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)
•Deglutition preservation after SWOARs-sparing IMRT.•Doubly clinical benefit of SWOARs-sparing IMRT on RT and Cancer-related dysphagia.•Lack of correlation between PROS and objective deglutition measures. To investigate changes of objective instrumental measures and correlate with patient reported o...
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| creator | Ursino, Stefano Malfatti, Giulia Felice, Francesca De Bonomo, Pierluigi Desideri, Isacco Franco, Pierfrancesco Arcadipane, Francesca Colosimo, Caterina Mazzola, Rosario Maddalo, Marta Morganti, Riccardo Fiacchini, Giacomo Coscarelli, Salvatore Bartolucci, Maurizio Vincentis, Marco De Angeletti, Diletta Biase, Franca De Juliani, Elsa Martino, Fabio Di Giuliano, Alessia Musio, Daniela Paiar, Fabiola |
| description | •Deglutition preservation after SWOARs-sparing IMRT.•Doubly clinical benefit of SWOARs-sparing IMRT on RT and Cancer-related dysphagia.•Lack of correlation between PROS and objective deglutition measures.
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.
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 |
| doi_str_mv | 10.1016/j.radonc.2024.110651 |
| format | Article |
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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.
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.
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.
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.</description><identifier>ISSN: 0167-8140</identifier><identifier>ISSN: 1879-0887</identifier><identifier>EISSN: 1879-0887</identifier><identifier>DOI: 10.1016/j.radonc.2024.110651</identifier><identifier>PMID: 39581350</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Deglutition ; Fiberoptic Endoscopic Evaluation of Swallowing ; Head and Neck cancer ; MDADI ; SWOARs-sparing Intensity and Modulated Radiotherapy ; Videofluoroscopy</subject><ispartof>Radiotherapy and oncology, 2025-02, Vol.203, p.110651, Article 110651</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><rights>Copyright © 2024. Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1921-895e4262980b4895cc262d6aaa186bfda790fbbec70214fa17fbf2bc9a130f383</cites><orcidid>0000-0001-8999-5208 ; 0000-0002-7381-078X ; 0000-0001-9832-4799 ; 0000-0003-3018-2338 ; 0000-0003-4820-8006</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.radonc.2024.110651$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39581350$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ursino, Stefano</creatorcontrib><creatorcontrib>Malfatti, Giulia</creatorcontrib><creatorcontrib>Felice, Francesca De</creatorcontrib><creatorcontrib>Bonomo, Pierluigi</creatorcontrib><creatorcontrib>Desideri, Isacco</creatorcontrib><creatorcontrib>Franco, Pierfrancesco</creatorcontrib><creatorcontrib>Arcadipane, Francesca</creatorcontrib><creatorcontrib>Colosimo, Caterina</creatorcontrib><creatorcontrib>Mazzola, Rosario</creatorcontrib><creatorcontrib>Maddalo, Marta</creatorcontrib><creatorcontrib>Morganti, Riccardo</creatorcontrib><creatorcontrib>Fiacchini, Giacomo</creatorcontrib><creatorcontrib>Coscarelli, Salvatore</creatorcontrib><creatorcontrib>Bartolucci, Maurizio</creatorcontrib><creatorcontrib>Vincentis, Marco De</creatorcontrib><creatorcontrib>Angeletti, Diletta</creatorcontrib><creatorcontrib>Biase, Franca De</creatorcontrib><creatorcontrib>Juliani, Elsa</creatorcontrib><creatorcontrib>Martino, Fabio Di</creatorcontrib><creatorcontrib>Giuliano, Alessia</creatorcontrib><creatorcontrib>Musio, Daniela</creatorcontrib><creatorcontrib>Paiar, Fabiola</creatorcontrib><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)</title><title>Radiotherapy and oncology</title><addtitle>Radiother Oncol</addtitle><description>•Deglutition preservation after SWOARs-sparing IMRT.•Doubly clinical benefit of SWOARs-sparing IMRT on RT and Cancer-related dysphagia.•Lack of correlation between PROS and objective deglutition measures.
