{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:29:09Z","timestamp":1790314149279,"version":"4.1.0"},"reference-count":67,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004416","name":"Kom op tegen Kanker","doi-asserted-by":"publisher","award":["KOTK_KUL\/2020\/12167\/1"],"award-info":[{"award-number":["KOTK_KUL\/2020\/12167\/1"]}],"id":[{"id":"10.13039\/501100004416","id-type":"DOI","asserted-by":"publisher"}]},{"award":["KOTK_KUL\/2020\/12167\/1"],"award-info":[{"award-number":["KOTK_KUL\/2020\/12167\/1"]}],"id":[{"id":"https:\/\/ror.org\/05fsa3j22","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Post-radiation fibrosis is a common complication in patients with head and neck cancer (HNC), characterised by increased tissue stiffness and functional limitations. Shear wave elastography (SWE) enables objective assessment of tissue stiffness, while self-reported outcome measures provide insight into symptom burden. However, the longitudinal evolution of these outcomes and their relationship remains insufficiently described. This study aimed to characterise post-radiation fibrosis over time using objective SWE measurements of sternocleidomastoid (SCM) muscle stiffness and self-reported fibrosis-related symptoms, and to examine their longitudinal association. Methods: This prospective longitudinal study included 56 patients with HNC undergoing primary or postoperative (chemo)radiotherapy. Muscle stiffness was measured using SWE, and fibrosis-related symptoms were assessed with the Lymphoedema Symptom Intensity and Distress Survey-Head and Neck (LSIDS-H&amp;N) at 1 week, 6 weeks, 12 weeks, 6 months, and 12 months after the start of radiotherapy. Longitudinal analyses were performed using mixed-effects models adjusted for surgery and radiation dose, and within-subject associations were evaluated using repeated measures correlation. Results: Muscle stiffness increased over time, with estimated mean stiffness values rising from 4.12 m\/s at baseline to 4.76 m\/s at 6 months and 4.92 m\/s at 12 months. Significant increases were observed at 6 months (p = 0.007) and 12 months (p = 0.012) compared with baseline. In contrast, self-reported fibrosis-related symptoms remained stable, with no significant differences between time points. No significant within-subject association was found between muscle stiffness and self-reported fibrosis-related symptoms (r = \u22120.13, p = 0.498). Conclusions: Muscle stiffness measured with SWE increased over time following radiotherapy, whereas self-reported fibrosis-related symptoms remained stable. No significant longitudinal association was found between these outcomes, suggesting they may capture different aspects of fibrosis.<\/jats:p>","DOI":"10.3390\/cancers18121928","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:01:27Z","timestamp":1781492487000},"page":"1928","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Longitudinal Evaluation of Sternocleidomastoid Muscle Stiffness and Self-Reported Fibrosis-Related Symptoms After Radiotherapy in Patients with Head and Neck Cancer"],"prefix":"10.3390","volume":"18","author":[{"given":"Kaat","family":"Verbeelen","sequence":"first","affiliation":[{"name":"MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Antwerp, Belgium"},{"name":"Department of Rehabilitation Sciences, University of Leuven, 3000 Leuven, Belgium"},{"name":"CarEdOn Research Group, 3000 Leuven, Belgium"},{"name":"Pain in Motion International Research Group, 1000 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An","family":"De Groef","sequence":"additional","affiliation":[{"name":"MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Antwerp, Belgium"},{"name":"CarEdOn Research Group, 3000 Leuven, Belgium"},{"name":"Pain in Motion International Research Group, 1000 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5457-9922","authenticated-orcid":false,"given":"Kaat","family":"Van Aperen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, University of Leuven, 3000 Leuven, Belgium"},{"name":"CarEdOn Research Group, 3000 Leuven, Belgium"},{"name":"Laboratory of Experimental Radiotherapy, Department of Oncology, University of Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9204-8364","authenticated-orcid":false,"given":"Ceren","family":"Gursen","sequence":"additional","affiliation":[{"name":"MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Antwerp, Belgium"},{"name":"Department of Rehabilitation Sciences, University of Leuven, 3000 Leuven, Belgium"},{"name":"CarEdOn Research Group, 3000 Leuven, Belgium"},{"name":"Faculty of Rehabilitation Sciences, Hacettepe University, 06100 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5540-4796","authenticated-orcid":false,"given":"Sandra","family":"Nuyts","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Radiotherapy, Department of Oncology, University of Leuven, 3000 Leuven, Belgium"},{"name":"Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8117-7080","authenticated-orcid":false,"given":"Nele","family":"Devoogdt","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, University of Leuven, 3000 Leuven, Belgium"},{"name":"CarEdOn Research Group, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7170-3518","authenticated-orcid":false,"given":"Michel G. C. A. M.","family":"Mertens","sequence":"additional","affiliation":[{"name":"MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Antwerp, Belgium"},{"name":"CarEdOn Research Group, 3000 Leuven, Belgium"},{"name":"Pain in Motion International Research Group, 1000 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"c4684","DOI":"10.1136\/bmj.c4684","article-title":"Head and neck cancer\u2014Part 1: Epidemiology, presentation, and prevention","volume":"341","author":"Mehanna","year":"2010","journal-title":"Br. Med. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1001\/jamaoto.2022.0810","article-title":"Persistent Tobacco Use After Treatment for Head and Neck Cancer","volume":"148","author":"Rubin","year":"2022","journal-title":"JAMA Otolaryngol. 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