Systematic assessment of the effect of functional exercise on the prevention of radiation-induced trismus among patients with nasopharyngeal carcinoma after radiotherapy: a Meta-analysis

Abstract

Objective To systematically review the effect of functional exercise on the prevention of radiation-induced trismus among patients with nasopharyngeal carcinoma (NPC) . Methods Articles about the randomized controlled trials (RCT) of functional exercise to prevent radiation-induced trismus in patients with NPC after radiotherapy were retrieved from the established date of databases to the 31st December of 2018 in electronic databases such as Cochrane Library, PubMed, EMbase, China National Knowledge Internet (CNKI) , VIP and Wanfang database. After literature selection, extraction and literature quality evaluation by two people according to inclusion and exclusion criteria, Revman 5.3 was used for Meta-analysis of outcome indicators. Results A total of 10 articles were enrolled, including 978 patients. The quality grade of all included literature was B. Maximum interincisal opening (MIO) is the outcome index of 6 articles. Meta-analysis showed that functional exercise could alleviate the reduction of MIO in NPC patients receiving radiotherapy [MD=4.59, 95%CI (3.29, 5.90) , P<0.000 1]. The degree of difficulty in opening the mouth was the outcome index of 8 articles. The results of Meta-analysis showed that functional exercise had a positive effect on the improvement of the difficulty of opening mouth in NPC patients [OR=0.23, 95%CI (0.13, 0.41) , P<0.000 1]. Conclusions Functional exercise can delay the process of reducing MIO of patients with NPC after radiotherapy, reducing the difficulty of opening the mouth, and have a positive effect on improving function and patients' quality of life. Key words: Nasopharyngeal carcinoma; Functional exercise; Radiotherapy; Radiation-induce trismus; Maximum interincisal opening; Meta-analysis