{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:55:11Z","timestamp":1792410911154,"version":"4.4.0"},"reference-count":32,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Background: We sought to determine whether pretreatment total masseter muscle volume (TMMV) measures can predict radiation-induced trismus (RIT) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) receiving concurrent chemoradiotherapy (C-CRT). Methods: We retrospectively reviewed the medical records of LA-NPC patients who received C-CRT and had pretreatment maximum mouth openings (MMO) greater than 35 mm. MMO of 35 mm or less after C-CRT were considered RIT. We employed receiver operating characteristic (ROC) curve analysis to explore the correlation between pre-treatment TMMV readings and RIT status. Results: Out of the 112 eligible patients, 22.0% of them received a diagnosis of RIT after C-CRT. The optimal TMMV cutoff that was significantly linked to post-C-CRT RIT rates was determined to be 35.0 cc [area under the curve: 79.5%; sensitivity: 75.0%; and specificity: 78.6%; Youden index: 0.536] in the ROC curve analysis. The incidence of RIT was significantly higher in patients with TMMV \u2264 5.0 cc than in those with TMMV &gt; 35.0 cc [51.2% vs. 8.7%; Odds ratio: 6.79; p &lt; 0.001]. A multivariate logistic regression analysis revealed that pre-C-CRT MMO \u2264 41.6 mm (p = 0.001), mean masticatory apparatus dose V56.5 \u2265 34% group (p = 0.002), and TMMV \u2264 35 cc were the independent predictors of significantly elevated rates of RIT. Conclusion: The presence of a smaller pretreatment TMMV is a reliable and independent novel biological marker that can confidently predict higher RIT rates in LA-NPC patients who receive C-CRT.<\/jats:p>","DOI":"10.3390\/tomography10010007","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T09:39:57Z","timestamp":1704879597000},"page":"79-89","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Use of Pre-Chemoradiotherapy Total Masseter Muscle Volume as a Novel Predictor of Radiation-Induced Trismus in Locally Advanced Nasopharyngeal Carcinoma Patients"],"prefix":"10.3390","volume":"10","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 06490, Turkey"},{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Kyrenia, Kyrenia 9265, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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 01120, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5871-0695","authenticated-orcid":false,"given":"Umur Anil","family":"Pehlivan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Baskent University, Adana 01120, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0633-5648","authenticated-orcid":false,"given":"Busra","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, School of Dental Medicine, Bahcesehir University, Istanbul 34353, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Ayberk","family":"Besen","sequence":"additional","affiliation":[{"name":"Clinics of Medical Oncology, Adana Seyhan Medical Park Hospital, Adana 01120, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1932-9784","authenticated-orcid":false,"given":"Huseyin","family":"Mertsoylu","sequence":"additional","affiliation":[{"name":"Clinics of Medical Oncology, Istinye University, Adana Medical Park Hospital, Adana 01120, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berrin","family":"Pehlivan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine, Bahcesehir University, Istanbul 34450, 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 34450, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.4103\/sajc.sajc_15_18","article-title":"The epidemiology, treatment, and determinants of outcome of primary head and neck cancers at the Jos University Teaching Hospital","volume":"7","author":"Adoga","year":"2018","journal-title":"South Asian J. 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