Abstract
A common side effect of managing head and neck cancer is trismus, which devastates patients’ quality of life. The purpose of this study was to investigate prophylactic exercise interventions for preventing trismus and difficulty in mouth opening in head and neck cancer. Five databases were searched for randomized controlled trials. Network meta-analysis was performed with risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI). This study finally included 11 randomized controlled trials (n = 805). Trismus risk in patients who received exercise with phone call follow up (E + P) was significantly lower than those received usual care (RR = 0.42; 95% CI: 0.29 to 0.61) and exercise alone (RR = 0.33; 95% CI: 0.18 to 6.22). Mouth opening in usual care was significantly lower than in the tri-integrated strategy group (MD = 15.22; 95% CI: 8.88 to 21.56). Exercise is recommended for preserving mouth opening distance in patients with head and neck cancer. Tri-integrated strategies could be an effective method for preventing trismus.
Highlights
Head and neck cancer is the seventh most common type of cancer worldwide
Most trials seemed to be at high risk of performance bias, detection bias, and attrition bias (Supplementary Table S2), and they contributed to some concerns and major concerns in the confidence ratings of the network meta-analysis of trismus incidence and mouth opening distance (Table 2)
Trismus incidence among patients who received exercise with phone call follow ups was significantly lower than that among patients who received usual care (RR = 0.42; 95% confidence interval (CI): 0.29–0.61) or exercise alone (RR = 0.33; 95% CI: 0.18–6.22; Figure 3B)
Summary
Head and neck cancer is the seventh most common type of cancer worldwide. In. 2018, 887,659 new-onset cases occurred, and 453,307 patients died due to head and neck cancers [1]. The majority of patients with head and neck cancers received their diagnosis near age 50 years [2]. Many medical treatments have been implemented to manage head and neck cancers [3,4] and extend life expectancy. The average life expectancy of patients with head and neck cancers is approximately 10 to 13 years [2]. Some side effects may occur after head and neck cancer treatment, and the effects can be long-term [3,4]
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