{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:46:04Z","timestamp":1791852364036,"version":"4.3.4"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dysphagia"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To prospectively investigate changes in M.D. Anderson Dysphagia Inventory (MDADI) scores in patients affected by naso- and oropharynx cancer after definitive radiochemotherapy (ChemoRT) using swallowing organs at risk (SWOARs)-sparing IMRT.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>MDADI questionnaires were collected at baseline and at 6 and 12\u00a0months after treatment. MDADI scores were categorized as follows:\u2009\u2265\u200980 \u201coptimal,\u201d 80\u201360 \u201cadequate,\u201d\u2009&lt;\u200960 \u201cpoor\u201d deglutition-related quality of life (QoL) group, and dichotomized as \u201coptimal\u201d vs \u201cadequate\/poor\u201d for the analysis. A mean MDADI composite (MDADI-C) change of 10 points was considered as minimal clinically important difference (MCID).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Sixty-three patients were enrolled of which 47 were considered for the analysis. At baseline, 26 (55%) were \u201coptimal\u201d and 21 (45%) were \u201cadequate\/poor.\u201d The mean baseline MDADI-C score was 93.6 dropping to 81 at 6\u00a0months (<jats:italic>p<\/jats:italic>\u2009=\u20090.013) and slightly rising to 85.5 at 12\u00a0months (<jats:italic>p<\/jats:italic>\u2009=\u20090.321) for the \u201coptimal\u201d group. Indeed, the mean baseline MDADI-C score was 64.3 rising to 77.5 at 6\u00a0months (<jats:italic>p<\/jats:italic>\u2009=\u20090.006) and stabilizing at 76 at 12\u00a0months (<jats:italic>p<\/jats:italic>\u2009=\u20090.999) for the \u201cadequate\/poor\u201d group. A statistically significant but not clinically relevant worsening of the MDADI-C score was reported for the \u201coptimal\u201d group, whereas both a statistically significant and clinically meaningful improvement of the MDADI-C score were reported for the \u201cadequate\/poor\u201d group from before to post-treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our results suggest a doubly clinical benefit of dose optimization to SWOARs to minimize the RT sequalae in patients with a baseline \u201coptimal\u201d deglutition-related QoL and to recover from cancer dysphagia in those with a baseline \u201cadequate\/poor\u201d deglutition-related QoL.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00455-022-10434-4","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T11:24:38Z","timestamp":1652959478000},"page":"159-170","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-2338","authenticated-orcid":false,"given":"Stefano","family":"Ursino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Calistri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"De Felice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Bonomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isacco","family":"Desideri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierfrancesco","family":"Franco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Arcadipane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Colosimo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Mazzola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Maddalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Gonnelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Malfatti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Morganti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Musio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Paiar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"issue":"1","key":"10434_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21590","volume":"70","author":"RL Siegel","year":"2020","unstructured":"Siegel RL, Miller KD, Jemal A. Cancer statistics. Am Cancer Soc. 2020;70(1):7\u201330. https:\/\/doi.org\/10.3322\/caac.21590.","journal-title":"Am Cancer Soc"},{"key":"10434_CR2","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1016\/S01406736(05)73666-7","volume":"355","author":"JP Pignon","year":"2000","unstructured":"Pignon JP, Bourhis J, Domenge C, Design\u00e8 L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-analysis of chemotherapy on head and neck cancer. Lancet Lond Engl. 2000;355:949\u201355. https:\/\/doi.org\/10.1016\/S01406736(05)73666-7.","journal-title":"Lancet Lond Engl"},{"key":"10434_CR3","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1177\/0194599811414506","volume":"145","author":"JA