{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:52:23Z","timestamp":1782784343717,"version":"3.54.5"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010318","name":"University of Manitoba","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010318","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> The study objectives were: provide longitudinal data on upper aerodigestive tract function and late complications following IMRT for nasopharyngeal carcinoma, and elucidate factors that might predict a worse outcome. The hypotheses were: (1) Despite advances such as IMRT, radiation will cause significant functional decline and late complications that often progress or arise years after treatment. (2) Larger radiation volume will be associated with poorer outcomes. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Longitudinal, observational cohort study of nasopharyngeal carcinoma patients with retrospective analysis of prospectively collected, population-based data. Late sequelae and validated measures of overall performance, speech, and swallowing were documented pre-treatment and 3,6,12, 24, 36 and \u2265\u200960-months post-treatment. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Forty-two patients treated curatively with radiation (N\u2009=\u20099) or chemoradiation (N\u2009=\u200933) were followed for a median 74\u00a0months. Functional outcomes showed an initial nadir at 3\u00a0months associated with acute effects of treatment, followed by initial recovery. There was subsequent functional decline years post-treatment with advancing dysphagia\/aspiration, trismus, muscle spasm, and hypoglossal nerve palsy. Univariable regression analysis revealed that increasing high-dose radiation volumes (PTV 70\u00a0Gy) were associated with increased likelihood of less than solid diet (Performance Status Scale (PSS)\u2014Normalcy of Diet score\u2009&lt;\u200950; p\u2009=\u20090.04), and reduced PSS\u2014Understandability of Speech ( p\u2009=\u20090.005). The probability of poor outcome increased with time. Eleven percent of patients were tube feed dependent at \u2265\u20095\u00a0years. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Despite improvements in radiation delivery, late effects of radiation remain common. Higher radiation volumes are associated with poorer outcomes that worsen over time. <\/jats:p><\/jats:sec><jats:sec><jats:title>Graphical Abstract<\/jats:title><jats:p> <\/jats:p><\/jats:sec>","DOI":"10.1186\/s40463-022-00593-7","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T07:42:42Z","timestamp":1667893362000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Longitudinal functional outcomes and late effects of radiation following treatment of nasopharyngeal carcinoma: Secondary analysis of a prospective cohort study"],"prefix":"10.1177","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2281-5158","authenticated-orcid":false,"given":"Gia","family":"Gill","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Max Rady College of Medicine, University of Manitoba, GB421 - 820 Sherbrook Street, R3A 1R9, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciaran","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Max Rady College of Medicine, University of Manitoba, GB421 - 820 Sherbrook Street, R3A 1R9, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace","family":"Myers","sequence":"additional","affiliation":[{"name":"Speech Language Pathology, Department of Psychosocial Oncology, CancerCare Manitoba, Room ON1018, 675 McDermot Ave, R3E 0V9, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan D.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Max Rady College of Medicine, University of Manitoba, 750 Bannatyne Ave, R3E 0W2, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Lambert","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, CancerCare Manitoba, Room ON-2114, 675 McDermot Ave, R3E 0V9, Winnipeg, MB, Canada"},{"name":"CancerCare Research Institute, CancerCare Manitoba, CancerCare Manitoba Research Institute Office, 675 McDermot Ave, R4E 0V9, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Cooke","sequence":"additional","affiliation":[{"name":"Section of Radiation Oncology, Department of Radiology, Max Rady College of Medicine, University of Manitoba, Room GA216, 820 Sherbrook Street, R3T 2N2, Winnipeg, MB, Canada"},{"name":"Radiation Oncology, CancerCare Manitoba, 820 Sherbrook Street GA216, R3T 2N2, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Max Rady College of Medicine, University of Manitoba, GB421 - 820 Sherbrook Street, R3A 1R9, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,1,1]]},"reference":[{"key":"bibr1-s40463-022-00593-7","unstructured":"National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology. Head and Neck Cancer. Version 3.2021. Fort Washington (PA): National Comprehensive Cancer Network; 2021 Available from: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology. Melanoma. Version 2.2016. Fort Washington (PA): National Comprehensive Cancer Network; 2016 Available from"},{"key":"bibr2-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.2349\/biij.2.1.e19"},{"key":"bibr3-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-015-0068-4"},{"key":"bibr4-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2003\/065)"},{"key":"bibr5-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-007-0335-8"},{"key":"bibr6-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19840501)53:9<2002::AID-CNCR2820530933>3.0.CO;2-W"},{"key":"bibr7-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19900801)66:3<564::AID-CNCR2820660326>3.0.CO;2-D"},{"key":"bibr8-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19960601)77:11<2294::AID-CNCR17>3.0.CO;2-S"},{"key":"bibr9-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1179\/136132899805577051"},{"key":"bibr10-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200409000-00009"},{"key":"bibr11-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(20000501)88:9<2164::AID-CNCR24>3.0.CO;2-5"},{"key":"bibr12-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.5988"},{"key":"bibr13-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-40618-3"},{"key":"bibr14-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(02)00325-0"},{"key":"bibr15-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(02)00060-9"},{"key":"bibr16-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.04.014"},{"key":"bibr17-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(94)90312-3"},{"key":"bibr18-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.0079"},{"key":"bibr19-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.03.079"},{"key":"bibr20-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-015-1974-6"},{"key":"bibr21-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.05.013"},{"key":"bibr22-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-34803-y"},{"key":"bibr23-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701005"},{"key":"bibr24-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2016.02.001"},{"key":"bibr25-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25412"},{"key":"bibr26-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2019.05.009"},{"key":"bibr27-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2013.03.005"},{"key":"bibr28-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29207"},{"key":"bibr29-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2012.07.011"},{"key":"bibr30-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.05.022"},{"key":"bibr31-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.12.028"},{"key":"bibr32-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(02)02724-4"},{"key":"bibr33-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2012.10.012"},{"key":"bibr34-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1201\/b15450"},{"key":"bibr35-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1007\/s00066-011-0047-2"},{"key":"bibr36-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000171019.80351.46"},{"key":"bibr37-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1177\/154411130301400305"},{"key":"bibr38-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/17942449"},{"issue":"1","key":"bibr39-s40463-022-00593-7","first-page":"23","volume":"71","author":"Whitmyer CC","year":"1997","journal-title":"J Dent Hyg"},{"key":"bibr40-s40463-022-00593-7","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-007-0345-5"}],"container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1186\/s40463-022-00593-7","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40463-022-00593-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1186\/s40463-022-00593-7","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40463-022-00593-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1186\/s40463-022-00593-7","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T16:23:20Z","timestamp":1741623800000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1186\/s40463-022-00593-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1186\/s40463-022-00593-7"],"URL":"https:\/\/doi.org\/10.1186\/s40463-022-00593-7","relation":{},"ISSN":["1916-0216","1916-0216"],"issn-type":[{"value":"1916-0216","type":"print"},{"value":"1916-0216","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"article-number":"41"}}