scholarly journals Protocol for the trismus trial—therabite versus wooden spatula in the amelioration of trismus in patients with head and neck cancer: randomised pilot study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e021938
Author(s):  
Rana Lee ◽  
Alex Molassiotis ◽  
Simon N Rogers ◽  
Rhiannon Tudor Edwards ◽  
David Ryder ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Objective Assessment ◽  
Mouth Opening ◽  
Standard Of Care ◽  
Good Clinical Practice ◽  
Open Label ◽  
North West ◽  
Primary Surgery

IntroductionPatients can develop trismus from their head and neck cancer or as a result of treatment. Trismus affects the jaw muscles and makes mouth opening difficult. To potentially combat trismus, patients could undertake proactive jaw stretching exercises prior to, during and after radiotherapy, although currently these are not the standard of care.Methods and analysisThis is a randomised, open-label, controlled, two-centre feasibility study, to assess the objective and subjective effectiveness and cost-effectiveness of therabite use compared with wooden spatula in ameliorating trismus in patients treated for stage 3 and 4 oral and oropharyngeal cancer, managed either by primary surgery followed by (chemo)radiotherapy or primary (chemo)radiotherapy. The principal objective assessment is measurement of maximum jaw opening. Assessments in all cases will be performed preradiotherapy and again at 3 and 6 months postintervention.Secondary aims of the study will be (1) to assess whether therabite or the wooden spatula intervention improves patients’ quality of life, (2) reduce the level of post-treatment clinical management/healthcare use and (3) a nested qualitative study will explore the experience of the patient taking part in the intervention; data will be transcribed verbatim and analysis will be based on content analysis methods using the interview questions as the framework for examination.Ethics and disseminationNorth West Greater Manchester granted ethical approval (REC Reference 11/NW/0744). Good Clinical Practice and the Declaration of Helsinki have been adhered to. The results will be presented internationally and submitted to a peer-reviewed journal. Head and neck cancer charities and information websites will also be approached.Trial registration numberNCT01733797.

Induction Chemotherapy in Locally Advanced Head and Neck Cancer: A New Standard of Care?

2008 ◽  
Vol 22 (6) ◽  
pp. 1155-1163 ◽  
Author(s):  
Jochen H. Lorch ◽  
Marshall R. Posner ◽  
Lori J. Wirth ◽  
Robert I. Haddad
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Induction Chemotherapy ◽  
Neck Cancer ◽  
Locally Advanced ◽  
Standard Of Care ◽  
Advanced Head

A Scoping Review of Physiotherapeutic Interventions for Trismus in Head and Neck Cancer: Where Is the Manual Therapy?

2021 ◽  
pp. e20200068
Author(s):  
Joni Nedeljak ◽  
Susan Armijo-Olivo ◽  
Ivonne A. Hernandez ◽  
Suresh Nayar ◽  
Margaret L. McNeely
Keyword(s):  
At Risk ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Manual Therapy ◽  
Neck Cancer ◽  
Scoping Review ◽  
Mouth Opening ◽  
Common Side Effect ◽  
Completion Rates ◽  
Mesh Terms

Purpose: Trismus, or restricted mouth opening, is a common side effect of treatment for head and neck cancer. This scoping review examined the characteristics, extent, and nature of existing research on manual therapy and jaw-mobilizing devices to prevent and manage trismus related to head and neck cancer. Method: Six electronic databases were searched using the terms trismus, head and neck cancer, and physical therapy and the associated MeSH terms. The review focused on the factors related to intervention delivery: timing, adherence, completion rates, and adverse events. Results: Nine studies were included. Eight examined the use of a jaw-mobilizing device, and one explored the benefit of remote telephone support. Two studies involved cancer survivors at risk of trismus, five involved survivors with trismus, and two included survivors both with and at risk of trismus. No studies were found examining physiotherapist provision of manual therapy. Within-group comparisons supported the benefit of using a jaw-mobilizing device to manage trismus, whereas significant between-groups differences were found only in non-randomized controlled trials. Survivor symptoms and intervention burden were reported reasons for poor adherence and completion rates. Conclusions: No benefit was found for the use of jaw-mobilizing devices for the prevention of trismus. Given the potential of manual therapy to enhance outcomes, physical therapist–led research is warranted.

scholarly journals Prognostic factors associated with a restricted mouth opening (trismus) in patients with head and neck cancer: Systematic review

