Global Immune-Nutrition-Inflammation Index as a novel comprehensive biomarker in predicting the radiation-induced trismus rates in locally advanced nasopharyngeal carcinoma patients

Authors

  • Efsun Somay Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey https://orcid.org/0000-0001-8251-6913
  • Erkan Topkan Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey https://orcid.org/0000-0001-8120-7123
  • Sibel Bascil Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey https://orcid.org/0000-0002-0225-2477
  • Nilüfer Kılıc Durankuş Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey
  • Şükran Senyürek Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey
  • Düriye Ozturk Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey
  • Berrin Pehlivan Department of Radiation Oncology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
  • Ugur Selek Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey

DOI:

https://doi.org/10.17305/bb.2024.10616

Keywords:

Radiation-induced trismus, Global Immune-Nutrition-Inflammation Index (GINI), concurrent chemoradiotherapy, nasopharyngeal carcinoma

Abstract

In this study, we aimed to evaluate whether the novel pretreatment Global Immune-Nutrition-Inflammation Index (GINI) can predict radiation-induced trismus (RIT) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients undergoing concurrent chemoradiotherapy (CCRT). Data of LA-NPC patients presenting without RIT were reviewed retrospectively. Any post-CCRT maximum mouth openings (MMO) ≤ 35 mm were considered RIT. The GINI index was calculated using the formula: GINI = (CRP x Monocytes x Platelets x Neutrophils) ÷ (Albumin x Lymphocytes). We used receiver operating characteristic (ROC) curve analysis to examine the potential correlation between pretreatment GINI measures and post-CCRT RIT status. Logistic regression analysis examined the independence of the association between confounding factors and RIT rates. The study comprised 230 participants, and 52 (22.6%) received an RIT diagnosis. The optimal pre-CCRT GINI cutoff that dichotomizes RIT rates was determined to be 1,424 (area under the curve [AUC]: 76%; sensitivity: 75.0%; specificity: 71.7%; J-index: 0.463). RIT incidence was significantly higher in the GINI ≥ 1424 group than in its GINI < 1424 counterpart (43.3% vs. 9.3%; hazard ratio: 4.76; P < 0.001). Multivariate logistic regression analysis revealed that a pre-CCRT GINI ≥ 1424 was an independent predictor of increased RIT rates after definitive CCRT in this patient group (P < 0.001). In conclusion, the present results revealed that elevated pre-CCRT GINI measures (≥ 1424) can efficiently and independently predict elevated RIT rates in LA-NPC patients after CCRT.

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Global Immune-Nutrition-Inflammation Index as a novel comprehensive biomarker in predicting the radiation-induced trismus rates in locally advanced nasopharyngeal carcinoma patients

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Published

17-10-2024

Data Availability Statement

The data supporting this study's findings is available from the corresponding author, Efsun Somay, upon a reasonable special request.

How to Cite

1.
Global Immune-Nutrition-Inflammation Index as a novel comprehensive biomarker in predicting the radiation-induced trismus rates in locally advanced nasopharyngeal carcinoma patients. Biomol Biomed [Internet]. 2024 Oct. 17 [cited 2024 Dec. 12];24(6):1703–1710. Available from: https://bjbms.org/ojs/index.php/bjbms/article/view/10616