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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. [ABSTRACT FROM AUTHOR]

Background: 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. [ABSTRACT FROM AUTHOR]

Objective: The significance of pre‐hemoglobin‐to‐platelet ratio (HPR) in predicting the occurrence of radiation‐induced trismus (RIT) in locally advanced nasopharyngeal carcinoma patients (LA‐NPC) who received concurrent chemoradiotherapy (C‐CRT). Methods: The records of LA‐NPC patients with oral examination before and after C‐CRT were analyzed. Maximum mouth openings (MMO) were measured before and after C‐CRT to confirm RIT status, with an MMO of ≤35 mm defined as RIT. HPR values were calculated on the first day of C‐CRT. The relationship between the HPR values and RIT status was discovered using the receiver operating characteristic curve analysis. Results: A total of 43 patients RIT cases among 198 individuals were diagnosed. The optimal HPR cutoff that stratified the patients into two groups was 0.54. RIT incidence was found to be significantly higher in the HPR ≤0.54 group than its HPR >0.54 counterpart(p < 0.001). Univariately T3‐4 stage, mean masticator apparatus dose>57.2Gy, and pre‐C‐CRT MMO ≤40.7 mm were found as the other significant correlates of increased RIT rates(p < 0.05). All four variables seemed to be independently connected to greater RIT incidence in multivariate analysis (p < 0.05, for each). Conclusion: The risk of post‐C‐CRT RIT may be significantly increased when pre‐treatment HPR levels are low. [ABSTRACT FROM AUTHOR]

Objectives: To explore how well a unique combination of hemoglobin‐to‐platelet ratio (HPR) and pretreatment maximum mouth opening (MMO) predicts the prevalence of radiation‐induced trismus (RIT). Patients and methods: HPR and MMO cutoff values (0.54 and 40.7 mm) divided patients into two groups. To develop the novel HPR‐MMO index, four combinations of these factors were tested for predictive power: Group 1: HPR > 0.54 and MMO > 40.7 mm; Group 2: HPR ≤ 0.54 but MMO > 40.7 mm; Group 3: HPR > 0.54 but MMO ≤ 40.7 mm; Group 4: HPR ≤ 0.54 and MMO ≤ 40.7 mm. Results: Data of 198 patients with LA‐NPC was analyzed retrospectively. RIT rates for Groups 1 to 4 were 10.2%, 15.2%, 25%, and 59.4%. Groups 2 and 3 were merged to generate HPR‐MMO index because of statistically equivalent RIT rates: Low‐risk: HPR > 0.54 and MMO > 40.7 mm; Intermediate‐risk: HPR ≤ 0.54 but MMO > 40.7 mm or; HPR > 0.54 but MMO ≤ 40.7 mm; High‐risk: HPR ≤ 0.54 and MMO ≤ 40.7 mm. It was revealed that the low‐, high‐, and intermediate‐risk group's RIT rates; 10.2%, 59.4%, and 19.2%, respectively. Conclusion: The novel HPR‐MMO index may to classify LA‐NPC patients into low, intermediate, and high‐risk RIT groups. [ABSTRACT FROM AUTHOR]