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Article ; Online: Predicting Teeth Extraction after Concurrent Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer Patients Using the Novel GLUCAR Index

Efsun Somay / Erkan Topkan / Busra Yilmaz / Ali Ayberk Besen / Hüseyin Mertsoylu / Ugur Selek

Diagnostics, Vol 13, Iss 23, p

2023 Volume 3594

Abstract: To evaluate the value of the newly created GLUCAR index in predicting tooth extraction rates after concurrent chemoradiotherapy (C-CRT) in locally advanced nasopharyngeal carcinomas (LA-NPCs). Methods: A total of 187 LA-NPC patients who received C-CRT ... ...

Abstract	To evaluate the value of the newly created GLUCAR index in predicting tooth extraction rates after concurrent chemoradiotherapy (C-CRT) in locally advanced nasopharyngeal carcinomas (LA-NPCs). Methods: A total of 187 LA-NPC patients who received C-CRT were retrospectively analyzed. The GLUCAR index was defined as ′GLUCAR = (Fasting Glu cose × C RP/ A lbumin R atio) by utilizing measures of glucose, C-reactive protein (CRP), and albumin obtained on the first day of C-CRT. Results: The optimal GLUCAR cutoff was 31.8 (area under the curve: 78.1%; sensitivity: 70.5%; specificity: 70.7%, Youden: 0.412), dividing the study cohort into two groups: GLUCAR ˂ 1.8 (N = 78) and GLUCAR ≥ 31.8 (N = 109) groups. A comparison between the two groups found that the tooth extraction rate was significantly higher in the group with a GLUCAR ≥ 31.8 (84.4% vs. 47.4% for GLUCAR ˂ 31.8; odds ratio (OR):1.82; p < 0.001). In the univariate analysis, the mean mandibular dose ≥ 38.5 Gy group (76.5% vs. 54.9% for <38.5 Gy; OR: 1.45; p = 0.008), mandibular V55.2 Gy group ≥ 40.5% (80.3 vs. 63.5 for <40.5%, p = 0.004, OR; 1.30), and being diabetic (71.8% vs. 57.9% for nondiabetics; OR: 1.23; p = 0.007) appeared as the additional factors significantly associated with higher tooth extraction rates. All four characteristics remained independent predictors of higher tooth extraction rates after C-CRT in the multivariate analysis ( p < 0.05 for each). Conclusions: The GLUCAR index, first introduced here, may serve as a robust new biomarker for predicting post-C-CRT tooth extraction rates and stratifying patients according to their tooth loss risk after treatment.
Keywords	nasopharyngeal cancer ; tooth extraction ; glucose ; C-reactive protein ; albumin ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Pretreatment Masseter Muscle Volume Predicts Survival in Locally Advanced Nasopharyngeal Carcinoma Patients Treated with Concurrent Chemoradiotherapy

Umur Anil Pehlivan / Efsun Somay / Busra Yilmaz / Ali Ayberk Besen / Huseyin Mertsoylu / Ugur Selek / Erkan Topkan

Journal of Clinical Medicine, Vol 12, Iss 21, p

2023 Volume 6863

Abstract: Background and purpose: Muscle loss is a significant indicator of cancer cachexia and is associated with a poor prognosis in cancer patients. Given the absence of comparable studies, the current retrospective study sought to examine the correlation ... ...

