Pretreatment Pan-immune Inflammatory Value (PIV), PIV/Hb Ratio For Predicting Osteoradionecrosis Rates In Locally Advanced NPX Cancers.

[Virtual Presenter] We are excited to present to you on the importance of understanding the incidence of osteoradionecrosis (O-R-N--) effects of radiation therapy on bone remodeling the significance of the preoperative systemic immune-inflammation index and the potential for a biomarker to predict the development of O-R-N--. We will also discuss a recent systematic review and meta-analysis that found that I-M-R-T alone is not sufficient to decrease O-R-N rates in O-C-C patients highlighting the importance of identifying the involved risk factors. Additionally we will explore the negative impacts of O-R-N-J on patient-related quality of life metrics and the importance of considering the patient's biological condition and accompanying biomarkers in O-R-N risk assessment..

[Audio] O-R-N refers to bone death as a result of radiation therapy. The preoperative systemic immune-inflammation index can predict the likelihood of O-R-N--. The Pan-Immune-Inflammatory Value (P-I-V--) and H-P-R value are used to predict O-R-N rates in locally advanced N-P-X cancers. This slide aims to provide a clear understanding of the incidence of O-R-N effects of radiation therapy on bone remodeling the importance of the preoperative systemic immune-inflammation index and the role of P-I-V and H-P-R value in predicting O-R-N rates in locally advanced N-P-X cancers..

[Audio] Our topic today is slide 3 and we will be discussing the importance of the Pretreatment Pan-immune Inflammatory Value (P-I-V--) in predicting osteoradionecrosis (O-R-N--) rates in locally advanced N-P-X cancer patients. In recent studies it has been shown that the incidence of O-R-N in O-C-C patients treated with I-M-R-T alone is 8% (95% CI: 6%-11%). This underscores the importance of identifying the involved risk factors in order to decrease O-R-N rates. The Pretreatment Pan-immune Inflammatory Value (P-I-V--) is a novel and promising tool that can help identify the risk factors for O-R-N--. This systematic review has demonstrated that the PIV/Hb ratio can accurately predict O-R-N rates in locally advanced N-P-X cancer patients. In conclusion the Pretreatment Pan-immune Inflammatory Value (P-I-V--) is a valuable tool in predicting osteoradionecrosis (O-R-N--) rates in locally advanced N-P-X cancer patients. By identifying the involved risk factors healthcare providers can take proactive steps to decrease O-R-N rates and improve patient outcomes..

[Audio] O-R-N-J development is influenced by the patient’s biological condition and associated biomarkers. Although O-R-N-J rates are decreasing its negative impact on Q-O-L metrics remains a challenge. We recommend considering the biological condition and biomarkers of the patient in predicting O-R-N-J likelihood..

[Audio] Radiation has significant effects on bone physiology leading to injury proliferation and differentiation of surviving mesenchymal cells and osteoprecursor cells. This can cause vascular edema and hypovascularity on day 1 leading to reduced oxygen supply. By day 15 microvessels are completely obliterated resulting in bone damage. Clinicians should understand these effects to manage patients with locally advanced N-P-X cancers effectively..

[Audio] We will discuss the information about bone derivation and radiation damage. Normally bones are derived from osteoblasts which secrete osteoid. These cells become entrapped in their mineralized matrix to become osteocytes which have a lifespan of about 180 days. At the end of their lifespan osteocytes are stimulated to resorb old dysfunctional bone. However within 4 hours of radiation damage it causes osteocyte injury inhibits proliferation and differentiation of surviving mesenchymal cells and osteoprecursor cells. This causes vascular edema and hypovascularity from day 1 leading to reduced oxygen supply. Microvessels become completely obliterated at day 15..

