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).

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.

Stereotactic body radiotherapy as a boost after external beam radiotherapy for high-risk prostate cancer patients.

BACKGROUND: The effect of high-dose-rate (HDR) brachytherapy after external radiation in high-risk prostate cancer patients has been proven. Stereotactic body radiotherapy as a less invasive method has similar dosimetric results with HDR brachytherapy. This study aims to evaluate the prostate-specific antigen (PSA) response, acute side effects, and quality of life of patients who underwent stereotactic body radiotherapy (SBRT) as a boost after pelvic radiotherapy (RT). METHODS: A total of 34 patients diagnosed with high-risk prostate cancer treated with SBRT boost (21 Gy in three fractions) combined with whole pelvic RT (50 Gy in 25 fractions) were evaluated. Biochemical control has been evaluated with PSA before, and after treatment, acute adverse events were evaluated with radiation therapy oncology group (RTOG) grading scale and quality of life with the Expanded Prostate Cancer Index Composite (EPIC) scoring system. RESULTS: The mean follow-up of 34 patients was 41.2 months (range 7-52). The mean initial PSA level was 22.4 ng/mL. None of the patients had experienced a biochemical or clinical relapse of the disease. Grade 2 and higher acute gastrointestinal (GI) was observed in 14%, and genitourinary (GU) toxicity was observed in 29%. None of the patients had grade 3-4 late toxicity. CONCLUSIONS: SBRT boost treatment after pelvic irradiation has been used with a good biochemical control and acceptable toxicity in high-risk prostate cancer patients. More extensive randomized trial results are needed on the subject.

Hyperfractionated accelerated radiotherapy in locally advanced head and neck cancers.

PURPOSE: Head and neck cancers are rapidly proliferating and relatively radiosensitive tumors. The increase in the number of daily fractions and the decrease in total treatment time give promising results in clinical practice. PATIENTS AND METHODS: 20 patients diagnosed with head and neck cancer between August 2000 and July 2001 participated in this study. Median age was 63 years (range: 42-78). The tumors were mainly located in the larynx (40%), and in the hypopharynx (25%). Daily doses of 1.5 Gy thrice a day in 6-h intervals were given on each of 12 consecutive days with the exception of weekends. RESULTS: Median follow-up was 22 months (range: 1-62). The overall response rate was 90%, and grade IIII early toxicity was 24%. No grade IV early toxicity was observed. Grade IV late toxicity was observed just in 1 case. 5-year rates for locoregional recurrence, distant metastasis, progression-free survival, and overall survival were 45, 20, 20, and 25%, respectively. CONCLUSION: Our schedule was acceptable regarding the toxicity. However, the high incidence of locoregional failures urges us to modify the treatment modality.