Evidence map›Paper›PMID 42016183›Full record

ArticleClinical and translational radiation oncology2026

De-escalation of elective radiotherapy guided by FDG-PET lowers modeled late swallowing-related toxicity in head and neck cancer.

Florian Stritzke, Katharina Dvornikovich, Hin Lau, Thomas Tessonnier, Philipp Schröter, David Neugebauer, Nils Netzer, Lukas Bauer, Rubens Thölken, Erik Winter and 5 more

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Article in Clinical and translational radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Florian StritzkeHeidelberg University, Heidelberg Faculty of Medicine, Heidelberg, Germany.
Katharina DvornikovichHeidelberg University, Heidelberg Faculty of Medicine, Heidelberg, Germany.
Hin LauDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Thomas TessonnierDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Philipp SchröterDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
David NeugebauerDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Nils NetzerDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Lukas BauerDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Rubens ThölkenDepartment of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Erik WinterDepartment of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.
Semi HarrabiDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Andrea MairaniDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Uwe HaberkornDepartment of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.
Jürgen DebusDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Thomas HeldDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Whether FDG-PET-guided de-escalation of elective target volumes in radiotherapy of the head and neck reduces late toxicity remains uncertain. Therefore, we compared predicted toxicity of two de-escalation strategies-reduced elective nodal irradiation (RNI) and involved node irradiation (INI)-with standard elective nodal irradiation (ENI). Materials and Methods: In a within-patient plan comparison (n = 26), we generated RNI and INI plans using the same FDG-PET informed high-/intermediate-risk targets as ENI. RNI limited elective volumes to within 2 cm cranio-caudal from gross disease; INI omitted elective treatment. Proton plans were created in representative oropharyngeal cases. Co-primary outcomes were six-month normal-tissue complication probabilities (NTCPs) for dysphagia, feeding-tube dependence, and xerostomia. Results: Median total planning target volume decreased from 540 cm Conclusions: FDG-PET-guided volumetric de-escalation was associated with lower modeled late swallowing-related toxicity. These findings support the rationale for ongoing and future trials investigating volumetric de-escalation strategies.

Indexed as

De-escalationDysphagiaElective nodal irradiationFDG-PETHead and neck cancerNTCP modeling

Identifiers

PMID42016183
PMCPMC13092707

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