[Audio] Osteoradionecrosis is a serious complication that can cause injury to osteocytes and inhibit the proliferation and differentiation of surviving mesenchymal cells and osteoprecursor cells. This can lead to vascular edema and hypovascularity reducing the supply of oxygen to the affected area. Using the pretreatment pan-immune inflammatory value (P-I-V--) and PIV/Hb Ratio as potential predictors can help identify patients who are at higher risk and take appropriate measures to minimize the risk of osteoradionecrosis. Research has shown that higher P-I-V and PIV/Hb Ratio values are associated with an increased risk of osteoradionecrosis. Therefore healthcare providers may consider using these values to identify patients who are at higher risk and take appropriate measures to minimize the risk of osteoradionecrosis. In conclusion osteoradionecrosis is a serious complication that can occur following radiation therapy. By considering the potential predictors healthcare providers can help identify patients who are at higher risk and take appropriate measures to minimize the risk of osteoradionecrosis..

[Audio] The Impact of Pretreatment Pan-immune Inflammatory Value (P-I-V--) and PIV/Hb Ratio on the prediction of osteoradionecrosis rates in locally advanced N-P-X cancers. The damage caused by radiation within 4 hours of treatment can lead to osteocyte injury inhibiting proliferation and differentiation of surviving mesenchymal and osteoprecursor cells. This causes vascular edema and hypovascularity from day 1 leading to reduced oxygen supply. By day 15 microvessels become completely obliterated. Within 4 hours of radiation damage osteocyte injury chromosomal condensation and cell death occur. After 2 weeks high platelet counts high monocyte counts and low lymphocyte counts can be observed..

[Audio] Pretreatment Pan-immune Inflammatory Value (P-I-V--) and PIV/Hb Ratio need to be considered in locally advanced N-P-X cancers when predicting osteoradionecrosis rates. These inflammatory markers are crucial in estimating prognosis in cancer patients and help predict overall survival and disease-free survival after curative resection. Systemic Inflammation Index (S-I-I--) has been widely researched in this regard and high preoperative S-I-I values are associated with a less favorable overall survival independent of potential confounders. Hence it is important to consider these inflammatory markers when predicting osteoradionecrosis rates in locally advanced N-P-X cancers..

[Audio] We are excited to discuss the potential role of Pretreatment Pan-immune Inflammatory Value (P-I-V--) in predicting osteoradionecrosis rates in Locally Advanced N-P-X Cancers. The integrated prognostic score combining peripheral neutrophils lymphocytes and platelets is more powerful than individual cell type-based factors presumably due to better reflecting the balance of host inflammation and immune status. We have developed and verified multiple biomarkers including lymphocyte count neutrophil-lymphocyte ratio (N-L-R--) platelet–lymphocyte ratio (P-L-R--) and C-reactive protein (C-B-P--) with prognostic values in a broad spectrum of cancers. By incorporating these biomarkers into a combined score we can gain a more comprehensive understanding of the host inflammation and immune status in patients with Locally Advanced N-P-X Cancers which can ultimately lead to more personalized and effective treatment plans..

[Audio] Pretreatment Pan-immune Inflammatory Value (P-I-V--) is a new biological marker proposed to predict outcomes following oncologic treatment in head and neck cancer (H-N-C--) patients following definitive chemoradiation therapy (C-C-R-T-). P-I-V incorporates diverse mediators in the immune-inflammatory system and uses a composite measure comprising neutrophils platelets monocytes and lymphocytes to predict outcomes following oncologic treatment..

[Audio] The discussion focuses on the correlation between pretreatment Pan-immune inflammatory value (P-I-V--) and hypoxia in locally advanced N-P-X cancers. The mandibular bone receives its primary supply from the inferior alveolar artery and the periosteum. Elevated platelet counts can cause vascular occlusion resulting in bone hypoxia which can intensify the inflammatory response. The P-I-V is a marker of tissue viability and a high P-I-V value is associated with the risk of osteoradionecrosis. The PIV/Hb ratio can be utilized to predict the likelihood of osteoradionecrosis in locally advanced N-P-X cancers..

[Audio] Discuss the Pretreatment Pan-immune Inflammatory Value (P-I-V--) and its role in predicting osteoradionecrosis rates in locally advanced N-P-X cancers..

[Audio] Neutrophils also known as polymorphonuclear leukocytes play a critical role in the early stages of the inflammatory response. They can be found in low-oxygen hypoxic tissue environments such as the O-R-N--. In the context of locally advanced N-P-X cancers neutrophils have been found to be associated with increased rates of O-R-N--. This is because neutrophils can produce reactive oxygen species (R-O-S--) that can cause tissue damage and promote the formation of necrotic tissue. Therefore understanding the role of neutrophils in the development of O-R-N in locally advanced N-P-X cancers is important for the development of effective treatments for this disease..

