{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:10:07Z","timestamp":1789153807671,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Dysphagia is a major toxicity of chemoradiation (CRT) for oropharyngeal squamous cell carcinoma (OPSCC). Elective upper\u2010neck irradiation (UNI), omitting the low neck, may reduce esophageal inlet muscle (EIM) dose and improve swallowing outcomes compared to elective whole\u2010neck irradiation (WNI). We compared swallowing outcomes after UNI versus WNI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective review from 2015 to 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed OPSCC patients treated with definitive CRT who underwent baseline and post\u2010treatment videofluoroscopic swallow studies (VFSSs). Outcomes included swallowing kinematics, functional VFSS measures, feeding tube placement, and recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010two patients with p16\u2010positive OPSCC were included: 28 (54%) UNI and 24 (46%) WNI. T and N stages were balanced between treatment groups. Supraglottic, glottic, and constrictor doses were similar between UNI and WNI. EIM dose was lower in UNI than WNI (29.8 vs 36.1\u2009Gy,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.011). UNI was associated with a lower incidence of feeding tube placement during\/after CRT than WNI (22% vs 57%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.00643) and reduced hazards of feeding tube placement at 1 year post\u2010CRT when adjusted for T\/N stage and EIM dose (hazard ratio [HR] 0.25,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.006). No differences were seen in the incidence of esophageal dilation, pneumonia, or recurrence. No disease relapse was observed in the omitted contralateral low neck.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>UNI was associated with reduced EIM dose and lower rates of feeding tube placement compared to WNI, without compromising disease control. In OPSCC patients requiring elective contralateral neck irradiation, omitting the contralateral low neck is a promising de\u2010escalation strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70429","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:39:41Z","timestamp":1789151981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Objective Swallowing Outcomes After Sparing Contralateral Low\u2010Neck Elective Radiotherapy in Oropharyngeal Carcinoma: Single\u2010Institution Clinical Experience"],"prefix":"10.1002","author":[{"given":"Rex H.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Honjo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Witztum","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick K.","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue S.","family":"Yom","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3152-1023","authenticated-orcid":false,"given":"Jason W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2025.110933","article-title":"Associations between dosimetry and patient\u2010reported outcomes in oropharyngeal cancer: post hoc analysis of elective neck de\u2010escalation trials","volume":"209","author":"Tuo A","year":"2025","journal-title":"Radiother Oncol"},{"issue":"8","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/S1470-2045(23)00265-6","article-title":"Dysphagia\u2010optimised intensity\u2010modulated radiotherapy versus standard intensity\u2010modulated radiotherapy in patients with head and neck cancer (DARS): a phase 3, multicentre, randomised, controlled trial","volume":"24","author":"Nutting C","year":"2023","journal-title":"Lancet 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laryngeal cancer","volume":"109","author":"Sher DJ","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejca.2017.05.035","article-title":"Elective unilateral nodal irradiation in head and neck squamous cell carcinoma: a paradigm shift","volume":"82","author":"Al\u2010Mamgani A","year":"2017","journal-title":"Eur J Cancer"},{"issue":"4","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/S1470-2045(22)00058-4","article-title":"Elective upper\u2010neck versus whole\u2010neck irradiation of the uninvolved neck in patients with nasopharyngeal carcinoma: an open\u2010label, non\u2010inferiority, multicentre, randomised phase 3 trial","volume":"23","author":"Tang L\u2010L","year":"2022","journal-title":"Lancet Oncol"},{"issue":"17","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"2021","DOI":"10.1200\/JCO.23.02086","article-title":"Reduced\u2010volume irradiation of uninvolved neck in patients with nasopharyngeal cancer: updated results from an open\u2010label, noninferiority, multicenter, randomized phase III trial","volume":"42","author":"Huang C\u2010L","year":"2024","journal-title":"J Clin Oncol"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2023.109860","article-title":"Efficacy and toxicities of elective upper\u2010neck irradiation versus whole\u2010neck irradiation of the uninvolved neck in patients with nasopharyngeal carcinoma: a meta\u2010analysis","volume":"188","author":"Ding X","year":"2023","journal-title":"Radiother Oncol"},{"issue":"3","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.radonc.2011.05.015","article-title":"Delineation of organs at risk involved in swallowing for radiotherapy treatment planning","volume":"101","author":"Christianen MEMC","year":"2011","journal-title":"Radiother 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