{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:49:34Z","timestamp":1782103774383,"version":"3.54.5"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006190","name":"Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006190","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignancy originating from parafollicular C cells and often requires multimodal management, including surgery, targeted therapy, and radionuclide treatment. In elderly patients with MIBG-positive disease,\n                      <jats:sup>131<\/jats:sup>\n                      I-MIBG therapy remains clinically valuable but is frequently associated with mucosal injury and neuromuscular dysfunction, resulting in dysphagia and malnutrition. Conventional swallowing rehabilitation often provides limited benefit in this population, underscoring the need for individualized, technology-assisted approaches. This study evaluated the association between ultrasound-guided, nursing-led, phase-based swallowing rehabilitation and clinical outcomes in elderly patients with MIBG-positive MTC following\n                      <jats:sup>131<\/jats:sup>\n                      I-MIBG therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      This retrospective observational study analyzed 80 patients aged \u226565\u202fyears with post-therapy dysphagia (EAT-10\u202f\u2265\u202f3). Based on routine clinical practice, patients were categorized into a conventional rehabilitation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f40) and an ultrasound-guided rehabilitation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f40). Rehabilitation data over an eight-week period were analyzed. Outcomes included the Functional Oral Intake Scale (FOIS), MD Anderson Dysphagia Inventory (MDADI), EAT-10, ultrasound-derived suprahyoid muscle thickness and hyoid displacement, nutritional indices, aspiration events, and pneumonia-related readmissions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The ultrasound-guided rehabilitation group demonstrated significantly greater improvements in FOIS (+2.1\u202f\u00b1\u202f0.5 vs.\u202f+\u202f1.2\u202f\u00b1\u202f0.6;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), MDADI (+32% vs.\u202f+\u202f18%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and EAT-10 (\u22126.8\u202f\u00b1\u202f2.1 vs.\u202f\u2212\u202f3.4\u202f\u00b1\u202f1.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Ultrasound parameters showed marked increases in suprahyoid muscle thickness (+24%) and hyoid displacement (+19%). Compared with the conventional rehabilitation group, aspiration events decreased from 15 to 9%, and pneumonia-related readmissions declined from 15 to 5%. No rehabilitation-related adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Participation in ultrasound-guided, nursing-led, phase-based swallowing rehabilitation was associated with significant improvements in swallowing function, muscle performance, nutritional status, and quality of life in elderly patients with MIBG-positive MTC after\n                      <jats:sup>131<\/jats:sup>\n                      I-MIBG therapy. This approach appears safe, feasible, and scalable for geriatric oncology rehabilitation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1775946","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:33:28Z","timestamp":1782102808000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-guided, nursing-led, phase-based swallowing rehabilitation in elderly patients with MIBG-positive medullary thyroid carcinoma following 131I-MIBG therapy"],"prefix":"10.3389","volume":"13","author":[{"given":"Chunyan","family":"Hu","sequence":"first","affiliation":[{"name":"Center of Gerontology and Geriatrics, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1484815","DOI":"10.3389\/fendo.2024.1484815","article-title":"Unveiling new chapters in medullary thyroid carcinoma therapy: advances in molecular genetics and targeted treatment strategies","volume":"15","author":"Huai","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.3390\/jpm13071132","article-title":"Personalized medicine in medullary thyroid carcinoma: a broad review of emerging treatments","volume":"13","author":"Martins","year":"2023","journal-title":"J Pers Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"20420188251336091","DOI":"10.1177\/20420188251336091","article-title":"Systemic therapies for medullary thyroid carcinoma: state of the art","volume":"16","author":"Rom\u00e1n-Gonz\u00e1lez","year":"2025","journal-title":"Ther Adv Endocrinol Metab"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1187870","DOI":"10.3389\/fendo.2023.1187870","article-title":"Targeted radionuclide therapy in endocrine-related cancers: advances in the last decade","volume":"14","author":"Al-Toubah","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1007\/s40265-022-01675-6","article-title":"Pharmacologic management of persistent pain in cancer survivors","volume":"82","author":"Glare","year":"2022","journal-title":"Drugs"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"6823","DOI":"10.1080\/09638288.2025.2522790","article-title":"Effectiveness of swallowing rehabilitation exercises in older adults with swallowing disorders: a systematic review and network meta-analysis","volume":"47","author":"Chen","year":"2025","journal-title":"Disabil Rehabil"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"17","DOI":"10.24983\/scitemed.aohns.2025.00194","article-title":"Optimizing dysphagia management in head and neck cancer radiotherapy: advanced imaging, precision dosimetry, and rehabilitation","volume":"9","author":"Kundu","year":"2025","journal-title":"Arch Otorhinolaryngol Head Neck Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1007\/s00455-025-10824-4","article-title":"Effect of visual biofeedback using the Iowa oral performance instrument and auditory feedback on floor-of-the-mouth muscle activation and oral pressure during effortful swallowing in healthy older adults","volume":"40","author":"Sanjuan","year":"2025","journal-title":"Dysphagia."},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00455-025-10824-4","article-title":"Effect of visual biofeedback on floor-of-mouth muscle activation during effortful swallowing in older adults","volume":"40","author":"Oh","year":"2025","journal-title":"Dysphagia"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"708102","DOI":"10.3389\/fresc.2021.708102","article-title":"Emerging role of ultrasound in dysphagia assessment and intervention","volume":"2","author":"Hsiao","year":"2021","journal-title":"Front Rehabil Sci"},{"key":"ref11","first-page":"343","article-title":"Thyroid cancer survivorship: contemporary themes. 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