Radiotherapy and Oncology最新文献

{"title":"Randomized trials: When scientific rigor meets field reality.","authors":"J M Hannoun-Levi, A Savignoni, J Lemonnier, Youlia Kirova","doi":"10.1016/j.radonc.2024.110659","DOIUrl":"10.1016/j.radonc.2024.110659","url":null,"abstract":"<p><p>Results from prospective randomized trial results are required to provide practice-changing level-1 evidence. However, if such a trial is not feasible, we should not accept that consequently practice could not change. We discuss hereby a pragmatically approach based on methodological alternatives.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110659"},"PeriodicalIF":4.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aiming for patient safety indicators in radiation oncology - Results from a systematic literature review as part of the PaSaGeRO study.","authors":"Andrea Baehr, Maximilian Grohmann, Eva Christalle, Felicitas Schwenzer, Isabelle Scholl","doi":"10.1016/j.radonc.2024.110657","DOIUrl":"10.1016/j.radonc.2024.110657","url":null,"abstract":"<p><strong>Background: </strong>Patient Safety Indicators (PSIs) allow the evaluation of safety levels in healthcare settings. Despite their use in various medical fields, a specific and comprehensive PSI catalogue for radiation oncology (RO) is lacking. The Patient Safety in German Radiation Oncology (PaSaGeRO) study aims for the development of a specific PSI catalogue in radiation oncology.</p><p><strong>Objectives: </strong>The primary objective of this systematic literature review as part of the PaSaGeRO study is to identify, formulate, and categorize PSIs specific to RO to bridge existing gaps in comprehensive patient safety evaluation.</p><p><strong>Methods: </strong>An electronic search in PubMed included studies from 1989 onwards, in English or German, focusing on safety and quality indicators in RO, patient safety measures, or risk analyses. Exclusions were non-transferable, country-specific measures, techniques exclusive to specific departments, and legally mandated procedures. Additional sources were identified through reference tracking and professional society websites. Two experts independently extracted PSIs from the included references.</p><p><strong>Results: </strong>Out of 157 included publications and nine secondary sources, we identified and formulated 145 PSIs. These were categorized into patient-specific processes (82, 56%), quality and risk management (42, 28%), human resources (15, 10%), and institutional culture (13, 9%).</p><p><strong>Conclusion: </strong>The hereby developed PSIs provides a base for professionals to systematically evaluate and improve safety practices, addressing previously unmet needs in this field. By offering clear guidance on safety assessment, the catalogue has the potential to drive significant improvements in patient care and safety outcomes in RO. Funded by Deutsche Krebshilfe. Registered in the German Clinical Trials Register (DRKS00034690).</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110657"},"PeriodicalIF":4.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the time of day of chemoradiotherapy and durvalumab with tumor control in lung cancer.","authors":"Matthew T McMillan, Annemarie Shepherd, Alissa J Cooper, Adam J Schoenfeld, Abraham J Wu, Charles B Simone, Puneeth Iyengar, Daphna Y Gelblum, Jamie E Chaft, Daniel R Gomez, Narek Shaverdian","doi":"10.1016/j.radonc.2024.110658","DOIUrl":"10.1016/j.radonc.2024.110658","url":null,"abstract":"<p><strong>Background/purpose: </strong>The circadian clock governs the expression of genes related to immunity and DNA repair. We investigated whether the time of day of radiotherapy and/or systemic therapy infusions (chemotherapy or anti-PD-L1) are associated with disease control and survival in locally advanced non-small cell lung cancer (LA-NSCLC).</p><p><strong>Materials/methods: </strong>178 consecutive patients with inoperable LA-NSCLC who received definitive chemoradiotherapy followed by durvalumab between 5/2017-8/2022 were reviewed. Outcomes evaluated included progression-free survival (PFS), distant metastasis-free survival (DMFS), locoregional control (LRC), and overall survival (OS).