Abstract	Background and purpose: Muscle loss is a significant indicator of cancer cachexia and is associated with a poor prognosis in cancer patients. Given the absence of comparable studies, the current retrospective study sought to examine the correlation between the total masseter muscle volume (TMMV) before treatment and the survival outcomes in locally advanced nasopharyngeal cancer (LA-NPC) patients who received definitive concurrent chemoradiotherapy (CCRT). Methods: A three-dimensional segmentation model was used to determine the TMMV for each patient by analyzing pre-CCRT magnetic resonance imaging. The optimal TMMV cutoff values were searched using receiver operating characteristic (ROC) curve analyses. The primary and secondary endpoints were the relationship between the pre-CCRT TMMV measures and overall survival (OS) and progression-free survival (PFS), respectively. Results: Ninety-seven patients were included in this study. ROC curve analyses revealed 38.0 cc as the optimal TMMV cutoff: ≤38.00 cc ( n = 42) and >38.0 cc ( n = 55). Comparisons between the two groups showed that the TMMV>38.0 cc group had significantly longer PFS [Not reached (NR) vs. 28; p < 0.01] and OS (NR vs. 71; p < 0.01) times, respectively. The results of the multivariate analysis demonstrated that the T-stage, N-stage, number of concurrent chemotherapy cycles, and TMMV were independent associates of PFS ( p < 0.05 for each) and OS ( p < 0.05 for each) outcomes, respectively. Conclusion: The findings of the current retrospective research suggest that pretreatment TMMV is a promising indicator for predicting survival outcomes in LA-NPC patients receiving definitive CCRT.
Keywords	muscle loss ; masseter muscle ; locally advanced nasopharyngeal cancer ; chemoradiotherapy ; survival ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Chronically Radiation-Exposed Survivor Glioblastoma Cells Display Poor Response to Chk1 Inhibition under Hypoxia

Nareg Pinarbasi-Degirmenci / Ilknur Sur-Erdem / Vuslat Akcay / Yasemin Bolukbasi / Ugur Selek / Ihsan Solaroglu / Tugba Bagci-Onder

International Journal of Molecular Sciences, Vol 23, Iss 7051, p

2022 Volume 7051

Abstract: Glioblastoma is the most malignant primary brain tumor, and a cornerstone in its treatment is radiotherapy. However, tumor cells surviving after irradiation indicates treatment failure; therefore, better understanding of the mechanisms regulating ... ...

Abstract	Glioblastoma is the most malignant primary brain tumor, and a cornerstone in its treatment is radiotherapy. However, tumor cells surviving after irradiation indicates treatment failure; therefore, better understanding of the mechanisms regulating radiotherapy response is of utmost importance. In this study, we generated clinically relevant irradiation-exposed models by applying fractionated radiotherapy over a long time and selecting irradiation-survivor (IR-Surv) glioblastoma cells. We examined the transcriptomic alterations, cell cycle and growth rate changes and responses to secondary radiotherapy and DNA damage response (DDR) modulators. Accordingly, IR-Surv cells exhibited slower growth and partly retained their ability to resist secondary irradiation. Concomitantly, IR-Surv cells upregulated the expression of DDR-related genes, such as CHK1 , ATM , ATR , and MGMT , and had better DNA repair capacity. IR-Surv cells displayed downregulation of hypoxic signature and lower induction of hypoxia target genes, compared to naïve glioblastoma cells. Moreover, Chk1 inhibition alone or in combination with irradiation significantly reduced cell viability in both naïve and IR-Surv cells. However, IR-Surv cells’ response to Chk1 inhibition markedly decreased under hypoxic conditions. Taken together, we demonstrate the utility of combining DDR inhibitors and irradiation as a successful approach for both naïve and IR-Surv glioblastoma cells as long as cells are refrained from hypoxic conditions.
Keywords	glioblastoma ; radiotherapy ; radioresistance ; hypoxia ; DNA damage response ; Chk1 ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
Subject code	570
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Vaginal cuff brachytherapy practice in endometrial cancer patients

Yasemin Bolukbasi / Cem Onal / Zeynep Ozsaran / Sukran Senyurek / Eyub Yasar Akdemir / Ugur Selek / Ferah Yildiz

Journal of Contemporary Brachytherapy, Vol 13, Iss 2, Pp 152-

a report from the Turkish Oncology Group

2021 Volume 157

Keywords	brachytherapy ; vaginal cuff ; experience ; survey ; Medicine ; R
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Pretreatment Photopenia on 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Scans Predicts Poor Prognosis in Nasopharyngeal Cancer Patients Undergoing Concurrent Chemoradiotherapy

Erkan Topkan / Ugur Selek / Hüseyin Mertsoylu / Yurday Ozdemir / Ahmet Kucuk / Nese Torun / Ali Ayberk Besen

Clinical and Experimental Otorhinolaryngology, Vol 13, Iss 4, Pp 407-

2020 Volume 414

Abstract: Objectives To investigate the influence of pretreatment primary tumor or nodal photopenia (PP) on 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT), an indicator of tumor ischemia, on survival results of nasopharyngeal ... ...

