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search.filters.applied.f.publicationcategory: search.filters.publicationcategory.Makale - Uluslararası Hakemli DergiSubject: search.filters.subject.Osteoradionecrosis

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    Pre-Chemoradiotherapy High Platelet Counts Predict Jaw Osteoradionecrosis In Locally Advanced Nasopharyngeal Carcinoma Patients
    (Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-09-15) Somay, Efsun; Topkan, Erkan; Kucuk, Ahmet; Ozturk, Duriye; Ozkan, Emine Elif; Ozdemir, Beyza Sirin; Besen, Ali Ayberk; Mertsoylu, Huseyin; Pehlivan, Berrin; Selek, Ugur
    Introduction: This retrospective study aimed to investigate if pretreatment platelet (PLT) levels can predict the risk of osteoradionecrosis of the jaw (ORNJ) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) who received concurrent chemoradiotherapy (CCRT). Material &Methods: ORNJ instances were identified from LA-NPC patients' pre- and post-CCRT oral exam records. All pretreatment PLT values were acquired on the first day of CCRT. Receiver operating characteristic curve analysis was used to determine the optimal PLT cutoff that divides patients into two subgroups with distinctive ORNJ rates. The primary outcome measure was the association between pretreatment PLT values and ORNJ incidence rates. Results: The incidence of ORNJ was 8.8 % among the 240 LA-NPC patients analyzed. The ideal pre-CCRT PLT cutoff which divided the patients into two significantly different ORNJ rate groups was 285,000 cells/mu L (PLT <= 285,000 cells/mu L (N = 175) vs. PLT > 285,000 cells/mu L (N = 65)). A comparison of the two PLT groups revealed that the incidence of ORNJ was substantially higher in patients with PLT > 285,000 cells/L, than in those with PLT <= 285,000 cells/L, (26.2% vs. 2.3 %; P < 0.001). The presence of pre-CCRT >= 3 tooth extractions, any post-CCRT tooth extractions, mean mandibular dose >= 34.1 Gy, mandibular V57.5 Gy >= 34.7 %, and postCCRT tooth extractions > 9 months after CCRT completion were also associated with significantly increased ORNJ rates. A multivariate Cox regression analysis demonstrated that each characteristic had an independent significance on ORNJ rates after CCRT. Conclusion: An affordable and easily accessible novel biomarker, PLT> 285,000 cells/L, may predict substantially higher ORNJ rates after definitive CCRT in individuals with LA-NPC. (c) 2024 Elsevier Masson SAS. All rights reserved.
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    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-2213-2021
    We 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.