Pretreatment C-Reactive Protein/Albumin Ratio Can Predict Severity of Radiotherapy-Induced Oral Mucositis in Advanced Laryngeal Cancer Patients.

OBJECTIVE

Treatment methods of laryngeal cancer (LC) often include radiotherapy (RT), commonly combined with cytotoxic drugs. This approach is associated with early adverse effects, notably oral mucositis (OM). The C-reactive protein to albumin ratio (CAR) is a promising novel biomarker used to assess the severity of inflammatory responses in various chronic conditions. The aim of this study was to evaluate the predictive value of pretreatment CAR for the occurrence and severity of OM of varying grades during RT in patients with LC.

METHODS

The pretreatment CAR values were calculated in 68 patients treated with RT due to locally advanced or advanced LC.

RESULTS

The increased incidence of severe grade OM in LC patients between weeks III and VII of RT was significantly associated with higher CAR values. A high CAR was significantly correlated with an increased risk of grade 3 OM at the end of the IIIrd (p = 0.026), IVth (p = 0.018), Vth (p = 0.027), VIth (p = 0.018), and VIIth (p = 0.004) week of RT. Multivariable analysis demonstrates a higher probability of developing severe OM in LC patients with an elevated median CAR following IIIrd (p = 0.025), IVth (p = 0.025), Vth (p = 0.025), VIth (p = 0.020), and VIIth (p = 0.035) cycle of irradiation. Furthermore, CAR values allowed reliable differentiation of patients who developed grade 3 OM between the IIIrd-VIIth weeks of treatment (p < 0.001).

CONCLUSIONS

The pretreatment CAR value indicates clinical utility in predicting the likelihood of severe OM induced by RT-based therapy in patients with LC.