Diş Hekimliği Fakültesi / Faculty of Dentistry

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Author: search.filters.author.Topkan, Erkansearch.filters.applied.f.language: search.filters.language.en_US

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    Predictive Potential Of Pan-Immune-Inflammation Value / Hemoglobin Index As Biomarker For Osteoradionecrosis Risk In Locally Advanced Nasopharyngeal Carcinomas
    (JOURNAL OF STOMATOLOGY ORAL AND MAXILLOFACIAL SURGERY, 2024-03-27) Yilmaz, Busra; Somay, Efsun; Topkan, Erkan; Pehlivan, Berrin; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, Ugur
    Objective: We aimed to investigate whether the Pan-Immune-Inflammation-Value/Hemoglobin (PIV/Hb) index could predict the risk of osteoradionecrosis (ORN) in patients receiving concurrent chemoradiotherapy (CCRT) for locally advanced nasopharyngeal cancer (LA-NPC). Materials and methods: This retrospective analysis included LA-NPC patients who underwent CCRT and preCCRT oral exams at our institution's Departments of Radiation Oncology and Dentistry between January 2010 and December 2022. The relationship between ORN rates and PIV-Hb levels was explored using receiver operating characteristic curve analysis. The primary objective was to establish a correlation between pre-CCRT PIV-Hb levels and ORN rates, while the secondary objective was to identify other risk factors for ORN. Results: Of 249 eligible patients, 21 (8.4 %) were diagnosed with ORN. The optimal pre-CCRT PIV/Hb cutoff was 73.8, which divided patients into two subgroups with distinctive ORN risk estimates: Group 1: PIV/ Hb < 73.8 (N = 206), and Group 2: PIV/Hb >= 73.8 (N = 43). The results of the comparative analysis indicated that the cohort with PIV/Hb >= 73.8 exhibited substantially higher rates of ORN than the PIV/Hb < 73.8 cohort (44.2 % vs. 1.0 %; P < 0.001). The multivariate logistic regression analysis indicated that the pretreatment PIV/ Hb >= 73.8 was independently associated with higher ORN rates (P < 0.001). Conclusion: The results of our current investigation indicate that higher levels of pretreatment PIV/Hb were associated with a significant independent increase in ORN rates in LA-NPC patients who received CCRT. (c) 2024 Elsevier Masson SAS. All rights reserved.
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    Worth Of Pan-Immune-Inflammation Value In Trismus Prediction After Concurrent Chemoradiotherapy For Nasopharyngeal Carcinomas
    (INTERNATIONAL JOURNAL OF BIOLOGICAL MARKERS, 2024-01-21) Somay, Efsun; Yilmaz, Busra; Topkan, Erkan; Ozdemir, Beyza Sirin; Ozturk, Duriye; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, Ugur
    Objective: Radiation-induced trismus (RIT), one of the rare but serious side effects of concurrent chemoradiotherapy (C-CRT), is difficult to predict with high accuracy. We aimed to examine whether the pretreatment pan-immune-inflammation value (PIV) measures predict RIT in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) receiving C-CRT.Methods: Data of patients with LA-NPC who underwent C-CRT and had maximum mouth openings (MMO) > 35 mm were reviewed. Any MMO of 35 mm or less after C-CRT was considered RIT. All PIV values were computed using the complete blood count test results: PIV = (Platelets x Monocytes x Neutrophils) divided by Lymphocytes. The receiver operating characteristic analysis was employed to dissect a possible association between pre-treatment PIV readings and RIT status. Confounding variables were tested for their independent relationship with the RIT rates using logistic regression analysis.Results: The research comprised 223 participants, and RIT was diagnosed