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.
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.
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.
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.</description><subject>Deglutition</subject><subject>Fiberoptic Endoscopic Evaluation of Swallowing</subject><subject>Head and Neck cancer</subject><subject>MDADI</subject><subject>SWOARs-sparing Intensity and Modulated Radiotherapy</subject><subject>Videofluoroscopy</subject><issn>0167-8140</issn><issn>1879-0887</issn><issn>1879-0887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNp9kc2O0zAUhSMEYsrAGyDkZWeRYidpflggVeWv0qBKZRBL68a-7ri4drCTjvqkvA5OM7BkZV_fz-f4-iTJa0YXjLLy7WHhQTorFhnNigVjtFyyJ8mM1VWT0rquniaziFVpzQp6lbwI4UApzWhePU-u8mZZs3xJZ8nvD7g3Q6977SzpPAb0J7gUoHr0JDyAMe5B2z2Zf_uxXe3CTRo68OPB5uvujmhL7hEkASuJRfGTCLACfXhHJCpto_AJSdQdTB-IUwTIMW61QDvKd96FDsUFCv0gzyPS3yPZ9GA0WLIKwQk9vSi2diC1i30P3fliuTbRQ4AhWyuccfszma82u-3Ny-SZAhPw1eN6nXz_9PFu_SW93X7erFe3qWBNxtK6WWKRlVlT07aIhRCxkCUAsLpslYSqoaptUVQ0Y4UCVqlWZa1ogOVU5XV-ncwn3TjJrwFDz486CDQGLLoh8JzlWUnrguYRLSZUxKGDR8U7r4_gz5xRPkbKD3yKlI-R8inSeO3No8PQHlH-u_Q3wwi8nwCMc540eh6ExhiC1D5-LZdO_9_hDyRWuAI</recordid><startdate>20250201</startdate><enddate>20250201</enddate><creator>Ursino, Stefano</creator><creator>Malfatti, Giulia</creator><creator>Felice, Francesca De</creator><creator>Bonomo, Pierluigi</creator><creator>Desideri, Isacco</creator><creator>Franco, Pierfrancesco</creator><creator>Arcadipane, Francesca</creator><creator>Colosimo, Caterina</creator><creator>Mazzola, Rosario</creator><creator>Maddalo, Marta</creator><creator>Morganti, Riccardo</creator><creator>Fiacchini, Giacomo</creator><creator>Coscarelli, Salvatore</creator><creator>Bartolucci, Maurizio</creator><creator>Vincentis, Marco De</creator><creator>Angeletti, Diletta</creator><creator>Biase, Franca De</creator><creator>Juliani, Elsa</creator><creator>Martino, Fabio Di</creator><creator>Giuliano, Alessia</creator><creator>Musio, Daniela</creator><creator>Paiar, Fabiola</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8999-5208</orcidid><orcidid>https://orcid.org/0000-0002-7381-078X</orcidid><orcidid>https://orcid.org/0000-0001-9832-4799</orcidid><orcidid>https://orcid.org/0000-0003-3018-2338</orcidid><orcidid>https://orcid.org/0000-0003-4820-8006</orcidid></search><sort><creationdate>20250201</creationdate><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)</title><author>Ursino, Stefano ; Malfatti, Giulia ; Felice, Francesca De ; Bonomo, Pierluigi ; Desideri, Isacco ; Franco, Pierfrancesco ; Arcadipane, Francesca ; Colosimo, Caterina ; Mazzola, Rosario ; Maddalo, Marta ; Morganti, Riccardo ; Fiacchini, Giacomo ; Coscarelli, Salvatore ; Bartolucci, Maurizio ; Vincentis, Marco De ; Angeletti, Diletta ; Biase, Franca De ; Juliani, Elsa ; Martino, Fabio Di ; Giuliano, Alessia ; Musio, Daniela ; Paiar, Fabiola</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1921-895e4262980b4895cc262d6aaa186bfda790fbbec70214fa17fbf2bc9a130f383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Deglutition</topic><topic>Fiberoptic Endoscopic Evaluation of Swallowing</topic><topic>Head and Neck cancer</topic><topic>MDADI</topic><topic>SWOARs-sparing Intensity and Modulated Radiotherapy</topic><topic>Videofluoroscopy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ursino, Stefano</creatorcontrib><creatorcontrib>Malfatti, Giulia</creatorcontrib><creatorcontrib>Felice, Francesca