[Audio] Higher P-I-V and PIV/Hb ratio values are associated with a higher risk of osteoradionecrosis in patients with locally advanced N-P-X cancers. Clinicians and researchers should consider the P-I-V and PIV/Hb ratio when treating and studying patients with locally advanced N-P-X cancers to improve outcomes and prevent osteoradionecrosis..

[Audio] This presentation will discuss the utility of pre-chemoradiotherapy Pan-Immune-Inflammation-Value for predicting osteoradionecrosis rates in locally advanced nasopharyngeal cancers. The paper by Yilmaz B et al published in the journal Strahlentherapie und Onkologie highlights the importance of this value in predicting osteoradionecrosis rates in nasopharyngeal cancers. The P-I-V value is a combination of Platelet Monocyte Neutrophils and Lymphocytes. Thrombosis vascular occlusion hypoxia anoxia inflammation fibrosis high platelet count high monocyte count intravascular plaque formation hypoxia high neutrophil count inflammatory response low lymphocyte count venous occlusion hypoxia and fibrosis are associated with P-I-V--. Therefore it is important to consider the P-I-V value when diagnosing and treating nasopharyngeal cancers..

[Audio] Our retrospective study aimed to investigate the potential relationship between pre-treatment P-I-V measures and post-CCRT ORN rates in LA N-P-C--. Our findings suggest that a higher PIV/Hb ratio may be associated with a higher risk of O-R-N-..

[Audio] In this presentation we will discuss the importance of Pretreatment Pan-immune Inflammatory Value (P-I-V--) and the PIV/Hb ratio in predicting osteoradionecrosis rates in Non-Small Cell Lung Cancer (N-P-X--) cancers. We will first discuss the study design and methodology used in our research. We calculated the PIV/Hb value using routine complete blood counts from the first day of Chemotherapy and Radiation Therapy (C-C-R-T-). We identified osteoradionecrosis cases in post-CCRT oral examinations. We also conducted a literature review to determine the significance of P-I-V and the PIV/Hb ratio in predicting osteoradionecrosis rates in N-P-X cancers. Our study findings indicate that a high PIV/Hb ratio is associated with a higher risk of osteoradionecrosis in N-P-X cancers..

[Audio] 1. Ensure participants provide accurate data 2. Exclude patients with O-R-N diagnosis before C-C-R-T or steroid use in the past 30 days 3. Exclude patients with inflammatory conditions such as rheumatological diseases nephritic disorders viral hepatitis proven immunosuppressive disorders collagen vascular diseases or chronic inflammatory conditions. 4. Minimize potential biases in results and ensure study reliability and validity..

[Audio] We study the prediction of osteoradionecrosis rates in Locally Advanced N-P-X Cancers using Pretreatment Pan-immune Inflammatory Value (P-I-V--). Our treatment protocol involves thorough oral and dental examinations prior to C-C-R-T standard dental treatment and subsequent assessments at three months post-CCRT. We also evaluate the presence of oronucleosome (O-R-N--) using clinical and radiological diagnostic criteria. Our RT strategy includes 3D-CRT or I-M-R-T with high intermediate and low risk PTV’s of 70 Gy 59.4 Gy 54 Gy respectively. We prescribe cisplatin concurrently. We seek qualified LA-NPC patients to participate in this study..

[Audio] Continuous data was represented by medians and ranges while categorical variables were described by percentage frequency distributions. Intergroup comparisons were conducted using the appropriate statistical tests depending on the type of data being compared. The optimal cutoff values for continuous variables were determined using Receiver operating characteristic (R-O-C--) curve analysis and the time to occurrence of O-R-N was estimated using Kaplan-Meier curves. A multivariate Cox proportional hazard model was utilized to explore the relationships between patient disease and treatment variables and O-R-N prevalence rates. All statistical analyses were two-sided with a P-value of < 0.05 being deemed significant. This study offers valuable insights into the factors that contribute to O-R-N in locally advanced N-P-X cancers and can help inform treatment decisions and improve patient outcomes..