in 46 (20.6%) at a median time from C-CRT to RIT of 10 months (range: 5-18 months). Pre-C-CRT PIV levels and RIT rates were analyzed using receiver operating characteristic curve analysis, with 830 being the optimal cutoff (area under the curve: 92.1%; sensitivity: 87.5%; specificity: 85.5%; Youden index: 0.730). RIT was significantly more prevalent in the PIV > 830 cohort than its PIV <= 830 counterpart (60.3% vs. 5%; hazard ratio 5.79; P < 0.001). Multivariate logistic regression analysis revealed that advanced T-stage (P = 0.004), masticatory apparatus dose V58Gy >=%32 (P = 0.003), and PIV > 830 (P < 0.001) were independently linked with significantly elevated rates of RIT.Conclusion: The presence of elevated pre-C-CRT PIV i
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    The Use of Pre-Chemoradiotherapy Total Masseter Muscle Volume as a Novel Predictor of Radiation-Induced Trismus in Locally Advanced Nasopharyngeal Carcinoma Patients
    (TOMOGRAPHY, 2024-02-07) Somay, Efsun; Topkan, Erkan; Pehlivan, Umur Anil; Yilmaz, Busra; Besen, Ali Ayberk; Mertsoylu, Huseyin; Pehlivan, Berrin; Selek, Ugur
    Background: We sought to determine whether pretreatment total masseter muscle volume (TMMV) measures can predict radiation-induced trismus (RIT) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) receiving concurrent chemoradiotherapy (C-CRT). Methods: We retrospectively reviewed the medical records of LA-NPC patients who received C-CRT and had pretreatment maximum mouth openings (MMO) greater than 35 mm. MMO of 35 mm or less after C-CRT were considered RIT. We employed receiver operating characteristic (ROC) curve analysis to explore the correlation between pre-treatment TMMV readings and RIT status. Results: Out of the 112 eligible patients, 22.0% of them received a diagnosis of RIT after C-CRT. The optimal TMMV cutoff that was significantly linked to post-C-CRT RIT rates was determined to be 35.0 cc [area under the curve: 79.5%; sensitivity: 75.0%; and specificity: 78.6%; Youden index: 0.536] in the ROC curve analysis. The incidence of RIT was significantly higher in patients with TMMV <= 5.0 cc than in those with TMMV > 35.0 cc [51.2% vs. 8.7%; Odds ratio: 6.79; p < 0.001]. A multivariate logistic regression analysis revealed that pre-C-CRT MMO <= 41.6 mm (p = 0.001), mean masticatory apparatus dose V56.5 >= 34% group (p = 0.002), and TMMV <= 35 cc were the independent predictors of significantly elevated rates of RIT. Conclusion: The presence of a smaller pretreatment TMMV is a reliable and independent novel biological marker that can confidently predict higher RIT rates in LA-NPC patients who receive C-CRT.
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    Toxicities And Prognostic Factors In Elderly HPV-Associated Oropharyngeal Cancer Patients Treated With Radiotherapy Or Chemoradiotherapy
    (JOURNAL OF MEDICAL VIROLOGY, 2024-03-24) Topkan, Erkan; Somay, Efsun; Selek, Ugur
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    In Reference To Primary Site Surgical Resection In Cm1 Oral Cavity Squamous Cell Carcinoma
    (LARYNGOSCOPE INVESTIGATIVE OTOLARYNGOLOGY, 2024-12) Topkan, Erkan; Somay, Efsun; Selek, Ugur
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    Topkan's CARWL Index Efficiently Predicts the Radiation-Induced Tooth Loss Rates in Radically Treated Locally Advanced Nasopharyngeal Cancer Patients
    (TECHNOLOGY IN CANCER RESEARCH & TREATMENT, 2024-11-01) Somay, Efsun; Topkan, Erkan; Bascil, Sibel; Ozturk, Duriye; Senyurek, Sukran; Durankus, Nilufer Kilic; Selek, Ugur
