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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]

Although definitive chemoradiation (CRT) has been used for locally advanced laryngeal cancer for more than 2 decades, studies focusing on CRT failures in advanced laryngeal cancer are scarce. In this study, we aimed to determine the failure patterns and the survival outcomes in the patients who had recurrence after concurrent CRT for laryngeal cancer. Clinical records of the patients who had definitive concurrent CRT for laryngeal cancer between 2001 and 2014 at a tertiary referral center were reviewed. The end points of the study were 1-, 2-, and 3-year overall survival (OS) and disease-specific survival (DSS).In our results, there were 48 failures and the mean time period from the first diagnosis of disease to the diagnosis of recurrence was 18.0 months (range 2-72; standard deviation: 15.6). The most common recurrence pattern was local recurrence in 21 (47.9%) patients followed by regional recurrence in 11 (22.9%) patients. The 1 and 3 years OS rates were 41.7%, and 19.2% for the entire cohort, and 64.5%, and 29.7% for the patients who had not systemic recurrence at presentation of recurrence, respectively. The 1 and 3 years DSS rates were 43.5%, and 20.0% for the entire cohort, and 69.0%, and 31.8% for the patients who had not systemic recurrence at presentation of recurrence, respectively. All patients who had systemic recurrence initially (n = 13) died within 9 months (median = 4 months, range: 1-9 months). This study reveals that survival outcomes are unfavorable in the CRT failures and careful patient selection is critical to minimize failures. In the presence of systemic recurrence, disease course is aggressive. [ABSTRACT FROM AUTHOR]

OBJECTIVE The aim of the present study was to determine the electronic portal imaging (EPI) evaluation differences between the therapists in the reference of cone beam computed tomography (CBCT). METHODS In the present study, 62 EPI images belonging to 13 head and neck patients were evaluated separately by four therapists as offline, and the amount of shift in the center of fields was determined. CBCT obtained at the same time with the EPI images was accepted as reference, and the amount of shift in the center of fields was compared separately for each therapist with the results of EPI. RESULTS According to our results, the amount of shift in the center of fields had changed between therapists with 0-9.4 mm in the reference of CBCT. The probability of shifting center of fields to be >3 mm was 60% for the first therapist, 35% for the second therapist, 63% for the third therapist, and 50% for the fourth therapist. The probability of shifting center of fields to be >5 mm was 24%, 8%, 27%, and 14.5%, respectively. Analysis of variance for repeated measures test was applied to center shift values, and there were a significant difference in the groups (sig. <0.05) and a significant difference between the groups (sig. <0.05). CONCLUSION The usage of CBCT for the verification of treatment fields eliminates the differences in interpersonal evaluation. CBCT improves the set-up accuracy such that planning tumor volume expansion margin can be safely dropped. Therefore, CBCT should be the preferred imaging modality in intensity-modulated radiation therapy planning. [ABSTRACT FROM AUTHOR]

The primitive neuroectodermal tumors are the second common malignancies among the childhood brain tumors. Their prognosis are quite variable and the multidisciplinary treatment approach is required. The purpose of our study is to evaluate the factors that can affect overall survival. After the surgery, seventeen patients have received the radiotherapy (median 34.2 Gy to craniospinal region and median 54 Gy to posterior fossa at a 1.5-1.8 Gy daily fractionation dose) and the chemotherapy. The average preoperative tumor volume was 41.5 cm3. Eight patients were in a standard risk group and the rest was in a high risk group. The mean follow-up time was 27.8 months and the overall survival was three years. It has been found that the overall survival was affected by the unfavorable prognostic factors such as larger (>30 cm3) preoperative tumor volume, supratentorial location, being in high risk group and more than fifty days radiotherapy treatment. The preoperative large tumor volume and prolonged radiotherapy duration were determined as unfavorable prognostic factors in our study, that differ from the literature data. Due to the limited number of the patients in this study, these results should be confirmed with additional studies with larger patient groups. [ABSTRACT FROM AUTHOR]

Purpose: The current study reports on long-term quality of life (QoL) status after conventional radiotherapy in 187 nasopharyngeal carcinoma patients from 14 centers in Turkey. Patients and Methods: Patients with the diagnosis of nasopharyngeal carcinoma, who were treated in 14 centers in Turkey with minimum 6 months of follow-up and were in complete remission, were asked to complete Turkish versions of EORTC QLQ-C30 questionnaire and the HN-35 module. Each center participated with the required clinical data that included age at diagnosis, gender, symptoms on admission, follow-up period, treatment modalities, radiotherapy dose, and AJCC 1997 tumor stage. Each patient’s 33 QoL scores, which included function, global health status, and symptoms, were calculated as instructed in EORTC QLQ-C30 scoring manual. All of the scales and single-item measures range from 0 to 100. A high score represents a higher response level. Kruskal-Wallis and Mann-Whitney U nonparametric tests were used for comparisons. Results: One hundred eighty-seven patients with median age of 46 years (range, 16–79 years) participated and completed the questionnaires. Median follow-up time was 3.4 years (range, 6 months–24 years). All patients have received external-beam radiotherapy. Beside external-beam radiotherapy, 59 patients underwent brachytherapy boost, 70 patients received concomitant chemotherapy, and 95 patients received adjuvant/neoadjuvant chemotherapy. Most of the patients in the analysis (75%) were in advanced stage (Stage III, n = 85 [45.4%]; Stage IV, n = 55 [29%]). Mean global health status was calculated as 73. Parameters that increased global health status were male gender, early-stage disease, and less than 4-year follow-up (p < 0.05). Functional parameters were better in males and in early-stage disease. Factors that yielded better symptom scores were short interval after treatment (10 scores), male gender (7 scores), and lower radiation dose (6 scores). Neoadjuvant or adjuvant chemotherapy did not have any effect on QoL, whereas concomitant chemotherapy adversely affected 5 symptom scores. Conclusion: Quality of life is adversely affected in our nasopharyngeal carcinoma patients treated with combined therapies. The factors that adversely affect quality of life are advanced tumor stage, female gender, and long-term follow-up. Further controlled studies to evaluate both preradiotherapy and postradiotherapy status are necessary to clarify the contribution of each treatment modality to QoL. [Copyright &y& Elsevier]