age were found as predicting variables for CAM use. Majority of user patients wanted to add CAM to conventional therapies. CONCLUSION: Oncologist might be aware of the CAM issue and talk to their patients about the use of CAM. The documentation of CAM use in the medical history might be advised at the time of initial consultation in radiotherapy centers. Although CAM use is a method that patients want to use in addition to conventional treatments, it is not clear that these methods can be used together safely. It is thought that there is a need for prospective and innovative studies in modern oncology centers. [ABSTRACT FROM AUTHOR]

Amaç: Baş ve boyun kanseri istemsiz kilo kaybı riskini yükseltmektedir ve bu kayıp %10 seviyelerine ulaşabilmektedir. Bu durum tedavi sürekliliğini bozmakta ve tedavi sürecini dolayısıyla hastane kalım sürecini de uzatmaktadır. Tedavi sürecindeki bozulmanın düşük klinik yanıt, zayıf prognoz, düşük fonksiyonel performans, hayat kalitesinde azalma ve yüksek mortaliteye sebep verdiği gözlemlenmiştir. Bu çalışma, baş boyun kanseri hastalarında beslenme yönetiminin antropometri ve kanser prognozu üzerindeki etkilerinin tanımlanmasını amaçlamaktadır. Gereç ve Yöntem: Çalışmada 5 merkezden katılan 94 baş boyun kanser hastasının verileri dahil edilmiştir. Başlangıçta ölçülen boy, kilo, vücut kitle indeksi (VKİ) ve C3 seviyesi paravertebral kas hacmi nütrisyonel risk skoru (NRS) =3 olan ve tüm hasta grubu için 5. hafta ölçümleriyle kıyaslanmıştır. VKİ ve kas hacmi 5 haftalık değişimi tüm gruba ek olarak tümör yanıtı, tümör cevabı ve yeri alt grupları altında ayrıca kıyaslanmıştır. Albümin ve lenfosit ölçümleriyle hastaların prognostik nütrisyonel indeks (PNI) ve nütrisyonel risk indeks (NRI) değerleri hesaplanarak 5 haftalık VKİ ve kilo z-skoru değişimiyle kıyaslanmıştır. İstatistiksel anlamlılık p <0.05 olarak kabul edilmiştir. Bulgular: Demografik bilgiler Tablo 1a' da verilmiştir. Hastalarda 5 hafta sonunda kilo z-skoru ve VKİ'de anlamlı düzelme (sırasıyla, p<0.001 ve p<0.001) (Tablo 1b, Şekil 1a,b) ve VKİ'ne göre kilolu ve obez hasta sayılarında azalma gözlemlenmiştir, sırasıyla 6.4% ve 11.7% (Tablo 1c). PNI değeri yüksek olan hastaların C3 seviyesi paravertebral 1. hafta ile 5. hafta arası kas hacmindeki azalma da yüksek görülmüştür (p=0.037), NRI ile kas hacmi arasında bağlantı görülmemiştir (p=301). C3 paravertebral kas hacmi değişim Bunun dışında, hastaların 1. hafta ile 5. hafta arası ağırlık z-skoru ve VKİ miktarlarıyla, PNI ve NRI değerleri arasında bir korelasyon görülmemiştir (sırasıyla, p>0.066 ve p>0.210) (Tablo 1b). Ayrıca, C3 seviyesi paravertebral kas hacminde 5 haftalık süreçte anlamlı oranda azalma görülmüştür (p <0.001) (Tablo 1b ve Şekil 1c). NRS =3 olan hastalar ile tüm grup arasında VKİ düzelme miktarı açısından bir fark görülmemiştir (p=0.485). Tümör yeri, yanıtı ve evresi alt grupları ayrı ayrı incelendiğinde hepsinde 5 haftada anlamlı VKİ azalışı görülmüştür (p<0.036, tüm değişkenler için) (Tablo 2). Kas hacmindeki azalma ise sadece evre 2 kanser hastalarında ve oral cavite ile orofarenks lokasyonlu tümöre sahip hastalarda görülmemiştir (sırasıyla, p=0.196, p=0.695 ve p=0.889). Diğer hastaların kas hacminde anlamlı azalma görülmüştür (p<0.025) (Tablo 2). Beslenme yolu ile VKİ değişim miktarı arasında da bir anlamlılık görülmemiştir (p=0.063). Sonuç: Beslenme müdahalesi 5 haftalık izlem süresinde hastaların baş boyun kanser tipi, evresi ve risk skoru gözetmeksizin ideal VKİ'ye ve kiloya yaklaşmasını sağlamıştır. Çalışma kohortunun 53.2%'si kilolu ve obez hastalardan oluştuğundan, çalışmadaki VKİ ve kilo z-skoru bazlı düzelme kilo kaybı ile ortaya çıkmıştır. 5 haftalık izlem sonucu indekslerin kas hacmi ile aralarında bir korelasyon görülmemiştir. Ancak daha uzun vadeli bir izlem ile daha net sonuçlar elde edilecektir. [ABSTRACT FROM AUTHOR]

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