De</creatorcontrib><creatorcontrib>Bonomo, Pierluigi</creatorcontrib><creatorcontrib>Desideri, Isacco</creatorcontrib><creatorcontrib>Franco, Pierfrancesco</creatorcontrib><creatorcontrib>Arcadipane, Francesca</creatorcontrib><creatorcontrib>Colosimo, Caterina</creatorcontrib><creatorcontrib>Mazzola, Rosario</creatorcontrib><creatorcontrib>Maddalo, Marta</creatorcontrib><creatorcontrib>Morganti, Riccardo</creatorcontrib><creatorcontrib>Fiacchini, Giacomo</creatorcontrib><creatorcontrib>Coscarelli, Salvatore</creatorcontrib><creatorcontrib>Bartolucci, Maurizio</creatorcontrib><creatorcontrib>Vincentis, Marco De</creatorcontrib><creatorcontrib>Angeletti, Diletta</creatorcontrib><creatorcontrib>Biase, Franca De</creatorcontrib><creatorcontrib>Juliani, Elsa</creatorcontrib><creatorcontrib>Martino, Fabio Di</creatorcontrib><creatorcontrib>Giuliano, Alessia</creatorcontrib><creatorcontrib>Musio, Daniela</creatorcontrib><creatorcontrib>Paiar, Fabiola</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Radiotherapy and oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ursino, Stefano</au><au>Malfatti, Giulia</au><au>Felice, Francesca De</au><au>Bonomo, Pierluigi</au><au>Desideri, Isacco</au><au>Franco, Pierfrancesco</au><au>Arcadipane, Francesca</au><au>Colosimo, Caterina</au><au>Mazzola, Rosario</au><au>Maddalo, Marta</au><au>Morganti, Riccardo</au><au>Fiacchini, Giacomo</au><au>Coscarelli, Salvatore</au><au>Bartolucci, Maurizio</au><au>Vincentis, Marco De</au><au>Angeletti, Diletta</au><au>Biase, Franca De</au><au>Juliani, Elsa</au><au>Martino, Fabio Di</au><au>Giuliano, Alessia</au><au>Musio, Daniela</au><au>Paiar, Fabiola</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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)</atitle><jtitle>Radiotherapy and oncology</jtitle><addtitle>Radiother Oncol</addtitle><date>2025-02-01</date><risdate>2025</risdate><volume>203</volume><spage>110651</spage><pages>110651-</pages><artnum>110651</artnum><issn>0167-8140</issn><issn>1879-0887</issn><eissn>1879-0887</eissn><abstract>•Deglutition preservation after SWOARs-sparing IMRT.•Doubly clinical benefit of SWOARs-sparing IMRT on RT and Cancer-related dysphagia.•Lack of correlation between PROS and objective deglutition measures.
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.
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.
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.
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.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>39581350</pmid><doi>10.1016/j.radonc.2024.110651</doi><orcidid>https://orcid.org/0000-0001-8999-5208</orcidid><orcidid>https://orcid.org/0000-0002-7381-078X</orcidid><orcidid>https://orcid.org/0000-0001-9832-4799</orcidid><orcidid>https://orcid.org/0000-0003-3018-2338</orcidid><orcidid>https://orcid.org/0000-0003-4820-8006</orcidid></addata></record> |
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| ispartof | Radiotherapy and oncology, 2025-02, Vol.203, p.110651, Article 110651 |
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| language | eng |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Deglutition Fiberoptic Endoscopic Evaluation of Swallowing Head and Neck cancer MDADI SWOARs-sparing Intensity and Modulated Radiotherapy Videofluoroscopy |
| 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) |
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