ArticleCancer management and research2026
Inflammatory, Immune-Metabolic, and Vascular Biomarker Trajectories Across Treatment Modalities and Associations with Treatment-Related Complications in Oral Squamous Cell Carcinoma: A Prospective Study in Taiwan.
Article in Cancer management and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Oral squamous cell carcinoma (OSCC) is a substantial cancer burden in Taiwan, and multimodality treatment is associated with heterogeneous toxicities. Longitudinal inflammatory, immune-metabolic, and vascular biomarker changes across treatment intensities, and their links with complications, remain insufficiently defined. Purpose: To characterize biomarker trajectories across OSCC treatment modalities and identify baseline biomarkers associated with treatment-related complications. Methods: This prospective cohort study included patients with OSCC receiving surgery alone, surgery followed by concurrent chemoradiotherapy (CCRT), or CCRT followed by tegafur-uracil (UFUR) maintenance. Peripheral blood indices and vascular measures, including arterial stiffness index (ASI) and brachial-ankle pulse wave velocity (baPWV), were assessed at baseline and weeks 2, 12, and 24 after surgery. Temporal changes were analyzed using generalized estimating equations, and baseline biomarker associations with complications were examined using multivariable logistic regression. Results: Among 140 patients, 60 received surgery alone, 40 received CCRT, and 40 received CCRT followed by UFUR maintenance. Patients receiving CCRT showed sustained inflammatory activation, with neutrophil-to-lymphocyte ratio (NLR) peaking at week 12 (β = 4.90, p < 0.001). ASI and baPWV also increased in the CCRT groups at week 12. Elevated baseline NLR (≥3.5) was independently associated with postoperative infection (odds ratio [OR] = 1.52, p = 0.026), whereas low prognostic nutritional index (PNI <40.5) was associated with major complications (OR = 2.85, p = 0.028). Among patients receiving CCRT, low hemoglobin (<11 g/dL) was associated with febrile neutropenia (OR = 7.10, p = 0.003), while elevated systemic immune-inflammation index (SII ≥1100) and uric acid (≥5.3 mg/dL) were associated with severe mucositis. Conclusion: Blood-based and vascular biomarkers showed treatment-specific trajectories and were associated with clinically relevant complications. These exploratory findings may support risk-adapted toxicity monitoring in OSCC, although the proposed cutoffs require external validation.
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