{"paper_id":"0dbc7b9c-921e-4017-82b9-019194cf1bf3","body_text":"The impact of oral and oropharyngeal cancer patient’s medical profile on dental treatment needs and treatment-related toxicities. A cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The impact of oral and oropharyngeal cancer patient’s medical profile on dental treatment needs and treatment-related toxicities. A cross-sectional study Leticia Rodrigues-Oliveira, César Rivera, Xaviera A. López-Cortés, and 9 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1608385/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose: To characterize oral and oropharyngeal squamous cell carcinoma (OOPSCC) patients with dental needs before cancer treatment and to correlate their baseline characteristics with cancer treatment-related toxicities. Methods: A prospective cohort study that recruited OOPSCC patients referred to the Dental Oncology Service at the Instituto do Câncer do Estado de São Paulo, Brazil, for dental treatment between November/2019 and December/2020. Comorbidities, sociodemographic data, medication in use, treatment-related toxicities and altered laboratory tests results were correlated. Results: 110 patients were included. The most common comorbidities reported and altered laboratory results were respectively hypertension, dyslipidemia, diabetes and C-reactive protein, hemoglobin, and hematocrit. Toxicities were progressive over time. There was no correlation between the comorbidities and cancer treatment-related toxicities. There was a positive correlation between medications in use and oral mucositis (OM) and a negative correlation between medications and dysgeusia. OM was associated with altered laboratory findings, including thyroxine (T4) and free thyroxine (FT4) starting at D15; calcium at D5/10/30; urea at D25/30/33-35; creatinine at D15/30; alkaline phosphatase at D20/25; syphilis at D15/30. Family income and housing were OM predictors. Oral candidiasis (OC) was associated with syphilis and HIV at D20. Conclusion: Laboratory findings including altered T4, FT4, urea, calcium, alkaline phosphatase, creatinine, and syphilis may be useful clinical predictors of OM. Syphilis and HIV may also be considered reliable predictors of OC secondary to OOPSCC treatment. Despite the high frequency of comorbidities and abnormal laboratory results, dental treatment before cancer treatment resulted in no adverse events in our sample. Medical History Taking Medical Examination Dental Care Comorbidity Oral Cancer Oropharyngeal Cancer Figures Figure 1 Introduction Dental treatment of patients diagnosed with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC) poses a challenge for dentists. It requires an individualized treatment plan that is based on the patient’s dental and medical history, cancer stage, treatment modalities, prognosis, and hematological, physical and nutritional status [1–3]. It is recommended that the dental care for OOPSCC cancer patients be performed and completed before the onset of the oncologic treatment, especially for patients undergoing chemotherapy (CT), radiotherapy (RT), or chemoradiotherapy (CRT). Dental treatment must prioritize the removal of oral foci of infection that can interrupt the cancer treatment and impair prognostic outcomes. In this sense, periodontal, restorative, endodontic, and surgical procedures should be performed based on clinical and radiographic assessments, considering the oncologic treatment plan and schedule [1–2, 4]. Current literature shows that adequate oral care and proper dental treatment before the oncologic treatment, is associated with fewer oral and systemic infections. It minimizes the severity and duration of oral toxicities, such as oral mucositis (OM), radiation caries and osteoradionecrosis. It also contributes significantly to the success of the cancer treatment, avoiding interruptions, reducing overall costs, and improving the patients’ quality of life (QoL) [3–5]. However, many professionals are apprehensive to offer a comprehensive oral care because of their concern about inducing local and/or systemic complications during or after a dental procedure in the OOPSCC population, even though patients will be more benefited if dental care is initiated as soon as the diagnosis is made, thus minimizing the severity and duration of oral toxicities [3–5]. Although there are several dental care protocols for patients diagnosed with OOPSCC before cancer treatment [1–3,6–9], none of them considers systemic changes and underlying medical conditions of the patient. It is unknown whether dental treatment before cancer therapy could interfere with medical health, leading to medical complications, such as infection and bleeding. Therefore, this prospective cohort study aimed to characterize, through laboratory assessments, possible systemic changes in OOPSCC patients receiving dental treatment before cancer therapy. The comorbidities, sociodemographic data, medication in use, and laboratory changes were further correlated with the frequency and severity of head and neck (H&N) toxicities. Methods Patients This prospective cohort study recruited patients diagnosed with OOPSCC set to undergo oncologic treatment [i.e. surgery, CT, RT, or CRT], that were referred to the Dental Oncology Service at the Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil for dental treatment. Patients were recruited between November/2019 and December/2020. Ethical approval was obtained from the National Human Research Ethics Committee (CAAE: 23671019.1.1001.5418). All participants provided written informed consent. The study was conducted following the Declaration of Helsinki and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement [10]. Inclusion Criteria Fully or partially dentate OOPSCC patients over 18 years of age and able to provide written informed consent were included in the study, regardless the cancer treatment modality. Exclusion criteria Patients with recurrent OOPSCC that underwent a previous treatment, those who did not perform the blood tests prescribed, and cases in which patient’s data were not fully available from the electronic medical record system, were excluded from the study. Sociodemographic and clinicopathological characteristics Patients’ characteristics, including gender, ethnicity, age, habits (smoking, drinking and use of illicit drugs), years of education, current marital status, housing status, average monthly income, medical history, and medications in use, were collected during a standardized in-person interview. Tumor location, cancer staging (TNM, 8th edition) [11,12], p16 status, proposed cancer treatment protocol, the Eastern Cooperative Oncology Group (ECOG) [13] and the Karnofsky performance status (KPS) [14] scores were extracted from the Institutional Electronic Medical Record System. When indicated, all patients underwent dental procedures, including oral surgery, periodontal, endodontic, and restorative treatment. During dental treatment conditioning protocols, patients were followed-up to evaluate possible treatment complications, such as infection and persistent bleeding, among others. Anthropometric, pulse oximetry, blood pressure and body temperature measurements Height, weight, oxygen saturation levels, heart rate (HR), blood pressure (BP), and temperature were measured at the screening appointment. Height (cm) and weight (kg) were measured using a standardized scale with a stadiometer. Body mass index (BMI) was calculated as body weight divided by height squared (kg/m 2 ) [15]. A pulse oximeter was used to measure oxygen saturation levels and HR [16]. BP was measured using an electronic BP monitor on the right upper arm, and the participants were asked to rest in a sitting position for 5 minutes before the measurement [17,18]. Body temperature was measured with a digital thermometer in the axillary region [19]. Laboratory tests Venous blood was collected by a trained nurse using standard methods and sent to the hospital’s laboratory for a complete blood count (CBC) and a standard blood chemistry panel (Supplementary material 1) . The following exams were performed: - CBC with differential [erythrocytes, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, erythrocyte distribution width, erythrocyte distribution width (standard deviation), erythroblasts, platelets, mean platelet volume, leukocytes, neutrophils, eosinophil, basophil, lymphocytes, and monocytes]; - Basic electrolyte panel (sodium, potassium, chloride, iron, creatinine, urea, glucose, magnesium); - Metabolic panel [(calcium, bilirubin (total, direct, and indirect)], alkaline phosphatase, AST (aspartate aminotransferase), ALT (alanine aminotransferase, gamma-glutamyl transferase]; - Lipid panel [(total cholesterol, high-density lipoprotein (HDL), triglycerides, low-density lipoprotein (LDL), non-high-density lipoprotein (non-HDL), VLDL (very-low-density lipoprotein)]; - Thyroid function (TSH, T3, T4, FT4); - Glycated hemoglobin (Hemoglobin A1C); - Coagulation assay [prothrombin time (PT), International Normalized Ratio (INR), activated partial thromboplastin time (aPTT)]; - Human immunodeficiency virus (HIV); - Hepatitis B and C; − 25-Hydroxy Vitamin D; - C-reactive protein (CRP); - Syphilis. Treatment-related head and neck toxicities Systemic changes and abnormal laboratory results undertaken before the initiation of oncologic treatment were assessed and correlated with the treatment-related toxicities for patients submitted to RT or CRT. Included patients were clinically evaluated by a trained dentist for OM, radiodermatitis, dysgeusia and dysphagia outcomes following the Common Terminology Criteria for Adverse Events (NCI, version 4.0, 2010) [20], graded 0–4 at days 5/10/15/20/25/30/33–35 of radiation therapy. Additionally, oral candidiasis (OC), xerostomia, and trismus were evaluated qualitatively [21]. OHIP-14 The validated Brazilian Portuguese version of the Oral Health Impact Profile (OHIP-14) questionnaire was applied at the first appointment. It comprises 14 items including functional limitation, physical pain and disability, psychological discomfort and disability, social disability, and handicap. The responses were classified using a Likert scale with five options ranging from “never” (0) to “very often” (4) [22,23]. Statistical analysis Continuous variables such as clinicopathological, sociodemographic, anthropometric, pulse oximetry, BP, temperature measurements, and OHIP-14 data were summarized using mean values and standard deviations; categorical variables analysis evaluated frequencies, and percentages. For the laboratory results, the percentage of exams altered, mean values and standard deviation were evaluated. The chi-square test and fisher’s exact test were applied to evaluate whether curative or palliative treatment modalities were influenced by tumor location, cancer staging, p16 status, and smoking and drinking habits. Pearson correlation test was used to evaluate the association between medication in use and treatment-related toxicities (OM, dysgeusia, dysphagia, xerostomia, radiodermatitis, trismus, and OC). All treatment toxicities at treatment days 5/10/15/20/25/30/33–35 were associated with the laboratory findings. Additionally, using the two-tailed Spearman correlation test for a non-normal distribution, each toxicity outcome was evaluated when an altered laboratory exam was observed in more than four different times at evaluation days, therefore representing a greater chance of a real association and a possibility of correlation. In all analysis, a p-value < 0.05 was considered statistically significant. The worst OM score (group 1: grades 1/2 and group 2: grades 3/4) was correlated with the full data set. Continuous dataset (variables in its numerical forms), discrete dataset (coded data), and a full dataset including all data were used. A biomarker analysis was performed with accuracy, sensitivity, specificity, positive predictive value, negative predict value, and area under the ROC curve. A heat map was presented to evaluate the clinical predictors of OM. Results Sociodemographic and clinicopathological characteristics A total of 484 H&N cancer patients were referred to the Dental Oncology Service for dental treatment and evaluation within the study period. Of which, 110 (22.7%) met the eligibility criteria, and 368 (76%) were excluded due to edentulism, a H&N cancer diagnosis other than OOPSCC, a second OOPSC cancer diagnosis or for declining participation in the study. Six (1.3%) patients were further excluded for not doing the bloodwork prescribed. Most patients were male (n = 85; 77.3%), identified their ethnicity as white (n = 48; 43.6%) or brown (n = 48; 43.6%) and reported a history of tobacco (n = 94; 85.4%) and alcohol consumption (n = 94; 85.4%). Ages ranged from 23 to 83 (mean 57.32) years. Participants had an education level of 4 to 7 years (n = 42; 38.2%), were married/living with a partner (n = 46; 41.8%), owned a house (n = 72; 65.4%), and the most prevailing monthly income was of 1,045 Brazilian Real (BRL) [approximately $235.00 US Dollars (USD) − 2022 values] (n = 38; 34.5%). Fifty-four percent of patients (n = 60) were diagnosed with oropharyngeal squamous cell carcinoma, while 45.5% (n = 50) had an oral tumor. Advanced disease was frequently observed (stage III/IV n = 85; 77.3%). Summaries of the sociodemographic and clinicopathological characteristics are shown in Table 1 . Table 1 Sociodemographic, clinicopathological, oncologic treatment and referral to dental treatment characteristics of the included patients (n = 110). Variable Value Number of patients 110 Age, mean ± SD [range], years 57.32 ± 9.74 [87–23] Sex, no. (%) Female 26 (23.6) Male 84 (76.4) Ethnicity, no. (%) White 48 (43.6) Black 13 (11.8) Yellow Brown 1 (0.9) 48 (43.6) Cancer diagnosis, no. (%) Oral cavity 50 (45.5) Oropharynx 60 (54.5) Stage, no. (%) In situ 1 (0.9) I 10 (9.1) II 11 (10) III 22 (20) IVa/b/c 63 (57.3) Not informed 3 (2.7) P16 in oropharynx cases, no. (%) Negative 18 (30) Positive 16 (26.7) Not informed 26 (43.3) Smoker (current or past), no. (%) 94 (85.4) Drink alcohol (current or past), no. (%) 94 (85.4) Drug user (current or past) no. (%) 3 (2.7) Education No education or less than 1 year 6 (5.5) 1 to 3 years 4 (3.6) 4 to 7 years 42 (38.2) 8 to 10 years 13 (11.8) 11 to 14 years 25 (22.7) 15 or more years 20 (18.2) Marriage Single 28 (25.5) Married/ partnered 46 (41.8) Separated/ divorced 22 (20) Widowed 14 (12.7) Housing Own 72 (65.4) Rent 26 (23.6) Borrowed 12 (11) Average monthly income* < 1 minimum wage 32 (29.1) 1 minimum wage 38 (34.5) 2 to 4 minimum wages 33(30) 5 or + minimum wages Average family monthly income* 7 (6.4) < 1 minimum wage 13 (11.8) 1 minimum wage 30 (27.3) 2 to 4 minimum wages 55 (50) 5 or + minimum wages 12 (10.9) Cancer treatment Curative 82 (75.5) S 18 (22) S + induction CT + CRT 1 (1.2) S + CRT 18 (22) Induction CT + CRT 3 (3.6) RT 17 (20.7) CRT 25 (30.5) Palliative 28 (25.5) Referral Before radiotherapy 80 (72.8) During chemotherapy 3 (2.7) Before surgery 27 (24.5) Abbreviations: no., total number of patients; %, percentage; SD, standard deviation; S, surgery; CT, chemotherapy; CRT, chemoradiotherapy; RT, radiotherapy. *National minimum wage equals to 1212 BRL/Month in Brazil (approximately 235 USD − 2022 values) ECOG and KPS performances Most patients (n = 72; 65.5%) scored 1 for the ECOG performance status and 56 patients (50.9%) scored 90% for the KPS scale. Referral patterns and oncologic treatment plans Eighty patients (72.8%) patients were referred for dental treatment before the start of RT, 24.5% (n = 27) before surgery, and 2.7% (n = 3) during CT. Most of them (n = 82; 75.5%) were treated with curative intent and the most performed treatment modality was CRT (n = 25; 30.5%) [ Table 1 ]. Early stage tumors (I/II) were more frequently treated with a curative intent (P = 0.0). Self-reported medical conditions and medication in use Forty patients (36.4%) did not report having any medical conditions other than cancer, 31 (44.3%) reported having one, and 39 (55.7%) patients had two or more underlying medical conditions. The most common comorbidity reported was hypertension (n = 36, 51.4%), followed by dyslipidemia (n = 16, 22.8%) and diabetes (n = 11, 15.7%). Five (4.5%) patients reported HIV infection, three (2.7%) a syphilis diagnosis (2.7%) and two (1.8%) a hepatitis C virus infection. Five (4.5%) patients reported a previous cancer diagnosis (1 renal cancer, 2 skin cancer, and 2 Kaposi’s sarcoma). Full self-reported diagnoses can be seen in Table 2 . Fifty-one (46.4%) patients reported daily use of prescribed medication, with an average of three different medications. Most of them reported the use of more than one medication category (51%), and the most used were antihypertensives (56.9%), diuretics (25.5%), lipid-lowering agents (21.6%), and antidiabetic/ hypoglycemic agents (21.6%) (Supplementary material 2 ). Table 2 List of the comorbidities reported by the included patients (n = 110). Diagnosis Value n (%) Hypertension 36 (51.4) Dyslipidemia 16 (22.9) Diabetes 11 (15.7) Gastritis 9 (12.9) HIV 5 (7.1) Previous cancer 5 (7.1) Acute myocardial infarction 5 (7.1) Tuberculosis (treated) 5 (7.1) Obesity 5 (7.1) Asthma 3 (4.3) Gout 3 (4.3) Hypothyroidism 3 (4.3) Impaired vision 3 (4.3) Syphilis 3 (4.3) Anxiety 2 (2.9) Arrhythmia 2 (2.9) Stroke 2 (2.9) Bronchitis 2 (2.9) Hepatic steatosis 2 (2.9) Congestive heart failure 2 (2.9) Prediabetes 2 (2.9) Osteoporosis 2 (2.9) Hepatitis C 2 (2.9) Leg paresthesia 2 (2.9) Arthritis 1 (1.4) Chron disease 1 (1.4) Coronary artery disease 1 (1.4) Depression 1 (1.4) Dyspepsia 1 (1.4) Pulmonary emphysema 1 (1.4) Migraine 1 (1.4) Esophagitis 1 (1.4) Glaucoma 1 (1.4) Hemiparesis left 1 (1.4) Hepatitis B 1 (1.4) Spinal disc herniation 1 (1.4) Parkinson investigation 1 (1.4) Labyrinthitis 1 (1.4) Osteoarthritis 1 (1.4) Osteopenia 1 (1.4) Hearing loss 1 (1.4) Mitral valve prolapse 1 (1.4) Gastroesophageal reflux 1 (1.4) Poliomyelitis sequelae (leg) 1 (1.4) Abbreviations: no., total number of patients; %, percentage. Anthropometric, pulse oximetry, blood pressure and body temperature measurements The mean and standard deviation (SD) of body mass index was 23.86 (± 5.56), mean (SD) BP was 125.65 (± 25.58) x 84.46 (± 14.72) mmHg. Only 14.5% of patients presented BP measurements within the normal range. No patients had abnormal body temperature measurements or fever. The mean (SD) HR was 81.01 (± 17.48), and the mean O 2 saturation was 95.90 (± 2.31). Laboratory tests The laboratory results are summarized in Table 