Prophylactic Swallow Therapy for Patients with Head and Neck Cancer Undergoing Chemoradiotherapy: A Randomized Trial.

Autor: Messing BP; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA. bmessing@gbmc.org.; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia. bmessing@gbmc.org., Ward EC; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.; Centre for Functioning and Health Research, Queensland Government, Brisbane, QLD, Australia., Lazarus CL; Icahn School of Medicine at Mount Sinai, Thyroid Head and Neck Research Center, Thyroid Head and Neck Cancer (THANC) Foundation, Department of Otolaryngology Head & Neck Surgery, Mount Sinai Beth Israel, New York, USA., Kim M; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA., Zhou X; The Division of Biostatistics and Bioinformatics at the Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, USA., Silinonte J; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA., Gold D; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA., Harrer K; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA., Ulmer K; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA., Merritt S; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA., Neuner G; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA., Levine M; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA., Blanco R; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA.; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA., Saunders J; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA.; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA., Califano J; The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA.; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: Dysphagia [Dysphagia] 2017 Aug; Vol. 32 (4), pp. 487-500. Date of Electronic Publication: 2017 Apr 25.
DOI: 10.1007/s00455-017-9790-6
Abstrakt: 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.
Databáze: MEDLINE