Head & Neck ◽  
2020 ◽  
Vol 42 (9) ◽  
pp. 2696-2721 ◽  
Author(s):  
Sarah J. Geer ◽  
Phillip V. Rijn ◽  
Jan L.N. Roodenburg ◽  
Pieter U. Dijkstra
Keyword(s):  
Systematic Review ◽  
Head And Neck Cancer ◽  
Prognostic Factors ◽  
Head And Neck ◽  
Neck Cancer ◽  
Mouth Opening ◽  
Factors Associated

scholarly journals Special Issue about Head and Neck Cancers: HPV Positive Cancers

2020 ◽  
Vol 21 (9) ◽  
pp. 3388 ◽  
Author(s):  
Panagiota Economopoulou ◽  
Ioannis Kotsantis ◽  
Amanda Psyrri
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Economic Status ◽  
Locally Advanced ◽  
Standard Of Care ◽  
Papilloma Virus ◽  
High Risk Sexual Behavior ◽  
Hpv Status ◽  
Delays In Diagnosis

The oropharynx has become the leading primary site for Human Papilloma Virus (HPV)-associated head and neck cancer. HPV positive oropharyngeal squamous cell carcinoma (HPV+ OSCC) has emerged as an epidemic not easily recognized by many physicians, resulting in delays in diagnosis and management. HPV+ OSCC traditionally refers to younger, healthier patients with high economic status and high-risk sexual behavior and is related to improved prognosis. De-intensification strategies are being evaluated in ongoing clinical trials and if validated, might help spare severe morbidity associated with current cisplatin-based chemoradiotherapy, which is the standard of care for all patients with locally advanced head and neck cancer. On the other hand, whether HPV status represents an important prognostic factor for non-oropharyngeal sites remains to be elucidated.

Health related quality of life (HRQoL) and demographic characteristics of long term head and neck cancer survivors submitted to concomitant chemoradiation in Brazil

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18572-18572
Author(s):  
D. V. Santos ◽  
K. M. Kiyota ◽  
I. Snitcovsky ◽  
G. M. Leitão ◽  
M. H. Federico
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer ◽  
Financial Distress ◽  
Mouth Opening ◽  
Demographic Characteristics ◽  
Emotional Function ◽  
Related Quality ◽  
Eortc Qlq

18572 Background: Head and neck cancer (HNC) is a stigmatizing disease. In order to identify special needs in these patients (pts), we evaluated HRQoL and the demographic characteristics of HNC pts who had survived at least one year after chemoradiation. Methods: Our survey, done in may 2005, identified 42 pts alive (from 527 admitted from May 2002 to May 2004 treated with either exclusive (n = 19) or adjuvant (n = 23) chemoradiation. These pts as well 16 normal controls, were interviewed and invited to complete EORTC-QLQ-C30 and HN35. These questionnaires had already been validated for Brazilian Portuguese. Primary site was 12 oral cavity, 14 pharynx, 13 larynx, 3 not determined. Age 60.3 ± 9.0 y, 36 male and 6 female; 39 were squamous cell carcinoma and 3 other type; 28 were stage III or IV; 40 had no evidence of disease and two had recurrent disease at the time of survey. Comparison between groups were done by using the Mann-Whitney test and differences of at least 10 points was considered of clinical significance. Simple correlations were conducted between HRQoL variables and clinical correlates and demographics. The level of significance was established at p < 0.05. This work was conducted according to Helsinki declaration and Brazilian law. Results: Scores relative to global QoL (p = 0.18) and emotional function (p = 0.59) did not differ in pts as compared to controls. Pts presented worse scores in swallowing, senses, speech, pain, dental problems, xerostomia and mouth opening (all p < 0.05). Emotional function (r = 0.316, p = 0.041) and financial worries (r = −0.509, p = 0.001) impacted on global QoL, what did not happen with marital status, income and level of education, age or previous surgery. Chronic pain was more prevalent in oral cavity tumors than in other sites such as pharynx or larynx tumors (p = 0.046 and p = 0.030, respectively). Pts with larynx tumors presented worse cough score as compared to those with pharynx tumors (p = 0.009). Conclusions: Providing continuous oral and dental care seems to be important to address survivors’ concerns. Financial distress could be ameliorated by a better social support system. Tumor site seem to affect differently some domains of HRQoL, in contrast to organ preservation. No significant financial relationships to disclose.

Mouth opening in patients irradiated for head and neck cancer: A prospective repeated measures study

Oral Oncology ◽  
2015 ◽  
Vol 51 (5) ◽  
pp. 548-555 ◽  
Author(s):  
J.I. Kamstra ◽  
P.U. Dijkstra ◽  
M. van Leeuwen ◽  
J.L.N. Roodenburg ◽  
J.A. Langendijk
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Repeated Measures ◽  
Mouth Opening
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