</p><p><strong>Results: </strong>At a median follow up of 48.0 mo from durvalumab initiation, median PFS and OS were 26.2 mo and 50.0 mo, respectively. Median LRC and DMFS were not reached and 41.0 mo, respectively. Receiving > 50 % (N = 23) versus ≤ 50 % (N = 155) of radiotherapy treatments within 3 h of sunset was associated with younger age; otherwise, there were no other differences between cohorts. There were no significant differences in characteristics between patients who received > 50 % (N = 23) versus ≤ 50 % (N = 155) of durvalumab infusions within 3 h of sunset. On multivariable analysis, receiving > 50 % of radiotherapy treatments within 3 h of sunset was independently associated with reduced risk for progression (HR 0.39, p = 0.017) and distant metastasis (HR 0.27, p = 0.007); conversely, receiving > 50 % of durvalumab infusions within 3 h of sunset was independently associated with increased risk for distant metastasis (HR 2.13, p = 0.025). The timing of chemotherapy was not associated with disease outcomes.</p><p><strong>Conclusion: </strong>The time of day of radiotherapy and durvalumab infusion may be associated with disease control in LA-NSCLC, and the optimal time of treatment depends on the treatment modality.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110658"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The indispensable role of peer review in modern radiation oncology","authors":"Louis Potters","doi":"10.1016/j.radonc.2024.110647","DOIUrl":"10.1016/j.radonc.2024.110647","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110647"},"PeriodicalIF":4.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric impact of sparing base of heart on organ at risk doses during lung radiotherapy","authors":"Tom Marchant ,&nbsp;Joseph Wood ,&nbsp;Kathryn Banfill ,&nbsp;Alan McWilliam ,&nbsp;Gareth Price ,&nbsp;Corinne Faivre-Finn","doi":"10.1016/j.radonc.2024.110654","DOIUrl":"10.1016/j.radonc.2024.110654","url":null,"abstract":"<div><h3>Background</h3><div>Minimising heart exposure during lung radiotherapy (RT) is important due to association between increased cardiac dose and adverse outcomes such as cardiac toxicity and reduced overall survival. This study evaluated the impact of incorporating a cardiac avoidance area (CAA) located at the base of the heart on the dose received by cardiac subregions and thoracic organs at risk.</div></div><div><h3>Methods</h3><div>A comparative analysis was conducted on patients treated with lung RT at a single centre before and after the CAA was introduced as an anatomical region at risk (ARR) in April 2023. Two patient cohorts were analysed: those treated prior to CAA implementation (April 2021-March 2023, 923 patients) and those treated post implementation (April 2023-March 2024, 477 patients). For the second group, plans were optimised to keep CAA maximum dose to 1 cc below 19.5 <!--> <!-->Gy in 20 fractions (or equivalent biologically effective dose). Key dose metrics for the CAA, heart, lungs, oesophagus, and spinal canal were compared between the cohorts.</div></div><div><h3>Results</h3><div>The introduction of the CAA as an ARR resulted in significant reductions in CAA and overall heart dose, with median CAA maximum dose (EQD2) decreasing from 32.0 <!--> <!-->Gy₃ to 16.9 <!--> <!-->Gy₃ (p &lt; 0.001). No significant increases in dose were observed for other thoracic organs at risk.</div></div><div><h3>Conclusions</h3><div>Implementing a cardiac avoidance area in lung RT planning significantly reduces doses to critical heart regions without compromising the safety of other organs. This approach holds promise for reducing cardiac-related adverse events and improving overall survival in patients with lung cancer undergoing RT.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110654"},"PeriodicalIF":4.