[Audio] The objective of this presentation is to discuss the significance of pretreatment pan-immune inflammatory value (P-I-V--) in predicting osteoradionecrosis rates in locally advanced N-P-X cancers. To evaluate the relationship between pre-CCRT PIV levels and O-R-N rates we applied R-O-C curve analysis. Our findings indicate that P-I-V levels can serve as a useful predictor of O-R-N rates in locally advanced N-P-X cancers..

[Audio] We identified potential LA-NPC patients conducted a pre-treatment systemic and oral examination on all patients and standardized our oral management before and after C-C-R-T for 210 patients. After applying our exclusion criteria we were left with 84 patients who met our criteria..

[Audio] Our study revealed the significance of considering pretreatment inflammatory markers in planning and managing C-C-R-T for N-S-C-L-C patients. We discovered that P-I-V and Hb ratio may be valuable predictors of osteoradionecrosis in patients undergoing C-C-R-T-. Specifically our findings showed that a lower PIV/Hb ratio was associated with a higher risk of osteoradionecrosis. Further research is needed to validate our findings and develop strategies to mitigate the risk of osteoradionecrosis in this population..

[Audio] 84.8% of patients undergoing at least one extraction procedure (range: 0-5 extractions) oral health and treatment plans must be taken into consideration for patients with locally advanced N-P-X cancers. 21 O-R-N diagnoses were revealed in post-treatment examinations with an overall incidence of 10.0%. O-R-Ns manifested in the posterior region of the affected mandible and the median time from C-C-R-T completion to O-R-N diagnosis was 19 months (12-24 months). A comprehensive understanding of the potential for osteoradionecrosis in patients with locally advanced N-P-X cancers is important and preventative measures should be taken to reduce the incidence of O-R-N-..

[Audio] Our study found that a pretreatment pan-immune inflammatory value (P-I-V--) of 833 or greater was associated with a statistically significant increase in osteoradionecrosis rates. Additionally a marginal mandibular displacement (M-M-D--) of 58.1 Gy or greater was also associated with a statistically significant increase in osteoradionecrosis rates. The existence of pre-CCRT tooth extractions and post-CCRT tooth extractions was a significant predictor of osteoradionecrosis rates. The use of 3D-CRT technique was also found to be a significant predictor of osteoradionecrosis rates. Finally continued smoking was also a significant predictor of osteoradionecrosis rates..

[Audio] We discussed the incidence of osteoradionecrosis (O-R-N--) in locally advanced N-P-X cancers and retained six factors as independent predictors of O-R-N incidence rates. These factors are important in determining the likelihood of O-R-N occurring in patients undergoing C-C-R-T-. We will now present a bar graph demonstrating the incidence of O-R-N according to these factors..

[Audio] Our research findings show that patients who had ≥4 tooth extractions had nearly six times higher risk of O-R-N than those who had fewer than 4 tooth extractions. This demonstrates an explicit link between the number of tooth extractions and the likelihood of O-R-N following C-C-R-T-. This is the first novel finding of our current research. In conclusion our findings suggest that pre-CCRT PIV levels and the number of tooth extractions prior to C-C-R-T are important factors to consider when predicting O-R-N rates in locally advanced N-P-X cancers..

[Audio] We discuss the likelihood of osteoradionecrosis (O-R-N--) following multiple tooth extractions in this slide. The invasiveness of surgical procedures when multiple tooth extractions are performed indicates a deteriorated oral health status a well-established contributing factor in O-R-N development. Furthermore multiple tooth extractions (≥4) may lengthen the natural healing process beyond what is expected rendering the bony tissue more vulnerable to adverse effects of the long-lasting aggravated inflammation caused by radiation therapy (R-T---) or chemoradiation therapy (C-C-R-T-). Specifically multiple tooth extractions prior to C-C-R-T and the likelihood of O-R-N following C-C-R-T are discussed..

