Objective: The systemic inflammatory response (SIR) is known as an important factor associated with tumorigenesis and tumor progression, and can be reflected by inflammatory markers. One of the markers that reflect this is the lung immune prognostic index (LIPI). It is based on a derived neutrophil-to-lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) level. We aimed to investigate the significance of LIPI in locally advanced rectal cancer (LARC) patients treated with neoadjuvant chemoradiotherapy (NACRT). Methods: In this retrospective study, we stratified the patients according to LIPI score as good LIPI and intermediate (int)/poor LIPI. According to pathological response to NACRT, we divided the patients into two groups as those with complete response (CR) or near-CR, and those with partial response (PR) or poor/no response. We classified CR and near-CR as good response. We evaluated the predictive and prognostic significance of LIPI for NACRT response, disease-free survival (DFS), and overall survival (OS) by univariate and multivariate analyses. Results: We included 137 patients in the results, with 72 (52.6%) having good LIPI and 65 (47.4%) having int/poor LIPI. The median follow-up period was 44.7 months (range: 10-105 months). Thirteen patients (18.0%) in the good LIPI group and 22 patients (34.0%) in the int/poor LIPI group achieved good response. In multivariate analysis, we found only the LIPI score as an independent risk factor (hazard ratio (HR): 2.4, p = 0.04) for NACRT response. Median DFS was 89.2 months (95% CI: 11.4-167.0) in the int/poor LIPI group; however, the DFS of all study populations and patients in the good LIPI group did not reach the median value. In multivariate analysis for DFS, we identified abdominoperineal resection (APR) (HR: 2.21, p = 0.02), presence of tumor deposit (HR: 2.96, p = 0.003), and int/poor LIPI score (HR: 2.07, p = 0.02) as separate risk variables. OS of all study populations and the patients in the LIPI groups did not reach the median value. In multivariate analysis for OS, we identified APR (HR: 2.74, p = 0.02), surgical margin positivity (HR: 12.94, p < 0.001), and adjuvant CT (HR: 0.20, p = 0.002) as separate risk variables for OS. Conclusion: This is the first study investigating the predictive and prognostic significance of LIPI in LARC patients treated with NACRT. The results revealed that int/poor LIPI was associated with a higher rate of good response but shorter DFS compared to good LIPI. The baseline LIPI score serves as an easily accessible and useful prognostic index, and it has significant potential for making appropriate treatment decisions in LARC.

BACKGROUND: Socioeconomic factors affect the incidence, clinical progress, and prognosis of patients with breast cancer.The aim of the study is to investigate the effect of socioeconomic factors on the prognosis of women with breast cancer at the age of forty years or younger.MATERIALS AND METHODS: A total of 873 breast cancer patients were included in the study.Of these patients, 30.4% were below or at 40 years of age (n=265).Patients' clinicopathologic features and socioeconomic status (SES) were recorded.Effects of SES on clinicopathologic features were analyzed using qhi-square test.Kaplan-Meier Log Rank test was used for comparison of survival time.RESULTS: Thirty percent of the patients (n=265) was at 40 years of age or younger.Median age of the patients below and over 40 years was 35 (20-40) and 52 (41-85) years, respectively.Invasive ductal carcinoma rate was found higher in younger patients with lower SES.The rate of larger tumors (>5 cm) in younger patients with lower SES was found significantly higher.Although the rate of ER and PR negative tumors was found higher (p<0.04),hormone receptor status was not found affected by SES in younger patients.Median survival time for younger patients with lower and higher SES was found 73 and 116 months, respectively (p=0.035).CONCLUSION: Socioeconomic factors affect the tumor biology and clinical progress of breast cancer patients in all groups of age.Decreased overall survival among young patients with lower SES may be related to late diagnosis and/or difficulties in accessing treatment in addition to presence of unfavorable prognostic factors.

