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Abstract Objective: to clinically validate whether SW-IMRT actually reduce the occurrence of swallowing dysfunction as compared to ST-IMRT. Methods: Sixty patients with head and neck cancer required bilateral neck irradiation were randomized, planned and treated by simultaneous integrated boost IMRT technique. Doses of 70, 60 and 54 Gy (over 33 daily fractions) were prescribed to primary tumour, high-risk nodal regions and low-risk nodal regions, respectively. In the post-operative setting, two volumes were identified: CTV1 for the tumor bed and CTV2 for elective lymphatic areas. These volumes were irradiated to a total dose of 60 Gy/30fx and 54 Gy/30fx, respectively. Pharyngeal constrictor muscles (PCM; superior, middle, inferior), cricopharyngeus muscle, esophageal inlet, cervical esophagus, base of tongue and glottic and supraglottic larynx (SGL) were considered organs at risk related to swallowing dysfunction (SW-OARs) |