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Öğe An Investigation of the Role of Phase Angle in Malnutrition Risk Evaluation and Clinical Outcomes in Patients with Head and Neck or Brain Tumors Undergoing Radiotherapy(Routledge Journals, Taylor & Francis Ltd, 2024) Emir, Kubra Nur; Demirel, Birsen; Atasoy, Beste M.This cross-sectional study aimed to investigate the role of bioelectrical impedance analysis (BIA) and phase angle measurement in assessing malnutrition in head and neck (n = 37) and brain (n = 63) tumor patients received radiotherapy. Common nutritional screening and assessment tests were used to identify malnutrition in the patients. Each patient underwent these tests once, along with phase angle measurement. Additionally, inflammation parameters, including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic inflammatory index (SII), were calculated. All study results were correlated with the phase angle cutoff point of 5.72(degrees). The phase angle demonstrated significant correlations with subjective global assessment (SGA), mini nutritional assessment (MNA) scores, BIA parameters, nutritional index, NLR, and SII (p < 0.05). Moreover, in head and neck tumor patients, those with higher standardized phase angle values exhibited significantly better two-year overall survival (32.1% vs. 87.5%, p = 0.006). The phase angle measurement is a convenient, noninvasive, and reproducible method that can complement existing tools for assessing malnutrition risk in radiotherapy patients. The significant correlations observed between the phase angle and various nutritional, inflammation markers and prognosis highlight its potential utility. Further studies incorporating a larger patient cohort will be beneficial in establishing a standard phase angle reference value for cancer patients.Öğe Comparison of Three Nutritional Screening Tools to Predict Malnutrition Risk and Detect Distinctions Between Tools in Cancer Patients Receiving Radiochemotherapy(Routledge Journals, Taylor & Francis Ltd, 2018) Demirel, Birsen; Atasoy, Beste M.The aim of this study was to compare three screening tools for malnutrition in patients with head and neck cancers or central nervous system tumors (CNS) who are undergoing radio-chemotherapy. The study evaluated 124 adult cancer patients. The Subjective Global Assessment (SGA), Mini-Nutritional Assessment (MNA), and Nutritional Risk Screening 2002 (NRS-2002) were chosen to assess the risk of malnutrition. The prevalence of patients at nutritional risk was 31% with SGA, 31% with MNA and 23% with NRS-2002 in all patients. The agreement between SGA and MNA was substantial (k = 0.886, P<0.001); the agreement between SGA and NRS-2002 was moderate (k = 0.713, P<0.001); and the agreement between MNA and NRS-2002 was also moderate (k = 0.795, P<0.001). In subgroup analysis, SGA and MNA substantially (k = 0.973, P<0.001), SGA and NRS-2002 moderately (k =0.722, P<0.001), and MNA and NRS-2002 moderately (k =0.747, P<0.001) agreed in head and neck cancer patients. In CNS tumor patients, SGA and MNA slightly (k = 0.390, P = 0.005), SGA and NRS-2002 fairly (k = 0.457, P = 0.001), and MNA and NRS-2002 substantially (k = 0.878, P<0.001) agreed. The best agreement in tools was observed between SGA with MNA in all patients. Further studies in different tumor groups will enhance our understanding of current tools for malnutrition detection of radiotherapy patient.Öğe Mucositis-Induced Pain due to Barrier Dysfunction may have a Direct Effect on Nutritional Status and Quality of Life in Head and Neck Cancer Patients Receiving Radiotherapy(Kare Publ., 2020) Atasoy, Beste M.; Kayhan, Kıvanç Bektaş; Demirel, Birsen; Akdeniz, EsraOBJECTIVE To maintain the barrier function against mucositis-induced pain and to improve the nutritional status and quality of life in head and neck cancer patients during radiotherapy. METHODS All patients (n=30) used oral gel to reduce mucositis-induced pain. Patients were examined weekly for the severity of mucositis, pain and nutritional status. The quality of life parameters was measured at the beginning and at the end of treatment. There was no restriction for pain killers against mucositis. RESULTS The only significant factor affecting the severity and frequency of mucositis was the cumulative radiation dose (p<0.001). Despite the regular use of oral gel, weight loss was observed in 65% of the patients. There was no difference concerning the severity of mucositis, cumulative radiation doses, or mean dose of oral mucosa between patients with no risk or at risk, according to SGA. However, self-assessment pain scores were significantly better in the well-nourished group (p=0.05 vs. 0.015) with better scores for dry mouth (p=0.043), social eating (p=0.006), swallowing difficulties (p=0.001) and communication (p=0.049). CONCLUSION Supporting the barrier function alone does not help to reduce the severity and frequency of mucositis, nor the oral pain in high doses. Mucositis-induced pain may have a direct effect on malnutrition risk and quality of life in head and neck cancer patients. Powerful strategies are required to manage pain due to mucositis during curative radiotherapy.Öğe Translation, validity, and reliability of NUTRISCORE: the nutrition risk assessment screening test for Turkish cancer patients(Wiley, 2022) Ak, Elif; Demirel, Birsen; Atasoy, Beste M.; Yumuk, Perran FuldenPurpose The aim was to determine the validity and the reliability of the Turkish version of the screening test named NUTRISCORE in cancer patients. Methods The language validity of the Turkish form of the study scale was provided by the translationback-translation method. NUTRISCORE and nutritional risk screening (NRS)-2002, malnutrition screening tool (MST), and European Diagnostic Criteria (EDC) were administered to 240 volunteers in oncology clinics, and receiver operating characteristic curves (ROC) were calculated for the validity and reliability analysis. Cohen's kappa coefficient was used to determine the fit between the screening tests. Results Thirteen experts were consulted for scale content validity, and the content validity index was found to be 0.94. The scale was administered to 67 patients with 4-week intervals for test-retest reliability, and a positive, high-level and statistically significant relationship was found between the two measurements (r = 0.971, P < 0.01). Compared with the reference test NRS-2002, the specificity values of NUTRISCORE, MST, and EDC screening tests were found to be 100%, 83%, and 91%, whereas the sensitivity values of same screening tests were calculated as 85%, 91% and 81%, respectively. According to Cohen's kappa statistics, the kappa agreement between NRS-2002 and NUTRISCORE was 0.88, the kappa agreement between NRS-2002 and MST was 0.34, and it was found to be 0.73 for NRS-2002 and EDC. Conclusion The nutrition screening test named NUTRISCORE showed adequate validity and reliability in Turkish and can detect malnutrition risk of cancer patients treated in oncology clinics as a screening tool.