3 . The following tests presented a higher percentage of altered results: CRP (63.6%), hemoglobin (60%), erythrocytes (57.3%), hematocrit (59.1%), gamma-glutamyl transferase [GGT] (45.5%), 25-Hydroxy Vitamin D (47.3%), RDW-SD (36.4%), neutrophil counts (35.5%), eosinophil counts (35.5%), total cholesterol (35.5%), High-density lipoprotein (HDL) (35.5%), iron (34.5%) and glucose (34.5%). Overall, 11 (10%) of the included patients reported systemic infectious diseases at baseline. Although only three (2.7%) patients reported a syphilis diagnosis, 9 (8.2%) additional individuals tested positive for syphilis; thus, a total of 12 (10.9%) diagnoses of syphilis were observed in this study. Table 3 The laboratory results, percentage altered, range, mean and standard deviation. Laboratory tests n (%) altered Mean STDEV Complete blood count (CBC) Erythrocytes (x10 6 /mm 3 ) 63 (57.3) 4.26 0.73 Hemoglobin (g/dL) 66 (60) 12.60 1.91 Hematocrit (%) 65 (59.1) 37.66 5.51 MCV (fL) 20 (18.2) 88.64 6.07 MCH (pg) 13 (11.8) 29.66 2.34 MCHC (g/dL) 9 (8.2) 33.45 1.06 RDW-CV (%) 15 (13.6) 13.33 1.25 RDW-SD (fL) 40 (36.4) 43.00 4.65 Erythroblasts (%) 1 (0.9) 0.1 0.07 Platelets (x10 3 /mm 3 ) 25 (22.7) 325.57 115.38 MPV (fL) 30 (27.3) 10.20 1.10 Leukocytes (10 3 /mm 3 ) 27 (24.5) 9.09 4.10 Neutrophils (10 3 /mm 3 ) 39 (35.5) 6.66 6.64 Eosinophil (10 3 /mm 3 ) 39 (35.5) 0.26 0.28 Basophil (10 3 /mm 3 ) 27 (24.5) 0.05 0.05 Lymphocytes (10 3 /mm 3 ) 37 (33.6) 1.93 0.72 Monocytes (10 3 /mm 3 ) 35 (31.8) 0.73 0.30 Basic electrolyte panel Sodium (mEq/L) 12 (10.9) 138.66 3.30 Potassium (mEq/L) 17 (15.5) 4.53 0.45 Magnesium (mg/dL) 4 (3.63) 2.01 0.22 Chloride (mEq/L) 4 (3.6) 2.01 0.22 Iron (ug/dL) 38 (34.5) 76.43 34.15 Creatinine (mg/dL) 27 (24.5) 0.87 0.24 Glucose (mg/dL) 38 (34.5) 96.94 21.41 Urea (mg/dL) 11 (10) 34.72 15.69 Metabolic panel Calcium (mg/dL) 21 (19.1) 9.94 1.05 Bilirubin total (mg/dL) 11 (10) Bilirubin direct (mg/dL) 7 (6.4) Bilirubin indirect (mg/dL) 25 (22.7) Alkaline phosphatase (U/L) 12 (10.9) 85.68 31.73 Aspartate aminotransferase (U/L) 6 (5.5) 19.53 7.67 Gamma-glutamyl transferase (U/L) 50 (45.5) 83.99 91.09 Alanine aminotransferase (U/L) 14 (12.7) 21.28 14.07 Lipid panel Total cholesterol (mg/dL) 39 (35.5) 183.05 42.06 High-density lipoprotein (HDL) (mg/dL) 39 (35.5) 45.81 12.18 Low-density lipoprotein (LDL) (mg/dL) 12 (10.9) 114.15 35.89 Non-high-density lipoprotein (non-HDL) cholesterol (mg/dL) 26 (23.6) 138.39 40.82 VLDL (very-low-density lipoprotein) (mg/dL) 17 (15.5) 24.81 10.76 Triglycerides (mg/dL) 31 (28.2) 136.63 80.30 Thyroid function Thyroid stimulating hormone (TSH) (ul/mL) 15 (13.6) 2.56 2.19 Total triiodothyronine (T3) (ng/dL) 12 (10.9) Thyroxine (T4) (ug/dL) 2 (1.8) 8.66 1.77 Free thyroxine (free T4) (ng/dL) 6 (5.45) 1.27 0.22 Glycated hemoglobin (Hemoglobin A1C) (%) 14 (22.7) 5.35 0.80 Coagulation assay Prothrombin time (PT) (s) 2 (1.8) 14.43 1.20 International Normalized Ratio (INR) (s) 28 (25.5) 1.07 0.13 Activated partial thromboplastin time (aPTT) (s) 12 (10.9) 29.83 3.19 25-Hydroxy Vitamin D (ng/mL) 52 (47.3) 26.86 14.41 HBsAg (Hepatitis B surface antigen) 0 Anti-HBs (Hepatitis B surface antibody 18 (16.4) - - Anti-HBc (Hepatitis B core antibody) 9 (8.2) - - Hepatitis C 3 (2.7) - - HIV 5 (4.5) - - Syphilis 12 (10.9) - - C-reactive protein (CRP) (mg/L) 70 (63.3) 23.43 31.94 Abbreviations: STDEV: standard deviation; %: percentage. Treatment-related head and neck toxicities Sixty-three (57.3%) patients underwent full curative treatment (i.e. RT or CRT followed by previous surgery or not). Toxicities were progressive over time and independent of the chosen RT modality {intensity-modulated radiation therapy (IMRT) or 3-dimensional (3D)]. There was a positive correlation between the number of medications in use and OM (0.268) and a negative correlation between the number of medications in use and dysgeusia (− 0.257) outcomes. There were no correlations between the number of diagnosed comorbidities and toxicities. Full correlation values are shown in Supplementary material 3. The association of altered laboratory exam results performed prior oncological treatment and days 5/10/15/20/25/30 and 33–35 of treatment-related toxicities (OM, dysgeusia, dysphagia, xerostomia, radiodermatitis, trismus, and OC) can be seen in Table 4 . For the OM domain altered thyroxine (T4) and free thyroxine (FT4) had significative P values (P < 0.05) starting at D15; calcium levels altered at D5/10/30; urea levels altered at D25/30/D33-35; creatinine levels altered at D15/30; alkaline phosphatase levels altered at D20/25. Table 4 Treatment side effects and association with abnormal laboratory results. Laboratory exam Treatment side effects Oral mucositis Disgeusia Dysphagia Xerostomia D5 FT4 (p = 0) Erythroblasts (p = 0.007) Sodium (p = 0.019) Sodium (p = 0.019) Calcium (p = 0.002) Hepatitis C (p = 0.007) Aspartate aminotransferase (p = 0.013) Alanine aminotransferase (p = 0.001) 25-Hydroxy Vitamin D (p = 0.055) Basophil (p = 0.058) Hematocrit (p = 0.012) Erythrocytes (p = 0.002) Anti-HBc Hep B (p = 0.008) Cholesterol (p = 0.05) Calcium (p = 0.026) Potassium (p = 0.003) Monocyte (p = 0.042) VLDL (p = 0.033) Cholesterol (p = 0.023) D10 Leukocytes (p = 0.057) Hematocrit (p = 0.0058) Iron (p = 0.011) Calcium (p = 0.023) Syphilis (p = 0.012) Sodium (p = 0.044) MCH (p = 0.043) Hematocrit (p = 0.006) Erythrocyte (p = 0.001) Anti-HBc Hep B (p = 0.019) Gamma-glutamyl transferase (p = 0.027) FT4 (p = 0.054) Syphilis (p = 0.02) D15 aPTT (p = 0.019) FT4 (p = 0.035) T4 (p = 0.001) T3 (p = 0.001) Syphilis (p = 0.038) Creatinine (p = 0) Bilirubin (p = 0.01) FT4 (p = 0) T4 (p = 0.041) Eosinophil (p = 0.003) Hematocrit (p = 0.004) Erythrocytes (p = 0.003) Glucose (p = 0.045) Calcium (p = 0.011) Alkaline phosphatase (p = 0.028) FT4 (p = 0.04) Lymphocyte (p = 0) VLDL (p = 0.041) Cholesterol (p= Uric acid (p = 0.034) D20 FT4 (p = 0) T4 (p = 0.045) Basophil (p = 0) Eosinophil (p = 0.046) non-HDL (p = 0.057) Cholesterol (p = 0.031) Glucose (p = 0) Alkaline phosphatase (p = 0.002) TSH (p = 0.030) Basophil (p = 0.029) Hematocrit (p = 0.006) Erythroblasts (p = 0.005) Potassium (p = 0) MCHC (p = 0.001) Hematocrit (p = 0.023) Erythrocyte (p = 0.018) Aspartate aminotransferase (p = 0) Hepatitis (p = 0.029) HIV (p = 0) D25 Urea (p = 0.008) FT4 (p = 0) T4 (p = 0.004) Monocytes (p = 0.036) Basophil (p = 0.004) Glucose (p = 0.001) Alkaline phosphatase (p = 0.002) Hematocrit (p = 0.017) Erythrocytes (p = 0.020) Neutrophil (p = 0.049) Hematocrit (p = 0.001) Erythrocyte (p = 0.002) D30 Urea (p = 0.001) FT4 (p = 0) T4 (p = 0) Syphilis (p = 0.018) Glycated hemoglobin (p = 0.030) Creatinine (p = 0.007) Chloride (p = 0.039) Calcium (p = 0.044) Bilirubin (p = 0.035) Basophil (p = 0.008) Eosinophil (p = 0.019) Leukocyte (p = 0.048) Hematocrit (p = 0.025) Erythrocytes (p = 0.046) Prothrombin time (p = 0.028) T4 (p = 0.028) Magnesium (p = 0) Neutrophil (p = 0.018) MCHC (p = 0.034) Hematocrit (p = 0.007) Erythrocyte (p = 0.023) Anti-HBc Hep B (p = 0.023) Sodium (p = 0.025) D33/35 Urea (p = 0) FT4 (p = 0.02) T4 (p = 0.009) Hematocrit (p = 0.059) RDW-SD (p = 0.027) Hematocrit (p = 0.016) Creatinine (p = 0.052) T4 (p = 0.053) Magnesium (p = 0.001) T4 (p = 0.059) Sodium (p = 0.008) Glycated hemoglobin (p = 0.054) <table border=\"1\" id=\"Taba\"> <thead> <tr> <th align=\"left\">&nbsp;</th> <th align=\"left\"> <p>Laboratory exam</p> </th> <th align=\"left\">&nbsp;</th> <th align=\"left\">&nbsp;</th> </tr> </thead> <tbody> <tr> <td align=\"left\"> <p>Treatment side effects</p> </td> <td align=\"left\"> <p><strong>Radiodermatitis</strong></p> </td> <td align=\"left\"> <p><strong>Trismus</strong></p> </td> <td align=\"left\"> <p><strong>Candidiasis</strong></p> </td> </tr> <tr> <td align=\"left\"> <p>D5</p> </td> <td align=\"left\"> <p>Prothrombin time (p&thinsp;=&thinsp;0.024)</p> <p>Erythroblasts (p&thinsp;=&thinsp;0.001)</p> <p>25-Hydroxy Vitamin D (p&thinsp;=&thinsp;0.002)</p> </td> <td align=\"left\"> <p>aPTT (p&thinsp;=&thinsp;0)</p> <p>RDW-SD (p&thinsp;=&thinsp;0.003)</p> <p>MCV (p&thinsp;=&thinsp;0.001)</p> <p>HIV (p&thinsp;=&thinsp;0.044)</p> <p>Anti-Hep B (p&thinsp;=&thinsp;0.027)</p> </td> <td align=\"left\"> <p>MCHC (p&thinsp;=&thinsp;0.009)</p> <p>Triglycerides (p&thinsp;=&thinsp;0.047)</p> <p>Aspartate aminotransferase (p&thinsp;=&thinsp;0.002)</p> </td> </tr> <tr> <td align=\"left\"> <p>D10</p> </td> <td align=\"left\"> <p>MCH (p&thinsp;=&thinsp;0.014)</p> <p>Erythrocyte (p&thinsp;=&thinsp;0.021)</p> <p>Calcium (p&thinsp;=&thinsp;0.049)</p> </td> <td align=\"left\"> <p>aPTT (p&thinsp;=&thinsp;0)</p> <p>RDW-SD (p&thinsp;=&thinsp;0.001)</p> <p>Anti-Hep B (p&thinsp;=&thinsp;0.026)</p> </td> <td align=\"left\"> <p>Potassium (p&thinsp;=&thinsp;0.015)</p> <p>Alanine aminotransferase (p&thinsp;=&thinsp;0.035)</p> <p>Potassium (p&thinsp;=&thinsp;0)</p> </td> </tr> <tr> <td align=\"left\"> <p>D15</p> </td> <td align=\"left\"> <p>MCH (p&thinsp;=&thinsp;0.014)</p> </td> <td align=\"left\"> <p>aPTT (p&thinsp;=&thinsp;0)</p> <p>RDW-SD (p&thinsp;=&thinsp;0.004)</p> <p>MCV (p&thinsp;=&thinsp;0.001)</p> <p>Anti-HBc Hep B (p&thinsp;=&thinsp;0.026)</p> </td> <td align=\"left\"> <p>Potassium (p&thinsp;=&thinsp;0.05)</p> <p>Eosinophil (p&thinsp;=&thinsp;0.032)</p> <p>Triglycerides (p&thinsp;=&thinsp;0.035)</p> <p>Calcium (p&thinsp;=&thinsp;0.039)</p> </td> </tr> <tr> <td align=\"left\"> <p>D20</p> </td> <td align=\"left\"> <p>INR (p&thinsp;=&thinsp;0.006)</p> <p>Sodium (p&thinsp;=&thinsp;0)</p> <p>MCH (p&thinsp;=&thinsp;0.013)</p> <p>MCV (p&thinsp;=&thinsp;0)</p> <p>Chloride (p&thinsp;=&thinsp;0.017)</p> <p>Uric acid (p&thinsp;=&thinsp;0)</p> </td> <td align=\"left\"> <p>RDW-SD (p&thinsp;=&thinsp;0.004)</p> <p>MCV (p&thinsp;=&thinsp;0.001)</p> <p>Anti-HBc Hep B (p&thinsp;=&thinsp;0.026)</p> <p>aPTT (p&thinsp;=&thinsp;0)</p> </td> <td align=\"left\"> <p>aPTT (p&thinsp;=&thinsp;0.025)</p> <p>TSH (p&thinsp;=&thinsp;0.015)</p> <p>Syphilis (p&thinsp;=&thinsp;0.038)</p> <p>Eosinophil (p&thinsp;=&thinsp;0.016)</p> <p>HIV (p&thinsp;=&thinsp;0.018)</p> <p>Calcium (p&thinsp;=&thinsp;0.011)</p> </td> </tr> <tr> <td align=\"left\"> <p>D25</p> </td> <td align=\"left\"> <p>INR (p&thinsp;=&thinsp;0.017)</p> <p>Lymphocyte (p&thinsp;=&thinsp;0.004)</p> <p>Non-HDL (p&thinsp;=&thinsp;0.02)</p> <p>Cholesterol (p&thinsp;=&thinsp;0.009)</p> <p>Chloride (p&thinsp;=&thinsp;0)</p> </td> <td align=\"left\"> <p>aPTT (p&thinsp;=&thinsp;0)</p> <p>RDW-SD (p&thinsp;=&thinsp;0.002)</p> <p>MCV (p&thinsp;=&thinsp;0.001)</p> <p>Hematocrit (p&thinsp;=&thinsp;0.012)</p> <p>Erythrocyte (p&thinsp;=&thinsp;0.012)</p> <p>Anti-HBc hep B (p&thinsp;=&thinsp;0.023)</p> <p>Alkaline phosphatase (p&thinsp;=&thinsp;0.042)</p> </td> <td align=\"left\"> <p>FT4 (p&thinsp;=&thinsp;0.02)</p> <p>Eosinophil (p&thinsp;=&thinsp;0.03)</p> <p>Glucose (p&thinsp;=&thinsp;0.04)</p> <p>Alanine aminotransferase (p&thinsp;=&thinsp;0.019)</p> </td> </tr> <tr> <td align=\"left\"> <p>D30</p> </td> <td align=\"left\"> <p>INR (p&thinsp;=&thinsp;0.034)</p> <p>Potassium (p&thinsp;=&thinsp;0)</p> <p>Lymphocyte (p&thinsp;=&thinsp;0.013)</p> <p>Chloride (p&thinsp;=&thinsp;0)</p> <p>Bilirubin (p&thinsp;=&thinsp;0.053)</p> <p>Aspartate aminotransferase</p> <p>(p&thinsp;=&thinsp;0.019)</p> </td> <td align=\"left\"> <p>aPTT (p&thinsp;=&thinsp;0)</p> <p>RDW-SD (p&thinsp;=&thinsp;0.002)</p> <p>VCM (p&thinsp;=&thinsp;0.001)</p> <p>Hematocrit (p&thinsp;=&thinsp;0.031)</p> <p>Erythrocytes (p&thinsp;=&thinsp;0.033)</p> <p>Anti-HBc Hep B (p&thinsp;=&thinsp;0.022)</p> </td> <td align=\"left\"> <p>Potassium (p&thinsp;=&thinsp;0.024)</p> <p>Eosinophil (p&thinsp;=&thinsp;0.039)</p> <p>Iron (p&thinsp;=&thinsp;0.059)</p> <p>Calcium (p&thinsp;=&thinsp;0.037)</p> </td> </tr> <tr> <td align=\"left\"> <p>D33/35</p> </td> <td align=\"left\"> <p>FT4 (p&thinsp;=&thinsp;0.005)</p> <p>Potassium (p&thinsp;=&thinsp;0)</p> <p>Aspartate aminotransferase (p&thinsp;=&thinsp;0.01)</p> <p>Alkaline phosphatase (p&thinsp;=&thinsp;0.056)</p> </td> <td align=\"left\"> <p>aPTT (p&thinsp;=&thinsp;0)</p> <p>RDW-SD (p&thinsp;=&thinsp;0.031)</p> <p>MCV (p&thinsp;=&thinsp;0.007)</p> <p>Hematocrit (p&thinsp;=&thinsp;0.008)</p> <p>Erythrocyte (p&thinsp;=&thinsp;0.011)</p> <p>HDL cholesterol (p&thinsp;=&thinsp;0.044)</p> <p>Iron (p&thinsp;=&thinsp;0.050)</p> <p>Bilirubin (p&thinsp;=&thinsp;0.026)</p> <p>Alkaline phosphatase (p&thinsp;=&thinsp;0.039)</p> </td> <td align=\"left\"> <p>INR (p&thinsp;=&thinsp;0.003)</p> <p>CRP (p&thinsp;=&thinsp;0.026)</p> <p>Monocytes (p&thinsp;=&thinsp;0.062)</p> <p>LDL (p&thinsp;=&thinsp;0.041)</p> <p>Cholesterol (p&thinsp;=&thinsp;0.038)</p> <p>Glucose (p&thinsp;=&thinsp;0.005)</p> </td> </tr> </tbody> <tfoot> <tr> <td colspan=\"4\"><strong>Abbreviations</strong>: aPTT: Activated partial thromboplastin time; CRP - C-reactive protein; D: days; free T4 - Free thyroxine; HDL: High-density lipoprotein; Hep B &ndash; hepatitis B; HIV - human immunodeficiency virus; INR - International Normalized Ratio; LDL - Low-density lipoprotein; MCH - mean corpuscular hemoglobin; MCV - mean corpuscular volume; MCHC - mean corpuscular hemoglobin concentration; RDW-SD - Erythrocyte Distribution Width (standard deviation); TSH - Thyroid stimulating hormone; T3 - Total triiodothyronine; T4 - Thyroxine; VLDL - very-low-density lipoprotein.</td> </tr> </tfoot> </table> </div> <p>&nbsp;</p> <p>A positive syphilis diagnosis was correlated with mucositis at D15/30. OC was associated with syphilis and HIV at D20. Table&nbsp;<span class=\"InternalRef\">4</span> presents the full association between altered laboratory exams and treatment-related H&amp;N toxicities.</p> <p>When evaluating Table&nbsp;<span class=\"InternalRef\">4</span> for laboratory test exams that were altered and correlated with a toxicity in more than four different evaluation days with significative P values (P&thinsp;&lt;&thinsp;0.05), altered T4 and FT4 appear to be correlated with mucositis. Accordingly, a correlation between T4 and mucositis are seen in D20 (P&thinsp;=&thinsp;0.0234) and D25 (P&thinsp;=&thinsp;0.0281) and slightly lower at D30 (P&thinsp;=&thinsp;0.0718) and D33-35 (P&thinsp;=&thinsp;0.0503). Correlation between OM and FT4 are only significant at D33-35 (P&thinsp;=&thinsp;0.0426) but closely at D20 (P&thinsp;=&thinsp;0.0519), D25 (P&thinsp;=&thinsp;0.0958) and D30 (P&thinsp;=&thinsp;0.0875) (Table&nbsp;<span class=\"InternalRef\">5</span>).</p> <div class=\"gridtable\"> <table border=\"1\" id=\"Tab5\"> <caption> <div class=\"CaptionNumber\">Table 5</div> <div class=\"CaptionContent\"> <p>Mucositis association with abnormal laboratory results observed four times or more at different evaluation days.</p> </div> </caption> <thead> <tr> <th align=\"left\">&nbsp;</th> <th align=\"left\"> <p>D5</p> </th> <th align=\"left\"> <p>D15</p> </th> <th align=\"left\"> <p>D20</p> </th> <th align=\"left\"> <p>D25</p> </th> <th align=\"left\"> <p>D30</p> </th> <th align=\"left\"> <p>D35</p> </th> </tr> </thead> <tbody> <tr> <td align=\"left\"> <p><strong>T4</strong></p> </td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> </tr> <tr> <td align=\"left\"> <p>R</p> </td> <td align=\"left\">&nbsp;</td> <td align=\"left\"> <p>-0,1570</p> </td> <td align=\"left\"> <p>-0,2830</p> </td> <td align=\"left\"> <p>-0,2768</p> </td> <td align=\"left\"> <p>-0,2266</p> </td> <td align=\"left\"> <p>-0,2703</p> </td> </tr> <tr> <td align=\"left\"> <p>IC95%</p> </td> <td align=\"left\">&nbsp;</td> <td align=\"left\"> <p>-0,3941 to 0,09973</p> </td> <td align=\"left\"> <p>-0,5000 to -0,03260</p> </td> <td align=\"left\"> <p>-0,4966 to -0,02371</p> </td> <td align=\"left\"> <p>-0,4534 to 0,02776</p> </td> <td align=\"left\"> <p>-0,5099 to 0,008176</p> </td> </tr> <tr> <td align=\"left\"> <p>P</p> </td> <td align=\"left\">&nbsp;</td> <td align=\"left\"> <p>0,2154</p> </td> <td align=\"left\"> <p>0,0234*</p> </td> <td align=\"left\"> <p>0,0281*</p> </td> <td align=\"left\"> <p>0,0718</p> </td> <td align=\"left\"> <p>0,0503</p> </td> </tr> <tr> <td align=\"left\"> <p><strong>FT4</strong></p> </td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> <td align=\"left\">&nbsp;</td> </tr> <tr> <td align=\"left\"> <p>R</p> </td> <td align=\"left\"> <p>0,07591</p> </td> <td align=\"left\"> <p>-0,1388</p> </td> <td align=\"left\"> <p>-0,2441</p> </td> <td align=\"left\"> <p>-0,2117</p> </td> <td align=\"left\"> <p>-0,2154</p> </td> <td align=\"left\"> <p>-0,2796</p> </td> </tr> <tr> <td align=\"left\"> <p>IC95%</p> </td> <td align=\"left\"> <p>-0,1824 to 0,3244</p> </td> <td align=\"left\"> <p>-0,3783 to 0,1181</p> </td> <td align=\"left\"> <p>-0,4680 to 0,009257</p> </td> <td align=\"left\"> <p>-0,4426 to 0,04553</p> </td> <td align=\"left\"> <p>-0,4440 to 0,03957</p> </td> <td align=\"left\"> <p>-0,5173 to -0,001844</p> </td> </tr> <tr> <td align=\"left\"> <p>P</p> </td> <td align=\"left\"> <p>0,5543</p> </td> <td align=\"left\"> <p>0,2740</p> </td> <td align=\"left\"> <p>0,0519</p> </td> <td align=\"left\"> <p>0,0958</p> </td> <td align=\"left\"> <p>0,0875</p> </td> <td align=\"left\"> <p>0,0426*</p> </td> </tr> </tbody> <tfoot> <tr> <td colspan=\"7\">* statistically significant values.</td> </tr> <tr> <td colspan=\"7\">Abbreviation: D: day, T4: thyroxine, FT4: free thyroxine.</td> </tr> </tfoot> </table> <p>&nbsp;</p> </div> <p>The most important predictors for OM were family income and housing; both outcomes are presented in navy blue in the heat map (Fig.&nbsp;<span class=\"InternalRef\">1</span>).