Aim: To investigate survival outcomes and factors affecting the prognosis of patients with pancreatic cancer (PC) who received radiotherapy (RT).Material and Method: A total of 73 patients with PC who received RT between 2013 and 2021 were included in the study. Clinical, demographic, and histopathological features of the patients, and the goal of RT (adjuvant, definitive, neoadjuvant, or palliative) were recorded. Results: Median age of the patients was 62 (37-78). Male to female ratio was 1.6. In patients treated with adjuvant (n=52), definitive (n=13), and palliative (n=7) RT, median overall survival (OS) was 25.7 (11.6-39.7), 16 (7-67), and 9 (5-52) months, respectively. Survival time of 1 patient who received neoadjuvant RT was 26.6 months. Lymph node ratio (LNR) was significantly associated with OS. Patients with LNR ≤0.4 had better survival compared to those with LNR >0.4 (p=0.003). Furthermore, patients with LNR ≤0.4 and received adjuvant RT survived longer than the rest of the patients (12.1 vs. 7.7 months, p=0.001). Larger tumors (p=0.04) and LNR (p=0.003) were associated with poorer survival in univariate analysis, however, in the multivariate analysis, OS was found significantly affected only by LNR (p=0.01). Other factors were not found associated with survival. Conclusion: LNR had a strong correlation with OS in PC patients treated with radiation. Smaller LNR was associated with better survival in patients who received RT in the adjuvant setting.

Aims: Impact of adjuvant chemoradiation timing on the outcome of pancreatic cancer patients with positive surgical margins is unknown. The aim of this study was to evaluate the effect of adjuvant chemoradiation timing for margin positive pancreatic cancer patients. Methods: A total of 36 pancreatic adenocarcinoma patients with positive surgical margins and received adjuvant chemoradiation were included in the study. The median radiation dose was 50.4 Gy in 28 fractions. The primary study variable was the timing of chemoradiation, grouped as immediate (after ? 1 cycle of chemotherapy) and delayed (after two or more cycles of chemotherapy) chemoradiation. Gemcitabine (n = 16) and capecitabine (n = 20) were chemotherapy regimens administered with radiation. Results: Median follow-up time was 23.7 months. Thirteen patients (36%) received immediate and 23 (64%) received delayed chemoradiation. For immediate and delayed treatment groups, median overall survival was 13.5 and 42.5 months, and disease-free survival was 6.4 and 18.8 months, respectively. Disease-free survival and overall survival were better with delayed chemoradiation (p = 0.02). However, the two groups did not significantly differ in locoregional control (p = 0.96). Conclusion: Delaying chemoradiation until completion of systemic therapy improves disease-free survival and overall survival without any difference in locoregional failure compared to early chemoradiation in pancreatic cancer patients with positive surgical margins.

BACKGROUND: Propolis and its active component, caffeic acid phenethyl ester (CAPE), have been shown to have immunomodulatory, anti-tumoral, cytotoxic, anti-metastatic, anti-inflammatory, and antioxidant properties.Ionizing radiation induces radiolysis of water and generates free radicals that result in oxidative stress.In this study, we aimed to investigate protective effects of propolis and CAPE on the kidney tissue of rats against ionizing radiation-induced oxidative stress.MATERIALS AND METHODS: Forty-eight rats were divided into six groups; sham group, irradiation (IR), CAPE plus IR, propolis plus IR groups, and control groups of propolis and CAPE.Lipid hydroperoxide (LOOH) levels, total oxidant status (TOS), and oxidative stress index (OSI) were assayed to determine oxidative status.Total antioxidant status (TAS), total sulfhydryl (-SH) levels, paraoxonase, ceruloplasmin, and arylesterase activities were determined as antioxidant parameters.RESULTS: Kidney TOS, OSI, and LOOH levels were significantly higher in the IR group (P<0.001).TAS and -SH levels were significantly lower in the IR group compared to propolis plus IR, CAPE plus IR, and sham groups (P<0.001).Total -SH levels in the CAPE plus IR group were significantly higher than sham group, but were significantly decreased compared to propolis plus IR group (P<0.001).CONCLUSION: Ionizing radiation exposure results in oxidative stress in rat kidneys, and propolis and CAPE enhance antioxidant capacity and prevent kidney tissue from radiation-induced oxidative damage by improving antioxidant status.

Objective: Triple-negative breast cancers (TNBCs) are associated with younger age, advanced stage at diagnosis, ethnicity, lower socioeconomic status (SES), and poor prognosis. The aim of the study was to investigate clinicopathologic features of TNBC patients living in Southeastern Anatolia, and the association between socioeconomic and cultural factors and TNBC. Material and Methods: A total of 875 women were included in the study. The effects of socioeconomic factors and cultural factors on clinicopathologic features of TNBC patients were evaluated. The SES of the patients was categorized as lower and higher according to educational and health insurance status, and household income. Patients’ age at diagnosis, living area (rural or urban), SES, and ethnicity (Arabic, Armenian, Kurdish, and Turkish) were recorded. Results: Median age was 47 (20-85) and 10% (n=87) of the patients were diagnosed TNBC. TNBC rates were higher in patients ≤40 years. Younger age, lower SES, and Arabic and Kurdish ethnicities were associated with higher rates of TNBC. Conclusion: Although the majority of the breast cancer patients in our region were premenopausal, the rate of TNBC among them was found to be lower than the general rate of western countries. Socioeconomic and cultural factors may affect tumor biology and prognosis of the disease in patients with TNBC. In our study, younger age, lower SES, and ethnicity were found to be associated with higher rates of TNBC and worse prognosis.

