Diş Hekimliği Fakültesi / Faculty of Dentistry
Permanent URI for this collectionhttps://hdl.handle.net/11727/2120
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Item Predictive Potential Of Pan-Immune-Inflammation Value / Hemoglobin Index As Biomarker For Osteoradionecrosis Risk In Locally Advanced Nasopharyngeal Carcinomas(JOURNAL OF STOMATOLOGY ORAL AND MAXILLOFACIAL SURGERY, 2024-03-27) Yilmaz, Busra; Somay, Efsun; Topkan, Erkan; Pehlivan, Berrin; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, UgurObjective: We aimed to investigate whether the Pan-Immune-Inflammation-Value/Hemoglobin (PIV/Hb) index could predict the risk of osteoradionecrosis (ORN) in patients receiving concurrent chemoradiotherapy (CCRT) for locally advanced nasopharyngeal cancer (LA-NPC). Materials and methods: This retrospective analysis included LA-NPC patients who underwent CCRT and preCCRT oral exams at our institution's Departments of Radiation Oncology and Dentistry between January 2010 and December 2022. The relationship between ORN rates and PIV-Hb levels was explored using receiver operating characteristic curve analysis. The primary objective was to establish a correlation between pre-CCRT PIV-Hb levels and ORN rates, while the secondary objective was to identify other risk factors for ORN. Results: Of 249 eligible patients, 21 (8.4 %) were diagnosed with ORN. The optimal pre-CCRT PIV/Hb cutoff was 73.8, which divided patients into two subgroups with distinctive ORN risk estimates: Group 1: PIV/ Hb < 73.8 (N = 206), and Group 2: PIV/Hb >= 73.8 (N = 43). The results of the comparative analysis indicated that the cohort with PIV/Hb >= 73.8 exhibited substantially higher rates of ORN than the PIV/Hb < 73.8 cohort (44.2 % vs. 1.0 %; P < 0.001). The multivariate logistic regression analysis indicated that the pretreatment PIV/ Hb >= 73.8 was independently associated with higher ORN rates (P < 0.001). Conclusion: The results of our current investigation indicate that higher levels of pretreatment PIV/Hb were associated with a significant independent increase in ORN rates in LA-NPC patients who received CCRT. (c) 2024 Elsevier Masson SAS. All rights reserved.Item Worth Of Pan-Immune-Inflammation Value In Trismus Prediction After Concurrent Chemoradiotherapy For Nasopharyngeal Carcinomas(INTERNATIONAL JOURNAL OF BIOLOGICAL MARKERS, 2024-01-21) Somay, Efsun; Yilmaz, Busra; Topkan, Erkan; Ozdemir, Beyza Sirin; Ozturk, Duriye; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, UgurObjective: Radiation-induced trismus (RIT), one of the rare but serious side effects of concurrent chemoradiotherapy (C-CRT), is difficult to predict with high accuracy. We aimed to examine whether the pretreatment pan-immune-inflammation value (PIV) measures predict RIT in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) receiving C-CRT.Methods: Data of patients with LA-NPC who underwent C-CRT and had maximum mouth openings (MMO) > 35 mm were reviewed. Any MMO of 35 mm or less after C-CRT was considered RIT. All PIV values were computed using the complete blood count test results: PIV = (Platelets x Monocytes x Neutrophils) divided by Lymphocytes. The receiver operating characteristic analysis was employed to dissect a possible association between pre-treatment PIV readings and RIT status. Confounding variables were tested for their independent relationship with the RIT rates using logistic regression analysis.Results: The research comprised 223 participants, and RIT was diagnosed in 46 (20.6%) at a median time from C-CRT to RIT of 10 months (range: 5-18 months). Pre-C-CRT PIV levels and RIT rates were analyzed using receiver operating characteristic curve analysis, with 830 being the optimal cutoff (area under the curve: 92.1%; sensitivity: 87.5%; specificity: 85.5%; Youden index: 0.730). RIT was significantly more prevalent in the PIV > 830 cohort than its PIV <= 830 counterpart (60.3% vs. 5%; hazard ratio 5.79; P < 0.001). Multivariate logistic regression analysis