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    Evaluation of Nutritional Status and Anxiety Levels in Patients Applying to the Radiation Oncology Outpatient Clinic during the COVID-19 Pandemic: Turkish Society for Radiation Oncology Group Study (TROD 12:02)
    (Routledge Journals, Taylor & Francis Ltd, 2022) Caloglu, Vuslat Yurut; Akmansu, Muge; Yalman, Deniz; Gul, Sule Karabulut; Kocak, Zafer; Alicikus, Zumre Arican; Serarslan, Alparslan
    Cancer patients often face malnutrition, which negatively affects their response to cancer treatment. This study aims to analyze the effects of the COVID-19 pandemic on nutritional status and anxiety in cancer patients with different types and stages of cancer. This is a cross-sectional cohort study that includes 1,252 patients with varying cancer types from 17 radiation oncology centers. The nutritional risk scores (NRS-2002) and coronavirus anxiety scale (CAS) scores of all patients were measured. NRS-2002 >= 3 and CAS >= 5 were accepted as values at risk. Of all patients, 15.3% had NRS-2002 >= 3. Breast cancer was the most prevalent cancer type (24.5%) with the lowest risk of nutrition (4.9%, p < 0.001). Nutritional risk was significantly higher in patients with gastrointestinal cancer, head and neck cancer, and lung cancer (p < 0.005) and in patients with stage IV disease (p < 0.001). High anxiety levels (CAS >= 5) were significantly related to voluntary avoidance and clinical postponement of hospital visits due to the pandemic (p < 0.001), while clinical postponement was particularly frequent among patients with NRS-2002 < 3 (p = 0.0021). Fear and anxiety in cancer patients with COVID-19 cause hesitations in visiting hospitals, leading to disrupted primary and nutritional treatments. Thus, nutritional monitoring and treatment monitoring of cancer patients are crucial during and after radiotherapy.
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    A National Survey on the Current Status of Radiotherapy in Extensive Stage Small-cell Lung Cancer: Turkish Society of Radiation Oncology Thoracic Oncology Group Study
    (Kare Publ, 2023) Kirakli, Esra Korkmaz; Erdem, Sevilay; Yalman, Deniz; Saynak, Mert
    OBJECTIVE We aimed to investigate the current status and use of thoracic radiotherapy (TRT) and prophylactic cranial irradiation (PCI) in extensive-stage small-cell lung cancer (ES-SCLC) patients who responded to chemotherapy (ChT) through a nationwide survey. METHODS An electronic survey was created. We invited all the Turkish Society of Radiation Oncology-registered radiation oncologists (ROs). RESULTS A total of 101 ROs participated. TRT was routinely recommended to patients who responded to ChT by 76% of ROs. The highest agreement for TRT indication (%94) was in the case of symptomatic residual disease. The most commonly used fractionation scheme was 30 Gy in 10 fractions. There was an increase in the use of 30 Gy in 10 fractions after the publication of the CREST trial. The implementation criteria for TRT were site and number of metastases for 65% and 42% of respondents, respectively. PCI was recommended by 89% routinely. The most commonly (93%) used fractionation scheme was 25 Gy in 10 fractions. CONCLUSION This survey highlights the absence of consensus on the eligibility criteria and dosage of TRT in ES-SCLC within the Turkish RO community. The highest agreement for the TRT indication was in patients with symptomatic intrathoracic residual disease. The CREST trial impacted TRT indications and fractionation. There was high consistency in practice in terms of PCI indication, dose, and fractionation.
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    Screening for Nutritional Status in Radiation Oncology Outpatients: TROD 12-01 Study
    (Kare Publ, 2022) Akmansu, Muge; Kilic, Diclehan; Akyurek, Serap; Akboru, Halil; Arican Alicikus, Lutfiye Zumre; Yalman, Deniz; Yazici, Omer
    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.