Search

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]

As the Stereotactic Body Radiotherapy (SBRT) approach began to increase in treating patients with localized prostate cancer, it became necessary to investigate which methods used in practice were better. The aim of this study is to perform a dosimetric comparison of the advantages and disadvantages of SBRT treatments for localized prostate cancer delivered by CyberKnife (CK) and Varian Truebeam STX (FF and FFF). Seventeen intermediate and high-risk patients with localized prostate cancer were included in the study. SBRT plans for the CK system and Varian Truebeam STX systems with and without Flattening Filters (Tru-FF and Tru-FFF) were prepared for each patient. Plans prepared for each patient were planned at a fraction dose of 6.7 Gy at 6 MV energy and a target dose of 33.5 Gy in 5 fractions. For all plans, cumulative dose-volume histograms (DVHs) were generated for target volumes and organs at risk (OAR). The maximum doses of PTV (41 Gy) in CK plans are higher than the maximum doses (35 Gy) in VMAT plans prepared with Tru-FF or Tru-FFF beams. The mean dose of the rectal wall (10.06 ± 2.40Gy for CK) is still relatively low compared to other plans (13.46 ± 2.16 Gy for Tru-FF and 13.61 ± 2.32 Gy for Tru-FFF). The bladder wall (14 Gy for CK, 26 Gy for Tru-FF and Tru-FFF) and femoral head (6.8 Gy for CK, 9 Gy for Tru-FF and 9.4 Gy Tru-FFF) doses were also lower for CK plans. The CK plans provide better tumour control due to low doses in critical organs and high target doses than the Tru-FF or Tru-FFF plans. It was observed that CK and VMAT plans for SBRT with 6 MV photon beams provided acceptable results in term of treatment planning criteria such as Conformity Index and Homogeneity Index. It is recommended to use a target tracking system to provide an accurate and reliable SBRT treatment with VMAT and CK techniques. • SBRT with an image-guided system provides dose accuracy and precision at the target volume for prostate cancer. • CK and VMAT plans are acceptable plans as an SBRT technique in patients with localized prostate cancer. • There is no statistically significant difference in terms of HI, GI, treatment time, PTV and OAR doses between VMAT plans. • Prolonged treatment time may affect patient immobility. Thus, it is advantage that VMAT plans have a shorter treatment time. • Target is treated accurately in CK, lower doses are provided in bladder wall, rectum and femur thanks to real-time tracking system. [ABSTRACT FROM AUTHOR]

OBJECTIVES When surgery is not adequate, stereotactic body radiotherapy (SBRT) has been used for recurrent cancers. We report the outcomes of case series with pelvic recurrences from colorectal cancer irradiated with SBRT. METHODS Robotic Stereotactic Radiotherapy system was used. The dose fractionation scheme was individualized based on tumor volume and location and prior radiation dose. RESULTS Between February 2010 and December 2014, four patients were treated. Treatment regions were pelvic side wall for two patients and presacral for two patients. SBRT doses were 24 Gy in 3 fractions for three patients and 36.25 Gy in 5 fractions for one patient. One patient treated for pelvic side wall recurrence developed symptomatic noropathy at fist year. CONCLUSION Local recurrence in pelvis after modern combined modality treatment for colorectal cancer is rare. However it presents a therapeutic dilemma when it occurs; often symptomatic and eventually life threatening. SBRT can be a useful modality in this setting. [ABSTRACT FROM AUTHOR]

CDNK2 p16 plays a pivotal role in G1/S transition by regulating the p53 pathway, which was regulated by a nuclear oncoprotein, mouse double minute 2 (MDM2). Overexpression of the MDM2 gene has been shown in a number of tumor types, its gene amplification is found to associate with accelerated tumor development and failure to treatment in both hereditary and sporadic cancers. Although genetic association studies have revealed the relationship between certain genetic polymorphisms and genes that play important roles in the development and progression of colorectal cancer (CRC), it is still unknown. Therefore, the polymorphisms of p16 540 C>G, 580 C>T, and MDM2 SNP309 T>G designed to investigate the risk of CRC development and progression in a Turkish population. We enrolled 87 patients with CRC and 75 healthy controls into the study. Genotypings were determined using polymerase chain reaction-restriction fragment length polymorphism techniques. Genotype distributions of p16 540 C>G and 580 C>T were found in agreement with the Hardy-Weinberg equilibrium in patients and controls. MDM2 SNP309 T>G was found in agreement with the Hardy-Weinberg equilibrium in controls, but not in patients. The results of our study, the G allele of p16 540 C>G and GG genotype of MDM2 SNP309 T>G were found significantly lower in patients compared with controls ( p<0.001, p<0.05, respectively). Haplotype analyses have shown that the C allele of both the CDKN2 p16 540 C>G and 580 C>T variants together indicate a risk haplotype for the patient group; besides, carrying the G allele of p16 540 and G allele of MDM2 also seems a risk haplotype for the patient group. Our study is the first study that investigates the relationship among variants of CDKN2 p16 540 C>G, 580 C>T, and MDM2 SNP309 T>G risk of CRC and the development and progression in the Turkish population. The C alleles of CDKN2 p16 are associated with a risk haplotype for patients. Along with these alleles, the MDM2 SNP309 T > G also indicates a greater likelihood of progression of colorectal cancer. [ABSTRACT FROM AUTHOR]