Abstract
Evidence supporting prophylactic swallow exercises for patients with head and neck cancer (HNC) has not been universally demonstrated. This RCT examined diet level, feeding tube use, swallow function, and quality of life (QOL) of patients undergoing chemoradiotherapy who performed prophylactic swallowing exercises. Sixty HNC patients were randomized into exercise versus control groups. Swallowing, oromotor, toxicity, and QOL data were recorded (baseline, 3, 6, 12, 24 months). Physiological swallow function was examined at baseline and 3 months. Swallow exercises were completed twice daily. Oral intake at 3 months was 10% better in the exercise group, which was not statistically significant (p = 0.49). Significant (p < 0.05) differences in secondary outcomes including oromotor function, pharyngeal impairment, oral pharyngeal swallow efficiency, and incisal opening were noted at early time points (3–6 months) in the exercise group. Possible positive early improvements in swallow function are associated with swallowing exercises, although these improvements are not significant longer term.
Highlights
The National Institute of Dental and Craniofacial Research (NIDCR, 2015) estimates those side effects during and post-treatment will occur in almost all participants receiving radiation to the head and neck area [1]
Recent studies have investigated the detrimental effects of progressive neuropathy post radiation in the head and neck cancer patient [10, 11]
The clinical research associate randomized participants into an exercise or control group according to a predetermined single block, computer-generated randomization schedule originated by the study statistician
Summary
The National Institute of Dental and Craniofacial Research (NIDCR, 2015) estimates those side effects during and post-treatment will occur in almost all participants receiving radiation to the head and neck area [1]. Treatment-induced toxicities including mucositis, xerostomia, odynophagia, trismus, hypogeusia/dysgeusia, as well as the potential for infections, have a significant impact on swallow function [2,3,4,5,6,7,8]. Radiation therapy alters tissue integrity, leading to fibrosis [9]. Fibrosis impacts both the oral and pharyngeal muscles, contributing to reduced mobilization of muscles and structures during swallowing. Recent studies have investigated the detrimental effects of progressive neuropathy post radiation in the head and neck cancer patient [10, 11]. Significant radiation-associated dysphagia termed as late-RAD show worsening dysphagia sometimes developing years
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