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    Evaluation of Nutritional Status in Cancer Patients Underwent Radiotherapy: The Results of Biochemical, Body Composition with Bioelectrical Impedance Analysis, Anthropometric Measurements, and Patient-Generated Subjective Global Assessment
    (Selçuk Üniversitesi, 2023 Aralık) Duru Birgi, Sümerya; Baş, Dilşat; Öztürk, Şeniz; Hürmüz, Pervin; Karabulut, Erdem; Çağlar, Ahmetcan; Gültekin, Melis; Yazıcı, Gözde; Özyiğit, Gökhan
    Aim: This study aims to evaluate the nutritional status and the effect of radiotherapy (RT) on nutrition in all ambulatory cancer patients. Material and Method: In this prospective observational study 105 cancer patients with various diagnoses treated between 2013 and 2014 were evaluated. All patients were ?18 years old and had Karnofsky Performance Status ?70. Anthropometric measurements, body composition with bioelectric impedance and patient-generated Subjective Global Assessment (PG-SGA) tools were used. The height, weight, body mass index (BMI), triceps skin fold thickness, mid-upper arm circumference, hemoglobin and serum albumin levels were determined twice before and after RT. Additionally, nutrition-related symptoms and short-term weight loss results were determined by PG-SGA questionnaires. Results: The patients’ median age was 53 years (range, 18-82 years). At initial evaluation 74 patients were well nourished using the PG-SGA global rating. Malnutrition developed in totally 33 of these 74 patients after RT. The PG-SGA results after RT were significantly worse than before treatment. PGSGA revealed no significant relationship between nutritional status prior to RT and the parameters including gender, age, mean weight, BMI, disease duration, pre-RT hemoglobin and albumin levels. Post-RT evaluation showed a significant relationship between deterioration (PG-SGA B-C) and mean weight, BMI, serum albumin, hemoglobin levels and concomitant chemotherapy. Gastrointestinal and head and neck cancer patients had the most deterioration after RT. The weight, BMI, fat-free mass, total body water and the percentage weight loss of the patients at the end of RT were significantly lower than the initial assessment. Conclusion: It is considerable to use multiple tools for nutritional monitoring in terms of an effective and comprehensive assessment of malnutrition. Patients who received RT to the head and neck and upper abdomen region had a high risk of deterioration after treatment. These patients should be monitored carefully during all treatment periods.
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    A multi-institutional analysis of sequential versus 'sandwich' adjuvant chemotherapy and radiotherapy for stage IIIC endometrial carcinoma
    (KOREAN SOC GYNECOLOGY ONCOLOGY & COLPOSCOPY, 2019) Önal, Cem; Sarı, Sezin Yüce; Yıldırım, Berna Akkuş; Yavaş, Güler; Gültekin, Melis; Güler, Ozan Cem; Akyürek, Serap
    Objective: To analyze the outcomes of sequential or sandwich chemotherapy (ChT) and radiotherapy (RT) in patients with node-positive endometrial cancer (EC). Methods: Data from 4 centers were collected retrospectively for 179 patients with stage IIIC EC treated with postoperative RT and ChT (paclitaxel and carboplatin). Patients were either treated with 6 cycles of ChT followed by RT (sequential arm; 96 patients) or with 3 cycles of ChT, RT, and an additional 3 cycles of ChT (sandwich arm; 83 patients). Prognostic factors affecting overall survival (OS) and progression-free survival (PFS) were analyzed. Results: The 5-year OS and PFS rates were 64% and 59%, respectively, with a median followup of 41 months (range, 5-167 months). The 5-year OS rates were significantly higher in the sandwich than sequential arms (74% vs. 56%; p=0.03) and the difference for 5-year PFS rates was nearly significant (65% vs. 54%; p=0.05). In univariate analysis, treatment strategy, age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology, rate of myometrial invasion, and grade were prognostic factors for OS and PFS. In multivariate analysis, non-endometrioid histology, advanced FIGO stage, and adjuvant sequential ChT and RT were negative predictors for OS, whereas only non-endometrioid histology was a prognostic factor for PFS. Conclusion: Postoperative adjuvant ChT and RT for stage IIIC EC patients, either given sequentially or sandwiched, offers excellent clinical efficacy and acceptably low toxicity. Our data support the superiority of the sandwich regimen compared to the sequential strategy in stage IIIC EC patients for OS.
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    Pediatric and young adult (< 21) non-metastatic nasopharyngeal carcinoma patients treated with neoadjuvant cisplatin and docetaxel chemoradiotherapy with plasma EBV DNA quantification
    (WILEY-LISS, 2007) Varan, Ali; Özyar, Enis; Gültekin, Melis; Çorapcıoğlu, Funda; Köksal, Yavuz; Aydın, Burça; Akyüz, Canan
    [Abstract not Available]