</p> <h2>OHIP-14</h2> The mean OHIP-14 score from the study population was 19.5, ranging from 0 to 49. The worst domain reported was physical pain (4.37 out of possible 8), which evaluated pain and difficulty in eating (Supplementary material 4). Discussion Our study evaluated whether dental treatment before OOPSCC therapy alters existing systemic comorbidities. The results suggested that although OOPSCC patients have comorbidities and several abnormal laboratory tests results, the dental treatment in these cancer populations resulted in no adverse events. It was also observed that the OOPSCC diagnosis does not pose an additional challenge for the dentist, as treatment complications such as unexpected bleeding or infection were not identified in the population evaluated. It is recommended that OOPSCC patients should receive comprehensive oral assessment and dental treatment before cancer treatment. It ought to start right after the cancer diagnosis. When an oral/dental surgical procedure such dental extractions is indicated, ideally it should be concluded 2–3 weeks before the start of the cancer treatment to allow time for bone and soft tissue healing [2–4, 24]. We used comorbidity to refer to disease processes that coexist and are not related to the index disease being studied [25]. Current literature highlights that the frequency of comorbidities in OOPSCC patients is high compared to the general population, and it is mainly associated with chronic smoking and alcohol exposure [26,27]. A review demonstrated that approximately 60% of H&N cancer patients have concurrent illnesses [25]. Our study, which originally assessed a Latin American population with advanced OOPSCC, observed that 85.4% of patients had a history of tobacco/alcohol consumption. In addition, patients reported an overall comorbidity rate of 63.6% (44.3% one, while 55.7% with two or more concurrent). The most common comorbidities reported were hypertension (51.4%), followed by dyslipidemia (22.8%) and diabetes (15.7%). This is similar to the results of a study population of 10,524 H&N cancer patients (3049 diagnosed with oral and 2499 diagnosed with oropharyngeal cancer), with the most reported comorbidities being hypertension (59.6%), hyperlipidemia (31.4%), chronic obstructive pulmonary disease (COPD; 26.4%), and diabetes (21.1%) [29]. Comorbidities can impact the diagnosis, prognosis, survival and treatment of patients with cancer and dictates the cancer treatment modality and shapes the way dental treatment is provided [28,29]. The most frequent altered laboratory findings were elevated CRP, altered levels of hemoglobin, erythrocytes, hematocrit, GGT, 25-Hydroxy Vitamin D, RDW-SD, neutrophil counts, eosinophil counts, total cholesterol, HDL, iron, and glucose. A retrospective study of 261 H&N cancer patients that evaluated pre-therapeutic laboratory values also demonstrated that elevated CRP were the most frequent laboratory anomaly (60%), but they also observed impaired liver enzymes (30–50%), leukocytosis (20%), and anemia (10%) [30]. The results of our study suggest that the observed comorbidities do not require dental treatment modifications and do not generate complications related to invasive dental procedures. CRP is a nonspecific inflammation marker synthesized in response to acute inflammation or destruction of tissue cells and over-expressed levels are demonstrated to be prognostic markers in various tumors, including lung, lymphoma, and more recently, H&N cancers [31,32]. Altered liver function GGT can be explained by the chronic alcohol abuse in this population [30]. 25-Hydroxy Vitamin D monitors vitamin D levels, and deficiency is highly prevalent among adults, and low levels have been associated with hypertension, cancer, and diabetes mellitus [33,34]. Neutrophils, the most abundant leukocytes in the blood, are considered to be the first line of defense during inflammation and infections. High counts in the H&N cancer population are associated with poor cancer prognosis. Low counts are associated with infection [35,36]. The high incidence of altered blood glucose concentration is associated with the high number of diabetic patients in this targeted sample. The current literature suggests that general dentists may have limited experience in the care of the cancer patient. Professionals with experience in oral oncology are usually the ones who diagnose and manage oral conditions and diseases in OOPSCC patients [24]. While this may be true for patients already undergoing or that have already concluded cancer treatment, our study suggests that routine dental treatment before OOPSCC may be performed by general dentists. Although comorbidities and laboratory changes were observed in our study population, they did not generate relevant treatment complications that contraindicated dental treatment. H&N cancer treatment toxicities are frequent, affect patients' QoL, may cause treatment breaks, and eventually impair prognosis [3–4]. In our study, toxicities were progressive over time and independent of the chosen RT modality. There was a positive correlation between the number of medications in use and OM and a negative correlation between the number of medications in use and dysgeusia outcomes. To our knowledge, this is the first study to correlate the presence of comorbidities, laboratory changes and toxicities from the curative treatment (RT or CRT) in OOPSCC patients, and the provision of routine dental care before the start of cancer therapy. Because the findings of this study are unique, there is no existing literature to support or to compare our results. Nevertheless, some findings in the present study may be considered predictive of oral toxicities during oncological treatment. We demonstrated that urea levels were altered at D25/30/D33-35 and creatinine at D15/30 of RT or CRT treatment, pointing to altered renal function and impairment of drug metabolism in patients undergoing these treatment modalities. Ultimately, this could imply more severe mucositis [37]. Additionally, we observed that altered T4 and FT4 levels were correlated with OM. T4 altered levels and OM were seen in D20/25, and slightly less in D30/33–35. Correlation between OM and FT4 is only significant at D33-35, but also showed a trend at D20/25/30. A syphilis diagnosis was correlated with OM at D15, and OC was associated with syphilis and HIV diagnosis at D20 of the RT treatment. The baseline immunosuppression added to the cancer-treatment related immunosuppression might favor this scenario [38]. Of interest, we observed that both family income and housing were the most important predicting factors for OM. These predictors could be explained based on the sociodemographic context of OOPSCC patients in Brazil - a low income and low education level can affect compliance and follow-up of recommendations which could worsen OM grades [39]. Limitations of the present study include the short follow-up time after diagnosis and treatment. Because of this, it was not possible to directly correlate abnormal laboratory test values and the OOPSCC prognosis and cancer treatment outcomes. The heterogenic population that participated in the study, the different treatment modalities used to treat the patients, and some of the correlations observed are also limitations to be considered in this study. The mean OHIP-14 score from the study population was 19.5, and the worst domain reported was physical pain (4.37). These findings are similar to a study also conducted in Brazil with H&N cancer patients, in which the mean score obtained was 19.52 (± 11.79) and the physical pain (3.70 ± 2.44). These two findings ranked as the main factor affecting QoL [40]. Conclusions The results of this study suggested that although OOPSCC patients have a wide range of comorbidities and several abnormal laboratory results when their cancers are diagnosed, dental treatment before cancer therapy resulted in no adverse events in our sample. Thus, it reinforces that general dentists may safely perform dental procedures in these OOPSCC population. Laboratory findings may be useful clinical predictors of OM, including altered T4, FT4, urea, creatinine, calcium, alkaline phosphatase, creatinine, and a positive syphilis diagnosis. Systemic infectious diseases, such as syphilis and HIV may also be reliable clinical predictors of OC secondary to OOPSCC treatment. Declarations Funding: This work was supported in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. Alan Roger Santos-Silva is a research grantee of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil), process number 304941/2020-4. Xaviera A. López-Cortés is supported by the ANID FONDECYT Iniciación process number 11220897. Compliance with Ethical Standards Conflict of interest statement : None declared. Research involving Human Participants and/or Animals: Ethical approval was obtained from the National Human Research Ethics Committee (CAAE: 23671019.1.1001.5418). Informed consent: All participants provided written informed consent. Material availability: All data is provided in tables or supplementary materials. Author contributions: All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Leticia Rodrigues-Oliveira, Ana Carolina Prado-Ribeiro, Alan Roger Santos-Silva, Natalia Rangel Palmier, Xaviera A. López-Cortés, Luiz Alcino Gueiros, and César Rivera. Statistical analysis was performed by Xaviera A. López-Cortés, Luiz Alcino Gueiro, and César Rivera The first draft of the manuscript was written by Leticia Rodrigues-Oliveira and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. References Epstein JB, Güneri P, Barasch A (2014) Appropriate and necessary oral care for people with cancer: guidance to obtain the right oral and dental care at the right time. 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Oral Oncol 118:105296. https://doi:10.1016/j.oraloncology.2021.105296. Hong CHL, Hu S, Haverman T, et al (2018) A systematic review of dental disease management in cancer patients. Support Care Cancer 26(1): 155-174. https://doi:10.1007/s00520-017-3829-y Brennan MT, Woo SB, Lockhart PB (2008) Dental treatment planning and management in the patient who has cancer. Dent Clin North Am 52(1):19-vii. https://doi:10.1016/j.cden.2007.10.003 Jham BC, Reis PM, Miranda EL, et al (2008) Oral health status of 207 head and neck cancer patients before, during and after radiotherapy. Clin Oral Investig 12(1):19-24. https://doi:10.1007/s00784-007-0149-5 Tsuji K, Shibuya Y, Akashi M, et al (2015) Prospective study of dental intervention for hematopoietic malignancy. J Dent Res 94(2):289-296. https://doi:10.1177/0022034514561768 von Elm E, Altman DG, Egger M, et al (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344-349. https://doi:10.1016/j.jclinepi.2007.11.008 Brierley J, Gospodarowicz M, Wittekind C. UICC TNM classification of malignant tumours. Eighth ed. Chichester: Wiley; 2017. Amin M, Edge S, Greene F, et al (2017) AJCC cancer staging manual. Eighth ed. New York: Springer. Zubrod C, et al (1960) Appraisal of methods for the study of chemotherapy in man: Comparative therapeutic trial of nitrogen mustard and thiophosphoramide. Journal of Chronic Diseases 11:7-33. Karnofsky D, Burchenal J (1949) The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod C, ed. Evaluation of Chemotherapeutic Agents. New York, NY: Columbia University Press 191–205. World Health Organization (200) Obesity: preventing and managing the global epidemic. Report of a World Health Organization Consultation. Geneva: World Health Organization p. 256. WHO Obesity Technical Report Series, n. 284. Chan ED, Chan MM, Chan MM (2013) Pulse oximetry: understanding its basic principles facilitates appreciation of its limitations. Respir Med 107(6):789-99. Oliveira GMM, Mendes M, Malachias MVB, Morais J, Moreira Filho O, Coelho O, et al (2017) Diretrizes de 2017 para manejo da hipertensão arterial em cuidados primários nos países de língua portuguesa. Revista Portuguesa de Cardiologia. 36(11):789-798. Malachias MVB, Souza WKSB, Plavnik FL, Rodrigues CIS, Brandão AA, Neves MFT (2016) 7ª Diretriz brasileira de hipertensão arterial. Arq Bras Cardiol 107(3):1-103. Wunderlich CR (1868) [Das Verhalten der Eigenwaerme in Krankheiten.] Leipzig: Verlag Von Otto Wigand. Common Terminology Criteria for Adverse Events (NCI, version 4.0, 2010). Assessed June 22nd. https://www.eortc.be/services/doc/ctc/ctcae_4.03_2010-06-14_quickreference_5x7.pdf Sroussi HY, Epstein JB, Bensadoun RJ, et al (2017) Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med 6 (12): 2918-31. Slade GD. Derivation and validation of a short-form oral health impact profile (1997) Community Dent Oral Epidemiol 25(4):284-290. https://doi:10.1111/j.1600-0528.1997.tb00941.x Oliveira BH, Nadanovsky P (2005) Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form. Community Dent Oral Epidemiol 33(4):307-314. https://doi:10.1111/j.1600-0528.2005.00225.x Jawad H, Hodson NA, Nixon PJ (2015) A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1. Br Dent J 218(2):65-68. https://doi:10.1038/sj.bdj.2015.28 Paleri V, Wight RG, Silver CE, et al (2010) Comorbidity in head and neck cancer: a critical appraisal and recommendations for practice. Oral Oncol 46(10):712-719. https://doi:10.1016/j.oraloncology.2010.07.008 de Cássia Braga Ribeiro K, Kowalski LP, Latorre Mdo R. Perioperative complications, comorbidities, and survival in oral or oropharyngeal cancer (2003) Arch Otolaryngol Head Neck Surg 129(2):219-228. https://doi:10.1001/archotol.129.2.219 Habbous S, Harland LT, La Delfa A, et al (2014) Comorbidity and prognosis in head and neck cancers: Differences by subsite, stage, and human papillomavirus status. Head Neck 36(6):802-810. https://doi:10.1002/hed.23360 Eytan DF, Blackford AL, Eisele DW, Fakhry C (2019) Prevalence of Comorbidities among Older Head and Neck Cancer Survivors in the United States. Otolaryngol Head Neck Surg 160(1):85-92. https://doi:10.1177/0194599818796163 Schimansky S, Lang S, Beynon R, et al (2019) Association between comorbidity and survival in head and neck cancer: Results from Head and Neck 5000. Head Neck 41(4):1053-1062. https://doi:10.1002/hed.25543 Peter F, Wittekindt C, Finkensieper M, Kiehntopf M, Guntinas-Lichius O (2013) Prognostic impact of pretherapeutic laboratory values in head and neck cancer patients. J Cancer Res Clin Oncol 139(1):171-178. https://doi:10.1007/s00432-012-1320-1 Knittelfelder O, Delago D, Jakse G, et al (2020) The Pre-Treatment C-Reactive Protein Represents a Prognostic Factor in Patients with Oral and Oropharyngeal Cancer Treated with Radiotherapy. Cancers (Basel) 12(3):626. Published 2020 Mar 8. https://doi:10.3390/cancers12030626 Chen Y, Cong R, Ji C, Ruan W (2020) The prognostic role of C-reactive protein in patients with head and neck squamous cell carcinoma: A meta-analysis. Cancer Med 9(24):9541-9553. https://doi:10.1002/cam4.3520 Marchiori DM (2015) The prevalence of hypovitaminosis among us adults: data from the nhanes iii. 15. https:// doi.org/10.1016/j.jmpt.2016.02.001 Melamed ML, Michos ED, Post W, Astor B (2008) 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 168(15):1629-1637. https://doi:10.1001/archinte.168.15.162914 Uribe-Querol E, Rosales C (2015) Neutrophils in cancer: Two sides of the same coin. J Immunol Res 2015. Ocana A, Nieto-Jiménez C, Pandiella A, Templeton AJ (2017) Neutrophils in cancer: prognostic role and therapeutic strategies. Mol Cancer 16(1):137. https://doi:10.1186/s12943-017-0707-7 Mizuno H, Miyai H, Yokoi A, et al (2019) Relationship Between Renal Dysfunction and Oral Mucositis in Patients Undergoing Concurrent Chemoradiotherapy for Pharyngeal Cancer: A Retrospective Cohort Study. In Vivo 33(1):183-189. https://doi:10.21873/invivo.11457 Deng Z, Kiyuna A, Hasegawa M, Nakasone I, Hosokawa A, Suzuki M (2010) Oral candidiasis in patients receiving radiation therapy for head and neck cancer. Otolaryngol Head Neck Surg 143(2):242-247. https://doi:10.1016/j.otohns.2010.02.003 Rodrigues-Oliveira L, Kauark-Fontes E, Alves CGB, Tonaki JO, Gueiros LA, Moutinho K, Marta GN, Barros LRC, Santos-Silva AR, Brandão TB, Prado-Ribeiro AC (2021) COVID-19 impact on anxiety and depression in head and neck cancer patients: A cross-sectional study. Oral Dis. https://doi:10.1111/odi.13876. Epub ahead of print. de Melo NB, de Sousa VM, Bernardino ÍM, de Melo DP, Gomes DQ, Bento PM (2019) Oral health related quality of life and determinant factors in patients with head and neck cancer. Med Oral Patol Oral Cir Bucal 24(3):e281-e289. https://doi:10.4317/medoral.22670 Additional Declarations No competing interests reported. Supplementary Files Supplementarymaterial1.Laboratorytestsandthereferencevalues..docx Supplementarymaterial2.Medicationinusedataandthemostusedmedicationcategories..docx Supplementarymaterial3.Correlationanalysisbetweenthenumberofmedicationsinuseandthenumberofdiagnosesoftreatmentrelatedtoxicities..docx Supplementarymaterial4.OHIP14questionnairemeanscoreandstandarddeviationperanswerandmeantotalrangeandstandarddeviation..docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-1608385\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":102495523,\"identity\":\"c1c26a44-900a-4741-aaef-abaa2d987568\",\"order_by\":0,\"name\":\"Leticia Rodrigues-Oliveira\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University of Campinas (UNICAMP)\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Leticia\",\"middleName\":\"\",\"lastName\":\"Rodrigues-Oliveira\",\"suffix\":\"\"},{\"id\":102495525,\"identity\":\"d45b202c-9bf4-4ea6-937f-92c9cefc093f\",\"order_by\":1,\"name\":\"César Rivera\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Universidad de Talca (UTALCA)\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"César\",\"middleName\":\"\",\"lastName\":\"Rivera\",\"suffix\":\"\"},{\"id\":102495527,\"identity\":\"9b18b4d2-7ef9-48e8-a0e2-8561b8ceb9ba\",\"order_by\":2,\"name\":\"Xaviera A. 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full, continuous, and discrete datasets. The predictors were tested in all of the data in this investigation. The most important factors are family income and housing.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"Figure1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1608385/v1/d20567d6aa5a2d0ca3be06df.png\"},{\"id\":30175239,\"identity\":\"c45a5c51-2f58-42fd-9cd9-cb8554ac4964\",\"added_by\":\"auto\",\"created_at\":\"2022-12-11 22:29:32\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":652254,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1608385/v1/3a69993e-1cac-4eef-b990-83e4d50abd58.pdf\"},{\"id\":21082563,\"identity\":\"e1a05364-6774-40a7-bf7e-187685bbc243\",\"added_by\":\"auto\",\"created_at\":\"2022-05-04 19:36:23\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":89765,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementarymaterial1.Laboratorytestsandthereferencevalues..docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1608385/v1/21884b8d40699757569aecd1.docx\"},{\"id\":21082560,\"identity\":\"4aa3d881-647f-4713-a388-a222a2fb64ef\",\"added_by\":\"auto\",\"created_at\":\"2022-05-04 19:36:23\",\"extension\":\"docx\",\"order_by\":2,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":69252,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementarymaterial2.Medicationinusedataandthemostusedmedicationcategories..docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1608385/v1/0245323d1ec042980fc8bf08.docx\"},{\"id\":21082561,\"identity\":\"5dda4efc-68f2-40dd-b47f-89787d16a8d1\",\"added_by\":\"auto\",\"created_at\":\"2022-05-04 19:36:23\",\"extension\":\"docx\",\"order_by\":3,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":62811,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementarymaterial3.Correlationanalysisbetweenthenumberofmedicationsinuseandthenumberofdiagnosesoftreatmentrelatedtoxicities..docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1608385/v1/d00c07e29eb160650d6bada6.docx\"},{\"id\":21082562,\"identity\":\"52614b95-0a21-493f-b6f9-c8e7aec6932b\",\"added_by\":\"auto\",\"created_at\":\"2022-05-04 19:36:23\",\"extension\":\"docx\",\"order_by\":4,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":85977,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementarymaterial4.OHIP14questionnairemeanscoreandstandarddeviationperanswerandmeantotalrangeandstandarddeviation..docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1608385/v1/3f0fb8f9e9906d9f92d6c8d6.