{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:50:10Z","timestamp":1791625810282,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["T32DC009401"],"award-info":[{"award-number":["T32DC009401"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with recurrent head and neck cancer (HNC) often present with severe, persistent dysphagia and xerostomia following prior chemoradiation. Although swallowing impairments and salivary dysfunction have been reported in this population, prior longitudinal studies have not examined changes in salivary composition or how these changes relate to swallowing physiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study characterized longitudinal changes in swallowing and salivary function\u2014including composition\u2014following treatment with CLR 131, a novel tumor\u2010selective radiotherapeutic, combined with external beam radiation therapy (EBRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twelve patients with locoregionally recurrent HNC demonstrating CLR 131 uptake on SPECT\/CT imaging were enrolled. Videofluoroscopic swallowing (VFS) studies and stimulated saliva collections were performed at baseline, 3, 6, and 12\u2009months posttreatment. Outcomes included Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scores, swallowing temporal measures, patient\u2010reported dysphagia using Eating Assessment Tool (EAT\u201010), and salivary flow rate, pH, and extensional viscosity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, participants demonstrated significantly worse swallowing and salivary function than published normative data (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Most swallowing measures remained stable following treatment; however, time to laryngeal vestibule closure with 5\u2009mL pudding was prolonged at 3\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.02). Stimulated salivary flow rate declined significantly at 12\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while pH decreased at 3\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and extensional viscosity increased at 6\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.02). From baseline to 3\u2009months, EAT\u201010 scores were strongly associated with salivary pH and viscosity changes (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.84 and \u22120.99, respectively). No swallowing timing measures predicted DIGEST safety or efficiency grades.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that CLR 131\u2009+\u2009EBRT did not exacerbate objective swallowing impairment in the early post\u2010treatment period, but patient\u2010reported dysphagia was sensitive to post\u2010treatment salivary alterations. Integrating salivary assessments with instrumental and patient\u2010reported outcomes may enhance detection of functional toxicity and guide targeted dysphagia management in recurrent HNC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70309","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T06:05:16Z","timestamp":1778911516000},"page":"3032-3042","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Swallowing and Salivary Changes With\n                    <scp>CLR<\/scp>\n                    131 and Re\u2010Irradiation in Recurrent Head and Neck Cancer"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0868-2188","authenticated-orcid":false,"given":"Jenni","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Communication Sciences and Disorders University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Department of Medicine School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital  Madison Wisconsin USA"},{"name":"Center for Health Disparities Research, University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Gustafson","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Department of Medicine School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital  Madison Wisconsin USA"},{"name":"Center for Health Disparities Research, University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Hyun","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Alexandridis","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Nicosia","sequence":"additional","affiliation":[{"name":"Widener University  Chester Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"McCulloch","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Bruce","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical Oncology, and Palliative Care University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Kimple","sequence":"additional","affiliation":[{"name":"Department of Human Oncology University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Rogus\u2010Pulia","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Department of Medicine School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Geriatric Research Education and Clinical Center, William S. 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