Wilson","year":"2011","unstructured":"Wilson JA, Carding PN, Patterson JM. Dysphagia after non-surgical head and neck cancer treatment: patients\u2019 perspectives. Head Neck Surg. 2011;145:767\u201371. https:\/\/doi.org\/10.1177\/0194599811414506.","journal-title":"Head Neck Surg"},{"key":"10434_CR4","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1002\/hed.20250","volume":"27","author":"SJ Lovell","year":"2005","unstructured":"Lovell SJ, Wong HB, Loh KS, Raymond YSN, Wilson JA. Impact of dysphagia on quality-of-life in nasopharyngeal carcinoma. Head Neck. 2005;27:864\u201372. https:\/\/doi.org\/10.1002\/hed.20250.","journal-title":"Head Neck"},{"key":"10434_CR5","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1016\/j.ijrobp.2004.06.017","volume":"61","author":"NP Nguyen","year":"2005","unstructured":"Nguyen NP, Frank C, Moltz CC, Vos P, Smith HJ, Karlsson U, Dutta S, Mydyett A, Barloon J, Sallah S. Impact of dysphagia on quality of life after treatment of head and neck cancer. Int J Rad Oncol Biol Phys. 2005;61:772\u20138. https:\/\/doi.org\/10.1016\/j.ijrobp.2004.06.017.","journal-title":"Int J Rad Oncol Biol Phys"},{"key":"10434_CR6","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1016\/j.ijrobp.2009.05.049","volume":"77","author":"I Gluck","year":"2010","unstructured":"Gluck I, Feng FY, Lyden T, Haxer M, Worden F, Chepeha DB, Eisbruch A. Evaluating and reporting dysphagia in trials of chemoirradiation for head-and neck cancer. Int J Radiat Oncol Biol Phys. 2010;77:727\u201333. https:\/\/doi.org\/10.1016\/j.ijrobp.2009.05.049.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10434_CR7","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1007\/s00520-011-1342-2","volume":"20","author":"JA Raber-Durlacher","year":"2012","unstructured":"Raber-Durlacher JA, Brennan MT, Verdonck-de Leeuw IM, Gibson RK, Eilers JG, Sewnaik A, Bensadoun RJ, Fliedner MC, Silverman S, Spijkervet FKL. Swallowing dysfunction in cancer patients. Support Cancer Care. 2012;20:433\u201343. https:\/\/doi.org\/10.1007\/s00520-011-1342-2.","journal-title":"Support Cancer Care"},{"key":"10434_CR8","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1200\/JCO.2006.06.0079","volume":"24","author":"DI Rosenthal","year":"2006","unstructured":"Rosenthal DI, Lewin JS, Eisbruch A. Prevention and treatment of dysphagia and aspiration after chemoradiation for head and neck cancer. J Clin Oncol. 2006;24:2636\u201343. https:\/\/doi.org\/10.1200\/JCO.2006.06.0079.","journal-title":"J Clin Oncol"},{"key":"10434_CR9","first-page":"870","volume":"127","author":"AY Chen","year":"2001","unstructured":"Chen AY, Frankowsky R, Bishop-Leone J, Hebert T, Leyk S, Lewin J, Goepfert H. The development and validation of a dysphagia specific quality of life questionnaire for patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 2001;127:870\u20136.","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"10434_CR10","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1002\/hed.23306","volume":"36","author":"JM Patterson","year":"2014","unstructured":"Patterson JM, McColl E, Carding PN, Hildreth AJ, Kelly C, Wilson JA. Swallowing in the first year after chemoradiotherapy for head and neck cancer: clinician-and patient-reported outcomes. Head Neck. 2014;36:352\u20138. https:\/\/doi.org\/10.1002\/hed.23306.","journal-title":"Head Neck"},{"key":"10434_CR11","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1007\/s00455-011-9333-5","volume":"27","author":"B Cartmill","year":"2012","unstructured":"Cartmill B, Cornwell P, Ward E, Davidson W, Porceddu S. A prospective investigation of swallowing, nutrition, and patient-rated functional impact following altered fractionation radiotherapy with concomitant boost for oropharyngeal cancer. Dysphagia. 2012;27:32\u201345. https:\/\/doi.org\/10.1007\/s00455-011-9333-5.","journal-title":"Dysphagia"},{"key":"10434_CR12","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s00455-014-9519-8","volume":"29","author":"CL Lazarus","year":"2014","unstructured":"Lazarus CL, Husaini H, Hu K, Culliney B, Li Z, Urken M, Kacobson A, Persky M, Tran T, Concer C, Palacios C, Metcalfe-Klaw R, Kumar M, Bennet B, Harrison L. Functional outcomes and quality of life after chemoradiotherapy: baseline and 3 and 6 months post-treatment. Dysphagia. 