    Purpose To assess the usefulness of the novel CARWL index in predicting radiation-induced tooth loss (RITL) rates in locally advanced nasopharyngeal cancer (LA-NPC) patients undergoing concurrent chemoradiotherapy (C-CRT). Methods The study retrospectively examined data from 323 LA-NPC patients. The patients were divided into two groups based on cutoff values for CAR and weight loss (WL). The ideal cutoff for RITL was 3.0 g/dL [AUC: 83.0%, sensitivity: 83.6%, specificity: 81.4%, J-index: 0.650]. CARWL index was created by combining pretreatment CAR and WL status (WL <= 5.0% vs > 5.0%, resulting in four groups: Group 1: CAR < 3.0 and WL <= 5.0%, Group 2: CAR < 3.0 and WL > 5.0%, Group 3: CAR >= 3.0 and WL <= 5.0%, and Group 4: CAR > 3.0 and WL > 5.0%. Results RITL was diagnosed in 67.2% of patients. Since the RITL rates of Groups 2 and 3 were statistically indistinguishable, we combined them and created the three-tiered CARWL score groups: CARWL-0: CAR < 3.0 and WL <= 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR >= 3.0 and WL <= 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. Comparative analysis revealed that the RITL rates gradually and significantly increased from CARWL-0 to CARWL-2 score groups (49.4% vs 64.7% vs 83.0%; P <0.001) despite similar baseline disease and patient characteristics. Results of the multivariate analysis showed that higher CARWL score groups were independent and significant predictors of increased RITL rates (p < 0.001). Conclusion Present results suggest that the novel CARWL index is a reliable biomarker for predicting RITL incidence in LA-NPC patients.
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    Predicting Osteoradionecrosis Risk In Patients With Locoregionally Advanced Nasopharyngeal Carcinoma Undergoing Concurrent Chemoradiotherapy: The Value Of The Carwl Index
    (BIOMOLECULES AND BIOMEDICINE, 2024) Durankus, Nulifer Kilic; Somay, Efsun; Bascil, Sibel; Senyurek, Sukran; Ozturk, Duriye; Selek, Ugur; Topkan, Erkan
    Osteoradionecrosis (ORN) is a severe complication that can arise in patients with nasopharyngeal carcinoma due to the aggressive nature of chemoradiotherapy treatment. The purpose of our study was to assess the utility of the recently introduced CARWL index, which integrates the C-reactive protein-to-albumin ratio (CAR) and significant weight loss (SWL), in predicting the risk of ORN in patients with locoregionally advanced nasopharyngeal cancer (LA-NPC) undergoing concurrent chemoradiotherapy (CCRT). We conducted a retrospective cohort analysis on 304 patients with LA-NPC treated with CCRT. Patients were categorized into CARWL index groups based on CAR (cut-off: 3.0) and SWL (weight loss> 5% over the past six months): CARWL-0 (CAR< 3.0, SWL <= 5%), CARWL-1 (CAR< 3.0with SWL > 5% or CAR >= 3.0 with SWL <= 5%), and CARWL-2 (CAR >= 3.0 and SWL> 5%). The primary endpoint was the incidence of ORN in each CARWL index group. At a median follow-up of 67.2 months, 28 patients (9.2%) developed ORN. The incidence of ORN was 2.1%, 9.4%, and 16.3% in the CARWL-0, CARWL-1, and CARWL-2 groups, respectively (P< 0.001). Multivariate analysis identified smoking status (HR: 2.58, P= 0.034), N-stage (HR: 1.96, P= 0.008), T-stage (HR: 1.84, P= 0.017), pre-CCRT tooth extraction status (HR: 5.81, P< 0.001), post-CCRT tooth extraction status (HR: 6.82, P< 0.001), mandibular V55.8 Gy (HR: 6.12, P < 0.001), and CARWL score (HR: 5.67, P= 0.002) as significant predictors of ORN. The CARWL index is a reliable predictive tool for evaluating the risk of ORN in LA-NPC patients undergoing CCRT. If further validated, its use in clinical settings could aid in the early identification of high-risk patients and enable the implementation of personalized preventive strategies.