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"The impact of oral and oropharyngeal cancer patient’s medical profile on dental treatment needs and treatment-related toxicities. A cross-sectional study\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eDental treatment of patients diagnosed with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC) poses a challenge for dentists. It requires an individualized treatment plan that is based on the patient\\u0026rsquo;s dental and medical history, cancer stage, treatment modalities, prognosis, and hematological, physical and nutritional status [1\\u0026ndash;3].\\u003c/p\\u003e \\u003cp\\u003eIt is recommended that the dental care for OOPSCC cancer patients be performed and completed before the onset of the oncologic treatment, especially for patients undergoing chemotherapy (CT), radiotherapy (RT), or chemoradiotherapy (CRT). Dental treatment must prioritize the removal of oral foci of infection that can interrupt the cancer treatment and impair prognostic outcomes. In this sense, periodontal, restorative, endodontic, and surgical procedures should be performed based on clinical and radiographic assessments, considering the oncologic treatment plan and schedule [1\\u0026ndash;2, 4].\\u003c/p\\u003e \\u003cp\\u003eCurrent literature shows that adequate oral care and proper dental treatment before the oncologic treatment, is associated with fewer oral and systemic infections. It minimizes the severity and duration of oral toxicities, such as oral mucositis (OM), radiation caries and osteoradionecrosis. It also contributes significantly to the success of the cancer treatment, avoiding interruptions, reducing overall costs, and improving the patients\\u0026rsquo; quality of life (QoL) [3\\u0026ndash;5].\\u003c/p\\u003e \\u003cp\\u003eHowever, many professionals are apprehensive to offer a comprehensive oral care because of their concern about inducing local and/or systemic complications during or after a dental procedure in the OOPSCC population, even though patients will be more benefited if dental care is initiated as soon as the diagnosis is made, thus minimizing the severity and duration of oral toxicities [3\\u0026ndash;5].\\u003c/p\\u003e \\u003cp\\u003eAlthough there are several dental care protocols for patients diagnosed with OOPSCC before cancer treatment [1\\u0026ndash;3,6\\u0026ndash;9], none of them considers systemic changes and underlying medical conditions of the patient. It is unknown whether dental treatment before cancer therapy could interfere with medical health, leading to medical complications, such as infection and bleeding. Therefore, this prospective cohort study aimed to characterize, through laboratory assessments, possible systemic changes in OOPSCC patients receiving dental treatment before cancer therapy. The comorbidities, sociodemographic data, medication in use, and laboratory changes were further correlated with the frequency and severity of head and neck (H\\u0026amp;N) toxicities.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec3\\\"\\u003e\\n \\u003ch2\\u003ePatients\\u003c/h2\\u003e\\n \\u003cp\\u003eThis prospective cohort study recruited patients diagnosed with OOPSCC set to undergo oncologic treatment [i.e. surgery, CT, RT, or CRT], that were referred to the Dental Oncology Service at the Instituto do C\\u0026acirc;ncer do Estado de S\\u0026atilde;o Paulo (ICESP), S\\u0026atilde;o Paulo, Brazil for dental treatment. Patients were recruited between November/2019 and December/2020. Ethical approval was obtained from the National Human Research Ethics Committee (CAAE: 23671019.1.1001.5418). All participants provided written informed consent. The study was conducted following the Declaration of Helsinki and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement [10].\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec4\\\"\\u003e\\n \\u003ch2\\u003eInclusion Criteria\\u003c/h2\\u003e\\n \\u003cp\\u003eFully or partially dentate OOPSCC patients over 18 years of age and able to provide written informed consent were included in the study, regardless the cancer treatment modality.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec5\\\"\\u003e\\n \\u003ch2\\u003eExclusion criteria\\u003c/h2\\u003e\\n \\u003cp\\u003ePatients with recurrent OOPSCC that underwent a previous treatment, those who did not perform the blood tests prescribed, and cases in which patient\\u0026rsquo;s data were not fully available from the electronic medical record system, were excluded from the study.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec6\\\"\\u003e\\n \\u003ch2\\u003eSociodemographic and clinicopathological characteristics\\u003c/h2\\u003e\\n \\u003cp\\u003ePatients\\u0026rsquo; characteristics, including gender, ethnicity, age, habits (smoking, drinking and use of illicit drugs), years of education, current marital status, housing status, average monthly income, medical history, and medications in use, were collected during a standardized in-person interview. Tumor location, cancer staging (TNM, 8th edition) [11,12], p16 status, proposed cancer treatment protocol, the Eastern Cooperative Oncology Group (ECOG) [13] and the Karnofsky performance status (KPS) [14] scores were extracted from the Institutional Electronic Medical Record System.\\u003c/p\\u003e\\n \\u003cp\\u003eWhen indicated, all patients underwent dental procedures, including oral surgery, periodontal, endodontic, and restorative treatment. During dental treatment conditioning protocols, patients were followed-up to evaluate possible treatment complications, such as infection and persistent bleeding, among others.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec7\\\"\\u003e\\n \\u003ch2\\u003eAnthropometric, pulse oximetry, blood pressure and body temperature measurements\\u003c/h2\\u003e\\n \\u003cp\\u003eHeight, weight, oxygen saturation levels, heart rate (HR), blood pressure (BP), and temperature were measured at the screening appointment. Height (cm) and weight (kg) were measured using a standardized scale with a stadiometer. Body mass index (BMI) was calculated as body weight divided by height squared (kg/m\\u003csup\\u003e2\\u003c/sup\\u003e) [15].\\u003c/p\\u003e\\n \\u003cp\\u003eA pulse oximeter was used to measure oxygen saturation levels and HR [16]. BP was measured using an electronic BP monitor on the right upper arm, and the participants were asked to rest in a sitting position for 5 minutes before the measurement [17,18]. Body temperature was measured with a digital thermometer in the axillary region [19].\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec8\\\"\\u003e\\n \\u003ch2\\u003eLaboratory tests\\u003c/h2\\u003e\\n \\u003cp\\u003eVenous blood was collected by a trained nurse using standard methods and sent to the hospital\\u0026rsquo;s laboratory for a complete blood count (CBC) and a standard blood chemistry panel \\u003cstrong\\u003e(Supplementary material 1)\\u003c/strong\\u003e. The following exams were performed:\\u003c/p\\u003e\\n \\u003cp\\u003e- CBC with differential [erythrocytes, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, erythrocyte distribution width, erythrocyte distribution width (standard deviation), erythroblasts, platelets, mean platelet volume, leukocytes, neutrophils, eosinophil, basophil, lymphocytes, and monocytes];\\u003c/p\\u003e\\n \\u003cp\\u003e- Basic electrolyte panel (sodium, potassium, chloride, iron, creatinine, urea, glucose, magnesium);\\u003c/p\\u003e\\n \\u003cp\\u003e- Metabolic panel [(calcium, bilirubin (total, direct, and indirect)], alkaline phosphatase, AST (aspartate aminotransferase), ALT (alanine aminotransferase, gamma-glutamyl transferase];\\u003c/p\\u003e\\n \\u003cp\\u003e- Lipid panel [(total cholesterol, high-density lipoprotein (HDL), triglycerides, low-density lipoprotein (LDL), non-high-density lipoprotein (non-HDL), VLDL (very-low-density lipoprotein)];\\u003c/p\\u003e\\n \\u003cp\\u003e- Thyroid function (TSH, T3, T4, FT4);\\u003c/p\\u003e\\n \\u003cp\\u003e- Glycated hemoglobin (Hemoglobin A1C);\\u003c/p\\u003e\\n \\u003cp\\u003e- Coagulation assay [prothrombin time (PT), International Normalized Ratio (INR), activated partial thromboplastin time (aPTT)];\\u003c/p\\u003e\\n \\u003cp\\u003e- Human immunodeficiency virus (HIV);\\u003c/p\\u003e\\n \\u003cp\\u003e- Hepatitis B and C;\\u003c/p\\u003e\\n \\u003cp\\u003e\\u0026minus;\\u0026thinsp;25-Hydroxy Vitamin D;\\u003c/p\\u003e\\n \\u003cp\\u003e- C-reactive protein (CRP);\\u003c/p\\u003e\\n \\u003cp\\u003e- Syphilis.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec9\\\"\\u003e\\n \\u003ch2\\u003eTreatment-related head and neck toxicities\\u003c/h2\\u003e\\n \\u003cp\\u003eSystemic changes and abnormal laboratory results undertaken before the initiation of oncologic treatment were assessed and correlated with the treatment-related toxicities for patients submitted to RT or CRT. Included patients were clinically evaluated by a trained dentist for OM, radiodermatitis, dysgeusia and dysphagia outcomes following the Common Terminology Criteria for Adverse Events (NCI, version 4.0, 2010) [20], graded 0\\u0026ndash;4 at days 5/10/15/20/25/30/33\\u0026ndash;35 of radiation therapy. Additionally, oral candidiasis (OC), xerostomia, and trismus were evaluated qualitatively [21].\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003ch2\\u003eOHIP-14\\u003c/h2\\u003e\\n\\u003cp\\u003eThe validated Brazilian Portuguese version of the Oral Health Impact Profile (OHIP-14) questionnaire was applied at the first appointment. It comprises 14 items including functional limitation, physical pain and disability, psychological discomfort and disability, social disability, and handicap. The responses were classified using a Likert scale with five options ranging from \\u0026ldquo;never\\u0026rdquo; (0) to \\u0026ldquo;very often\\u0026rdquo; (4) [22,23].\\u003c/p\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec11\\\"\\u003e\\n \\u003ch2\\u003eStatistical analysis\\u003c/h2\\u003e\\n \\u003cp\\u003eContinuous variables such as clinicopathological, sociodemographic, anthropometric, pulse oximetry, BP, temperature measurements, and OHIP-14 data were summarized using mean values and standard deviations; categorical variables analysis evaluated frequencies, and percentages. For the laboratory results, the percentage of exams altered, mean values and standard deviation were evaluated.\\u003c/p\\u003e\\n \\u003cp\\u003eThe chi-square test and fisher\\u0026rsquo;s exact test were applied to evaluate whether curative or palliative treatment modalities were influenced by tumor location, cancer staging, p16 status, and smoking and drinking habits. Pearson correlation test was used to evaluate the association between medication in use and treatment-related toxicities (OM, dysgeusia, dysphagia, xerostomia, radiodermatitis, trismus, and OC). All treatment toxicities at treatment days 5/10/15/20/25/30/33\\u0026ndash;35 were associated with the laboratory findings. Additionally, using the two-tailed Spearman correlation test for a non-normal distribution, each toxicity outcome was evaluated when an altered laboratory exam was observed in more than four different times at evaluation days, therefore representing a greater chance of a real association and a possibility of correlation.\\u003c/p\\u003e\\n \\u003cp\\u003eIn all analysis, a p-value\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05 was considered statistically significant.\\u003c/p\\u003e\\n \\u003cp\\u003eThe worst OM score (group 1: grades 1/2 and group 2: grades 3/4) was correlated with the full data set. Continuous dataset (variables in its numerical forms), discrete dataset (coded data), and a full dataset including all data were used. A biomarker analysis was performed with accuracy, sensitivity, specificity, positive predictive value, negative predict value, and area under the ROC curve. A heat map was presented to evaluate the clinical predictors of OM.\\u003c/p\\u003e\\n\\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec13\\\"\\u003e\\n \\u003ch2\\u003eSociodemographic and clinicopathological characteristics\\u003c/h2\\u003e\\n \\u003cp\\u003eA total of 484 H\\u0026amp;N cancer patients were referred to the Dental Oncology Service for dental treatment and evaluation within the study period. Of which, 110 (22.7%) met the eligibility criteria, and 368 (76%) were excluded due to edentulism, a H\\u0026amp;N cancer diagnosis other than OOPSCC, a second OOPSC cancer diagnosis or for declining participation in the study. Six (1.3%) patients were further excluded for not doing the bloodwork prescribed.\\u003c/p\\u003e\\n \\u003cp\\u003eMost patients were male (n\\u0026thinsp;=\\u0026thinsp;85; 77.3%), identified their ethnicity as white (n\\u0026thinsp;=\\u0026thinsp;48; 43.6%) or brown (n\\u0026thinsp;=\\u0026thinsp;48; 43.6%) and reported a history of tobacco (n\\u0026thinsp;=\\u0026thinsp;94; 85.4%) and alcohol consumption (n\\u0026thinsp;=\\u0026thinsp;94; 85.4%). Ages ranged from 23 to 83 (mean 57.32) years. Participants had an education level of 4 to 7 years (n\\u0026thinsp;=\\u0026thinsp;42; 38.2%), were married/living with a partner (n\\u0026thinsp;=\\u0026thinsp;46; 41.8%), owned a house (n\\u0026thinsp;=\\u0026thinsp;72; 65.4%), and the most prevailing monthly income was of 1,045 Brazilian Real (BRL) [approximately $235.00 US Dollars (USD) \\u0026minus;\\u0026thinsp;2022 values] (n\\u0026thinsp;=\\u0026thinsp;38; 34.5%). Fifty-four percent of patients (n\\u0026thinsp;=\\u0026thinsp;60) were diagnosed with oropharyngeal squamous cell carcinoma, while 45.5% (n\\u0026thinsp;=\\u0026thinsp;50) had an oral tumor. Advanced disease was frequently observed (stage III/IV n\\u0026thinsp;=\\u0026thinsp;85; 77.3%). Summaries of the sociodemographic and clinicopathological characteristics are shown in Table\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e\\n \\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003ctable border=\\\"1\\\" id=\\\"Tab1\\\"\\u003e\\n \\u003ccaption\\u003e\\n \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e\\n \\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\n \\u003cp\\u003eSociodemographic, clinicopathological, oncologic treatment and referral to dental treatment characteristics of the included patients (n\\u0026thinsp;=\\u0026thinsp;110).\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eVariable\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eValue\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNumber of patients\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e110\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAge, mean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD [range], years\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e57.32\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;9.74 [87\\u0026ndash;23]\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSex, no. (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFemale\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e26 (23.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMale\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e84 (76.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eEthnicity, no. (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eWhite\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e48 (43.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBlack\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13 (11.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYellow\\u003c/p\\u003e\\n \\u003cp\\u003eBrown\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1 (0.9)\\u003c/p\\u003e\\n \\u003cp\\u003e48 (43.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCancer diagnosis, no. (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOral cavity\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e50 (45.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOropharynx\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e60 (54.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eStage, no. (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eIn situ\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1 (0.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eI\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e10 (9.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eII\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e11 (10)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eIII\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e22 (20)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eIVa/b/c\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e63 (57.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNot informed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3 (2.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eP16 in oropharynx cases, no. (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNegative\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18 (30)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePositive\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16 (26.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNot informed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e26 (43.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSmoker (current or past), no. (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e94 (85.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDrink alcohol (current or past), no. (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e94 (85.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDrug user (current or past) no. (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3 (2.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eEducation\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo education or less than 1 year\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6 (5.