Expiratory muscle strength training for radiation-associated aspiration after head and neck cancer: A case series

Purpose: Treatment of head and neck cancer (HNC) results in severe weight loss, mainly due to loss of lean body mass. Consequently, decreases in muscular strength and health-related quality of life (HRQL) occur. This study investigated the feasibility of a 12-week experimental (EXP) and conventional (CON) strength training intervention delivered after HNC treatment.Methods: Participants were randomized to an EXP group (n=11) involving eccentric strength training and neuromuscular electrical stimulation (NMES), or a CON group (n=11) involving dynamic strength training matched for training volume. Feasibility outcomes included recruitment, completion, adherence and evidence of progression. A neuromuscular assessment involving maximal isometric voluntary contractions (MIVCs) in the knee extensors was evaluated prior to and during incremental cycling to volitional exhaustion at baseline and after the interventions. Anthropometrics and patient-reported outcomes (PROs) were also assessed.Results: Although recruitment was challenging, completion was 82% in CON and 100% in EXP. Adherence was 81% in CON and 92% in EXP. Overall, MIVC increased by 19 ± 23%, muscle mass improved 18 ± 22%, cycling exercise time improved by 18 ± 13%, and improvements in HRQL and fatigue were clinically relevant.Conclusions: Both interventions were found to be feasible for HNC patients after treatment. Strength training significantly improved maximal muscle strength, muscle mass, and PROs after HNC treatment. Future research should include fully powered trials and consider the use of eccentric overloading and NMES during HNC treatment.Implications for Cancer Survivors: Eccentric overloading and NMES may be useful alternatives to conventional strength training after HNC treatment.

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Expiratory Muscle Strength Training in patients After Total Laryngectomy; A Feasibility Pilot Study

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420931889 ◽

2020 ◽

Vol 129 (12) ◽

pp. 1186-1194

Author(s):

Klaske E. van Sluis ◽

Anne F. Kornman ◽

Wim G. Groen ◽

Michiel W. M. van den Brekel ◽

Lisette van der Molen ◽

...

Keyword(s):

Muscle Strength ◽

Strength Training ◽

Outcome Measures ◽

Total Laryngectomy ◽

Case Series ◽

Expiratory Muscle ◽

Case Series Study ◽

Patient Reported ◽

Expiratory Muscle Strength Training ◽

Over Time

Objectives: Expiratory muscle strength training (EMST) is a threshold based device-driven treatment for improving expiratory pressure. EMST proved to be effective in different patient groups to improve cough function. To date, EMST has not been tested in the total laryngectomy population (TL). Methods: This prospective, randomized case-series study examined feasibility, safety, and compliance of EMST in a group of TL participants and its effects on pulmonary function, physical exertion, fatigue, and vocal functioning. Ten TL participants were included in the study to perform a 4 till 8 weeks of EMST. Objective and subjective outcome measures included manometry, spirometry, cardio pulmonary exercise testing (CPET), voice recordings, and patient reported outcome measures. Group means were reported and estimates of the effect are shown with a 95% confidence interval, using single sample t-tests. Results: Nine participants completed the full study protocol. Compliance to the training program was high. All were able to perform the training, although it requires adjustments of the device and skills of the participants. Maximum expiratory pressure (MEP) and vocal functioning in loudness improved over time. After EMST no changes were seen in other objective and subjective outcomes. Conclusions: EMST appears to be feasible and safe after total laryngectomy. MEP improved over time but no improvement in the clinically relevant outcome measures were seen in this sample of relatively fit participants. Further investigation of the training in a larger group of participants who report specifically pulmonary complaints is recommended to investigate if the increase in MEP results in clinical benefits. Level of Evidence: 4

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Analysing the risk factors in the incidence of Osteoradionecrosis in head and neck cancer patients: A case series

10.26226/morressier.5af5cdae738ab1001baf50e2 ◽

2018 ◽

Author(s):

Zain Iqbal

Keyword(s):

Risk Factors ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Case Series

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Orbital apex syndrome affecting head and neck cancer patients: A case series

Medicina Oral Patología Oral y Cirugia Bucal ◽

10.4317/medoral.21506 ◽

2017 ◽

pp. 0-0

Author(s):

AC Prado-Ribeiro ◽

AC Luiz ◽

MA. Montezuma ◽

MP Mak ◽

AR Santos-Silva ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Case Series ◽

Orbital Apex ◽

Orbital Apex Syndrome

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A Case series of Head and Neck Cancer: A Conversation with Giants and Legends in Oncology

Indian Journal of Cancer Education and Research ◽

10.21088/ijcer.2321.9815.5217.13 ◽

2017 ◽

Vol 5 (2) ◽

pp. 141-144

Author(s):

N Preethi Seshadri ◽

◽

Anita Ramesh ◽

M.G. Rajanandh ◽

Samuel Ignatious Bolledu ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Case Series

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Supportive Care Needs of Patients with Head and Neck Cancer Referred to Palliative Medicine

Otolaryngology ◽

10.1177/0194599820912029 ◽

2020 ◽

Vol 163 (2) ◽

pp. 356-363

Author(s):

Chen Lin ◽

Stephen Y. Kang ◽

Samantha Donermeyer ◽

Theodoros N. Teknos ◽

Sharla M. Wells-Di Gregorio

Keyword(s):

Quality Of Life ◽

Substance Use ◽

Head And Neck Cancer ◽

Supportive Care ◽

Head And Neck ◽

Neck Cancer ◽

Palliative Medicine ◽

Symptom Control ◽

Case Series

Objective Patients with head and neck cancer (HNC) face a unique set of unmet needs. A subset of these patients experience symptom control challenges related to their disease burden and treatments. A multidisciplinary approach involving palliative medicine is underutilized but crucial to identify and address these concerns. There is limited information on palliative integration with head and neck oncology. Study Design Case series with planned data collection. Setting Academic quaternary care center. Subjects and Methods We provide descriptive analyses of patients with HNC, including psychodiagnostic assessment and validated quality-of-life screening, from patients’ first encounter at outpatient palliative medicine. Results HNC (N = 80) contributed the greatest number of palliative referrals (25%) between 2010 and 2012. This cohort was 74% male and 79% Caucasian with a mean age of 53 years (95% CI, 51.1-54.9) and with stage IV disease of the oral cavity (28%) or oropharynx (31%). Sixty-three percent of patients had no evidence of disease. Seventy-five percent had a psychological history based on DSM-IV criteria ( Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), and 70% had a history of substance use disorder. The most distressing quality-of-life concerns were pain, housing and financial problems, and xerostomia. Conclusions Patients with HNC who were referred to palliative medicine are burdened by multiple physical, psychological, substance use, and social challenges. We recommend comprehensive cancer-specific screening, such as the James Supportive Care Screening, to triage patients to appropriate supportive care services. Palliative care is one of many services that these patients may need, and it should be utilized at any point of the disease trajectory rather than reserved for end-of-life care.

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