The Comprehensive Repair-Inflammation Index (CRII) Predicts Tooth Extraction After Chemoradiotherapy: A Continuous...

Area of Science:

• Oncology
• Radiotherapy
• Inflammation Research

Background:

• Tooth extraction (TE) is a frequent complication following chemoradiotherapy (CCRT) for locally advanced nasopharyngeal carcinoma (LA-NPC).
• Predictors of post-treatment TE remain incompletely understood.
• Systemic inflammation and host repair capacity are potential contributing factors.

Purpose of the Study:

• To investigate the association between the Comprehensive Repair-Inflammation Index (CRII) and the risk of TE after definitive CCRT in LA-NPC patients.
• To determine if CRII is an independent predictor of TE.
• To explore the relationship between CRII and mandibular dosimetry in predicting TE.

Main Methods:

• Retrospective analysis of 354 LA-NPC patients treated with definitive CCRT.
• CRII calculated from pre-treatment laboratory parameters.
• Logistic regression and segmented regression used to analyze the association between CRII and TE, adjusting for clinical and dosimetric variables.

Main Results:

• Tooth extraction occurred in 70.1% of patients.
• Higher CRII was significantly associated with increased TE risk (OR 1.49 per 10-unit increase).
• A nonlinear relationship was observed, with a breakpoint at CRII 145.7, above which TE risk markedly increased (OR 5.1). Mandibular dose parameters were not significant predictors.

Conclusions:

• The Comprehensive Repair-Inflammation Index (CRII) is an independent predictor of post-CCRT tooth extraction in LA-NPC.
• CRII demonstrates a nonlinear risk pattern, indicating significant systemic host-related factors influence TE risk.
• Findings suggest integrating systemic inflammation markers into risk assessment for post-treatment complications.