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1 to 3 years\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4 (3.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4 to 7 years\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e42 (38.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8 to 10 years\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13 (11.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e11 to 14 years\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e25 (22.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15 or more years\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e20 (18.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMarriage\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSingle\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e28 (25.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMarried/ partnered\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e46 (41.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSeparated/ divorced\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e22 (20)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eWidowed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14 (12.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHousing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOwn\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e72 (65.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRent\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e26 (23.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBorrowed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e12 (11)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAverage monthly income*\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;1 minimum wage\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e32 (29.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1 minimum wage\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e38 (34.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2 to 4 minimum wages\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e33(30)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5 or +\\u0026thinsp;minimum wages\\u003c/p\\u003e\\n \\u003cp\\u003eAverage family monthly income*\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7 (6.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;1 minimum wage\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13 (11.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1 minimum wage\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e30 (27.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2 to 4 minimum wages\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e55 (50)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5 or +\\u0026thinsp;minimum wages\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e12 (10.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCancer treatment\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCurative\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e82 (75.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eS\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18 (22)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eS\\u0026thinsp;+\\u0026thinsp;induction CT\\u0026thinsp;+\\u0026thinsp;CRT\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1 (1.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eS\\u0026thinsp;+\\u0026thinsp;CRT\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18 (22)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eInduction CT\\u0026thinsp;+\\u0026thinsp;CRT\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3 (3.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRT\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e17 (20.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCRT\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e25 (30.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePalliative\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e28 (25.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eReferral\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBefore radiotherapy\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e80 (72.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDuring chemotherapy\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3 (2.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBefore surgery\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e27 (24.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003ctfoot\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\"\\u003eAbbreviations: no., total number of patients; %, percentage; SD, standard deviation; S, surgery; CT, chemotherapy; CRT, chemoradiotherapy; RT, radiotherapy.\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\"\\u003e*National minimum wage equals to 1212 BRL/Month in Brazil (approximately 235 USD \\u0026minus;\\u0026thinsp;2022 values)\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tfoot\\u003e\\n \\u003c/table\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec14\\\"\\u003e\\n \\u003ch2\\u003eECOG and KPS performances\\u003c/h2\\u003e\\n \\u003cp\\u003eMost patients (n\\u0026thinsp;=\\u0026thinsp;72; 65.5%) scored 1 for the ECOG performance status and 56 patients (50.9%) scored 90% for the KPS scale.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec15\\\"\\u003e\\n \\u003ch2\\u003eReferral patterns and oncologic treatment plans\\u003c/h2\\u003e\\n \\u003cp\\u003eEighty patients (72.8%) patients were referred for dental treatment before the start of RT, 24.5% (n\\u0026thinsp;=\\u0026thinsp;27) before surgery, and 2.7% (n\\u0026thinsp;=\\u0026thinsp;3) during CT. Most of them (n\\u0026thinsp;=\\u0026thinsp;82; 75.5%) were treated with curative intent and the most performed treatment modality was CRT (n\\u0026thinsp;=\\u0026thinsp;25; 30.5%) \\u003cstrong\\u003e[\\u003c/strong\\u003eTable\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e\\u003cstrong\\u003e].\\u003c/strong\\u003e Early stage tumors (I/II) were more frequently treated with a curative intent (P\\u0026thinsp;=\\u0026thinsp;0.0).\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec16\\\"\\u003e\\n \\u003ch2\\u003eSelf-reported medical conditions and medication in use\\u003c/h2\\u003e\\n \\u003cp\\u003eForty patients (36.4%) did not report having any medical conditions other than cancer, 31 (44.3%) reported having one, and 39 (55.7%) patients had two or more underlying medical conditions.\\u003c/p\\u003e\\n \\u003cp\\u003eThe most common comorbidity reported was hypertension (n\\u0026thinsp;=\\u0026thinsp;36, 51.4%), followed by dyslipidemia (n\\u0026thinsp;=\\u0026thinsp;16, 22.8%) and diabetes (n\\u0026thinsp;=\\u0026thinsp;11, 15.7%). Five (4.5%) patients reported HIV infection, three (2.7%) a syphilis diagnosis (2.7%) and two (1.8%) a hepatitis C virus infection. Five (4.5%) patients reported a previous cancer diagnosis (1 renal cancer, 2 skin cancer, and 2 Kaposi\\u0026rsquo;s sarcoma). Full self-reported diagnoses can be seen in Table\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e. Fifty-one (46.4%) patients reported daily use of prescribed medication, with an average of three different medications. Most of them reported the use of more than one medication category (51%), and the most used were antihypertensives (56.9%), diuretics (25.5%), lipid-lowering agents (21.6%), and antidiabetic/ hypoglycemic agents (21.6%) \\u003cstrong\\u003e(Supplementary material 2\\u003c/strong\\u003e).\\u003c/p\\u003e\\n \\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003ctable border=\\\"1\\\" id=\\\"Tab2\\\"\\u003e\\n \\u003ccaption\\u003e\\n \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e\\n \\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\n \\u003cp\\u003eList of the comorbidities reported by the included patients (n\\u0026thinsp;=\\u0026thinsp;110).\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDiagnosis\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eValue n (%)\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHypertension\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e36 (51.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDyslipidemia\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e16 (22.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDiabetes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e11 (15.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eGastritis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e9 (12.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHIV\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e5 (7.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePrevious cancer\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e5 (7.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAcute myocardial infarction\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e5 (7.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eTuberculosis (treated)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e5 (7.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eObesity\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e5 (7.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAsthma\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e3 (4.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eGout\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e3 (4.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHypothyroidism\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e3 (4.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eImpaired vision\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e3 (4.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSyphilis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e3 (4.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAnxiety\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eArrhythmia\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eStroke\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBronchitis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHepatic steatosis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCongestive heart failure\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePrediabetes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOsteoporosis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHepatitis C\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eLeg paresthesia\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e2 (2.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eArthritis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eChron disease\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCoronary artery disease\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDepression\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDyspepsia\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePulmonary emphysema\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMigraine\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eEsophagitis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eGlaucoma\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHemiparesis left\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHepatitis B\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSpinal disc herniation\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eParkinson investigation\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eLabyrinthitis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOsteoarthritis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOsteopenia\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHearing loss\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMitral valve prolapse\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eGastroesophageal reflux\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePoliomyelitis sequelae (leg)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\"\\u003e\\n \\u003cp\\u003e1 (1.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003ctfoot\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\"\\u003eAbbreviations: no., total number of patients; %, percentage.\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tfoot\\u003e\\n \\u003c/table\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec17\\\"\\u003e\\n \\u003ch2\\u003eAnthropometric, pulse oximetry, blood pressure and body temperature measurements\\u003c/h2\\u003e\\n \\u003cp\\u003eThe mean and standard deviation (SD) of body mass index was 23.86 (\\u0026plusmn;\\u0026thinsp;5.56), mean (SD) BP was 125.65 (\\u0026plusmn;\\u0026thinsp;25.58) x 84.46 (\\u0026plusmn;\\u0026thinsp;14.72) mmHg. Only 14.5% of patients presented BP measurements within the normal range. No patients had abnormal body temperature measurements or fever. The mean (SD) HR was 81.01 (\\u0026plusmn;\\u0026thinsp;17.48), and the mean O\\u003csub\\u003e2\\u003c/sub\\u003e saturation was 95.90 (\\u0026plusmn;\\u0026thinsp;2.31).\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec18\\\"\\u003e\\n \\u003ch2\\u003eLaboratory tests\\u003c/h2\\u003e\\n \\u003cp\\u003eThe laboratory results are summarized in Table\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e. The following tests presented a higher percentage of altered results: CRP (63.6%), hemoglobin (60%), erythrocytes (57.3%), hematocrit (59.1%), gamma-glutamyl transferase [GGT] (45.5%), 25-Hydroxy Vitamin D (47.3%), RDW-SD (36.4%), neutrophil counts (35.5%), eosinophil counts (35.5%), total cholesterol (35.5%), High-density lipoprotein (HDL) (35.5%), iron (34.5%) and glucose (34.5%). Overall, 11 (10%) of the included patients reported systemic infectious diseases at baseline. Although only three (2.7%) patients reported a syphilis diagnosis, 9 (8.2%) additional individuals tested positive for syphilis; thus, a total of 12 (10.9%) diagnoses of syphilis were observed in this study.\\u003c/p\\u003e\\n \\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003ctable border=\\\"1\\\" id=\\\"Tab3\\\"\\u003e\\n \\u003ccaption\\u003e\\n \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e\\n \\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\n \\u003cp\\u003eThe laboratory results, percentage altered, range, mean and standard deviation.\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eLaboratory tests\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003en (%) altered\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMean\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eSTDEV\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eComplete blood count (CBC)\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eErythrocytes (x10\\u003csup\\u003e6\\u003c/sup\\u003e/mm\\u003csup\\u003e3\\u003c/sup\\u003e)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e63 (57.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e4.26\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.73\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHemoglobin (g/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e66 (60)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e12.60\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.91\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHematocrit (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e65 (59.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e37.66\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5.51\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMCV (fL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e20 (18.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e88.64\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.07\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMCH (pg)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e13 (11.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e29.66\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.34\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMCHC (g/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e9 (8.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e33.45\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.06\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRDW-CV (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e15 (13.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e13.33\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.25\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRDW-SD (fL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e40 (36.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e43.00\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4.65\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eErythroblasts (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e1 (0.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e0.1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.07\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePlatelets (x10\\u003csup\\u003e3\\u003c/sup\\u003e/mm\\u003csup\\u003e3\\u003c/sup\\u003e)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e25 (22.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e325.57\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e115.38\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMPV (fL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e30 (27.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e10.20\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.10\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eLeukocytes (10\\u003csup\\u003e3\\u003c/sup\\u003e/mm\\u003csup\\u003e3\\u003c/sup\\u003e)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e27 (24.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e9.09\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4.10\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNeutrophils (10\\u003csup\\u003e3\\u003c/sup\\u003e/mm\\u003csup\\u003e3\\u003c/sup\\u003e)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e39 (35.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e6.66\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.64\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eEosinophil (10\\u003csup\\u003e3\\u003c/sup\\u003e/mm\\u003csup\\u003e3\\u003c/sup\\u003e)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e39 (35.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e0.26\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.28\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBasophil (10\\u003csup\\u003e3\\u003c/sup\\u003e/mm\\u003csup\\u003e3\\u003c/sup\\u003e)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e27 (24.