[Audio] We will discuss the correlation between Pretreatment Pan-immune Inflammatory Value (P-I-V--) and osteoradionecrosis (O-R-N--) rates in locally advanced N-P-X (neoadjuvant radiation xenograft) cancers. The systemic immune-inflammation index (S-I-I--) is a biomarker that reflects the balance between the patient's inflammatory and immune status. It is a blend of the platelet neutrophil and lymphocyte counts. A recent study found that patients with a higher pretreatment S-I-I value were more likely to undergo pre-CCRT tooth extractions. This suggests that higher S-I-I levels could indicate an aggravated inflammatory state which could indirectly link the development of O-R-N to P-I-V--. To understand the correlation between P-I-V and O-R-N rates we need to consider the three main components of P-I-V which are platelets monocytes and neutrophils. P-I-V is calculated by multiplying the platelet count by the monocyte count and the neutrophil count. Lymphocytes are not included in P-I-V but they play an important role in regulating the immune response. In summary the pretreatment P-I-V and S-I-I values could provide valuable information for predicting O-R-N rates in locally advanced N-P-X cancers. However further research is needed to confirm these findings and develop more accurate biomarkers for O-R-N prediction..

[Audio] Hemoglobin represents a state of systemic and localized hypoxia that can impact both systemic and local health. Inflammatory diseases can exacerbate this issue causing persistent hypoxia throughout the body. Higher platelet counts than required for adequate hemostasis may compromise blood flow in the inferior alveolar artery of the jaw bone leading to vascular occlusion and hypoxia. However the predictive value of Hemoglobin-to-Platelet Ratio (H-P-R--) in post-treatment O-R-N incidence rates in patients with locally advanced nasopharyngeal carcinoma managed with concurrent chemoradiotherapy has yet to be determined. Further research is needed to determine the effectiveness of using H-P-R as a predictor of O-R-N incidence rates..

[Audio] During the revitalization process injured tissue requires increased oxygenation. This process includes cell proliferation angiogenesis collagen synthesis epithelialization and bacterial defense mechanisms..

[Audio] We aim to investigate whether H-P-R can predict the occurrence of O-R-N after C-C-R-T in LA-NPC. By understanding the relationship between H-P-R and O-R-N we hope to improve treatment outcomes for patients with LA-NPC..

[Audio] Criteria for inclusion and exclusion for our study on the Pretreatment Pan-immune Inflammatory Value (P-I-V--) PIV/Hb Ratio For Predicting Osteoradionecrosis Rates In Locally Advanced N-P-X Cancers. Eligible participants must be 18 years or older have squamous cell carcinoma of the nasopharynx have proven locally advanced disease per A-J-C-C 8th ed. and have undergone conclusive C-CRT. They must also have accessible pre-C-CRT and follow-up records of panoramic radiography and pre-C-CRT complete blood count tests. Additionally participants must not have a history of other cancers previous RT/ CCRT/ O-R-N or steroid use in the past 30 days before the start of C-CRT. However participants with inflammatory conditions such as rheumatological diseases nephritic disorders viral hepatitis proven immunosuppressive disorders collagen vascular diseases or chronic inflammatory conditions are not eligible for this study..

[Audio] We reviewed the institutional clinical records of LA-NPC patients who underwent oral and dental exams before C-CRT between 2010 and 2019. We selected a subset of patients who had both an elevated P-I-V and Hb Ratio. We compared the treatment outcomes of these patients to those of patients who did not meet these criteria. Our results showed that patients with an elevated P-I-V and Hb Ratio were more likely to develop osteoradionecrosis (O-R-N--) after C-CRT compared to those without. These findings suggest that PIV/Hb Ratio may be a useful predictor of O-R-N rates in LA-NPC patients undergoing C-CRT..

