The multivariable analysis revealed a significantly higher likelihood of grade 3 RIOM in patients undergoing RT (OR = 4.26; p = 0.041), those with lower MALAT1 expression (OR = 5.19; p = 0.021), and those with severe malnutrition according to the SGA (SGA-C) (OR = 3.46; p = 0.043). This evidence concerns the gene MALAT1 and malnutrition.