2014;29:365\u201375. https:\/\/doi.org\/10.1007\/s00455-014-9519-8.","journal-title":"Dysphagia"},{"key":"10434_CR13","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1002\/lary.26153","volume":"127","author":"RP Goepfert","year":"2016","unstructured":"Goepfert RP, Lewin JS, Barrow MP, Fuller CD, Lai SY, Song J, Hobbs BH, Brandon Gunn G, Beadle BM, Rosenthal DI, Garden AS, Merill SK, Papadimitrakopoulou VA, Schwartz DL, Hutcheson KA. Predicting two-year longitudinal MD Anderson Dysphagia Inventory outcomes after intensity modulated radiotherapy for locoregionally advanced oropharyngeal carcinoma. Laryngoscope. 2016;127:842\u20138. https:\/\/doi.org\/10.1002\/lary.26153.","journal-title":"Laryngoscope"},{"key":"10434_CR14","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1016\/j.ijrobp.2009.10.002","volume":"78","author":"DL Schwartz","year":"2010","unstructured":"Schwartz DL, Hutcheson K, Barringer D, Tucker SL, Kies M, Holsinger FC, Ang KK, Morrison HM, Rosenthal DI, Garden AS, Dong L, Lewin JS. Candidate dosimetric predictors of long-term swallowing dysfunction following oropharyngeal IMRT. Int J Radiat Oncol Biol Phys. 2010;78:1356\u201365. https:\/\/doi.org\/10.1016\/j.ijrobp.2009.10.002.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10434_CR15","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1007\/s00455-018-9913-8","volume":"34","author":"E Orlandi","year":"2019","unstructured":"Orlandi E, Miceli R, Infante G, Mirabile A, Alterio D, Cossu Rocca M, Denaro N, Vigna-Taglianti R, Merlotti A, Schindler A, Pizzorni N, Fallai C, Licitra L, Bossi P. Predictors of patient-reported dysphagia following IMRT plus chemotherapy in oropharyngeal cancer. Dysphagia. 2019;34:52\u201362. https:\/\/doi.org\/10.1007\/s00455-018-9913-8.","journal-title":"Dysphagia"},{"key":"10434_CR16","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/s00066-017-1160-7","volume":"193","author":"S Ursino","year":"2017","unstructured":"Ursino S, D\u2019Angelo E, Mazzola R, Merlotti A, Morganti R, Cristauda A, Paiar F, Musio D, Alterio D, Bacigalupo A, Russi EG, Lohr F. A comparison of swallowing dysfunction after three-dimensional conformal and intensity-modulated radiotherapy: a systematic review by the Italian head and neck radiotherapy study group. Strahlenther Onkol. 2017;193:877\u201389. https:\/\/doi.org\/10.1007\/s00066-017-1160-7.","journal-title":"Strahlenther Onkol"},{"key":"10434_CR17","doi-asserted-by":"publisher","first-page":"e93","DOI":"10.1016\/j.ijrobp.2010.12.067","volume":"8","author":"A Eisbruch","year":"2011","unstructured":"Eisbruch A, Hyungjin MK, Feng FY, Lyden TH, Haxer MJ, Feng M, Worden FP, Bradford CR, Prince ME, Moyer JS, Wolf GT, Chepeha DB, Haken RKT. Chemo-IMRT of oropharymgeal cancer aiming to reduce dysphagia: swallowing organs late complication probabilities and dosimetric correlates. Int J Radiat Oncol Biol Phys. 2011;8:e93\u20139. https:\/\/doi.org\/10.1016\/j.ijrobp.2010.12.067.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10434_CR18","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.radonc.2015.11.009","volume":"118","author":"M Christianen","year":"2016","unstructured":"Christianen M, Van der Schaaf A, Van der Laan H, Verdonck-de Leeuw I, Doornaert P, Chouvalova O, Steenbakkers RJHM, Leemas CR, Osting SF, Van Der Laan BFAM, Roodenburg JLN, Slotman BJ, Bijl H, Langendijk JA. Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: clinical validation according to the model-based approach. Radiother Oncol. 2016;118:298\u2013303. https:\/\/doi.org\/10.1016\/j.radonc.2015.11.009.","journal-title":"Radiother Oncol"},{"issue":"9","key":"10434_CR19","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1186\/s13014-014-0264-9","volume":"29","author":"A Merlotti","year":"2014","unstructured":"Merlotti A, Alterio D, Vigna Taglianti R, Muraglia A, Lastrucci L, Manzo R, Gambaro G, Caspiani O, Miccich\u00e8 F, Deodato F, Pergolizzi S, Franco P, Corv\u00f2 R, Russi EG, Sanguineti G. Technical guidelines for head and neck cancer on behalf of the Italian association of radiation oncology-head and neck working group. Radiat Oncol. 2014;29(9):264. https:\/\/doi.org\/10.1186\/s13014-014-0264-9.","journal-title":"Radiat Oncol"},{"key":"10434_CR20","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.radonc.2011.05.015","volume":"101","author":"Christianen ME, Langendijk JA, Westerlaan HE, VanDerWater TA, Bijl HP","year":"2011","unstructured":"Christianen ME, Langendijk JA, Westerlaan HE, VanDerWater TA, Bijl HP. Delineation of organs at risk involved in swallowing for radiotherapy treatment planning. Radiother Oncol. 