ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2016
Beyond mean pharyngeal constrictor dose for beam path toxicity in non-target swallowing muscles: Dose-volume correlates of chronic radiation-associated dysphagia (RAD) after oropharyngeal intensity modulated radiotherapy.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03455608 (PRO-ACTIVE), which is not on this map. Cited by 57 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
PRO-ACTIVE: Comparing The Effectiveness of Prophylactic Swallow Intervention for Patients Receiving Radiotherapy for Head and Neck Cancer
Who cites it
57 citing papers in PubMed, 4 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Prognostic models for radiation-induced complications after radiotherapy in head and neck cancer patients.The Cochrane database of systematic reviews · 2025Pooled it
- Risk prediction models for dysphagia after radiotherapy among patients with head and neck cancer: a systematic review and meta-analysis.Frontiers in oncology · 2025Pooled it
- 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.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2017Pooled it
- The Changes in Pharyngeal Constrictor Muscles Related to Head and Neck Radiotherapy: A Systematic Review.Technology in cancer research & treatmentPooled it
- Manual Therapy for Fibrosis-Related Late Effect Dysphagia in head and neck cancer survivors: the pilot MANTLE trial.BMJ open · 2021Trial
- A prospective longitudinal assessment of MRI signal intensity kinetics of non-target muscles in patients with advanced stage oropharyngeal cancer in relationship to radiotherapy dose and post-treatment radiation-associated dysphagia: Preliminary findings from a randomized trial.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2019Trial
- Clinical factors impacting on late dysphagia following radiotherapy in patients with head and neck cancer.The British journal of radiology · 2018Trial
- Acupuncture for Chemoradiation Therapy-Related Dysphagia in Head and Neck Cancer: A Pilot Randomized Sham-Controlled Trial.The oncologist · 2016Trial
- Dysphagia optimized knowledge-based planning for head and neck cancer.Journal of applied clinical medical physics · 2026Article
- Patient-Reported Dysphagia and Swallowing-Related Quality of Life up to 10 Years After (Chemo)radiotherapy for Head and Neck Cancer: A Cross-Sectional Study.Head & neck · 2026Article
- Article
- Precision rehabilitation for swallowing dysfunction after radiotherapy in head and neck cancer: current evidence, key controversies, and future perspectives.Frontiers in oncology · 2026Review
- Deep learning NTCP model for late dysphagia after radiotherapy for head and neck cancer patients based on 3D dose, CT and segmentations.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2025Article
- FAPI-positron emission tomography for radiotherapy in head and neck cancer: applications and future directions.Physics and imaging in radiation oncology · 2025Review
- Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in Head and Neck Cancer Patients with Late Radiation-Associated Dysphagia: Swallowing Safety, Efficacy, and Dysphagia Phenotype.Current oncology (Toronto, Ont.) · 2025Article
- Article
- A new computed tomography-based approach to quantify swallowing muscle volume by measuring tongue muscle area in a single slice.Journal of cachexia, sarcopenia and muscle · 2024Article
- Chemoradiation to the submental muscles alters hyoid movement during swallowing in a rat model.Journal of applied physiology (Bethesda, Md. : 1985) · 2024Article
- Swallowing-related muscle inflammation and fibrosis induced by a single dose of radiation exposure in mice.Laboratory animal research · 2024Article
- Article
Corrections and comments
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Authors and funding
1 author at 2 institutions in 2 countries.
Funding
Abstract
PURPOSE/OBJECTIVE(S): We sought to identify swallowing muscle dose-response thresholds associated with chronic radiation-associated dysphagia (RAD) after IMRT for oropharyngeal cancer. MATERIALS/
methodsT1-4 N0-3 M0 oropharyngeal cancer patients who received definitive IMRT and systemic therapy were examined. Chronic RAD was coded as any of the following ⩾12months post-IMRT: videofluoroscopy/endoscopy detected aspiration or stricture, gastrostomy tube and/or aspiration pneumonia. DICOM-RT plan data were autosegmented using a custom region-of-interest (ROI) library and included inferior, middle and superior constrictors (IPC, MPC, and SPC), medial and lateral pterygoids (MPM, LPM), anterior and posterior digastrics (ADM, PDM), intrinsic tongue muscles (ITM), mylo/geniohyoid complex (MHM), genioglossus (GGM), masseter (MM), buccinator (BM), palatoglossus (PGM), and cricopharyngeus (CPM), with ROI dose-volume histograms (DVHs) calculated. Recursive partitioning analysis (RPA) was used to identify dose-volume effects associated with chronic-RAD, for use in a multivariate (MV) model.
resultsOf 300 patients, 34 (11%) had chronic-RAD. RPA showed DVH-derived MHM V69 (i.e. the volume receiving⩾69Gy), GGM V35, ADM V60, MPC V49, and SPC V70 were associated with chronic-RAD. A model including age in addition to MHM V69 as continuous variables was optimal among tested MV models (AUC 0.835).
conclusionIn addition to SPCs, dose to MHM should be monitored and constrained, especially in older patients (>62-years), when feasible.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.