Response to “comment on a submandibular gland-sparing radiotherapy study: a methodological and analytical perspective”

We thank the authors for their interest and constructive comments on our study. This response clarifies methodological aspects and the scope of our work evaluating scintigraphic assessment of irradiated submandibular glands. The study was initiated during the COVID-19 pandemic, resulting in patient dropouts and limiting stratified analyses due to small subgroup sizes. Nevertheless, our cohort includes scintigraphy data from 27 spared and 53 unspared submandibular glands, representing a comparatively large dataset for long-term functional evaluation. Scintigraphy protocols were standardized to minimize technical variability, although unavoidable physiological and patient-related factors may have influenced measurements. The primary aim was to characterize scintigraphic parameters following irradiation; analyses of dose-response relationships, temporal modeling, and correlations with patient-reported xerostomia outcomes are ongoing. With a median follow-up of three years, no locoregional recurrences were observed near spared glands, supporting the oncological safety of submandibular gland sparing.