2011;101:394\u2013402. https:\/\/doi.org\/10.1016\/j.radonc.2011.05.015.","journal-title":"Radiother Oncol"},{"key":"10434_CR21","first-page":"97","volume":"129","author":"A Schindler","year":"2008","unstructured":"Schindler A, Borghi E, Tiddia C, Ginocchio D, Felisati G, Ottaviani F. Adaptation and validation of the Italian MD Anderson dysphagia inventory (MDADI). Rev Laryngol Otol Rhinol. 2008;129:97\u2013100.","journal-title":"Rev Laryngol Otol Rhinol"},{"key":"10434_CR22","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1002\/lary.25778","volume":"126","author":"KA Hutcheson","year":"2016","unstructured":"Hutcheson KA, Portwood M, Lisec A, Barringer DA, Gries K, Lewin JS. What is a clinically relevant difference in MDADI scores between groups of head and neck cancer patients? Laryngoscope. 2016;126:1108\u201313. https:\/\/doi.org\/10.1002\/lary.25778.","journal-title":"Laryngoscope"},{"key":"10434_CR23","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s00455-014-9519-8","volume":"29","author":"CL Lazarus","year":"2014","unstructured":"Lazarus CL, Husaini H, Hu K, Culliney B, Li Z, Urken M, Jacobson A, Persky M, Tran T, Concert C, Palacios D, Metcalfe-Klaw R, Kumar M, Bennet B, Harrison L. Functional outcomes and quality of life after chemoradiotherapy: baseline and 3 and 6 months post-treatment. Dysphagia. 2014;29:365\u201375. https:\/\/doi.org\/10.1007\/s00455-014-9519-8.","journal-title":"Dysphagia"},{"key":"10434_CR24","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1016\/j.ijrobp.2009.10.002","volume":"78","author":"DL Schwartz","year":"2010","unstructured":"Schwartz DL, Hutcheson K, Barringer D, Tucker SL, Kies M, Holsinger FC, Ang KK, Morrison WH, Rosenthal DI, Garden AS, Dong L, Lewin JS. Candidate dosimetric predictors of longterm swallowing dysfunction following oropharyngeal IMRT. Int J Radiat Oncol Biol Phys. 2010;78:1356\u201365. https:\/\/doi.org\/10.1016\/j.ijrobp.2009.10.002.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10434_CR25","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1007\/s00520-020-05628-1","volume":"29","author":"N Jovanovic","year":"2021","unstructured":"Jovanovic N, Dreyer C, Hawkins S, Thouless K, Palma D, Doyle PC, Theurer JA. The natural history of weight and swallowing outcomes in oropharyngeal cancer patients following radiation or concurrent chemoradiation therapy. Support Care Cancer. 2021;29:1597\u2013607.","journal-title":"Support Care Cancer"},{"key":"10434_CR26","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/j.oraloncology.2014.09.009","volume":"50","author":"JWG Roe","year":"2014","unstructured":"Roe JWG, Drinnan MJ, Carding PN, Harrington KJ, Nutting CM. Patient-reported outcomes following parotid-sparing intensity-modulated radiotherapy for head and neck cancer. How important is dysphagia? Oral Oncol. 2014;50:1182\u20137.","journal-title":"Oral Oncol"},{"key":"10434_CR27","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.radonc.2020.04.021","volume":"148","author":"SR Grant","year":"2020","unstructured":"Grant SR, Hutcheson KA, Ye R, Garden AS, Morrison WH, Rosenthal DI, Gunn GB, Fuller CD, Phan J, Reddy JP, Moreno AC, Lewin JS, Sturgis EM, Ferrarotto R, Frank SJ. Prospective longitudinal patient-reported outcomes of swallowing following intensity modulated proton therapy for oropharyngeal cancer. Radiother Oncol. 2020;148:133\u20139.","journal-title":"Radiother Oncol"},{"key":"10434_CR28","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/s00066-020-01697-7","volume":"197","author":"S Ursino","year":"2021","unstructured":"Ursino S, Giuliano A, DiMartino F, Cocuzza P, Molinari A, Stefanelli A, Giusti P, Aringhieri G, Morganti R, Neri E, Traino C, Paiar F. Incorporating dose\u2013volume histogram parameters of swallowing organs at risk in a videofluoroscopy-based predictive model of radiation-induced dysphagia after head and neck cancer intensity-modulated radiation therapy. Strahlenther Onkol. 2021;197:209\u201318. https:\/\/doi.org\/10.1007\/s00066-020-01697-7.","journal-title":"Strahlenther Onkol"},{"key":"10434_CR29","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s00455-016-9710-1","volume":"31","author":"SN King","year":"2016","unstructured":"King SN, Dunlap NE, Tennant PA, Pitts T. Pathophysiology of radiation-induced dysphagia in head and neck cancer. Dysphagia. 