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e0.05\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.05\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eLymphocytes (10\\u003csup\\u003e3\\u003c/sup\\u003e/mm\\u003csup\\u003e3\\u003c/sup\\u003e)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e37 (33.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e1.93\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.72\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMonocytes (10\\u003csup\\u003e3\\u003c/sup\\u003e/mm\\u003csup\\u003e3\\u003c/sup\\u003e)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e35 (31.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e0.73\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.30\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eBasic electrolyte panel\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSodium (mEq/L)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e12 (10.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e138.66\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.30\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePotassium (mEq/L)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e17 (15.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e4.53\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.45\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMagnesium (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e4 (3.63)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e2.01\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.22\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eChloride (mEq/L)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e4 (3.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e2.01\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.22\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eIron (ug/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e38 (34.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e76.43\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e34.15\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCreatinine (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e27 (24.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e0.87\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.24\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eGlucose (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e38 (34.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e96.94\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e21.41\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eUrea (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e11 (10)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e34.72\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15.69\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eMetabolic panel\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCalcium (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e21 (19.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e9.94\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.05\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBilirubin total (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e11 (10)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBilirubin direct (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e7 (6.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eBilirubin indirect (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e25 (22.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAlkaline phosphatase (U/L)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e12 (10.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e85.68\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e31.73\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAspartate aminotransferase (U/L)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e6 (5.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e19.53\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.67\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eGamma-glutamyl transferase (U/L)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e50 (45.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e83.99\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e91.09\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAlanine aminotransferase (U/L)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e14 (12.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e21.28\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.07\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eLipid panel\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eTotal cholesterol (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e39 (35.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e183.05\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e42.06\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHigh-density lipoprotein (HDL) (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e39 (35.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e45.81\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e12.18\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eLow-density lipoprotein (LDL) (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e12 (10.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e114.15\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e35.89\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNon-high-density lipoprotein (non-HDL) cholesterol (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e26 (23.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e138.39\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e40.82\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eVLDL (very-low-density lipoprotein) (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e17 (15.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e24.81\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e10.76\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eTriglycerides (mg/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e31 (28.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e136.63\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e80.30\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eThyroid function\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eThyroid stimulating hormone (TSH) (ul/mL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e15 (13.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e2.56\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.19\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eTotal triiodothyronine (T3) (ng/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e12 (10.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eThyroxine (T4) (ug/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e2 (1.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e8.66\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.77\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFree thyroxine (free T4) (ng/dL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e6 (5.45)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e1.27\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.22\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eGlycated hemoglobin (Hemoglobin A1C)\\u003c/strong\\u003e (%)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e14 (22.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e5.35\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.80\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eCoagulation assay\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eProthrombin time (PT) (s)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e2 (1.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e14.43\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.20\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eInternational Normalized Ratio (INR) (s)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e28 (25.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e1.07\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.13\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eActivated partial thromboplastin time (aPTT) (s)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e12 (10.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e29.83\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.19\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e25-Hydroxy Vitamin D (ng/mL)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e52 (47.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e26.86\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.41\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHBsAg (Hepatitis B surface antigen)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAnti-HBs (Hepatitis B surface antibody\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e18 (16.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAnti-HBc (Hepatitis B core antibody)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e9 (8.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHepatitis C\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e3 (2.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHIV\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e5 (4.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSyphilis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e12 (10.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eC-reactive protein (CRP) (mg/L)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e70 (63.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e23.43\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e31.94\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003ctfoot\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"6\\\"\\u003eAbbreviations: STDEV: standard deviation; %: percentage.\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tfoot\\u003e\\n \\u003c/table\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv class=\\\"Section2\\\" id=\\\"Sec19\\\"\\u003e\\n \\u003ch2\\u003eTreatment-related head and neck toxicities\\u003c/h2\\u003e\\n \\u003cp\\u003eSixty-three (57.3%) patients underwent full curative treatment (i.e. RT or CRT followed by previous surgery or not). Toxicities were progressive over time and independent of the chosen RT modality {intensity-modulated radiation therapy (IMRT) or 3-dimensional (3D)]. There was a positive correlation between the number of medications in use and OM (0.268) and a negative correlation between the number of medications in use and dysgeusia (\\u0026minus;\\u0026thinsp;0.257) outcomes. There were no correlations between the number of diagnosed comorbidities and toxicities. Full correlation values are shown in \\u003cstrong\\u003eSupplementary material 3.\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003cp\\u003eThe association of altered laboratory exam results performed prior oncological treatment and days 5/10/15/20/25/30 and 33\\u0026ndash;35 of treatment-related toxicities (OM, dysgeusia, dysphagia, xerostomia, radiodermatitis, trismus, and OC) can be seen in Table \\u003cspan class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e. For the OM domain altered thyroxine (T4) and free thyroxine (FT4) had significative P values (P\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05) starting at D15; calcium levels altered at D5/10/30; urea levels altered at D25/30/D33-35; creatinine levels altered at D15/30; alkaline phosphatase levels altered at D20/25.\\u003c/p\\u003e\\n \\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003ctable border=\\\"1\\\" id=\\\"Tab4\\\"\\u003e\\n \\u003ccaption\\u003e\\n \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 4\\u003c/div\\u003e\\n \\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\n \\u003cp\\u003eTreatment side effects and association with abnormal laboratory results.\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\" colspan=\\\"7\\\"\\u003e\\n \\u003cp\\u003eLaboratory exam\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eTreatment side effects\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eOral mucositis\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eDisgeusia\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eDysphagia\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eXerostomia\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003eErythroblasts (p\\u0026thinsp;=\\u0026thinsp;0.007)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eSodium (p\\u0026thinsp;=\\u0026thinsp;0.019)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSodium (p\\u0026thinsp;=\\u0026thinsp;0.019)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003eHepatitis C (p\\u0026thinsp;=\\u0026thinsp;0.007)\\u003c/p\\u003e\\n \\u003cp\\u003eAspartate aminotransferase (p\\u0026thinsp;=\\u0026thinsp;0.013)\\u003c/p\\u003e\\n \\u003cp\\u003eAlanine aminotransferase (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003e25-Hydroxy Vitamin D (p\\u0026thinsp;=\\u0026thinsp;0.055)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eBasophil (p\\u0026thinsp;=\\u0026thinsp;0.058)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.012)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocytes (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-HBc Hep B (p\\u0026thinsp;=\\u0026thinsp;0.008)\\u003c/p\\u003e\\n \\u003cp\\u003eCholesterol (p\\u0026thinsp;=\\u0026thinsp;0.05)\\u003c/p\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.026)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePotassium (p\\u0026thinsp;=\\u0026thinsp;0.003)\\u003c/p\\u003e\\n \\u003cp\\u003eMonocyte (p\\u0026thinsp;=\\u0026thinsp;0.042)\\u003c/p\\u003e\\n \\u003cp\\u003eVLDL (p\\u0026thinsp;=\\u0026thinsp;0.033)\\u003c/p\\u003e\\n \\u003cp\\u003eCholesterol (p\\u0026thinsp;=\\u0026thinsp;0.023)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD10\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eLeukocytes (p\\u0026thinsp;=\\u0026thinsp;0.057)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.0058)\\u003c/p\\u003e\\n \\u003cp\\u003eIron (p\\u0026thinsp;=\\u0026thinsp;0.011)\\u003c/p\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.023)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003eSyphilis (p\\u0026thinsp;=\\u0026thinsp;0.012)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eSodium (p\\u0026thinsp;=\\u0026thinsp;0.044)\\u003c/p\\u003e\\n \\u003cp\\u003eMCH (p\\u0026thinsp;=\\u0026thinsp;0.043)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.006)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocyte (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-HBc Hep B (p\\u0026thinsp;=\\u0026thinsp;0.019)\\u003c/p\\u003e\\n \\u003cp\\u003eGamma-glutamyl transferase (p\\u0026thinsp;=\\u0026thinsp;0.027)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0.054)\\u003c/p\\u003e\\n \\u003cp\\u003eSyphilis (p\\u0026thinsp;=\\u0026thinsp;0.02)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD15\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0.019)\\u003c/p\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0.035)\\u003c/p\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eT3 (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eSyphilis (p\\u0026thinsp;=\\u0026thinsp;0.038)\\u003c/p\\u003e\\n \\u003cp\\u003eCreatinine (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003eBilirubin (p\\u0026thinsp;=\\u0026thinsp;0.01)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0.041)\\u003c/p\\u003e\\n \\u003cp\\u003eEosinophil (p\\u0026thinsp;=\\u0026thinsp;0.003)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.004)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocytes (p\\u0026thinsp;=\\u0026thinsp;0.003)\\u003c/p\\u003e\\n \\u003cp\\u003eGlucose (p\\u0026thinsp;=\\u0026thinsp;0.045)\\u003c/p\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.011)\\u003c/p\\u003e\\n \\u003cp\\u003eAlkaline phosphatase (p\\u0026thinsp;=\\u0026thinsp;0.028)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0.04)\\u003c/p\\u003e\\n \\u003cp\\u003eLymphocyte (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eVLDL (p\\u0026thinsp;=\\u0026thinsp;0.041)\\u003c/p\\u003e\\n \\u003cp\\u003eCholesterol (p=\\u003c/p\\u003e\\n \\u003cp\\u003eUric acid (p\\u0026thinsp;=\\u0026thinsp;0.034)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD20\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0.045)\\u003c/p\\u003e\\n \\u003cp\\u003eBasophil (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eEosinophil (p\\u0026thinsp;=\\u0026thinsp;0.046)\\u003c/p\\u003e\\n \\u003cp\\u003enon-HDL (p\\u0026thinsp;=\\u0026thinsp;0.057)\\u003c/p\\u003e\\n \\u003cp\\u003eCholesterol (p\\u0026thinsp;=\\u0026thinsp;0.031)\\u003c/p\\u003e\\n \\u003cp\\u003eGlucose (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eAlkaline phosphatase (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003eTSH (p\\u0026thinsp;=\\u0026thinsp;0.030)\\u003c/p\\u003e\\n \\u003cp\\u003eBasophil (p\\u0026thinsp;=\\u0026thinsp;0.029)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.006)\\u003c/p\\u003e\\n \\u003cp\\u003eErythroblasts (p\\u0026thinsp;=\\u0026thinsp;0.005)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003ePotassium (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eMCHC (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.023)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocyte (p\\u0026thinsp;=\\u0026thinsp;0.018)\\u003c/p\\u003e\\n \\u003cp\\u003eAspartate aminotransferase (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHepatitis (p\\u0026thinsp;=\\u0026thinsp;0.029)\\u003c/p\\u003e\\n \\u003cp\\u003eHIV (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD25\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eUrea (p\\u0026thinsp;=\\u0026thinsp;0.008)\\u003c/p\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0.004)\\u003c/p\\u003e\\n \\u003cp\\u003eMonocytes (p\\u0026thinsp;=\\u0026thinsp;0.036)\\u003c/p\\u003e\\n \\u003cp\\u003eBasophil (p\\u0026thinsp;=\\u0026thinsp;0.004)\\u003c/p\\u003e\\n \\u003cp\\u003eGlucose (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eAlkaline phosphatase (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.017)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocytes (p\\u0026thinsp;=\\u0026thinsp;0.020)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eNeutrophil (p\\u0026thinsp;=\\u0026thinsp;0.049)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocyte (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD30\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eUrea (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eSyphilis (p\\u0026thinsp;=\\u0026thinsp;0.018)\\u003c/p\\u003e\\n \\u003cp\\u003eGlycated hemoglobin (p\\u0026thinsp;=\\u0026thinsp;0.030)\\u003c/p\\u003e\\n \\u003cp\\u003eCreatinine (p\\u0026thinsp;=\\u0026thinsp;0.007)\\u003c/p\\u003e\\n \\u003cp\\u003eChloride (p\\u0026thinsp;=\\u0026thinsp;0.039)\\u003c/p\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.044)\\u003c/p\\u003e\\n \\u003cp\\u003eBilirubin (p\\u0026thinsp;=\\u0026thinsp;0.035)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003eBasophil (p\\u0026thinsp;=\\u0026thinsp;0.008)\\u003c/p\\u003e\\n \\u003cp\\u003eEosinophil (p\\u0026thinsp;=\\u0026thinsp;0.019)\\u003c/p\\u003e\\n \\u003cp\\u003eLeukocyte (p\\u0026thinsp;=\\u0026thinsp;0.048)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.025)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocytes (p\\u0026thinsp;=\\u0026thinsp;0.046)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eProthrombin time (p\\u0026thinsp;=\\u0026thinsp;0.028)\\u003c/p\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0.028)\\u003c/p\\u003e\\n \\u003cp\\u003eMagnesium (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eNeutrophil (p\\u0026thinsp;=\\u0026thinsp;0.018)\\u003c/p\\u003e\\n \\u003cp\\u003eMCHC (p\\u0026thinsp;=\\u0026thinsp;0.034)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.007)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocyte (p\\u0026thinsp;=\\u0026thinsp;0.023)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-HBc Hep B (p\\u0026thinsp;=\\u0026thinsp;0.023)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSodium (p\\u0026thinsp;=\\u0026thinsp;0.025)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD33/35\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eUrea (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0.02)\\u003c/p\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0.009)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.059)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"3\\\"\\u003e\\n \\u003cp\\u003eRDW-SD (p\\u0026thinsp;=\\u0026thinsp;0.027)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.016)\\u003c/p\\u003e\\n \\u003cp\\u003eCreatinine (p\\u0026thinsp;=\\u0026thinsp;0.052)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0.053)\\u003c/p\\u003e\\n \\u003cp\\u003eMagnesium (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eT4 (p\\u0026thinsp;=\\u0026thinsp;0.059)\\u003c/p\\u003e\\n \\u003cp\\u003eSodium (p\\u0026thinsp;=\\u0026thinsp;0.008)\\u003c/p\\u003e\\n \\u003cp\\u003eGlycated hemoglobin (p\\u0026thinsp;=\\u0026thinsp;0.054)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003c/table\\u003e\\n \\u003c/div\\u003e\\n \\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\"\\u003e\\u0026nbsp;\\u003c/div\\u003e\\n \\n \\u003ctable border=\\\"1\\\" id=\\\"Taba\\\"\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eLaboratory exam\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eTreatment side effects\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eRadiodermatitis\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eTrismus\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eCandidiasis\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eProthrombin time (p\\u0026thinsp;=\\u0026thinsp;0.024)\\u003c/p\\u003e\\n \\u003cp\\u003eErythroblasts (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003e25-Hydroxy Vitamin D (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eRDW-SD (p\\u0026thinsp;=\\u0026thinsp;0.003)\\u003c/p\\u003e\\n \\u003cp\\u003eMCV (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eHIV (p\\u0026thinsp;=\\u0026thinsp;0.044)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-Hep B (p\\u0026thinsp;=\\u0026thinsp;0.027)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMCHC (p\\u0026thinsp;=\\u0026thinsp;0.009)\\u003c/p\\u003e\\n \\u003cp\\u003eTriglycerides (p\\u0026thinsp;=\\u0026thinsp;0.047)\\u003c/p\\u003e\\n \\u003cp\\u003eAspartate aminotransferase (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD10\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMCH (p\\u0026thinsp;=\\u0026thinsp;0.014)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocyte (p\\u0026thinsp;=\\u0026thinsp;0.021)\\u003c/p\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.049)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eRDW-SD (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-Hep B (p\\u0026thinsp;=\\u0026thinsp;0.026)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePotassium (p\\u0026thinsp;=\\u0026thinsp;0.015)\\u003c/p\\u003e\\n \\u003cp\\u003eAlanine aminotransferase (p\\u0026thinsp;=\\u0026thinsp;0.035)\\u003c/p\\u003e\\n \\u003cp\\u003ePotassium (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD15\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMCH (p\\u0026thinsp;=\\u0026thinsp;0.014)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eRDW-SD (p\\u0026thinsp;=\\u0026thinsp;0.004)\\u003c/p\\u003e\\n \\u003cp\\u003eMCV (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-HBc Hep B (p\\u0026thinsp;=\\u0026thinsp;0.026)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePotassium (p\\u0026thinsp;=\\u0026thinsp;0.05)\\u003c/p\\u003e\\n \\u003cp\\u003eEosinophil (p\\u0026thinsp;=\\u0026thinsp;0.032)\\u003c/p\\u003e\\n \\u003cp\\u003eTriglycerides (p\\u0026thinsp;=\\u0026thinsp;0.035)\\u003c/p\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.039)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD20\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eINR (p\\u0026thinsp;=\\u0026thinsp;0.006)\\u003c/p\\u003e\\n \\u003cp\\u003eSodium (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eMCH (p\\u0026thinsp;=\\u0026thinsp;0.013)\\u003c/p\\u003e\\n \\u003cp\\u003eMCV (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eChloride (p\\u0026thinsp;=\\u0026thinsp;0.017)\\u003c/p\\u003e\\n \\u003cp\\u003eUric acid (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRDW-SD (p\\u0026thinsp;=\\u0026thinsp;0.004)\\u003c/p\\u003e\\n \\u003cp\\u003eMCV (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-HBc Hep B (p\\u0026thinsp;=\\u0026thinsp;0.026)\\u003c/p\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0.025)\\u003c/p\\u003e\\n \\u003cp\\u003eTSH (p\\u0026thinsp;=\\u0026thinsp;0.015)\\u003c/p\\u003e\\n \\u003cp\\u003eSyphilis (p\\u0026thinsp;=\\u0026thinsp;0.038)\\u003c/p\\u003e\\n \\u003cp\\u003eEosinophil (p\\u0026thinsp;=\\u0026thinsp;0.016)\\u003c/p\\u003e\\n \\u003cp\\u003eHIV (p\\u0026thinsp;=\\u0026thinsp;0.018)\\u003c/p\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.011)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD25\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eINR (p\\u0026thinsp;=\\u0026thinsp;0.017)\\u003c/p\\u003e\\n \\u003cp\\u003eLymphocyte (p\\u0026thinsp;=\\u0026thinsp;0.004)\\u003c/p\\u003e\\n \\u003cp\\u003eNon-HDL (p\\u0026thinsp;=\\u0026thinsp;0.02)\\u003c/p\\u003e\\n \\u003cp\\u003eCholesterol (p\\u0026thinsp;=\\u0026thinsp;0.009)\\u003c/p\\u003e\\n \\u003cp\\u003eChloride (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eRDW-SD (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003cp\\u003eMCV (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.012)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocyte (p\\u0026thinsp;=\\u0026thinsp;0.012)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-HBc hep B (p\\u0026thinsp;=\\u0026thinsp;0.023)\\u003c/p\\u003e\\n \\u003cp\\u003eAlkaline phosphatase (p\\u0026thinsp;=\\u0026thinsp;0.042)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0.02)\\u003c/p\\u003e\\n \\u003cp\\u003eEosinophil (p\\u0026thinsp;=\\u0026thinsp;0.03)\\u003c/p\\u003e\\n \\u003cp\\u003eGlucose (p\\u0026thinsp;=\\u0026thinsp;0.04)\\u003c/p\\u003e\\n \\u003cp\\u003eAlanine aminotransferase (p\\u0026thinsp;=\\u0026thinsp;0.019)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD30\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eINR (p\\u0026thinsp;=\\u0026thinsp;0.034)\\u003c/p\\u003e\\n \\u003cp\\u003ePotassium (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eLymphocyte (p\\u0026thinsp;=\\u0026thinsp;0.013)\\u003c/p\\u003e\\n \\u003cp\\u003eChloride (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eBilirubin (p\\u0026thinsp;=\\u0026thinsp;0.053)\\u003c/p\\u003e\\n \\u003cp\\u003eAspartate aminotransferase\\u003c/p\\u003e\\n \\u003cp\\u003e(p\\u0026thinsp;=\\u0026thinsp;0.019)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eRDW-SD (p\\u0026thinsp;=\\u0026thinsp;0.002)\\u003c/p\\u003e\\n \\u003cp\\u003eVCM (p\\u0026thinsp;=\\u0026thinsp;0.001)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.031)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocytes (p\\u0026thinsp;=\\u0026thinsp;0.033)\\u003c/p\\u003e\\n \\u003cp\\u003eAnti-HBc Hep B (p\\u0026thinsp;=\\u0026thinsp;0.022)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePotassium (p\\u0026thinsp;=\\u0026thinsp;0.024)\\u003c/p\\u003e\\n \\u003cp\\u003eEosinophil (p\\u0026thinsp;=\\u0026thinsp;0.039)\\u003c/p\\u003e\\n \\u003cp\\u003eIron (p\\u0026thinsp;=\\u0026thinsp;0.059)\\u003c/p\\u003e\\n \\u003cp\\u003eCalcium (p\\u0026thinsp;=\\u0026thinsp;0.037)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD33/35\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFT4 (p\\u0026thinsp;=\\u0026thinsp;0.005)\\u003c/p\\u003e\\n \\u003cp\\u003ePotassium (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eAspartate aminotransferase (p\\u0026thinsp;=\\u0026thinsp;0.01)\\u003c/p\\u003e\\n \\u003cp\\u003eAlkaline phosphatase (p\\u0026thinsp;=\\u0026thinsp;0.056)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eaPTT (p\\u0026thinsp;=\\u0026thinsp;0)\\u003c/p\\u003e\\n \\u003cp\\u003eRDW-SD (p\\u0026thinsp;=\\u0026thinsp;0.031)\\u003c/p\\u003e\\n \\u003cp\\u003eMCV (p\\u0026thinsp;=\\u0026thinsp;0.007)\\u003c/p\\u003e\\n \\u003cp\\u003eHematocrit (p\\u0026thinsp;=\\u0026thinsp;0.008)\\u003c/p\\u003e\\n \\u003cp\\u003eErythrocyte (p\\u0026thinsp;=\\u0026thinsp;0.011)\\u003c/p\\u003e\\n \\u003cp\\u003eHDL cholesterol (p\\u0026thinsp;=\\u0026thinsp;0.044)\\u003c/p\\u003e\\n \\u003cp\\u003eIron (p\\u0026thinsp;=\\u0026thinsp;0.050)\\u003c/p\\u003e\\n \\u003cp\\u003eBilirubin (p\\u0026thinsp;=\\u0026thinsp;0.026)\\u003c/p\\u003e\\n \\u003cp\\u003eAlkaline phosphatase (p\\u0026thinsp;=\\u0026thinsp;0.039)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eINR (p\\u0026thinsp;=\\u0026thinsp;0.003)\\u003c/p\\u003e\\n \\u003cp\\u003eCRP (p\\u0026thinsp;=\\u0026thinsp;0.026)\\u003c/p\\u003e\\n \\u003cp\\u003eMonocytes (p\\u0026thinsp;=\\u0026thinsp;0.062)\\u003c/p\\u003e\\n \\u003cp\\u003eLDL (p\\u0026thinsp;=\\u0026thinsp;0.041)\\u003c/p\\u003e\\n \\u003cp\\u003eCholesterol (p\\u0026thinsp;=\\u0026thinsp;0.038)\\u003c/p\\u003e\\n \\u003cp\\u003eGlucose (p\\u0026thinsp;=\\u0026thinsp;0.005)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003ctfoot\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"4\\\"\\u003e\\u003cstrong\\u003eAbbreviations\\u003c/strong\\u003e: aPTT: Activated partial thromboplastin time; CRP - C-reactive protein; D: days; free T4 - Free thyroxine; HDL: High-density lipoprotein; Hep B \\u0026ndash; hepatitis B; HIV - human immunodeficiency virus; INR - International Normalized Ratio; LDL - Low-density lipoprotein; MCH - mean corpuscular hemoglobin; MCV - mean corpuscular volume; MCHC - mean corpuscular hemoglobin concentration; RDW-SD - Erythrocyte Distribution Width (standard deviation); TSH - Thyroid stimulating hormone; T3 - Total triiodothyronine; T4 - Thyroxine; VLDL - very-low-density lipoprotein.\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tfoot\\u003e\\n \\u003c/table\\u003e\\n \\u003c/div\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003cp\\u003eA positive syphilis diagnosis was correlated with mucositis at D15/30. OC was associated with syphilis and HIV at D20. Table\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e presents the full association between altered laboratory exams and treatment-related H\\u0026amp;N toxicities.\\u003c/p\\u003e\\n \\u003cp\\u003eWhen evaluating Table\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e for laboratory test exams that were altered and correlated with a toxicity in more than four different evaluation days with significative P values (P\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05), altered T4 and FT4 appear to be correlated with mucositis. Accordingly, a correlation between T4 and mucositis are seen in D20 (P\\u0026thinsp;=\\u0026thinsp;0.0234) and D25 (P\\u0026thinsp;=\\u0026thinsp;0.0281) and slightly lower at D30 (P\\u0026thinsp;=\\u0026thinsp;0.0718) and D33-35 (P\\u0026thinsp;=\\u0026thinsp;0.0503). Correlation between OM and FT4 are only significant at D33-35 (P\\u0026thinsp;=\\u0026thinsp;0.0426) but closely at D20 (P\\u0026thinsp;=\\u0026thinsp;0.0519), D25 (P\\u0026thinsp;=\\u0026thinsp;0.0958) and D30 (P\\u0026thinsp;=\\u0026thinsp;0.0875) (Table\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e5\\u003c/span\\u003e).\\u003c/p\\u003e\\n \\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003ctable border=\\\"1\\\" id=\\\"Tab5\\\"\\u003e\\n \\u003ccaption\\u003e\\n \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 5\\u003c/div\\u003e\\n \\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\n \\u003cp\\u003eMucositis association with abnormal laboratory results observed four times or more at different evaluation days.\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD5\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD15\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD20\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD25\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD30\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eD35\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eT4\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eR\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,1570\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,2830\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,2768\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,2266\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,2703\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eIC95%\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,3941 to 0,09973\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,5000 to -0,03260\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,4966 to -0,02371\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,4534 to 0,02776\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,5099 to 0,008176\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eP\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,2154\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,0234*\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,0281*\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,0718\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,0503\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eFT4\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eR\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,07591\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,1388\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,2441\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,2117\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,2154\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,2796\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eIC95%\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,1824 to 0,3244\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,3783 to 0,1181\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,4680 to 0,009257\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,4426 to 0,04553\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,4440 to 0,03957\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-0,5173 to -0,001844\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eP\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,5543\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,2740\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,0519\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,0958\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,0875\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0,0426*\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003ctfoot\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"7\\\"\\u003e* statistically significant values.\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"7\\\"\\u003eAbbreviation: D: day, T4: thyroxine, FT4: free thyroxine.\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tfoot\\u003e\\n \\u003c/table\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003cp\\u003eThe most important predictors for OM were family income and housing; both outcomes are presented in navy blue in the heat map (Fig.\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e).\\u003c/p\\u003e\\n \\u003ch2\\u003eOHIP-14\\u003c/h2\\u003e\\n\\u003c/div\\u003e\\n\\u003cp\\u003eThe mean OHIP-14 score from the study population was 19.5, ranging from 0 to 49. The worst domain reported was physical pain (4.37 out of possible 8), which evaluated pain and difficulty in eating (Supplementary material 4).\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eOur study evaluated whether dental treatment before OOPSCC therapy alters existing systemic comorbidities. The results suggested that although OOPSCC patients have comorbidities and several abnormal laboratory tests results, the dental treatment in these cancer populations resulted in no adverse events. It was also observed that the OOPSCC diagnosis does not pose an additional challenge for the dentist, as treatment complications such as unexpected bleeding or infection were not identified in the population evaluated.\\u003c/p\\u003e \\u003cp\\u003eIt is recommended that OOPSCC patients should receive comprehensive oral assessment and dental treatment before cancer treatment. It ought to start right after the cancer diagnosis. When an oral/dental surgical procedure such dental extractions is indicated, ideally it should be concluded 2\\u0026ndash;3 weeks before the start of the cancer treatment to allow time for bone and soft tissue healing [2\\u0026ndash;4, 24].\\u003c/p\\u003e \\u003cp\\u003eWe used comorbidity to refer to disease processes that coexist and are not related to the index disease being studied [25]. Current literature highlights that the frequency of comorbidities in OOPSCC patients is high compared to the general population, and it is mainly associated with chronic smoking and alcohol exposure [26,27]. A review demonstrated that approximately 60% of H\\u0026amp;N cancer patients have concurrent illnesses [25]. Our study, which originally assessed a Latin American population with advanced OOPSCC, observed that 85.4% of patients had a history of tobacco/alcohol consumption. In addition, patients reported an overall comorbidity rate of 63.6% (44.3% one, while 55.7% with two or more concurrent).