scholarly journals Swallowing Exercise During Head and Neck Cancer Treatment: Results of a Randomized Trial

Dysphagia ◽  
2021 ◽  
Author(s):  
Sara Fredslund Hajdú ◽  
Irene Wessel ◽  
Susanne Oksbjerg Dalton ◽  
Signe Janum Eskildsen ◽  
Christoffer Johansen
Keyword(s):  
Head And Neck Cancer ◽  
Usual Care ◽  
Head And Neck ◽  
Physical Function ◽  
Neck Cancer ◽  
Swallowing Function ◽  
Substantial Impact ◽  
Positive Effects ◽  
Swallowing Exercises ◽  
Active Controls

AbstractThe diagnosis and treatment of head and neck cancer (HNC) can have substantial impact on swallowing function, nutritional balance, physical function and quality of life (QoL). Early initiated swallowing exercises are hypothesized to improve swallowing function in HNC patients. The aim was to investigate the effects of swallowing exercises and progressive resistance training (PRT) during radiotherapy on swallowing function, physical function and QoL in patients with pharynx-, larynx-, oral cavity cancer or unknown primary compared to usual care. In a multi-centre RCT participants were assigned to (a) twice-weekly PRT and daily swallowing exercises throughout treatment or (b) usual care. Outcomes were measured at end of treatment and 2, 6 and 12 months after. Primary outcome was penetration aspiration score (PAS). Data were analysed on an “intention-to-treat” basis by GEE logistic regression model, linear mixed effects model and cox regression. Of 371 invited HNC patients, 240 (65%) enrolled. Five participants were excluded. At 12 months follow-up, 59 (25%) participants were lost. Analyses showed significant effect on mouth opening, QoL, depression and anxiety at 12 months when comparing intervention to non-active controls. The trial found no effect on swallowing safety in HNC undergoing radiotherapy, but several positive effects were found on secondary outcomes when comparing to non-active controls. The intervention period may have been too short, and the real difference between groups is too small. Nevertheless, the need to identify long-lasting intervention to slow down or avoid functional deteriorations is ever more crucial as the surviving HNC population is growing.

scholarly journals Swallowing Function in Patients With Head and Neck Cancer Prior to Treatment

2000 ◽  
Vol 126 (3) ◽  
pp. 371 ◽  
Author(s):  
Kerstin M. Stenson ◽  
Ellen MacCracken ◽  
Marcy List ◽  
Daniel J. Haraf ◽  
Bruce Brockstein ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Swallowing Function

scholarly journals Dysphagia and Its Impact on Quality of Life of Head and Neck Cancer Patients: Institution Based Cross sectional Study

2020 ◽  
Author(s):  
Tseganesh Asefa Yifru ◽  
Sezer Kisa ◽  
Negalegn Getahun Dinegde ◽  
Niguse Tadele Atnafu
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Low Income ◽  
Swallowing Function ◽  
Advanced Tumor ◽  
Swallowing Problems

Abstract Objective: Assessing swallowing function using symptom-specific questionnaires on head and neck cancer (HNC) patients and supporting impaired swallowing to improve quality of life (QoL) of patients is recommended in different studies. However, there is no data that shows the effect of dysphagia on quality of life of Ethiopian patients. Hence, this study assessed the effect of dysphagia on quality of life domains of the MD Anderson Dysphagia inventory (MDADI) among head and neck cancer patients.Results: The study sample consisted of mostly male (53.90%), employed (70.6%), single (57.80 %) and completed some level of formal education (66.60 %) with mean age of 42.58 years (SD ± 14.08 years) and medical expense for about 69.6% of patients was covered by the government. Most of the patients were suffering from advanced stage HNC (59.80%) and squamous cell carcinoma (62.70%) and the most prevalent tumor location was nasal cavity/ nasopharyngeal carcinoma (40.20%). The mean MDADI composite score was 53.29 (SD± 15.85). Being female, low income, suffering from laryngeal/ hypo pharyngeal cancer, suffering from advanced tumor and those undergoing a single modality therapy were key determinants of poor QoL related to swallowing problems in HNC patients.

scholarly journals SIP SMART: A parallel group randomised feasibility trial of a tailored pre-treatment Swallowing Intervention Package compared with usual care for patients with head and neck cancer