2016;31:339\u201351. https:\/\/doi.org\/10.1007\/s00455-016-9710-1.","journal-title":"Dysphagia"},{"key":"10434_CR30","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.ijrobp.2011.06.1954","volume":"83","author":"G Carnaby-Mann","year":"2012","unstructured":"Carnaby-Mann G, Crary MA, Schmalfuss I, Amdur R. \u201cPharyngocise\u201d: randomized controlled trial of preventative exercises to maintain muscle structure and swallowing function during head-and neck chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2012;83:210\u20139. https:\/\/doi.org\/10.1016\/j.ijrobp.2011.06.1954.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10434_CR31","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1001\/jamoto.2013.4715","volume":"139","author":"KA Hutcheson","year":"2013","unstructured":"Hutcheson KA, Bhayani MK, Beadle BM, Gold KA, Shinn EH, Lai SY, Lewin J. Eat and exercise during radiotherapy or chemoradiotherapy for pharyngeal cancers: use it or lose it. JAMA Otolaryngol Head Neck Surg. 2013;139:1127\u201334. https:\/\/doi.org\/10.1001\/jamoto.2013.4715.","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"10434_CR32","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.oraloncology.2017.12.021","volume":"77","author":"F De Felice","year":"2018","unstructured":"De Felice F, DeVincentiis M, Luzzi V, Magliulo G, Tombolini M, Ruoppolo G, Polimeni A. Late radiation-associated dysphagia in head and neck cancer patients: evidence, research and management. Oral Oncol. 2018;77:125\u201330. https:\/\/doi.org\/10.1016\/j.oraloncology.2017.12.021.","journal-title":"Oral Oncol"},{"key":"10434_CR33","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1016\/j.critrevonc.2015.06.005","volume":"96","author":"A Schindler","year":"2015","unstructured":"Schindler A, Denaro N, Russi EG, Pizzorni N, Bossi P, Merlotti A, Spadola Bissetti M, Numico G, Gava A, Orlandi E, Caspiani O, Buglione M, Alterio D, Bacigalupo A, De Sanctis V, Pavanato G, Ripamonti C, Merlano M, Licitra L, Sanguineti G, Langendijk JA, Murphy B. Dysphagia in head and neck cancer patients treated with radiotherapy and systemic therapies: literature review and consensus. Crit Rev Oncol Hematol. 2015;96:372\u201384. https:\/\/doi.org\/10.1016\/j.critrevonc.2015.06.005.","journal-title":"Crit Rev Oncol Hematol"},{"key":"10434_CR34","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1080\/02841860701491041","volume":"46","author":"K Jensen","year":"2007","unstructured":"Jensen K, Lambertsen K, Torkov P, Dahl M, Jensen AB, Grau C. Patient assessed symptoms are poor predictors of objective findings. Results from a cross sectional study in patients treated with radiotherapy for pharyngeal cancer. Acta Oncol. 2007;46:1159\u201368. https:\/\/doi.org\/10.1080\/02841860701491041.","journal-title":"Acta Oncol"}],"container-title":["Dysphagia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00455-022-10434-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00455-022-10434-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00455-022-10434-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T17:08:43Z","timestamp":1674580123000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00455-022-10434-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,19]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10434"],"URL":"https:\/\/doi.org\/10.1007\/s00455-022-10434-4","relation":{},"ISSN":["0179-051X","1432-0460"],"issn-type":[{"value":"0179-051X","type":"print"},{"value":"1432-0460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,19]]},"assertion":[{"value":"7 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2022","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The Missing Open Access funding information has been added in the Funding Note.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Stefano Ursino received personal honoraria for presentations from Astra Zeneca and Nestl\u00e8 and support for attending meetings (including travels, hotel accommodation, and dinner) from Merck Serono and Kyowakirin. Fabiola Paiar received personal honoraria for presentations from Astra Zeneca, Nestl\u00e8, Merck Serono, Varian, and Kyowakirin and support for attending meetings (including travels, hotel accommodation, and dinner) from Merck Serono, Kyowakirin, Varian, Nestl\u00e8, and Astra Zeneca. Rosario Mazzola received personal honoraria for presentations from Astellas and Jansen. All other authors declared no competing financial interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Ethics Committee of the Coordinating Center (Protocol number 42380) and that of each participating center; all patients signed a study-specific informed consent form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}