ArticleTechnology in cancer research & treatment
Topkan's CARWL Index Efficiently Predicts the Radiation-Induced Tooth Loss Rates in Radically Treated Locally Advanced Nasopharyngeal Cancer Patients.
Article in Technology in cancer research & treatment. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- The Host Tissue Repair Vulnerability Index (HTRVI): A Composite Biomarker for Predicting Osteoradionecrosis in Locally Advanced Nasopharyngeal Carcinoma.Medical sciences (Basel, Switzerland) · 2026Article
- The Comprehensive Repair-Inflammation Index (CRII) Predicts Tooth Extraction After Chemoradiotherapy: A Continuous and Nonlinear Modeling Analysis.Journal of clinical medicine · 2026Article
- Reply to Chaturvedi et al. (https://doi.org/10.1007/s12070-024-05190-w).Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2025Article
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7 authors.
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Abstract
purposeTo 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).
methodsThe 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 ≤ 5.0% vs > 5.0%, resulting in four groups: Group 1: CAR < 3.0 and WL ≤ 5.0%, Group 2: CAR < 3.0 and WL > 5.0%, Group 3: CAR ≥ 3.0 and WL ≤ 5.0%, and Group 4: CAR > 3.0 and WL > 5.0%.
resultsRITL 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 < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. 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 <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 < 0.001).
conclusionPresent results suggest that the novel CARWL index is a reliable biomarker for predicting RITL incidence in LA-NPC patients.
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