{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T01:42:37Z","timestamp":1794274957072,"version":"4.9.0"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We prospectively assessed acute and late toxicity in post\u2010operative oral cavity squamous cell carcinoma (PO\u2010OCSCC) treated with adjuvant dysphagia optimized intensity\u2010modulated radiotherapy (Do\u2010IMRT) versus standard IMRT (S\u2010IMRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Fifty\u2010six patients of PO\u2010SCC without indications of concurrent chemotherapy were alternatively allocated to adjuvant Do\u2010IMRT (<jats:italic>n<\/jats:italic>\u2009=\u200928) versus S\u2010IMRT (<jats:italic>n<\/jats:italic>\u2009=\u200928) arms. High\u2010 and low\u2010risk planning target volume received 60 and 54\u2009Gy, respectively, in 30 fractions over 6\u2009weeks. Dysphagia aspiration\u2010related structures (DARS) were contoured in both arms. While dosimetric constraints were given in Do\u2010IMRT arm, doses to DARS were only observed without dose constraints in S\u2010IMRT arm. Acute and late toxicity were assessed by common terminology criteria for adverse events (CTCAE) v5.0 and RTOG criteria, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The primary site of disease was buccal mucosa (64% vs. 53%) and oral tongue (21% vs. 32%), in Do\u2010IMRT and S\u2010IMRT, respectively. The mean doses to DARS was significantly less with Do\u2010IMRT (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) as compared to S\u2010IMRT. Median follow\u2010up was 24.2\u2009months. Grade \u22652 oral pain was less in the Do\u2010IMRT arm (50% vs. 78.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.05). Grade \u22652 late dysphagia at 2\u2009years were significantly less in Do\u2010IMRT arm (0% vs. 17.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.016). Two\u2010year locoregional control was 89.2% in Do\u2010IMRT and 78.5% in S\u2010IMRT (<jats:italic>p<\/jats:italic>\u2009=\u20090.261).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>DARS can be spared in PO\u2010OCSCC patients treated with Do\u2010IMRT without compromising coverage of the target volumes. Limiting doses to DARS leads to lesser acute and late toxicity without compromising locoregional control.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27541","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T03:27:55Z","timestamp":1697081275000},"page":"3119-3128","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Toxicities and clinical outcome of adjuvant dysphagia optimized versus standard intensity\u2010modulated radiotherapy for post\u2010operative oral cavity cancers: A prospective comparative study"],"prefix":"10.1002","volume":"45","author":[{"given":"Ayushi","family":"Patni","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhup","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5713-0963","authenticated-orcid":false,"given":"Ajeet Kumar","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vachaspati Kumar","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoop Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohini","family":"Khurana","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahat","family":"Hadi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shantanu","family":"Sapru","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surendra Prasad","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dr Ram Manohar Lohia Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Indian Council of Medical Research.National Centre for Disease Informatics and Research.https:\/\/www.ncdirindia.org\/. 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