Page 54 - ARNM-3-1

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
Combining pan-immune-inflammation value

and pretreatment tooth extractions in predicting
osteoradionecrosis of the jaw: A pilot study

Efsun Somay * , Erkan Topkan 2 , Sükran Senyürek 3 ,
1
Nilüfer Kılıç Durankuş 3 , Düriye Öztürk 4 , and Ugur Selek 3
1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara,
Turkey
2 Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
3 Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey
4 Department of Radiation Oncology, School of Medicine, Afyonkarahisar Health and Science
University, Afyonkarahisar, Turkey

Abstract

Previously, we demonstrated that the pan-immune-inflammation value (PIV) and
pretreatment tooth extraction (TE) were independent predictors of osteoradionecrosis
of the jaws (ORNJ) in patients with locally advanced nasopharyngeal carcinoma
(LA-NPC) undergoing concurrent chemoradiotherapy (C-CRT). This study aimed
*Corresponding author: to determine if combining PIV and TE, termed the PIV-TE-ORNJ index, and could
Efsun somay improve the prediction of ORNJ prevalence in the same scenario. We divided
(esomay@baskent.edu.tr)
patients into two groups based on each factor, with the PIV and TE cutoffs at 833 and
Citation: Somay E, Topkan E, 4, respectively, as determined in our previous study. The novel PIV-TE-ORNJ index,
Senyürek S, Durankuş NK,
Öztürk D, Selek U. Combining which combined these factors, revealed four probable groups: Group 1, PIV < 833
pan-immune-inflammation value and TE < 4; Group 2, PIV < 833 but TE ≥ 4; Group 3, TE < 4 but PIV ≥ 833; and Group 4,
and pretreatment tooth extractions PIV ≥ 833 and TE ≥ 4. The medical records of 220 patients with LA-NPC were reviewed
in predicting osteoradionecrosis of
the jaw: A pilot study. Adv Radiother retrospectively. Comparisons between four groups revealed that the ORNJ rates for
Nucl Med. 2025;3(1):46-56. Groups 1 – 4 were 1.1%, 6.6%, 6.1%, and 43.8%, respectively (P < 0.001). Because the
doi: 10.36922/arnm.5799 ORNJ rates in Groups 2 and 3 were interchangeable (P = 0.91), these groups were
Received: November 6, 2024 merged, and a three-tiered novel PIV-TE-ORNJ index was created: low risk, PIV < 833
and TE < 4; intermediate risk, PIV < 833 but TE ≥ 4, or TE < 4 but PIV ≥ 833; and high
Revised: November 20, 2024
risk, PIV ≥ 833 and TE ≥ 4. Comparisons between the three groups demonstrated that
Accepted: December 20, 2024 the low- and high-risk groups had the lowest (1.1%) and highest (43.8%) ORNJ rates,
Published online: January 17, respectively, whereas the ORNJ rate of the intermediate-risk group was in between
2025 (6.4%) (P < 0.001 for each). The PIV-TE-ORNJ index successfully stratified patients with
Copyright: © 2025 Author(s). LA-NPC into low-, intermediate-, and high-risk groups after C-CRT.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution Keywords: Tooth extraction; Pan-immune-inflammation value; Nasopharyngeal cancer;
License, permitting distribution, Concurrent chemoradiotherapy; Osteoradionecrosis
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional Locally advanced nasopharyngeal carcinomas (LA-NPCs) comprise approximately
affiliations 70% of nasopharyngeal carcinomas (NPCs), for which concurrent chemoradiotherapy

Volume 3 Issue 1 (2025) 46 doi: 10.36922/arnm.5799