Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey.
Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University, Ankara, Turkey.
Oral Dis. 2023 Oct;29(7):2962-2970. doi: 10.1111/odi.14363. Epub 2022 Sep 12.
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).
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.
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 T 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).
The risk of post-C-CRT RIT may be significantly increased when pre-treatment HPR levels are low.
探讨血红蛋白血小板比值（HPR）在预测接受同期放化疗（C-CRT）的局部晚期鼻咽癌（LA-NPC）患者中发生放射性张口困难（RIT）的意义。
分析了接受 C-CRT 前后进行口腔检查的 LA-NPC 患者的记录。通过测量 C-CRT 前后的最大张口度（MMO）来确认 RIT 状态，MMO≤35mm 定义为 RIT。在 C-CRT 第一天计算 HPR 值。使用受试者工作特征曲线分析发现 HPR 值与 RIT 状态之间的关系。
在 198 名患者中诊断出 43 例 RIT 病例。将患者分为两组的最佳 HPR 截止值为 0.54。HPR≤0.54 组的 RIT 发生率明显高于 HPR＞0.54 组（p<0.001）。单变量 T 分期、平均咀嚼肌装置剂量>57.2Gy 和 C-CRT 前 MMO≤40.7mm 也被发现是 RIT 发生率增加的其他显著相关因素（p<0.05）。在多变量分析中，似乎所有四个变量都与更大的 RIT 发生率独立相关（p<0.05，每个变量）。
治疗前 HPR 水平较低时，C-CRT 后发生 RIT 的风险可能显著增加。
