The unique CARWL score stratifies locally advanced nasopharyngeal cancer patients receiving concurrent chemoradiotherapy into risk groups for radiation-induced trismus
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View abstract on PubMed
Summary
This summary is machine-generated.The novel CARWL score effectively stratifies patients with locally advanced nasopharyngeal carcinoma (LA-NPC) into different risks for radiation-induced trismus (RIT) after chemoradiotherapy. This scoring system integrates C-reactive protein-to-albumin ratio (CAR) and significant weight loss (SWL) for precise risk assessment.
Area Of Science
- Oncology
- Radiation Oncology
- Biomarkers
Background
- Locally advanced nasopharyngeal carcinoma (LA-NPC) treatment often involves chemoradiotherapy (C-CRT).
- Radiation-induced trismus (RIT) is a common and debilitating side effect of C-CRT for LA-NPC.
- Accurate risk stratification for RIT is crucial for patient management and treatment planning.
Purpose Of The Study
- To evaluate the utility of the novel CARWL score in stratifying LA-NPC patients into distinct RIT risk groups following definitive C-CRT.
- To assess the combined predictive value of C-reactive protein-to-albumin ratio (CAR) and significant weight loss (SWL) for RIT development.
Main Methods
- Retrospective analysis of 286 LA-NPC patients treated with C-CRT.
- Measurement of maximum mouth opening (MMO) at baseline and serial follow-ups.
- Documentation of pre-C-CRT CAR values and significant weight loss (SWL > 5%) in the preceding six months.
- Definition of RIT as MMO ≤ 35 mm.
Main Results
- The optimal CAR cut-off was determined as 3.03 via ROC analysis.
- Patients were stratified into three CARWL score groups: CARWL-0 (low risk), CARWL-1 (intermediate risk), and CARWL-2 (high risk).
- RIT incidence significantly increased across the groups: 8.7% (CARWL-0), 23.2% (CARWL-1), and 44.2% (CARWL-2) (P < 0.001).
Conclusions
- The CARWL scoring system effectively stratifies LA-NPC patients into different RIT risk categories post-C-CRT.
- This novel score integrates readily available clinical and laboratory parameters for precise risk assessment.
- The CARWL score shows promise for improving prognostication and guiding clinical decisions in LA-NPC management.
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