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- Title
Low hemoglobin levels predict increased radiation‐induced trismus rates in nasopharyngeal cancer.
- Authors
Somay, Efsun; Yilmaz, Busra; Topkan, Erkan; Pehlivan, Berrin; Selek, Uğur
- Abstract
Purpose: To investigate the predictive significance of hemoglobin (Hb) values in the incidence of radiation‐induced trismus (RIT) in locally advanced nasopharyngeal carcinoma (LA‐NPC) patients who received concurrent chemoradiotherapy (C‐CRT). Methods: Data of LA‐NPC patients were examined before and after C‐CRT and to confirm the presence of RIT, maximum mouth openings (MMO) were measured; RIT is defined as an MMO of ≤35 mm. All Hb values were derived from complete blood count tests obtained on the first day of C‐CRT. The receiver operating characteristic (ROC) curve analysis was used to scrutinize a possible connection between pre‐treatment Hb values and RIT status. Results: Two hundred and twenty three patients were included in the study and RIT was diagnosed in 46 (20.6%) patients. The Hb cutoff in ROC curve analysis that separated the patients into two groups was 12.05 g/dL [Area under the curve (AUC): 82.7%; sensitivity: 72.9%; and specificity: 71.3%]. RIT was significantly more prevalent in the Hb ≤ 12 g/dL group than in its counterpart (41.9% vs. 7.3%; p < 0.001). In multivariate analysis, Hb ≤ 12, anemia, pre‐C‐CRT MMO < 41.4 mm, and masticatory apparatus doseV58 Gy < 32% groups were found to be independently associated with significantly increased rates of RIT. Conclusion: Low pre‐C‐CRT Hb and anemia status are novel biological markers that independently predict higher RIT rates in LA‐NPC undergoing C‐CRT.
- Subjects
ANEMIA; CANCER relapse; RECEIVER operating characteristic curves; MULTIVARIATE analysis; CANCER chemotherapy; PRE-tests &; post-tests; RADIATION carcinogenesis; CANCER patient psychology; TRISMUS; NASOPHARYNX tumors; SENSITIVITY &; specificity (Statistics)
- Publication
Oral Diseases, 2024, Vol 30, Issue 3, p1052
- ISSN
1354-523X
- Publication type
Article
- DOI
10.1111/odi.14605