Abstract	Objectives To investigate the influence of pretreatment primary tumor or nodal photopenia (PP) on 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT), an indicator of tumor ischemia, on survival results of nasopharyngeal cancers (NPCs) treated with concurrent chemoradiotherapy (C-CRT). Methods The pre-C-CRT FDG PET-CT scans of 104 patients with NPC (cT1-4 N0-3 M0) were retrospectively examined to determine the presence of PP (PP+). Our primary endpoint was the influence of PP+ on overall survival (OS), while the progression-free survival (PFS) and locoregional PFS (LRPFS) constituted the secondary endpoints. Results The PP+ was detected in 29 (27.9%): nine (8.7%), seven (6.7%), and 13 (12.5%) in the primary tumor alone, primary tumor plus neck nodes, and neck nodes alone, respectively. Because the PP+ cases were small by count per location, all comparative analyses were performed according to overall PP+/ PP– status instead of per detected site. At a median follow-up of 67.8 months (range, 9 to 130 months), the median survival times were not reached (NR) for the entire population, while 5-year OS, LRPFS, and PFS rates were 73.3%, 68.2%, and 63.4%, respectively. Comparatively the PP+ patients exhibited significantly poorer median OS (49.8 months vs. NR, P<0.001), LRPFS (40.7 months vs. NR, P=0.001), and PFS (31.8 months vs. NR, P=0.002) durations than their PP– counterparts. Furthermore, the PP+ retained its independent prognostic significance in multivariate analysis (P<0.001). Conclusion Present results uncovered the pre-C-CRT PP as an independent predictor of poor prognosis for NPC patients, which underscore the requirement for the fortification of the local and systemic treatments in hypoxic NPCs.
Keywords	nasopharyngeal neoplasms ; concurrent chemoradiotherapy ; photopenia ; fdg-pet-ct ; prognosis ; Medicine ; R ; Otorhinolaryngology ; RF1-547
Subject code	610
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	Korean Society of Otorhinolaryngology-Head and Neck Surgery
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Oncology

Meritxell Arenas / Nam Nguyen / Pierfrancesco Franco / Ugur Selek / Angeles Rovirosa / Sebastia’ Sabater

BioMed Research International, Vol

Management of Elderly Cancer Patients

2018 Volume 2018

Keywords	Medicine ; R
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Significance of overall concurrent chemoradiotherapy duration on survival outcomes of stage IIIB/C non-small-cell lung carcinoma patients

Erkan Topkan / Yurday Ozdemir / Ahmet Kucuk / Ali Ayberk Besen / Huseyin Mertsoylu / Ahmet Sezer / Ugur Selek

PLoS ONE, Vol 14, Iss 7, p e

Analysis of 956 patients.

2019 Volume 0218627

Abstract: Background To investigate the detrimental effects of prolonged overall radiotherapy duration (ORTD) on survival outcomes of stage IIIB/C NSCLC patients treated with concurrent chemoradiotherapy (C-CRT). Methods The study cohort consisted of 956 patients ... ...

