{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T03:59:17Z","timestamp":1778644757449,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the predictive significance of hemoglobin (Hb) values in the incidence of radiation\u2010induced trismus (RIT) in locally advanced nasopharyngeal carcinoma (LA\u2010NPC) patients who received concurrent chemoradiotherapy (C\u2010CRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data of LA\u2010NPC patients were examined before and after C\u2010CRT and to confirm the presence of RIT, maximum mouth openings (MMO) were measured; RIT is defined as an MMO of \u226435\u2009mm. All Hb values were derived from complete blood count tests obtained on the first day of C\u2010CRT. The receiver operating characteristic (ROC) curve analysis was used to scrutinize a possible connection between pre\u2010treatment Hb values and RIT status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and twenty three patients were included in the study and RIT was diagnosed in 46 (20.6%) patients. The Hb cutoff in ROC curve analysis that separated the patients into two groups was 12.05\u2009g\/dL [Area under the curve (AUC): 82.7%; sensitivity: 72.9%; and specificity: 71.3%]. RIT was significantly more prevalent in the Hb\u2009\u2264\u200912\u2009g\/dL group than in its counterpart (41.9% vs. 7.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In multivariate analysis, Hb\u2009\u2264\u200912, anemia, pre\u2010C\u2010CRT MMO\u2009&lt;\u200941.4\u2009mm, and masticatory apparatus doseV58 Gy\u2009&lt;\u200932% groups were found to be independently associated with significantly increased rates of RIT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low pre\u2010C\u2010CRT Hb and anemia status are novel biological markers that independently predict higher RIT rates in LA\u2010NPC undergoing C\u2010CRT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.14605","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T06:52:03Z","timestamp":1683528723000},"page":"1052-1060","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Low hemoglobin levels predict increased radiation\u2010induced trismus rates in nasopharyngeal cancer"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8251-6913","authenticated-orcid":false,"given":"Efsun","family":"Somay","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Baskent University  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Busra","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry Baskent University  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-7123","authenticated-orcid":false,"given":"Erkan","family":"Topkan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine Baskent University  Adana Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berrin","family":"Pehlivan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Bahcesehir University  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U\u011fur","family":"Selek","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine Koc University  Istanbul Turkey"},{"name":"Department of Radiation Oncology, MD Anderson Cancer Center The University of Texas  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-010-0847-4"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12663-012-0447-6"},{"key":"e_1_2_12_4_1","first-page":"1","article-title":"Nutritional anemias. 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