Ab. No. 140 Non-Surgical Interventions for the Prevention and Treatment of Radiation-Induced Fibrosis and Its Associated Disability in Patients With Head and Neck Cancer: An ICF Framework-Based Systematic Review

Abstract

Introduction: To outline non-surgical interventions effective in preventing or treating the effects of Radiation-induced fibrosis (RIF) in Head and Neck Cancer (HNC) Survivors across domains of International Classification of Functioning, Disability and Health (ICF). RIF is a debilitating, long term sequalae of radiotherapy in HNC survivors. ICF provides an opportunity to map limitation in body functions, activity and participation with interventions but has not been used in understanding the impact of RIF in HNC survivors. Methods: Studies reporting non-surgical interventions for prevention/treatment of RIF. The review was registered in PROSPERO. Using a systematic review framework, a comprehensive search was run in six databases, independently screened, and verified by authors. Risk-of-Bias was determined using NIH quality assessment tool. Qualitative descriptive analysis was performed for the included studies. Intervention targets and outcomes were mapped to ICF domains. Results: Fifteen of 7966 retrieved studies representing data of 603 participants were included for the review. Fourteen studies were of fair and one of good quality. Seven studies representing 294 participants aimed at prevention while eight representing 309 participants aimed at treatment of RIF. Interventions studied included- exercise, electrotherapy, orthotics, swallow therapy and pharmacotherapy. Studies weren’t mutually exclusive for ICF domains. Among prevention studies, four focused on body structure, six on body function, and one on activity and participation. Among treatment studies, five addressed body structure, seven on body function, and five on activity and participation. Conclusion: Non-surgical interventions for prevention or treatment of RIF are available across ICF domains. However, the studies are limited in numbers and are of fair quality. Implications: This review provides a summary of the current state of research evidence and could be useful in providing direction to future research for prevention/treatment of RIF in HNC survivors.