Typically, bone metastasis causes osteolytic and osteoblastic lesions resulting from the interactions of tumor cells with osteoclasts and osteoblasts. In addition to these interactions, tumor tissues may grow inside bones and cause mass lesions. In the present study, we aimed to demonstrate the negative impact of a tumor mass in a large cohort of patients with bone metastatic cancer. Data from 335 patients with bone metastases were retrospectively reviewed. For the analysis, all patients were divided into three subgroups with respect to the type of bone metastasis: osteolytic, osteoblastic, or mixed. The patients were subsequently categorized as having bone metastasis with or without a tumor mass, and statistically significant differences in median survival and 2-year overall survival were observed between these patients (the median survival and 2-year overall survival were respectively 3 months and 16% in patients with a tumor mass and 11 months and 26% in patients without a tumor mass; p<0.001). According to multivariate analysis, the presence of bone metastasis with a tumor mass was found to be an independent prognostic factor (p=0.011, hazard ratio: 1.62, 95% confidence interval: 1.11-1.76). Bone metastasis with a tumor mass was more strongly associated with osteolytic lesions, other primary diseases (except for primary breast and prostate cancers), and spinal cord compression. Bone metastasis with a tumor mass is a strong and independent negative prognostic factor for survival in cancer patients.

This study aimed to investigate the factors affecting permanent sensorineural hearing loss (SNHL) and causing changes in bone conduction (BC) thresholds over time in patients after receiving radiotherapy (RT) or chemoradiotherapy (CRT) to the head and neck region. A total of 63 patients with irradiated HNC that were admitted to the Radiation Oncology Department between 2011 and 2018 were included in the study. All patients were assessed with pure tone audiometry at eight different time points (first before RT and last five years after completion of RT). A chi-square test was used to analyze the variables that affected permanent SNHL occurrence. Repeated measure analysis of variance was conducted to investigate the factors affecting change in the BC threshold at pure-tone average (0.5–2 kHz) and the air conduction (AC) threshold at 4 and 6 kHz frequencies over time. Median follow-up was 52 months (range, 12–110 months). SNHL was found in 18 (14%) of the 126 ears. According to the receiver operating characteristic analysis, the cut-off values of cochlear D_mean and D_max radiation doses were 40 Gy [p=0.017, area under the curve (AUC): 0.676] and 45 Gy (p=0.008, AUC: 0.695). D_mean (≤40 Gy vs. >40 Gy) and D_max (≤45 Gy vs. >45 Gy) cochlear doses and age (≤40 vs. >40 years) were determined as factors affecting SNHL in the chi-square test. Repeated measures showed that BC thresholds between 0.5–2 kHz and AC thresholds at 4 and 6 kHz increased over time. Age (≤40 vs. >40 years), treatment of head and neck cancer (RT vs. CRT), cisplatin use, and D_mean (≤40 Gy vs. >40 Gy) and D_max cochlear dose (≤45 Gy vs. >45 Gy) were important factors affecting the course of BC threshold over time. D_mean and D_max cochlear doses and age were found to be associated with permanent SNHL. Conduction thresholds worsened over time at all frequencies, and this trend was affected by cochlear doses, age, CRT, and cisplatin use.

UYARI Bu üründe yer alan bilgiler sadece lisanslı tıbbi çalışanlar için kaynak olarak sunulmuştur. Herhangi bir konuda profesyonel tıbbi danışmanlık veya tıbbi tanı amacıyla kullanılmamalıdır. Akademisyen Kitabevi ve alıcı arasında herhangi bir şekilde doktor-hasta, terapist-hasta ve/veya başka bir sağlık sunum hizmeti ilişkisi oluşturmaz. Bu ürün profesyonel tıbbi kararların eşleniği veya yedeği değildir. Akademisyen Kitabevi ve bağlı şirketleri, yazarları, katılımcıları, partnerleri ve sponsorları ürün bilgilerine dayalı olarak yapılan bütün uygulamalardan doğan, insanlarda ve cihazlarda yaralanma ve/veya hasarlardan sorumlu değildir. İlaçların veya başka kimyasalların reçete edildiği durumlarda, tavsiye edilen dozunu, ilacın uygulanacak süresi, yöntemi ve kontraendikasyonlarını belirlemek için, okuyucuya üretici tarafından her ilaca dair sunulan güncel ürün bilgisini kontrol etmesi tavsiye edilmektedir. Dozun ve hasta için en uygun tedavinin belirlenmesi, tedavi eden hekimin hastaya dair bilgi ve tecrübelerine dayanak oluşturması, hekimin kendi sorumluluğundadır. Akademisyen Kitabevi, üçüncü bir taraf tarafından yapılan ürüne dair değişiklikler, tekrar paketlemeler ve özelleştirmelerden sorumlu değildir.