Abstract	Background To investigate the detrimental effects of prolonged overall radiotherapy duration (ORTD) on survival outcomes of stage IIIB/C NSCLC patients treated with concurrent chemoradiotherapy (C-CRT). Methods The study cohort consisted of 956 patients who underwent C-CRT for stage IIIB/C NSCLC. Primary endpoint was the association between the ORTD and overall survival (OS) with locoregional progression-free survival (LRPFS) and PFS comprising the secondary endpoints. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of the cut-off that interacts with survival outcomes. Multivariate Cox model was utilized to identify the independent associates of survival outcomes. Results The ROC curve analysis exhibited significance at 49 days of ORTD cut-off that dichotomized patients into ORTD<50 versus ORTD≥50 days groups for OS [area under the curve (AUC): 82.8%; sensitivity: 81.1%; specificity: 74.8%], LRPFS (AUC: 91.9%; sensitivity: 90.6%; specificity: 76.3%), and PFS (AUC: 76.1%; sensitivity: 72.4%; specificity: 68.2%), respectively. Accordingly, ORTD≥50 days group had significantly shorter median OS (P<0.001), LRPFS (P<0.001), and PFS (P<0.001); and 10-year actuarial locoregional control (P<0.001) and distant metastases-free (P<0.011) rates than the ORTD<50 days group. The ORTD retained its significant association with survival outcomes at multivariate analyses independent of the other favorable covariates (p<0.001, for OS, LRPFS, and PFS): Stage IIIB disease (versus IIIC), lymph node bulk <2 cm (versus ≥2 cm), and 2-3 chemotherapy cycles (versus 1). The higher sensitivity for LRPFS (90.6%) than PFS (72.4%) on ROC curve analysis suggested the prolonged ORTD-induced decrements in locoregional control rates as the major cause of the poor survival outcomes. Conclusions Longer ORTD beyond ≥50 days was associated with significantly poorer OS, LRPFS and PFS outcomes, where reduced locoregional control rates appeared to be the main causative.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Intensity-Modulated Radiotherapy versus 3-Dimensional Conformal Radiotherapy Strategies for Locally Advanced Non-Small-Cell Lung Cancer

Uğur Selek / Yasemin Bölükbaşı / James W. Welsh / Erkan Topkan

Balkan Medical Journal, Vol 31, Iss 4, Pp 286-

2014 Volume 294

Abstract: Chemoradiotherapy is the current standard of care in patients with advanced inoperable stage IIIA or IIIB non-small cell lung cancer (NSCLC). Three-dimensional radiotherapy (3DCRT) has been a trusted method for a long time and has well-known drawbacks, ... ...

Abstract	Chemoradiotherapy is the current standard of care in patients with advanced inoperable stage IIIA or IIIB non-small cell lung cancer (NSCLC). Three-dimensional radiotherapy (3DCRT) has been a trusted method for a long time and has well-known drawbacks, most of which could be improved by Intensity Modulated Radiotherapy (IMRT). IMRT is not currently the standard treatment of locally advanced NSCLC, but almost all patients could benefit to a degree in organ at risk sparing, dose coverage conformality, or dose escalation. The most critical step for a radiation oncology department is to strictly evaluate its own technical and physical capabilities to determine the ability of IMRT to deliver an optimal treatment plan. This includes calculating the internal tumor motion (ideally 4DCT or equivalent techniques), treatment planning software with an up-to-date heterogeneity correction algorithm, and daily image guidance. It is crucial to optimise and individualise the therapeutic ratio for each patient during the decision of 3DCRT versus IMRT. The current literature rationalises the increasing use of IMRT, including 4D imaging plus PET/CT, and encourages the applicable knowledge-based and individualised dose escalation using advanced daily image-guided radiotherapy.
Keywords	3-D conformal radiotherapy ; intensity modulated radiotherapy ; lung cancer ; Medicine ; R
Subject code	610
Language	English
Publishing date	2014-12-01T00:00:00Z
Publisher	Galenos Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Linguistic Validation of the Turkish Version of the M.D. Anderson Symptom Inventory - Head and Neck Cancer Module

G. Brandon Gunn / David I. Rosenthal / Banu Atalar / Enis Özyar / Tito R. Mendoza / Charles S. Cleeland / Uğur Selek

Balkan Medical Journal, Vol 33, Iss 3, Pp 339-

2016 Volume 343

Abstract: Background: The use of patient symptom reports with frequent symptom assessment may be preferred over the more commonly used health-related quality of life questionnaires. Aims: We sought to linguistically validate the Turkish version of the M.D. ... ...