Ionizing radiation leads to release of free radicals into the systemic circulation from irradiated tissues. These free radicals cause oxidative stress in distant organs. Oxidative status may be reversed by naturally occurring antioxidant agents. The aim of this study was to investigate protective and antioxidant effects of Nigella sativa oil (NSO) and thymoquinone (TQ) in kidney tissue of rats exposed to cranial irradiation. Forty-eight Sprague-Dawley rats were divided into six groups: IR group received irradiation (IR) to total cranium plus saline; IR plus NSO group received IR and NSO; IR plus TQ group received IR and TQ; sham group did not receive NSO, TQ or IR; control group of TQ received dimethyl sulfoxide; control group of NSO received saline. Total oxidant status (TOS), oxidative stress index (OSI) and lipid hydroperoxide (LOOH) levels were studied as oxidative parameters, and total antioxidant status (TAS), total sulfhydryl levels, paraoxonase (PON), ceruloplasmin (Cp) and arylesterase activities were determined as antioxidative parameters in the kidney tissue of rats. Kidney TOS, OSI and LOOH levels were significantly lower in IR plus TQ, IR plus NSO and sham groups compared to IR group (p < 0.001). TAS, PON and Cp activities in IR group were significantly lower compared to the control group (p < 0.001). PON and Cp activities were significantly higher in IR plus NSO and IR plus TQ groups compared to IR group (p < 0.001). In conclusion, free radicals generated by cranial ionizing radiation exposure cause oxidative stress in kidney. NSO and TQ exhibit protective and antioxidant effects against oxidative damage in rats.

Background: The purpose of this study was to investigate the radioprotective effects of thymoquinone against radiation-induced damage in the salivary glands of rats exposed to total cranial gamma irradiation.Methods: Thirty-two Sprague-Dawley rats were divided into 4 groups to test the radioprotective effectiveness of thymoquinone by intraperitoneal injection. An appropriate control group was also studied. Biochemical parameters in liver tissue of rats were determined by spectrophotometer.Results: Glutathione peroxidase (GSH-Px), glutathione-S-transferase (GST), total (enzymatic plus nonenzymatic) superoxide scavenger activity (TSSA), nonenzymatic superoxide scavenger activity (NSSA), and superoxide dismutase (SOD) activities were significantly decreased, whereas xanthine oxidase, nitric oxide synthase activities, malondialdehyde, nitric oxide, and peroxynitrite levels were significantly increased in the irradiation group when compared to the control and sham control groups.Conclusion: Results showed that thymoquinone reduces oxidative and nitrosative stress parameters and has antioxidant effects and a free radical scavenging activity.

Background : Our purpose was to invesgate propolis and its component caffeic acid phenethyl ester (CAPE) for their anoxidant effects on the brainssue of rats exposed to ionizing radiaon (IR). Materials and Methods : Fi&y-four male albino Sprague-Dawley rats, divided into six groups, were designed as normal control group, cranial irradiaon of 5 Gray alone, irradiaon plus CAPE, irradiaon plus propolis, control groups of propolis and CAPE. Oxidave/anoxidave status indicators, lipid peroxidaon and anoxidant enzyme s, were determined by biochemical methods in homogenized brainssue of rats. Results : Malondialdehyde level, the lipid peroxidaon index, in the irradiaon alone group was found to be significantly increased compared to all of the other groups (p<0.001). Enzyme acvies of superoxide dismutase (SOD) were 504.93, 720.70 and 659.98 for irradiaon alone group, irradiaon p lus CAPE group and irradiaon plus propolis group, respecvely. Enzyme acvity of SOD in the irradiaon alone group was found to be significantly decreased compared to the groups received propolis or CAPE (p<0.003). Enzyme acvity of glutathione peroxidase was not found stascally different among all of the groups. Conclusion: Propolis and CAPE were found to be beneficial agents in protecng brainssue against IR-induced oxidave damage.