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating and reporting LET and RBE-weighted dose in proton therapy for glioma – The Dutch approach","authors":"Dirk Wagenaar ,&nbsp;Steven J.M. Habraken ,&nbsp;Ilaria Rinaldi ,&nbsp;Daniëlle B.P. Eekers ,&nbsp;Miranda Kramer ,&nbsp;Jaap P.M. Jaspers ,&nbsp;Dik van Gent ,&nbsp;Lara Barazzuol ,&nbsp;Yvonne L.B. Klaver ,&nbsp;Jaap Zindler ,&nbsp;Ida Coremans ,&nbsp;Inge Compter ,&nbsp;Daniel Scandurra ,&nbsp;Hiska L. van der Weide ,&nbsp;Stefan Both ,&nbsp;Mischa Hoogeman ,&nbsp;Mirko Unipan ,&nbsp;Alejandra Méndez Romero","doi":"10.1016/j.radonc.2024.110653","DOIUrl":"10.1016/j.radonc.2024.110653","url":null,"abstract":"<div><h3>Background and purpose</h3><div>With proton therapy, the relative biological effectiveness (RBE) accounts for increased DNA damage caused by higher linear energy transfer (LET) compared to photons. However, the LET and hence the RBE varies along the proton range, particularly at the Bragg peak, introducing challenges in proton treatment planning for brain tumors. The aim of this paper is to standardize evaluating and reporting LET and RBE in proton therapy for patients with grade 2 and 3 IDH mutant gliomas among the Dutch proton therapy centers.</div></div><div><h3>Materials and methods</h3><div>A working group, comprising experts from three Dutch proton therapy centers, conducted nine meetings between 2020 and 2023. A joint literature review supported the standardized evaluation and reporting of LET and RBE. Questionnaires sent out to the three Dutch proton centers in 2020 and 2023 provided input for discussions on clinical practices. Three clinical examples were chosen to illustrate the application of the recommended methodology in treatment planning.</div></div><div><h3>Results</h3><div>Following the literature review, a guideline on evaluation and reporting using the dose averaged LET (LET_d) of primary and secondary protons calculated in water normalized to unit density was established. The McNamara variable RBE model with an α/β value of 2 Gy was selected for reporting.</div></div><div><h3>Conclusion</h3><div>The study presents a harmonization of approaches to evaluating and reporting LET and variable RBE in a guideline for the three Dutch proton therapy centers, providing clarity for future clinical interpretation. Having chosen a single variable RBE model offers practicality, although its accuracy remains a topic of ongoing research.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110653"},"PeriodicalIF":4.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of depressive and anxiety symptoms in patients with head and neck cancer undergoing radiotherapy: A systematic review and meta-analysis of longitudinal studies","authors":"Pablo Jiménez-Labaig ,&nbsp;Claudia Aymerich ,&nbsp;Antonio Rullan ,&nbsp;Jon Cacicedo ,&nbsp;Irene Braña ,&nbsp;Christopher Nutting ,&nbsp;Kate Newbold ,&nbsp;Kevin J. Harrington ,&nbsp;Ana Catalan","doi":"10.1016/j.radonc.2024.110649","DOIUrl":"10.1016/j.radonc.2024.110649","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Patients with head and neck cancer (HNC) are particularly vulnerable to mental health concerns. Radiotherapy (RT) remains a key treatment modality for these malignancies, offering high chances of cure. However, the effects on mental health are not well defined. We aim to characterize longitudinally the prevalence and risk of depressive and anxiety symptoms over the course of RT in patients with HNC.</div></div><div><h3>Material and methods</h3><div>A literature search was performed from database inception until November 1st, 2024. PROSPERO/MOOSE-compliant and pre-registered (PROSPERO:CRD42023441432) systematic review identified studies longitudinally reporting in patients with HNC undergoing curative intent RT. Pooled prevalence and odds ratio of clinically significant anxiety and depressive symptoms between different treatment timepoints were estimated using random-effects meta-analysis.</div></div><div><h3>Results</h3><div>18 studies (total sample 1,920, mean age 59.9[SD = 3.17], 22.2 % female, 93.0 % white ethnicity) were included. Before RT, a pooled prevalence of depressive symptoms of 18.1 % (95 % confidence intervals [CI] = 13.1 %-24.4 %) was found. Short-term after completing RT (≤3 months), the prevalence of depressive symptoms peaked to 26.1 % (95 %CI = 18.9 %-35.0 %), decreasing in long-term (≥6 months) assessments to 16.4 % (95 %CI = 12.6 %-21.0 %). Anxiety symptoms continuously decreased from baseline (pooled prevalence 29.9 % [95 %CI = 27.3 %–32.7 %]) to 17.4 % (95 %CI = 12.1 %-24.5 %) in the long-term. Female and married patients showed higher prevalence of depressive symptoms. Those who underwent surgery showed a lower prevalence of anxiety symptoms.