PMID- 35587295 OWN - NLM STAT- MEDLINE DCOM- 20230126 LR - 20230325 IS - 1432-0460 (Electronic) IS - 0179-051X (Print) IS - 0179-051X (Linking) VI - 38 IP - 1 DP - 2023 Feb TI - Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO). PG - 159-170 LID - 10.1007/s00455-022-10434-4 [doi] AB - OBJECTIVES: To prospectively investigate changes in M.D. Anderson Dysphagia Inventory (MDADI) scores in patients affected by naso- and oropharynx cancer after definitive radiochemotherapy (ChemoRT) using swallowing organs at risk (SWOARs)-sparing IMRT. METHODS: MDADI questionnaires were collected at baseline and at 6 and 12 months after treatment. MDADI scores were categorized as follows: >/= 80 "optimal," 80-60 "adequate," < 60 "poor" deglutition-related quality of life (QoL) group, and dichotomized as "optimal" vs "adequate/poor" for the analysis. A mean MDADI composite (MDADI-C) change of 10 points was considered as minimal clinically important difference (MCID). RESULTS: Sixty-three patients were enrolled of which 47 were considered for the analysis. At baseline, 26 (55%) were "optimal" and 21 (45%) were "adequate/poor." The mean baseline MDADI-C score was 93.6 dropping to 81 at 6 months (p = 0.013) and slightly rising to 85.5 at 12 months (p = 0.321) for the "optimal" group. Indeed, the mean baseline MDADI-C score was 64.3 rising to 77.5 at 6 months (p = 0.006) and stabilizing at 76 at 12 months (p = 0.999) for the "adequate/poor" group. A statistically significant but not clinically relevant worsening of the MDADI-C score was reported for the "optimal" group, whereas both a statistically significant and clinically meaningful improvement of the MDADI-C score were reported for the "adequate/poor" group from before to post-treatment. CONCLUSION: Our results suggest a doubly clinical benefit of dose optimization to SWOARs to minimize the RT sequalae in patients with a baseline "optimal" deglutition-related QoL and to recover from cancer dysphagia in those with a baseline "adequate/poor" deglutition-related QoL. CI - (c) 2022. The Author(s). FAU - Ursino, Stefano AU - Ursino S AUID- ORCID: 0000-0003-3018-2338 AD - Radiation Oncology Unit, University Hospital Santa Chiara, Via Roma 67, 56100, Pisa, Italy. stefano.ursino@med.unipi.it. FAU - Calistri, Elisa AU - Calistri E AD - Radiation Oncology Unit, University Hospital Santa Chiara, Via Roma 67, 56100, Pisa, Italy. FAU - De Felice, Francesca AU - De Felice F AD - Radiation Oncology Unit, University Hospital La Sapienza, Viale del Policlinico 155, 00161, Rome, Italy. FAU - Bonomo, Pierluigi AU - Bonomo P AD - Radiation Oncology Unit, University Hospital Careggi, Largo Brambilla 3, 50134, Florence, Italy. FAU - Desideri, Isacco AU - Desideri I AD - Radiation Oncology Unit, University Hospital Careggi, Largo Brambilla 3, 50134, Florence, Italy. FAU - Franco, Pierfrancesco AU - Franco P AD - Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy. FAU - Arcadipane, Francesca AU - Arcadipane F AD - Department of Oncology, Radiation Oncology, University of Turin, Via Camillo Benso di Cavour 31, 10123, Turin, Italy. FAU - Colosimo, Caterina AU - Colosimo C AD - Radiation Oncology Unit, University Hospital Santa Chiara, Via Roma 67, 56100, Pisa, Italy. AD - Radiation Oncology Unit, S.Luca Hospital, Via Guglielmo Lippi Francesconi 556, 55100, Lucca, Italy. FAU - Mazzola, Rosario AU - Mazzola R AD - Advanced Radiation Oncology Department, IRCCS Sacro Cuore-Don Calabria Hospital Cancer Care Center, Via Sempreboni 5, 37024, Verona, Italy. FAU - Maddalo, Marta AU - Maddalo M AD - Radiation Oncology Unit, Department of Medical and Surgical Specialties, Radiological Science and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Via del Medolo 2, 25123, Brescia, Italy. FAU - Gonnelli, Alessandra AU - Gonnelli A AD - Radiation Oncology Unit, University Hospital Santa Chiara, Via Roma 67, 56100, Pisa, Italy. FAU - Malfatti, Giulia AU - Malfatti G AD - Radiation Oncology Unit, University Hospital Santa Chiara, Via Roma 67, 56100, Pisa, Italy. FAU - Morganti, Riccardo AU - Morganti R AD - Department of Clinical and Experimental Medicine, Section of Statistics, Via Roma 67, 56100, Pisa, Italy. FAU - Musio, Daniela AU - Musio D AD - Radiation Oncology Unit, University Hospital La Sapienza, Viale del Policlinico 155, 00161, Rome, Italy. FAU - Paiar, Fabiola AU - Paiar F AD - Radiation Oncology Unit, University Hospital Santa Chiara, Via Roma 67, 56100, Pisa, Italy. LA - eng PT - Journal Article DEP - 20220519 PL - United States TA - Dysphagia JT - Dysphagia JID - 8610856 SB - IM MH - Humans MH - *Deglutition Disorders/etiology MH - Prospective Studies MH - Quality of Life MH - Deglutition MH - *Radiotherapy, Intensity-Modulated/adverse effects MH - Organs at Risk MH - *Head and Neck Neoplasms/complications/radiotherapy MH - Patient Reported Outcome Measures MH - Medical Oncology PMC - PMC9118191 OTO - NOTNLM OT - Cancer-related dysphagia OT - Deglutition OT - Head and neck cancer OT - MDADI OT - Patient-reported outcomes OT - Treatment-related dysphagia COIS- Stefano Ursino received personal honoraria for presentations from Astra Zeneca and Nestle and support for attending meetings (including travels, hotel accommodation, and dinner) from Merck Serono and Kyowakirin. Fabiola Paiar received personal honoraria for presentations from Astra Zeneca, Nestle, Merck Serono, Varian, and Kyowakirin and support for attending meetings (including travels, hotel accommodation, and dinner) from Merck Serono, Kyowakirin, Varian, Nestle, and Astra Zeneca. Rosario Mazzola received personal honoraria for presentations from Astellas and Jansen. All other authors declared no competing financial interests. EDAT- 2022/05/20 06:00 MHDA- 2023/01/27 06:00 PMCR- 2022/05/19 CRDT- 2022/05/19 11:24 PHST- 2021/07/07 00:00 [received] PHST- 2022/02/25 00:00 [accepted] PHST- 2022/05/20 06:00 [pubmed] PHST- 2023/01/27 06:00 [medline] PHST- 2022/05/19 11:24 [entrez] PHST- 2022/05/19 00:00 [pmc-release] AID - 10.1007/s00455-022-10434-4 [pii] AID - 10434 [pii] AID - 10.1007/s00455-022-10434-4 [doi] PST - ppublish SO - Dysphagia. 2023 Feb;38(1):159-170. doi: 10.1007/s00455-022-10434-4. Epub 2022 May 19.