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    Nivolumab-induced sensory ganglionopathy
    (Sage Publications Ltd, 2023) Coskun, Ozlem; Sahin, Hasan; Yalcin, Selim; Sahin, Yekta C.; Coskun, Ugur
    Introduction Nivolumab is s a human monoclonal antibody. Due to its widespread use in many cancers, including Merkel cell carcinoma, adverse reactions associated with nivolumab, such as neuropathies, endocrinopathies, gastrointestinal problems, and skin toxicities have been increasing. Sensory ganlionopathy is rarely observed in these patients. Case description We present a 63-year-old male with a medical history of Merkel cell carcinoma that recurred two times in the inguinal region. After undergoing surgery with adjuvant radiotherapy, a second surgery was performed. The patient suffered from tingling in all four limbs plus difficulty in walking after initiation of the third dose of nivolumab. Management and outcome After 1 month of 1 mg/kg/day methylprednisolone treatment, he showed significant improvement. Subsequently, the systemic corticosteroid regimen was tapered to 5 mg every other day. The treatment resulted in significant improvement in all extremities. Discussion Sensory ganlionopathy can be seen as a side effect of an immune checkpoint inhibitor, even though it is very extraordinary. This is the case in the literature to develop sensory ganlionopathy due to nivolumab. We believe that patients using nivolumab may develop sensory ganlionopathy and management should be taken on this point.
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    Risk Factors of Nasopharyngeal Carcinoma in Turkey - an Epidemiological Survey of the Anatolian Society of Medical Oncology
    (Asian Pacific Organization Cancer Prevention, 2011) Turkoz, Fatma Paksoy; Celenkoglu, Gokhan; Dogu, Gamze Gokoz; Kalender, Mehmet Emin; Coskun, Ugur; Alkis, Necati; Arslan, Ulku Yalcintas
    Background: Nasopharyngeal carcinoma is a rare disease in most parts of the world with a multifactorial etiology involving an interaction of genetic, viral, environmental and dietary risk factors. This is the first epidemiologic study aimed to evaluate the risk factors of nasopharyngeal carcinoma in the Turkish population. Methods: We conducted a multicentric, retrospective, case-control study using a standardized questionnaire which captured age, sex, occupation, household type, blood group, dietary habits, smoking, alcohol consumption and oral hygiene. The study included 183 cases and 183 healthy controls matched by sex and age. Multiple logistic regression and univariate analysis were employed. Results: The peak age incidence was 40-50 years and the male to female ratio was 2:1. We observed significant associations between elevated nasopharyngeal carcinoma risk and low socioeconomic status, rural household type (OR: 3.95, p<0.001), farming (OR: 4.24, p<0.001) and smoking (OR: 3.15, p<0.001). Consumption of french fries (OR: 1.44, p=0.024), fried meat (OR: 1.05, p=0.023) and tea (OR: 5.55, p<0.001) were associated with elevated risk, while fresh fruit consumption was associated with reduced risk (OR: 0.59, p=0.011). An irregular meal pattern was also a risk factor (OR: 1.75, p=0.012). There were no significant associations between consumption of grain, diary products, alcohol and nasopharyngeal carcinoma risk (p>0.05); furthermore salty foods had a borderline p value (OR: 2.14, p=0.053). Blood type A increased the risk (OR: 2.03, p=0.002) while blood type 0 was a protective factor (OR: 0.53, p=0.009). Rare habit of teeth brushing (OR: 6.17, p<0.001) and >= 10 decayed teeth before diagnosis (OR: 2.17, p<0.001) increased the risk. Conclusions: The nasopharyngeal carcinoma risk factors described in the literature are also applicable for the Turkish population. People with type A blood are at risk in Turkey. Salted foods have also a border risk out of the endemic regions. This is the only study showing that poor oral hygene is a serious risk factor for nasopharyngeal carcinoma.