</div></div><div><h3>Conclusions</h3><div>High prevalence of clinically significant depressive and anxiety symptoms were found in patients with HNC undergoing RT, from baseline to long-term follow-up. The weeks following completion of RT are key, as depressive symptoms increase in this period. Screening and interventions prior to, during, and especially immediately post-RT would be beneficial.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110649"},"PeriodicalIF":4.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical reflection of radiotherapy on osseous free flaps in mandibular segmental resection and immediate reconstruction in locally advanced oral squamous cell carcinoma: A cohort study","authors":"Jakob Fenske ,&nbsp;Claudius Steffen ,&nbsp;Friedrich Mrosk ,&nbsp;Philipp Lampert ,&nbsp;Eirini Nikolaidou ,&nbsp;Marcus Beck ,&nbsp;Max Heiland ,&nbsp;Kilian Kreutzer ,&nbsp;Christian Doll ,&nbsp;Steffen Koerdt ,&nbsp;Carsten Rendenbach","doi":"10.1016/j.radonc.2024.110652","DOIUrl":"10.1016/j.radonc.2024.110652","url":null,"abstract":"<div><h3>Background and purpose</h3><div>With standard radiotherapy protocols after R0 resection of advanced local oral squamous cell carcinoma (OSCC) and primary reconstruction of segmental defects, a high radiation dose is applied to healthy tissue in autologous microvascular free flaps. Considering the potential consequences of flap complications and associated surgeries for patients, data is lacking on whether postoperative radiotherapy (PORT) of the flap volume is indicated at all.</div></div><div><h3>Materials and methods</h3><div>Patients with segmental mandibular resection and immediate reconstruction with osseous free flaps due to advanced OSCC between 2012 and 2022 were analyzed retrospectively regarding overall (OS), disease-free survival (DFS), local failure-free survival (LFFS), the need for secondary surgeries as well as flap complications and compared between patients with and without PORT in a matched-pair approach with occurrence of flap complications as a primary endpoint.</div></div><div><h3>Results</h3><div>105 patients matched the inclusion criteria. The maximum follow-up period was 60 months. 68 patients received PORT. 74 patients were included in the final analysis. No case of disease recurrence inside the free flap was recorded. There were no significant differences in DFS (p = 0.21), OS (p = 0.33) and LFFS (p = 0.6) between both cohorts. Occurrence of osteoradionecrosis (p = 0.03) and bone exposure (p = 0.003) was higher in irradiated flaps. In patients with PORT, the demand for secondary surgeries due to flap complications was significantly higher (p = 0.009). Radiation doses were not increased in patients with flap ORN.</div></div><div><h3>Conclusion</h3><div>PORT is associated with higher flap complications and need for secondary surgeries in advanced stage OSCC. Given a recurrence rate of zero inside the flap without PORT and the improbability of recurrence within healthy transplanted tissue, the usefulness of applying high radiation doses to this vulnerable tissue is questioned. Further refinements of RT planning should be evaluated and tested in a RCT trial.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110652"},"PeriodicalIF":4.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based multiple-CT optimization: An adaptive treatment planning approach to account for anatomical changes in intensity-modulated proton therapy for head and neck cancers","authors":"Muyu Liu ,&nbsp;Bo Pang ,&nbsp;Shuoyan Chen ,&nbsp;Yiling Zeng ,&nbsp;Qi Zhang ,&nbsp;Hong Quan ,&nbsp;Yu Chang ,&nbsp;Zhiyong Yang","doi":"10.1016/j.radonc.2024.110650","DOIUrl":"10.1016/j.radonc.2024.110650","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Intensity-modulated proton therapy (IMPT) is particularly susceptible to range and setup uncertainties, as well as anatomical changes.</div></div><div><h3>Purpose</h3><div>We present a framework for IMPT planning that employs a deep learning method for dose prediction based on multiple-CT (MCT). The extra CTs are created from cone-beam CT (CBCT) using deformable registration with the primary planning CT (PCT). Our method also includes a dose mimicking algorithm.