Abstract	Background: The use of patient symptom reports with frequent symptom assessment may be preferred over the more commonly used health-related quality of life questionnaires. Aims: We sought to linguistically validate the Turkish version of the M.D. Anderson Symptom Inventory-Head and Neck module (MDASI-HN) patient reported outcome questionnaire. Study Design: Validation study. Methods: Following standard forward and backward translation of the original and previously validated English MDASI-HN into a Turkish version (T-MDASI-HN), it was administered to patients with head and neck cancer able to read and understand Turkish. Patients were then cognitively debriefed to evaluate their understanding and comprehension of the T-MDASI-HN. Individual and group responses are presented using descriptive statistics. Results: Twenty-six participants with head and neck cancer completed the T-MDASIHN and accompanying cognitive debriefing. Overall, 97 percent of the individual TMDASI-HN items were completed. Average recorded time to complete the 28 item TMDASI-HN questionnaire was 5.4 minutes (range 2-10). Average overall ease of completion, understandability, and acceptability were favorably rated at 1.0, 1.1, and 0.2, respectively, on scales from 0 to 10. Only 5 of the 26 of participants reported trouble completing any single questionnaire items, namely the “difficulty remembering” item for 3 individuals. Conclusion: The T-MDASI-HN is linguistically valid with ease of completion, relevance, comprehensibility, and applicability and it can be a useful clinical and research tool.
Keywords	Head and neck cancer ; patient-reported questionnaire ; patient symptoms ; Turkish MDASI-HN ; Medicine ; R
Subject code	616
Language	English
Publishing date	2016-06-01T00:00:00Z
Publisher	Galenos Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma

Saadettin Kılıçkap / İbrahim Barışta / Şükran Ülger / İsmail Çelik / Ayşe Kars / Yavuz Özışık / Gülten Tekuzman / Uğur Selek / Ferah Yıldız

Balkan Medical Journal, Vol 30, Iss 2, Pp 178-

A Single Center Experience

2013 Volume 185

Abstract: Background: Hodgkin’s lymphoma (HL) is a B cell lymphoma characterized by the presence of Reed-Sternberg cells. HL comprises 1% of all cancer cases and 14% of all lymphoma cases. Aims: We designed a retrospective study to investigate the clinical ... ...

Abstract	Background: Hodgkin’s lymphoma (HL) is a B cell lymphoma characterized by the presence of Reed-Sternberg cells. HL comprises 1% of all cancer cases and 14% of all lymphoma cases. Aims: We designed a retrospective study to investigate the clinical features and prognostic factors of HL patients diagnosed at an experienced oncology centre. Study Design: Retrospective study. Methods: Demographic characteristics, histopathological and clinical features, treatment modalities and response to treatment were obtained from hospital records. Dates of initial diagnosis, remission and relapse, last visit and death were recorded for survival analyses. Results: We analysed data of 391 HL patients (61% male, 39% female; mean age 35.7±15.1 years). The most common classical HL histological subtype was nodular sclerosing HL (NSHL) (42.7%). The most common stage was II 50.4%. The most common chemotherapy regimen was doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) (70.6%). Five and 10-year survival rates were 90% and 84%, respectively. Early-stage patients with good prognostic factors had better overall and relapse-free survival rates. The presence of “B” symptoms, albumin level, Eastern Cooperative Oncology Group (ECOG) performance score, and LDH were prognostic factors that affect the survival in both univariate and multivariate analyses. Conclusion: This is the first study that demonstrates the demographic, clinical and prognostic features of HL patients in Turkey, and provides a general picture of the HL patients in our country.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2013-06-01T00:00:00Z
Publisher	Galenos Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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