[Audio] The text is about discussing the value of pretreatment pan-immune inflammatory value (P-I-V--) and PIV/Hb ratio in predicting osteoradionecrosis rates in locally advanced N-P-X cancers. Patients underwent thorough baseline oral and dental examinations including panoramic radiographs and were enrolled in a standard dental treatment protocol that emphasized oral hygiene. Following C-C-R-T professional oral hygiene care was provided at three-month intervals for two years with assessments conducted biannually and upon the development of any oral grievances. The presence of O-R-N was evaluated using clinical and radiological diagnostic criteria. The RT strategy treatment included 3D-CRT or I-M-R-T with high intermediate and low risk P-T-Vs of 70 Gy 59.4 Gy and 54 Gy respectively delivered in 33 daily fractions (5d/w). Cisplatin concurrent was administered at 75-80 milligrams/m2 (every 3 weeks) or 35 milligrams/m2 (weekly). Potentially qualified LA-NPC patients were subjected to an oral protocol that included a thorough oral and dental evaluation before C-C-R-T standard dental treatment protocol and subsequent assessments at three months and biannually post C-C-R-T with O-R-N diagnosis based on clinical and radiological criteria..

[Audio] Our analysis identified optimal cutoff points of P-I-V levels of 833 and Hb Ratio of 0.48 for predicting O-R-N rates in patients with Locally Advanced Non-Pulmonary X-ray (N-P-X--) cancers who received chemoradiation (C-C-R-T-). P-I-V levels less than 833 and Hb Ratio levels greater than 0.48 separated the research population into two groups with significantly different O-R-N rates. The findings suggest that P-I-V and Hb Ratio can be useful predictors of O-R-N rates in patients with Locally Advanced Non-Pulmonary X-ray (N-P-X--) cancers who received chemoradiation (C-C-R-T-)..

[Audio] Discuss the use of Pretreatment Pan-immune Inflammatory Value (P-I-V--) and Pretreatment Pan-immune Inflammatory Value (P-I-V--)/ Hemoglobin (Hb) Ratio as predictors of osteoradionecrosis rates in locally advanced N-P-X cancers. The focus of our presentation is on patient search selection and follow-up for potential LA-NPC patients (N=267). We conducted a pre-treatment systemic and oral examination on all 267 patients. During the standard oral management before and after C-C-R-T we eliminated 74 patients based on exclusion criteria..

[Audio] We conducted research on the relationship between Pretreatment Pan-immune Inflammatory Value (P-I-V--) and osteoradionecrosis in locally advanced N-P-X cancers. We studied 47 patients with a median age of 54 years and a male gender preponderance. Our research included examining the teeth extracted before beginning C-CRT with an average of 3 teeth extracted. Our findings have significant implications for the treatment of N-P-X cancers..

[Audio] The findings of this study indicate the value of pretreatment pan-immune inflammatory value (P-I-V--) and PIV/Hb ratio for predicting osteoradionecrosis rates in locally advanced N-P-X cancers. The study focused on the post-C-CRT follow-up period and identified that 83.9% of patients required at least one extraction (range: 0--5) and the median time from C-CRT to tooth extractions was 7 months (range: 1--13). After a median follow-up of 20.8 months (range: 12.4--27.6) a total of 21 O-R-N cases were identified indicating an O-R-N incidence of 10.9%. All O-R-Ns occurred in the affected mandible's posterior region and after tooth extraction specifically in areas with higher RT doses. All O-R-Ns were diagnosed in patients receiving a MMD>41.2 Gy. This study emphasizes the importance of monitoring pretreatment pan-immune inflammatory value (P-I-V--) PIV/Hb ratio for predicting osteoradionecrosis rates in locally advanced N-P-X cancers during the post-C-CRT follow-up period..

[Audio] We'll discuss the relationship between Pretreatment Pan-immune Inflammatory Value (P-I-V--) and osteoradionecrosis (O-R-N--) rates in locally advanced N-P-X cancers. Our study found a significant difference in post-C-CRT ORN incidence rates based on the Hb Ratio. The HPR≤0.48 group had a significantly higher O-R-N incidence rate (30.0% against 2.3% for HPR>0.48; P0.48 group) when compared to the HPR>0.48 group. Additionally we discovered that a pretreatment HPR≤0.48 value was significantly associated with more advanced O-R-N (stage 2) when compared to an HPR>0.48 (8.3% against 0.0%; P<0.001) based on Notani's O-R-N staging. Overall our findings suggest that Pretreatment Pan-immune Inflammatory Value (P-I-V--) and the Hb Ratio are important factors to consider when predicting O-R-N rates in locally advanced N-P-X cancers. Do you have any questions?.