Objective: Many cancer patients treated with radiotherapy suffer severe side effects during and after their treatment. The aim of this study was to investigate the effects of irradiation and the addition of Nigella sativa oil (NSO) on the oxidant/antioxidant system in the liver tissue of irradiated rats. Methods: A total of 24 Sprague-Dawley rats were randomly distributed into three groups of equal numbers. The control group received neither NSO nor irradiation but received 1-ml saline orally. The irradiation group (IR) received total head 5 gray (Gy) of gamma irradiation as a single dose, plus 1-ml saline orally. The IR plus NSO group received both total head 5 Gy of gamma irradiation as a single dose and 1 g/kg/day NSO orally through an orogastric tube starting one hour before irradiation and continuing for 10 days. Results: While liver tissue total oxidant status (TOS), lipid hydroperoxide (LOOH) level, and oxidative stress index (OSI) were significantly increased in the IR group compared to the control group, total antioxidant status (TAS), sulfhydryl (-SH) levels, and PON activity were significantly decreased. Cp activity in the IR plus NSO and IR groups was higher than in the control group. ARYL activity in the IR plus NSO supplemented group was higher than that in other groups. Conclusions: NSO reduces oxidative stress markers and has antioxidant effects, which also augments the antioxidant capacity in the liver tissue of rats.

To investigate Nigella sativa oil (NSO) and Thymoquinone (TQ) for their antioxidant effects on the brain tissue of rats exposed to ionizing radiation.Fifty-four male albino Wistar rats, divided into six groups, were designed as group I (normal control group) did not receive NSO, TQ or irradiation; group II (control group of TQ) received dimethyl sulfoxide and sham irradiation; group III (control group of NSO) received saline and sham irradiation; group IV (irradiation plus NSO group) received both 5 Gray of gamma irradiation to total cranium and NSO; group V (irradiation plus TQ group) received both irradiation and TQ; group VI (irradiation alone group) received irradiation plus saline. Alterations in nitric oxide (NO) and peroxynitrite (ONOO−) levels, and nitric oxide synthase (NOS) enzyme activity were measured by biochemical methods in homogenized brain tissue of rats.Levels of NO and ONOO−, and enzyme activity of NOS in brain tissue of the rats treated with NSO or TQ were found to be lower than in received IR alone (p<0.002)Nigella sativa oil (NSO) and its active component, TQ, clearly protect brain tissue from radiation-induced nitrosative stress.

PURPOSE:To evaluate the relationship between fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) maximum standardized uptake value (SUV(max)) and pain response to radiation therapy (RT) in patients with bone metastasis. MATERIALS AND METHODS:Institutional ethical board approval for the study was obtained, with informed consent, for this prospective study. Thirty-one patients with metastatic bone pain who underwent FDG PET/computed tomography before RT were included. Patients were diagnosed with lung (n = 16), breast (n = 7), stomach (n = 2), and head and neck cancers (n = 3), as well as unknown primary tumor (n = 3). Eighty-five painful metastatic locations with FDG PET scans geographically corresponding to 40 treatment fields were evaluated. Pain scores using visual analog scale or faces pain rating scale and SUV(max) at each location were recorded. All patients were treated with a single fraction 8 Gy RT. Pain scores after RT were assessed at weeks 2, 4, 8, 12, 16, 20, and 24. The pretreatment pain scores and pain response to RT were compared with FDG PET SUV(max) of each location. Pearson correlation, independent t test, one-way analysis of variance, and χ(2) tests were used for statistical analysis. RESULTS:Median SUV(max) and initial pain scores for all locations were 7.2 (range, 1.5-22.5) and 6 (range, 2-8), respectively. Median follow-up time was 24 (range, 3-112) weeks. Median SUV(max) was 4.5 (range, 3.1-7.3), 4.75 (range, 1.5-10.3), 8.8 (range, 5.2-11.9), and 12.1 (range, 7-22.5) for pretreatment pain scores of 2, 4, 6, and 8, respectively. SUV(max) was correlated with pretreatment pain scores (P < .0001). SUV(max) and pretreatment pain scores were also significantly associated with pain response to RT. Median SUV(max) for locations with complete response, partial response, pain progression, and indeterminate response was 5.2, 9.75, 10.8, and 6.4, respectively (P ≤ .001). CONCLUSION:FDG PET SUV(max) correlated with initial pain severity and pain response to RT and can be used as a predictive factor for treatment response in patients with painful bone metastasis treated with palliative RT.