revealed that advanced T-stage (P = 0.004), masticatory apparatus dose V58Gy >=%32 (P = 0.003), and PIV > 830 (P < 0.001) were independently linked with significantly elevated rates of RIT.Conclusion: The presence of elevated pre-C-CRT PIV iItem The Use of Pre-Chemoradiotherapy Total Masseter Muscle Volume as a Novel Predictor of Radiation-Induced Trismus in Locally Advanced Nasopharyngeal Carcinoma Patients(TOMOGRAPHY, 2024-02-07) Somay, Efsun; Topkan, Erkan; Pehlivan, Umur Anil; Yilmaz, Busra; Besen, Ali Ayberk; Mertsoylu, Huseyin; Pehlivan, Berrin; Selek, UgurBackground: We sought to determine whether pretreatment total masseter muscle volume (TMMV) measures can predict radiation-induced trismus (RIT) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) receiving concurrent chemoradiotherapy (C-CRT). Methods: We retrospectively reviewed the medical records of LA-NPC patients who received C-CRT and had pretreatment maximum mouth openings (MMO) greater than 35 mm. MMO of 35 mm or less after C-CRT were considered RIT. We employed receiver operating characteristic (ROC) curve analysis to explore the correlation between pre-treatment TMMV readings and RIT status. Results: Out of the 112 eligible patients, 22.0% of them received a diagnosis of RIT after C-CRT. The optimal TMMV cutoff that was significantly linked to post-C-CRT RIT rates was determined to be 35.0 cc [area under the curve: 79.5%; sensitivity: 75.0%; and specificity: 78.6%; Youden index: 0.536] in the ROC curve analysis. The incidence of RIT was significantly higher in patients with TMMV <= 5.0 cc than in those with TMMV > 35.0 cc [51.2% vs. 8.7%; Odds ratio: 6.79; p < 0.001]. A multivariate logistic regression analysis revealed that pre-C-CRT MMO <= 41.6 mm (p = 0.001), mean masticatory apparatus dose V56.5 >= 34% group (p = 0.002), and TMMV <= 35 cc were the independent predictors of significantly elevated rates of RIT. Conclusion: The presence of a smaller pretreatment TMMV is a reliable and independent novel biological marker that can confidently predict higher RIT rates in LA-NPC patients who receive C-CRT.Item Systemic Inflammation Score for Predicting Radiation-Induced Trismus and Osteoradionecrosis of the Jaw Rates in Locally Advanced Nasopharyngeal Carcinoma Patients(2023) Somay, Efsun; Sezen, Duygu; Selek, Ugur; Besen, Ali Ayberk; Mertsoylu, Huseyin; Topkan, Erkan; 0000-0001-8120-7123; AAG-2213-2021We sought to determine the predictive value of the systemic inflammation score (SIS) for radiation-induced trismus (RIT) and osteora-dionecrosis of the jaw (ORNJ) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients treated with concurrent chemoradio-therapy (C-CRT). LA-NPC patients (n= 188) who underwent C-CRT and pre-and post-C-CRT oral examinations from August 2010 to January 2022 were included. The three-tiered SIS groups were created using the serum albumin and lymphocyte-to-monocyte ratio (LMR) measures obtained on the first day of C-CRT: SIS-0: Albumin >= 40 g/dL and LMR >= 4.44); SIS-1: Albumin < 40 g/dL and LMR < 4.44 or albumin >= 0 g/dL and LMR >= 4.44; and SIS-2: Albumin < 40 g/dL and LMR <4.44. The primary objective was to ascertain whether there were irrefutable associations between pretreatment SIS groups and the respective post-C-CRT RIT and ORNJ rates. RIT and ORNJ were diagnosed in 33 (17.6%) and 21 (11.1%) patients, respectively. There were 12 (32.4%), 13 (12.7%), and 18 (45.0%) cases diagnosed with RIT in the respective SIS-0, SIS-1, and SIS-2 groups (p< 0.001). Similarly, there were 1 (2.7%), 11 (9.9%), and 9 (22.5%) cases with ORNJ diagnoses in the corresponding SIS groups (p< 0.001). The multivariate analysis's findings revealed that the SIS grouping was an independent predictor of RIT (p< 0.001) and ORNJ incidence rates (p< 0.001). Our study's findings indicate that the novel pretreatment SIS grouping is a dependable biomarker-based system, which can accurately predict the rates of RIT and ORNJ in LA-NPC patients who receive definitive C-CRT.