[Audio] We discussed the pretreatment Pan-immune Inflammatory Value (P-I-V--) PIV/Hb Ratio For Predicting Osteoradionecrosis Rates In Locally Advanced N-P-X Cancers. The results of the univariate analysis revealed that in addition to the HPR≤0.48 a mandibular V64≥27% Gy (P=0.002) pre-C-CRT≥5 tooth extractions (P<0.001) were the other adverse factors linked to a higher O-R-N incidence rate. The findings of the multivariate logistic regression analysis indicated that all six variables retained their independent significance in terms of their impact on the post-C-CRT ORN incidence rates (P<0.05 for each). We carried out further analyses to look for possible correlations between dosimetric variables but none were found between V64 M-M-P-D or M-M-D--. We believe that this study has important implications for the management of locally advanced N-P-X cancers as it identifies the most significant adverse factors that contribute to the development of O-R-N--. By understanding these factors we can develop more effective treatment strategies and improve patient outcomes..

[Audio] According to our latest research on the Pretreatment Pan-immune Inflammatory Value (P-I-V--) and its association with Osteoradionecrosis (O-R-N--) rates in locally advanced N-P-X cancers we conducted a multivariate logistic regression analysis to identify six variables that are significant predictors of post-C-CRT ORN incidence rates. We are delighted to report that all six variables maintained their independence in predicting O-R-N incidence rates with a p-value of less than 0.05. This highlights the strength of these variables as predictors of O-R-N rates in locally advanced N-P-X cancers..

[Audio] Discuss the importance of establishing a strong correlation between the severity of jaw trauma and the incidence of O-R-N after C-CRT. The results showed that low pre-CCRT HPR levels (≤0.48) were associated with significantly increased O-R-N rates. Additionally patients who had ≥5 extractions pre-CCRT and any number of extractions post-C-CRT had a significantly higher risk of O-R-N--. These findings suggest that tooth extractions preceding RT can reduce the frequency of O-R-N but not eliminate it. Establishing a strong correlation between the extent of trauma related to extractions and the incidence of post-C-CRT ORN is crucial to draw more reliable conclusions..

[Audio] P-I-V and Pretreatment Pan-immune Inflammatory Value/Hb Ratio For Predicting Osteoradionecrosis Rates In Locally Advanced N-P-X Cancers..

[Audio] To enhance the success of your treatment it is crucial to consider the role of Pretreatment Pan-immune Inflammatory Value (P-I-V--) and its correlation with smoking and Osteoradionecrosis (O-R-N--). In the study conducted by Kowolik and others it was found that the accumulation of dental plaque indicated inadequate oral hygiene resulting in an increase in neutrophil count and a decrease in lymphocyte count. This demonstrated the impact of dental plaque on systemic inflammatory response dynamics. Similarly Acharya and others showed that the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio exhibit potential as biomarkers that reflect the correlation between periodontal health and systemic conditions. Therefore it is important to address the impact of poor oral hygiene on overall health. Smoking also has a biphasic influence on neutrophils resulting in an increase in neutrophil levels but a decrease in their efficacy. This can lead to the development of O-R-N which is a serious condition in locally advanced N-P-X cancers. In the present study there was a substantial association between smoking and O-R-N but no statistically significant correlation was found between P-I-V and smoking. This suggests that P-I-V may play a role in the development of O-R-N but its impact is not as significant as smoking. In conclusion it is essential to consider the impact of P-I-V smoking and O-R-N on treatment outcomes. By addressing these factors we can enhance the success of your treatment and improve overall health..

[Audio] Our model can be used as a basis for earlier identification of high-risk patients. This model allows for stricter follow-up protocols the use of more strict dosimetric constraints for the jaw the prompt implementation of necessary oral hygiene and anti-infective measures and the avoidance of invasive procedures like tooth extraction and dental implant placement to the greatest extent possible. High pretreatment P-I-V value was an independent and strong predictor of significantly higher O-R-N rates post-CCRT in LA-NPC patients. Pretreatment HPR ≤ 0.48 was a strong predictor of significantly higher O-R-N incidence following C-CRT. These findings need validation and large-scale prospective research in order to confirm their effectiveness..