A systematic review of trismus induced by cancer therapies in head and neck cancer patients

Bensadoun, René-Jean; Riesenbeck, D.; Lockhart, Peter B.; Elting, Linda S.; Spijkervet, Fred K. L.; Brennan, Michael T

doi:10.1007/s00520-010-0847-4

Cited by 188 publications

(180 citation statements)

References 23 publications

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“…Our results demonstrated that patients who fed trough NTF had greater MMO restriction compared to patients who remained feeding orally. The mandibular hypomobility caused by the use of NTF accelerates the degeneration of the muscles and the temporomandibular joint caused by RT 50 . Several studies have reported the use of chewing gum for the treatment of trismus 19,26 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of acute radiation effects on mandibular movements of patients with head and neck cancer

Bragante

Nascimento

Motta

2012

Rev. bras. fisioter.

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Section: Discussionmentioning

confidence: 99%

Evaluation of acute radiation effects on mandibular movements of patients with head and neck cancer

Bragante

Nascimento

Motta

2012

Rev. bras. fisioter.

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“…When the temporomandibular joint and masticatory muscles are irradiated, there is a risk of developing trismus [6,7]. This risk increases in proportion to radiation dose and irradiated volume of relevant anatomical structures [2,8,9]. The reported prevalence of trismus after radiotherapy for head and neck cancer ranges from 25% to 42% [2,9].…”

mentioning

confidence: 99%

“…Many patients with head and neck cancer suffer from trismus (a mouth opening of 35 millimeters (mm) or less), especially after radiotherapy [1,2]. Fibrosis is considered one of the biological mechanisms leading to late radiation-induced side effects [3][4][5].…”

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confidence: 99%

Predictors for trismus in patients receiving radiotherapy

et al. 2016

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Background: Trismus, a restricted mouth opening in head and neck cancer patients may be caused by tumor infiltration in masticatory muscles, radiation-induced fibrosis or scarring after surgery. It may impede oral functioning severely. The aims of our study were to determine: (1) the incidence of trismus at various time points; and (2) the patient, tumor, and treatment characteristics that predict the development of trismus after radiotherapy in head and neck cancer patients using a large database (n ¼ 641). Methods: Maximal mouth opening was measured prior to and 6, 12, 18, 24, 36, and 48 months after radiotherapy. Patient, tumor, and treatment characteristics were analyzed as potential predictors for trismus using a multivariable logistic regression analysis. Results: At six months after radiotherapy, 28.1% of the patients without trismus prior to radiotherapy developed trismus for the first time. At subsequent time points the incidence declined. Over a total period of 48 months after radiotherapy, the incidence of trismus was 3.6 per 10 person years at risk. Patients who had tumors located in the oral cavity, oropharynx or nasopharynx, and the salivary glands or ear, and who had a longer overall treatment time of radiotherapy, were more likely to develop trismus in the first six months after radiotherapy. Maximal mouth opening was a predictor for developing trismus at all time points. Conclusion: Incidence of trismus is 3.6 per 10 person years at risk. Tumor localization and overall treatment time of radiotherapy are predictors for developing trismus the first six months after radiotherapy. Maximal mouth opening is a significant predictor for developing trismus at all time points. Regular measurements of maximal mouth opening are needed to predict trismus.

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“…5 To the best of our knowledge, our study is the first to show that TC Qigong training was able to attenuate the deterioration in mouth opening capacity among NPC survivors. The participants that did not undergo TC Qigong training demonstrated a dramatic decrease in interincisor distance over the 12-month study period (Table 3).…”

Section: Discussionmentioning

confidence: 95%

“…1 Currently, the primary medical management for NPC is radiotherapy, while chemotherapy and surgery (eg, nasopharyngectomy) are elective treatments. 2 Although previous research has shown that these aggressive treatment methods can successfully control tumors and thus increase overall survival rates, 1 survivors generally experience many associated side effects, such as neck muscle fibrosis, 3,4 trismus or restricted mouth opening, 5,6 and shoulder dysfunctions. 7 The disease can also directly cause chronic symptoms, such as pain and fatigue.…”

Section: Introductionmentioning

confidence: 99%

The Effects of a 6-Month Tai Chi Qigong Training Program on Temporomandibular, Cervical, and Shoulder Joint Mobility and Sleep Problems in Nasopharyngeal Cancer Survivors

Fong

Lee

et al. 2014

Integr Cancer Ther

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Introduction. Nasopharyngeal cancer (NPC) survivors often sustain head-neck-shoulder impairments from conventional treatments, which could disturb sleep. This novel study aimed to examine the efficacy of Tai Chi (TC) Qigong in optimizing temporomandibular joint (TMJ), cervical, and shoulder joint mobility and reducing sleep problems in NPC survivors. Methods. Fifty-two NPC survivors participated in the study. The experimental group (n = 25) received 6 months of TC Qigong training (1.5 h/session; 4 sessions/wk including self-practice) while the control group (n = 27) received no training. Cervical side flexion and rotation, shoulder flexion and horizontal flexion range of motion (ROM), mouth opening capacity (interincisor distance), and sleep problems (Medical Outcomes Study Sleep Scale) were assessed at baseline, mid-intervention (3 months), immediately after TC Qigong training, and at 6-month follow-up. Results. Intention-to-treat analysis revealed improvement in cervical side flexion ROM only (P < .008) and unchanged shoulder and TMJ mobility (P > .008) after the TC Qigong training. Deterioration was observed in shoulder flexion ROM and mouth opening capacity in the no-training controls over time (P < .008). Sleep problems also decreased in the TC Qigong group (P < .008), and this effect was most profound during the follow-up period. In addition, improvement in cervical side flexion ROM was associated with a reduction in sleep problems in the experimental group after TC Qigong training (P < .05). Conclusions. The 6-month TC Qigong intervention improved neck mobility, maintained TMJ and shoulder joint mobility, and reduced sleep problems for NPC survivors. TC Qigong could be an effective nonpharmacological intervention for managing progressive trismus, chronic neck and shoulder hypomobility, and reducing sleep problems among NPC survivors.

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A systematic review of trismus induced by cancer therapies in head and neck cancer patients

Cited by 188 publications

References 23 publications

Evaluation of acute radiation effects on mandibular movements of patients with head and neck cancer

Evaluation of acute radiation effects on mandibular movements of patients with head and neck cancer

Predictors for trismus in patients receiving radiotherapy

The Effects of a 6-Month Tai Chi Qigong Training Program on Temporomandibular, Cervical, and Shoulder Joint Mobility and Sleep Problems in Nasopharyngeal Cancer Survivors

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