\\u003c/p\\u003e \\u003cp\\u003eThe most common comorbidities reported were hypertension (51.4%), followed by dyslipidemia (22.8%) and diabetes (15.7%). This is similar to the results of a study population of 10,524 H\\u0026amp;N cancer patients (3049 diagnosed with oral and 2499 diagnosed with oropharyngeal cancer), with the most reported comorbidities being hypertension (59.6%), hyperlipidemia (31.4%), chronic obstructive pulmonary disease (COPD; 26.4%), and diabetes (21.1%) [29]. Comorbidities can impact the diagnosis, prognosis, survival and treatment of patients with cancer and dictates the cancer treatment modality and shapes the way dental treatment is provided [28,29].\\u003c/p\\u003e \\u003cp\\u003eThe most frequent altered laboratory findings were elevated CRP, altered levels of hemoglobin, erythrocytes, hematocrit, GGT, 25-Hydroxy Vitamin D, RDW-SD, neutrophil counts, eosinophil counts, total cholesterol, HDL, iron, and glucose. A retrospective study of 261 H\\u0026amp;N cancer patients that evaluated pre-therapeutic laboratory values also demonstrated that elevated CRP were the most frequent laboratory anomaly (60%), but they also observed impaired liver enzymes (30\\u0026ndash;50%), leukocytosis (20%), and anemia (10%) [30].\\u003c/p\\u003e \\u003cp\\u003eThe results of our study suggest that the observed comorbidities do not require dental treatment modifications and do not generate complications related to invasive dental procedures. CRP is a nonspecific inflammation marker synthesized in response to acute inflammation or destruction of tissue cells and over-expressed levels are demonstrated to be prognostic markers in various tumors, including lung, lymphoma, and more recently, H\\u0026amp;N cancers [31,32]. Altered liver function GGT can be explained by the chronic alcohol abuse in this population [30]. 25-Hydroxy Vitamin D monitors vitamin D levels, and deficiency is highly prevalent among adults, and low levels have been associated with hypertension, cancer, and diabetes mellitus [33,34]. Neutrophils, the most abundant leukocytes in the blood, are considered to be the first line of defense during inflammation and infections. High counts in the H\\u0026amp;N cancer population are associated with poor cancer prognosis. Low counts are associated with infection [35,36]. The high incidence of altered blood glucose concentration is associated with the high number of diabetic patients in this targeted sample.\\u003c/p\\u003e \\u003cp\\u003eThe current literature suggests that general dentists may have limited experience in the care of the cancer patient. Professionals with experience in oral oncology are usually the ones who diagnose and manage oral conditions and diseases in OOPSCC patients [24]. While this may be true for patients already undergoing or that have already concluded cancer treatment, our study suggests that routine dental treatment before OOPSCC may be performed by general dentists. Although comorbidities and laboratory changes were observed in our study population, they did not generate relevant treatment complications that contraindicated dental treatment.\\u003c/p\\u003e \\u003cp\\u003eH\\u0026amp;N cancer treatment toxicities are frequent, affect patients' QoL, may cause treatment breaks, and eventually impair prognosis [3\\u0026ndash;4]. In our study, toxicities were progressive over time and independent of the chosen RT modality. There was a positive correlation between the number of medications in use and OM and a negative correlation between the number of medications in use and dysgeusia outcomes.\\u003c/p\\u003e \\u003cp\\u003eTo our knowledge, this is the first study to correlate the presence of comorbidities, laboratory changes and toxicities from the curative treatment (RT or CRT) in OOPSCC patients, and the provision of routine dental care before the start of cancer therapy. Because the findings of this study are unique, there is no existing literature to support or to compare our results.\\u003c/p\\u003e \\u003cp\\u003eNevertheless, some findings in the present study may be considered predictive of oral toxicities during oncological treatment. We demonstrated that urea levels were altered at D25/30/D33-35 and creatinine at D15/30 of RT or CRT treatment, pointing to altered renal function and impairment of drug metabolism in patients undergoing these treatment modalities. Ultimately, this could imply more severe mucositis [37]. Additionally, we observed that altered T4 and FT4 levels were correlated with OM. T4 altered levels and OM were seen in D20/25, and slightly less in D30/33\\u0026ndash;35. Correlation between OM and FT4 is only significant at D33-35, but also showed a trend at D20/25/30.\\u003c/p\\u003e \\u003cp\\u003eA syphilis diagnosis was correlated with OM at D15, and OC was associated with syphilis and HIV diagnosis at D20 of the RT treatment. The baseline immunosuppression added to the cancer-treatment related immunosuppression might favor this scenario [38].\\u003c/p\\u003e \\u003cp\\u003eOf interest, we observed that both family income and housing were the most important predicting factors for OM. These predictors could be explained based on the sociodemographic context of OOPSCC patients in Brazil - a low income and low education level can affect compliance and follow-up of recommendations which could worsen OM grades [39].\\u003c/p\\u003e \\u003cp\\u003eLimitations of the present study include the short follow-up time after diagnosis and treatment. Because of this, it was not possible to directly correlate abnormal laboratory test values and the OOPSCC prognosis and cancer treatment outcomes. The heterogenic population that participated in the study, the different treatment modalities used to treat the patients, and some of the correlations observed are also limitations to be considered in this study.\\u003c/p\\u003e \\u003cp\\u003eThe mean OHIP-14 score from the study population was 19.5, and the worst domain reported was physical pain (4.37). These findings are similar to a study also conducted in Brazil with H\\u0026amp;N cancer patients, in which the mean score obtained was 19.52 (\\u0026plusmn;\\u0026thinsp;11.79) and the physical pain (3.70\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.44). These two findings ranked as the main factor affecting QoL [40].\\u003c/p\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eThe results of this study suggested that although OOPSCC patients have a wide range of comorbidities and several abnormal laboratory results when their cancers are diagnosed, dental treatment before cancer therapy resulted in no adverse events in our sample. Thus, it reinforces that general dentists may safely perform dental procedures in these OOPSCC population. Laboratory findings may be useful clinical predictors of OM, including altered T4, FT4, urea, creatinine, calcium, alkaline phosphatase, creatinine, and a positive syphilis diagnosis. Systemic infectious diseases, such as syphilis and HIV may also be reliable clinical predictors of OC secondary to OOPSCC treatment.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eFunding:\\u0026nbsp;\\u003c/strong\\u003eThis work was supported in part by the Coordena\\u0026ccedil;\\u0026atilde;o de Aperfei\\u0026ccedil;oamento de Pessoal de N\\u0026iacute;vel Superior - Brasil (CAPES) - Finance Code 001. Alan Roger Santos-Silva is a research grantee of the Conselho Nacional de Desenvolvimento Cient\\u0026iacute;fico e Tecnol\\u0026oacute;gico (CNPq, Brazil), process number 304941/2020-4. Xaviera A. L\\u0026oacute;pez-Cort\\u0026eacute;s is supported by the ANID FONDECYT Iniciaci\\u0026oacute;n process number 11220897.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompliance with Ethical Standards\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConflict of interest statement\\u003c/strong\\u003e: None declared.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResearch involving Human Participants and/or Animals:\\u0026nbsp;\\u003c/strong\\u003eEthical approval was obtained from the National Human Research Ethics Committee (CAAE: 23671019.1.1001.5418).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eInformed consent:\\u0026nbsp;\\u003c/strong\\u003eAll participants provided written informed consent.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMaterial availability:\\u0026nbsp;\\u003c/strong\\u003eAll data is provided in tables or supplementary materials.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor contributions:\\u0026nbsp;\\u003c/strong\\u003eAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Leticia Rodrigues-Oliveira, Ana Carolina Prado-Ribeiro, Alan Roger Santos-Silva, Natalia Rangel Palmier, Xaviera A. L\\u0026oacute;pez-Cort\\u0026eacute;s, Luiz Alcino Gueiros, and C\\u0026eacute;sar Rivera. Statistical analysis was performed by Xaviera A. L\\u0026oacute;pez-Cort\\u0026eacute;s, Luiz Alcino Gueiro, and C\\u0026eacute;sar Rivera The first draft of the manuscript was written by Leticia Rodrigues-Oliveira and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n \\u003cli\\u003eEpstein JB, G\\u0026uuml;neri P, Barasch A (2014) Appropriate and necessary oral care for people with cancer: guidance to obtain the right oral and dental care at the right time. Support Care Cancer 22(7): 1981-1988. https://doi:10.1007/s00520-014-2228-x\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eLevi LE, Lalla RV (2018) Dental Treatment Planning for the Patient with Oral Cancer. Dent Clin North Am 62(1):121-130. https://doi:10.1016/j.cden.2017.08.009\\u003c/li\\u003e\\n \\u003cli\\u003eCarvalho CG, Medeiros-Filho JB, Ferreira MC (2018) Guide for health professionals addressing oral care for individuals in oncological treatment based on scientific evidence. Support Care Cancer 26(8):2651-2661. https://doi:10.1007/s00520-018-4111-7\\u003c/li\\u003e\\n \\u003cli\\u003eSamim F, Epstein JB, Zumsteg ZS, Ho AS, Barasch A (2016) Oral and dental health in head and neck cancer survivors. Cancers Head Neck 1(1):1\\u0026ndash;7. https://doi.org/10.1186/s41199-016-0015-8\\u003c/li\\u003e\\n \\u003cli\\u003eRodrigues-Oliveira L, Kowalski LP, Santos M, Marta GN, Bensadoun RJ, Martins MD, Lopes MA, Castro G Jr, William WN Jr, Chaves ALF, Migliorati CA, Salloum RG, Rodrigues-Fernandes CI, Kauark-Fontes E, Brand\\u0026atilde;o TB, Santos-Silva AR, Prado-Ribeiro AC (2021) Direct costs associated with the management of mucositis: A systematic review. Oral Oncol 118:105296. https://doi:10.1016/j.oraloncology.2021.105296.\\u003c/li\\u003e\\n \\u003cli\\u003eHong CHL, Hu S, Haverman T, et al (2018) A systematic review of dental disease management in cancer patients. Support Care Cancer 26(1): 155-174. https://doi:10.1007/s00520-017-3829-y\\u003c/li\\u003e\\n \\u003cli\\u003eBrennan MT, Woo SB, Lockhart PB (2008) Dental treatment planning and management in the patient who has cancer. 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Derivation and validation of a short-form oral health impact profile (1997) Community Dent Oral Epidemiol 25(4):284-290. https://doi:10.1111/j.1600-0528.1997.tb00941.x\\u003c/li\\u003e\\n \\u003cli\\u003eOliveira BH, Nadanovsky P (2005) Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form. Community Dent Oral Epidemiol 33(4):307-314. https://doi:10.1111/j.1600-0528.2005.00225.x\\u003c/li\\u003e\\n \\u003cli\\u003eJawad H, Hodson NA, Nixon PJ (2015) A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1. Br Dent J 218(2):65-68. https://doi:10.1038/sj.bdj.2015.28\\u003c/li\\u003e\\n \\u003cli\\u003ePaleri V, Wight RG, Silver CE, et al (2010) Comorbidity in head and neck cancer: a critical appraisal and recommendations for practice. Oral Oncol 46(10):712-719. https://doi:10.1016/j.oraloncology.2010.07.008\\u003c/li\\u003e\\n \\u003cli\\u003ede C\\u0026aacute;ssia Braga Ribeiro K, Kowalski LP, Latorre Mdo R. Perioperative complications, comorbidities, and survival in oral or oropharyngeal cancer (2003) Arch Otolaryngol Head Neck Surg 129(2):219-228. https://doi:10.1001/archotol.129.2.219\\u003c/li\\u003e\\n \\u003cli\\u003eHabbous S, Harland LT, La Delfa A, et al (2014) Comorbidity and prognosis in head and neck cancers: Differences by subsite, stage, and human papillomavirus status. Head Neck 36(6):802-810. https://doi:10.1002/hed.23360\\u003c/li\\u003e\\n \\u003cli\\u003eEytan DF, Blackford AL, Eisele DW, Fakhry C (2019) Prevalence of Comorbidities among Older Head and Neck Cancer Survivors in the United States. Otolaryngol Head Neck Surg 160(1):85-92. https://doi:10.1177/0194599818796163\\u003c/li\\u003e\\n \\u003cli\\u003eSchimansky S, Lang S, Beynon R, et al (2019) Association between comorbidity and survival in head and neck cancer: Results from Head and Neck 5000. Head Neck 41(4):1053-1062. https://doi:10.1002/hed.25543\\u003c/li\\u003e\\n \\u003cli\\u003ePeter F, Wittekindt C, Finkensieper M, Kiehntopf M, Guntinas-Lichius O (2013) Prognostic impact of pretherapeutic laboratory values in head and neck cancer patients. J Cancer Res Clin Oncol 139(1):171-178. https://doi:10.1007/s00432-012-1320-1\\u003c/li\\u003e\\n \\u003cli\\u003eKnittelfelder O, Delago D, Jakse G, et al (2020) The Pre-Treatment C-Reactive Protein Represents a Prognostic Factor in Patients with Oral and Oropharyngeal Cancer Treated with Radiotherapy. Cancers (Basel) 12(3):626. Published 2020 Mar 8. https://doi:10.3390/cancers12030626\\u003c/li\\u003e\\n \\u003cli\\u003eChen Y, Cong R, Ji C, Ruan W (2020) The prognostic role of C-reactive protein in patients with head and neck squamous cell carcinoma: A meta-analysis. Cancer Med 9(24):9541-9553. https://doi:10.1002/cam4.3520\\u003c/li\\u003e\\n \\u003cli\\u003eMarchiori DM (2015) The prevalence of hypovitaminosis among us adults: data from the nhanes iii. 15. https:// doi.org/10.1016/j.jmpt.2016.02.001\\u003c/li\\u003e\\n \\u003cli\\u003eMelamed ML, Michos ED, Post W, Astor B (2008) 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 168(15):1629-1637. https://doi:10.1001/archinte.168.15.162914\\u003c/li\\u003e\\n \\u003cli\\u003eUribe-Querol E, Rosales C (2015) Neutrophils in cancer: Two sides of the same coin. J Immunol Res 2015.\\u003c/li\\u003e\\n \\u003cli\\u003eOcana A, Nieto-Jim\\u0026eacute;nez C, Pandiella A, Templeton AJ (2017) Neutrophils in cancer: prognostic role and therapeutic strategies. Mol Cancer 16(1):137. https://doi:10.1186/s12943-017-0707-7\\u003c/li\\u003e\\n \\u003cli\\u003eMizuno H, Miyai H, Yokoi A, et al (2019) Relationship Between Renal Dysfunction and Oral Mucositis in Patients Undergoing Concurrent Chemoradiotherapy for Pharyngeal Cancer: A Retrospective Cohort Study. \\u003cem\\u003eIn Vivo\\u003c/em\\u003e 33(1):183-189. https://doi:10.21873/invivo.11457\\u003c/li\\u003e\\n \\u003cli\\u003eDeng Z, Kiyuna A, Hasegawa M, Nakasone I, Hosokawa A, Suzuki M (2010) Oral candidiasis in patients receiving radiation therapy for head and neck cancer. Otolaryngol Head Neck Surg 143(2):242-247. https://doi:10.1016/j.otohns.2010.02.003\\u003c/li\\u003e\\n \\u003cli\\u003eRodrigues-Oliveira L, Kauark-Fontes E, Alves CGB, Tonaki JO, Gueiros LA, Moutinho K, Marta GN, Barros LRC, Santos-Silva AR, Brand\\u0026atilde;o TB, Prado-Ribeiro AC (2021) COVID-19 impact on anxiety and depression in head and neck cancer patients: A cross-sectional study. Oral Dis. https://doi:10.1111/odi.13876. Epub ahead of print.\\u003c/li\\u003e\\n \\u003cli\\u003ede Melo NB, de Sousa VM, Bernardino \\u0026Iacute;M, de Melo DP, Gomes DQ, Bento PM (2019) Oral health related quality of life and determinant factors in patients with head and neck cancer. Med Oral Patol Oral Cir Bucal 24(3):e281-e289. https://doi:10.4317/medoral.22670\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Medical History Taking, Medical Examination, Dental Care, Comorbidity, Oral Cancer, Oropharyngeal Cancer\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-1608385/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-1608385/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003ePurpose: \\u003c/strong\\u003eTo characterize oral and oropharyngeal squamous cell carcinoma (OOPSCC) patients with dental needs before cancer treatment and to correlate their baseline characteristics with cancer treatment-related toxicities. \\u003c/p\\u003e\\u003cp\\u003e\\u003cstrong\\u003eMethods: \\u003c/strong\\u003eA prospective cohort study that recruited OOPSCC patients referred to the Dental Oncology Service at the Instituto do Câncer do Estado de São Paulo, Brazil, for dental treatment between November/2019 and December/2020. Comorbidities, sociodemographic data, medication in use, treatment-related toxicities and altered laboratory tests results were correlated.\\u003cstrong\\u003e \\u003c/strong\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cstrong\\u003eResults: \\u003c/strong\\u003e110 patients were included. The most common comorbidities reported and altered laboratory results were respectively hypertension, dyslipidemia, diabetes and C-reactive protein, hemoglobin, and hematocrit. Toxicities were progressive over time. There was no correlation between the comorbidities and cancer treatment-related toxicities. There was a positive correlation between medications in use and oral mucositis (OM) and a negative correlation between medications and dysgeusia. OM was associated with altered laboratory findings, including thyroxine (T4) and free thyroxine (FT4) starting at D15; calcium at D5/10/30; urea at D25/30/33-35; creatinine at D15/30; alkaline phosphatase at D20/25; syphilis at D15/30. Family income and housing were OM predictors. Oral candidiasis (OC) was associated with syphilis and HIV at D20.\\u003cstrong\\u003e \\u003c/strong\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cstrong\\u003eConclusion: \\u003c/strong\\u003eLaboratory findings including altered T4, FT4, urea, calcium, alkaline phosphatase, creatinine, and syphilis may be useful clinical predictors of OM. Syphilis and HIV may also be considered reliable predictors of OC secondary to OOPSCC treatment. Despite the high frequency of comorbidities and abnormal laboratory results, dental treatment before cancer treatment resulted in no adverse events in our sample.\\u003c/p\\u003e\",\"manuscriptTitle\":\"The impact of oral and oropharyngeal cancer patient’s medical profile on dental treatment needs and treatment-related toxicities. 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