{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:15:18Z","timestamp":1793319318620,"version":"4.5.0"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technol Cancer Res Treat"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the usefulness of the novel CARWL index in predicting radiation-induced tooth loss (RITL) rates in locally advanced nasopharyngeal cancer (LA-NPC) patients undergoing concurrent chemoradiotherapy (C-CRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study retrospectively examined data from 323 LA-NPC patients. The patients were divided into two groups based on cutoff values for CAR and weight loss (WL). The ideal cutoff for RITL was 3.0 g\/dL [AUC: 83.0%, sensitivity: 83.6%, specificity: 81.4%, J-index: 0.650]. CARWL index was created by combining pretreatment CAR and WL status (WL\u2009\u2264\u20095.0% vs\u2009&gt;\u20095.0%, resulting in four groups: Group 1: CAR\u2009&lt;\u20093.0 and WL\u2009\u2264\u20095.0%, Group 2: CAR\u2009&lt;\u20093.0 and WL\u2009&gt;\u20095.0%, Group 3: CAR\u2009\u2265\u20093.0 and WL\u2009\u2264\u20095.0%, and Group 4: CAR\u2009&gt;\u20093.0 and WL\u2009&gt;\u20095.0%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>RITL was diagnosed in 67.2% of patients. Since the RITL rates of Groups 2 and 3 were statistically indistinguishable, we combined them and created the three-tiered CARWL score groups: CARWL-0: CAR &lt;\u20093.0 and WL\u2009\u2264\u20095.0%; CARWL-1: CAR\u2009&lt;\u20093.0 and WL\u2009&gt;\u20095.0%, or CAR\u2009\u2265\u20093.0 and WL\u2009\u2264\u20095.0%; and CARWL-2: CAR\u2009&gt;\u20093.0 and WL\u2009&gt;\u20095.0%. Comparative analysis revealed that the RITL rates gradually and significantly increased from CARWL-0 to CARWL-2 score groups (49.4% vs 64.7% vs 83.0%; P &lt;0.001) despite similar baseline disease and patient characteristics. Results of the multivariate analysis showed that higher CARWL score groups were independent and significant predictors of increased RITL rates (p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Present results suggest that the novel CARWL index is a reliable biomarker for predicting RITL incidence in LA-NPC patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15330338241292234","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T02:52:42Z","timestamp":1729219962000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Topkan's CARWL Index Efficiently Predicts the Radiation-Induced Tooth Loss Rates in Radically Treated Locally Advanced Nasopharyngeal Cancer Patients"],"prefix":"10.1177","volume":"23","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erkan","family":"Topkan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibel","family":"Bascil","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duriye","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukran","family":"Senyurek","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilufer Kilic","family":"Durankus","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-3140","authenticated-orcid":false,"given":"Ugur","family":"Selek","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,17]]},"reference":[{"key":"bibr1-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.60.9347"},{"key":"bibr2-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1515\/med-2023-0673"},{"key":"bibr3-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2020.04.003"},{"key":"bibr4-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1007\/16833_2024_278"},{"key":"bibr5-15330338241292234","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13233594"},{"key":"bibr6-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2021.06.021"},{"key":"bibr7-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2011.03.003"},{"key":"bibr8-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-023-02937-9"},{"key":"bibr9-15330338241292234","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S334556"},{"key":"bibr10-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/2803044"},{"key":"bibr11-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12083"},{"key":"bibr12-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1177\/154405910708601118"},{"key":"bibr13-15330338241292234","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-021-01516-0"},{"key":"bibr14-15330338241292234","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"bibr15-15330338241292234","unstructured":"White SC, Pharoah MJ. 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