</div></div><div><h3>Methods</h3><div>The MCT IMPT planning pipeline involves prediction of robust dose from input images using a deep learning model with a U-net architecture. Deliverable plans may then be created by solving a dose mimicking problem with the predictions as reference dose. Model training, dose prediction and plan generation are performed using a dataset of 55 patients with head and neck cancer in this retrospective study. Among them, 38 patients were used as training set, 7 patients were used as validation set, and 10 patients were reserved as test set for final evaluation.</div></div><div><h3>Results</h3><div>We demonstrated that the deliverable plans generated through subsequent MCT dose mimicking exhibited greater robustness than the robust plans produced by the PCT, as well as enhanced dose sparing for organs at risk. MCT plans had lower D_2% (76.1 Gy vs. 82.4 Gy), better homogeneity index (7.7% vs. 16.4%) of CTV1 and better conformity index (70.5% vs. 61.5%) of CTV2 than the robust plans produced by the primary planning CT for all test patients.</div></div><div><h3>Conclusions</h3><div>We demonstrated the feasibility and advantages of incorporating daily CBCT images into MCT optimization. This approach improves plan robustness against anatomical changes and may reduce the need for plan adaptations in head and neck cancer treatments.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110650"},"PeriodicalIF":4.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deglutition preservation after swallowing (SWOARs)-sparing IMRT in head and neck cancers: definitive results of a multicenter prospective study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO).","authors":"Stefano Ursino, Giulia Malfatti, Francesca De Felice, Pierluigi Bonomo, Isacco Desideri, Pierfrancesco Franco, Francesca Arcadipane, Caterina Colosimo, Rosario Mazzola, Marta Maddalo, Riccardo Morganti, Giacomo Fiacchini, Salvatore Coscarelli, Maurizio Bartolucci, Marco De Vincentis, Diletta Angeletti, Franca De Biase, Elsa Juliani, Fabio Di Martino, Alessia Giuliano, Daniela Musio, Fabiola Paiar","doi":"10.1016/j.radonc.2024.110651","DOIUrl":"10.1016/j.radonc.2024.110651","url":null,"abstract":"<p><strong>Background: </strong>To investigate changes of objective instrumental measures and correlate with patient reported outcomes (PROs) of radiation-induced dysphagia (RID) after swallowing organs at risk (SWOARs)-sparing IMRT.</p><p><strong>Methods: </strong>Patients (pts) underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Videofluoroscopy (VFS) and M.D. Anderson Dysphagia Inventory (MDADI) questionnaire at baseline, 6 and 12 months after treatment. They were categorized in two groups: MDADI-C ≥ 80 and MDADI-C < 80. Pharyngeal residue (PR) and penetration (P) or aspiration (A) were considered as surrogate of RID.</p><p><strong>Results: </strong>Between 2016 and 2022 we enrolled 75 pts, 40 (53 %) MDADI-C ≥ 80 and 35 (47 %) MDADI-C < 80 at baseline. Among MDADI-C ≥ 80 the mean baseline PR score at FEES was 0,42 rising to 1,36 at 6 months (p = 0,001) and stabilizing to 1,15 at 12 months (p = 0,21); indeed, the mean baseline PR score at VFS was 0,55 rising to 1 at 6 months (p = 0,069) and slightly dropping to 0,7 at 12 months (p = 0,069). Among MDADI-C < 80 the mean baseline PR score at FEES was 0,56 rising to 1,07 at 6 months (p = 0,012) and stabilizing to 1,07 at 12 months (p = 0,99); indeed the mean baseline PR score at VFS was 0,67 rising to 1,19 at 6 months (p = 0,04) and dropping to 0,78 at 12 months (p = 0,04). No correlation was found between PROs and objective measures.</p><p><strong>Conclusion: </strong>Our results show optimal acceptable deglutition preservation from major complications after SWOARs-sparing IMRT by means of low objective scores in both MDADI-C groups. Lack of correlation between PROs and objective measures suggest that referred RID is likely associated to persistence of SWOARs inflammation rather than to a real impairment of function.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110651"},"PeriodicalIF":4.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}