2020 ◽  
Author(s):  
Roganie Govender ◽  
Christina H Smith ◽  
Helen Barratt ◽  
Benjamin Gardner ◽  
Stuart Taylor
Keyword(s):  
Head And Neck Cancer ◽  
Usual Care ◽  
Head And Neck ◽  
Neck Cancer ◽  
Feasibility Trial ◽  
Size Estimation ◽  
Intervention Package ◽  
Parallel Group ◽  
Pre Treatment

Abstract Background: Dysphagia or difficulty in swallowing affects quality of life for most patients with head and neck cancer. SIP SMART – [Swallowing Intervention Package: Self-Monitoring, Assessment, Rehabilitation Training] aims to improve post-treatment swallowing outcomes through a targeted and tailored pre-treatment intervention. This feasibility study assessed 1) recruitment and retention, 2) patient acceptability of randomisation and participation, 3) patient adherence, and 4) sought to identify a suitable primary outcome for a definitive trial, including sample size estimation. Methods: This two-arm parallel group non-blinded randomised feasibility trial took place within a head and neck centre at a teaching hospital in London, UK. Patients newly diagnosed with stage III/IV head and neck cancer were recruited and underwent 6-month follow-up. Patients were randomised to SIP-SMART or usual care via an online web-based system. SIP SMART comprised two 45-minute consultations including a baseline clinical and instrumental swallowing assessment, relevant educational information, targeted swallowing exercises, and specific behaviour change strategies to increase exercise adherence. Usual care comprised a single session including a baseline clinical assessment and generic information about the likely impact of treatment on swallowing. Results: A total of 106 patients were identified at pre-screening, 70 were assessed for eligibility. Twenty-six patients did not meet eligibility criteria [0.37, 95% CI 0.27 to 0.49]. Five of 44 [0.11, 95% CI 0.05 to 0.24] eligible patients were not approached by researchers during clinic. Seven [0.18, 95% CI 0.08 to 0.33] of the 39 approached declined participation. Target recruitment (32 consented patients) was achieved within the timeframe. At 6-months 29/32 [0.91, 95% CI 0.76 to 0.97] patients remained in the trial. Acceptability of randomisation and participation in the intervention was favourable, and adherence to the exercises exceeded the pre-defined 35% minimum criterion. The MD Anderson Dysphagia Inventory swallow related quality of life measure was selected as the most suitable primary outcome for sample size estimation. No adverse effects arose from the intervention, or study participation. Conclusions: A definitive trial of the SIP SMART intervention compared to usual care is feasible and can be undertaken with patients with head and neck cancer treated within the NHS. Trial Registration: ISRCTN40215425

scholarly journals Effects of a Multidisciplinary Residential Nutritional Rehabilitation Program in Head and Neck Cancer Survivors—Results from the NUTRI-HAB Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2117
Author(s):  
Marianne Boll Kristensen ◽  
Irene Wessel ◽  
Anne Marie Beck ◽  
Karin B. Dieperink ◽  
Tina Broby Mikkelsen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Weight ◽  
Head And Neck Cancer ◽  
Cancer Survivors ◽  
Head And Neck ◽  
Physical Function ◽  
Neck Cancer ◽  
Controlled Trial ◽  
Nutritional Rehabilitation

Head and neck cancer survivors frequently experience nutritional challenges, and proper rehabilitation should be offered. The trial objective was to test the effect of a multidisciplinary residential nutritional rehabilitation programme addressing physical, psychological, and social aspects of eating problems after treatment. In a randomized controlled trial, 71 head and neck cancer survivors recruited through a nationwide survey were randomized to the program or a wait-list control group. Inclusion was based on self-reported interest in participation. The primary outcome was change in body weight. Secondary outcomes included physical function, quality of life, and symptoms of anxiety and depression. Differences between groups at the 3-month follow-up were tested. No significant differences were seen in body weight change, but there were overall trends towards greater improvements in physical function (hand grip strength: p = 0.042; maximal mouth opening: p = 0.072) and quality of life (“Role functioning”: p = 0.041; “Speech problems”: p = 0.040; “Pain”: p = 0.048) in the intervention group. To conclude, a multidisciplinary residential nutritional rehabilitation program had no effect on body weight in head and neck cancer survivors with self-reported interest in participation, but it may have effect on physical function and quality of life. Further research on relevant outcomes, inclusion criteria, and the program’s effect in different subgroups is needed.

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