{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:42:44Z","timestamp":1784122964825,"version":"3.55.0"},"reference-count":88,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Patients with head and neck cancer (HNC) face a high risk of malnutrition and sarcopenia, often exacerbated by the toxicities of chemoradiotherapy, such as dysphagia, xerostomia, and mucositis. These Nutritional Impact Symptoms significantly compromise oral intake and negatively affect quality of life. This paper presents a conceptual framework designed to support clinicians in optimizing oral intake through personalized nutritional management. Central to this approach is the integration of systematic screening using MUST, the Malnutrition Universal Screening Tool (MUST), and the Nutritional Risk Screening 2002 (NRS-2002). Furthermore, functional assessment of swallowing via instrumental studies (VFSS\/FEES) is essential for tailoring dietary textures according to the International Dysphagia Diet Standardization Initiative framework. Key nutritional strategies include high-energy and high-protein oral fortification, the use of oral nutritional supplements, and specific dietary adjustments addressing pain management and sensory alterations. A multidisciplinary approach involving nutritionists, speech-language pathologists, and oncologists is paramount to transition from reactive symptom management to proactive \u201cadaptive nutrition,\u201d ultimately improving clinical outcomes and patient survival.<\/jats:p>","DOI":"10.3390\/nu18081180","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T08:56:07Z","timestamp":1775724967000},"page":"1180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Conceptual Framework for Managing Oral Intake in Head and Neck Cancer Patients Undergoing Chemoradiotherapy"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-0748","authenticated-orcid":false,"given":"Marco","family":"Cintoni","sequence":"first","affiliation":[{"name":"UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Centro di Ricerca e Formazione in Nutrizione Umana, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Leonardi","sequence":"additional","affiliation":[{"name":"UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6569-1082","authenticated-orcid":false,"given":"Pauline Celine","family":"Raoul","sequence":"additional","affiliation":[{"name":"UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Longo","sequence":"additional","affiliation":[{"name":"UOC Radioterapia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Massaccesi","sequence":"additional","affiliation":[{"name":"UOC Radioterapia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Palombaro","sequence":"additional","affiliation":[{"name":"UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. 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Gemelli 8, 00168 Rome, Italy"},{"name":"Centro di Ricerca e Formazione in Nutrizione Umana, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmeralda","family":"Capristo","sequence":"additional","affiliation":[{"name":"Centro di Ricerca e Formazione in Nutrizione Umana, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"UOS Medicina della Grande Obesit\u00e0, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6230-1779","authenticated-orcid":false,"given":"Antonio","family":"Gasbarrini","sequence":"additional","affiliation":[{"name":"Centro di Ricerca e Formazione in Nutrizione Umana, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"UOC Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5455-8737","authenticated-orcid":false,"given":"Maria Antonietta","family":"Gambacorta","sequence":"additional","affiliation":[{"name":"UOC Radioterapia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Dipartimento di Scienze Radiologiche ed Ematologiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8463-7062","authenticated-orcid":false,"given":"Maria Cristina","family":"Mele","sequence":"additional","affiliation":[{"name":"UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. 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