title: Alterations of ghrelin with weights and correlation among ghrelin, cytokine and survival in patients receiving chemoradiotherapy for gastrointestinal cancers.
abstract: OBJECTIVE
  This study involved 30 patients (16 had gastric, 9 pancreatic and 5 gall bladder cancer) who had received concomitant chemoradiotherapy (CRT). Blood ghrelin and IL-6 values were compared before, in the last week of, and 3 months after CRT. Meanwhile, changes in body weight of patients were also investigated with changes in ghrelin and IL-6 levels before, in the last week of, and after radiotherapy (RT).
  
  
  METHODS
  Informed consent of the patients and the ethical committee approval from Cukurova University Medical Faculty were taken. Blood ghrelin and IL-6 levels were measured by using the ELISA method. Survival analysis was performed by the Kaplan Maier method, and data were evaluated by using the SPSS 19.0 package. Categorical measurements were calculated as numbers and percentages, whereas numerical data were summarized as mean and standard deviation.
  
  
  RESULTS
  The correlation between ghrelin and IL-6 values at the baseline of RT and overall survival rates at the end of the 30-month follow up was analyzed. Accordingly, ghrelin values were also changed in line with changes in patients' weights (P < 0.001). Patients with ghrelin values above 35 pg/ml before RT had longer survival rates at the end of the 30-month follow up (P = 0.001). Overall survival rates in patients with IL-6 value at or below 3.9 pg/ml before RT were longer than patients with IL-6 value above 3.9 pg/ml (P = 0.021).
  
  
  CONCLUSIONS
  Therefore, the initiation of ghrelin analogue prophylactically in patients receiving chemoradiotherapy with gastrointestinal system malignancies can both prevent weight loss by increasing appetite and decrease severity of inflammation, thereby increasing survival.
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, Cukurova University Adana, Turkey.
authors.forename: Feryal
authors.initials: F
authors.lastname: Karaca
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Cukurova University Adana, Turkey.
authors.forename: Cigdem Usul
authors.initials: CU
authors.lastname: Afsar
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Cukurova University Adana, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Gunaldi
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, Cukurova University Adana, Turkey.
authors.forename: Erkut
authors.initials: E
authors.lastname: Erkurt
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Cukurova University Adana, Turkey.
authors.forename: Vehbi
authors.initials: V
authors.lastname: Ercolak
authors.affiliation: Department of Biostatistic, Faculty of Medicine, Cukurova University Adana, Turkey.
authors.forename: Yasar
authors.initials: Y
authors.lastname: Sertdemir
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Cukurova University Adana, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Paydas
keywords: Ghrelin; cancer; radiotherapy; survival; weight