Identifying Gaps in Research on Rehabilitation for Patients With Head and Neck Cancer: A Scoping Review

Parke, Sara; Oza, Sonal; Shahpar, Sam; Ngo‐Huang, An; Herbert, Aliea; Barksdale, Touré; Gerber, Lynn H.

doi:10.1016/j.apmr.2019.03.022

Cited by 13 publications

(16 citation statements)

References 26 publications

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“…Substantial efforts are being made to improve HRQOL in patients with HNSCC by developing e-health applications, including self-monitoring of HRQOL and self-help interventions 231 . These innovations carry the promise of sustainably improving supportive care and empowerment of HNSCC survivors 232 . Measurement precision of HRQOL by PROMs can benefit from other data sources as biomarkers and from objective measures (collected using, for example, wearable devices, such as a smart watch, that record and analyse physical activity) 233 .…”

Section: Moving Forwardsmentioning

confidence: 99%

Head and neck squamous cell carcinoma

Johnson

Burtness

Leemans

et al. 2020

Nat Rev Dis Primers

2,251

1,926

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Most head and neck cancers are derived from the mucosal epithelium in the oral cavity, pharynx and larynx and are known collectively as head and neck squamous cell carcinoma (HNSCC). Oral cavity and larynx cancers are generally associated with tobacco consumption, alcohol abuse or both, whereas pharynx cancers are increasingly attributed to infection with human papillomavirus (HPV), primarily HPV-16. Thus, HNSCC can be separated into HPV-negative and HPV-positive HNSCC. Despite evidence of histological progression from cellular atypia through various degrees of dysplasia, ultimately leading to invasive HNSCC, most patients are diagnosed with late-stage HNSCC without a clinically evident antecedent pre-malignant lesion. Traditional staging of HNSCC using the tumour-node-metastasis system has been supplemented by the 2017 AJCC/UICC staging system, which incorporates additional information relevant to HPV-positive disease. Treatment is generally multimodal, consisting of surgery followed by chemoradiotherapy (CRT) for oral cavity cancers and primary CRT for pharynx and larynx cancers. The EGFR monoclonal antibody cetuximab is generally used in combination with radiation in HPV-negative HNSCC where comorbidities prevent the use of cytotoxic chemotherapy. The FDA approved the immune checkpoint inhibitors pembrolizumab and nivolumab for treatment of recurrent or metastatic HNSCC and pembrolizumab as primary treatment for unresectable disease. Elucidation of the molecular genetic landscape of HNSCC over the past decade has revealed new opportunities for therapeutic intervention. Ongoing efforts aim to integrate our understanding of HNSCC biology and immunobiology to identify predictive biomarkers that will enable delivery of the most effective, least-toxic therapies.

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Section: Moving Forwardsmentioning

confidence: 99%

Head and neck squamous cell carcinoma

Johnson

Burtness

Leemans

et al. 2020

Nat Rev Dis Primers

2,251

1,926

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“…CRT implies the greatest disability compared to surgery or RT alone. For example, nutrition impact symptoms such as xerostomia, dysphagia, trismus and oral pain have been described [13,14]. Consequently, all of these biopsychofunctional impairments, due not only to the illness but also to the treatments, have a significant impact on the general QoL of these patients.…”

Section: Introductionmentioning

confidence: 99%

Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis

Burgos-Mansilla

Galiano‐Castillo

Lozano‐Lozano

et al. 2021

JCM

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The objective was to describe the effectiveness of different physical therapy modalities to improve Quality of Life (QoL) in Head and Neck Cancer (HNC) survivors. PubMed, Scopus, Web of Science, CINAHL and Cochrane Library were searched for randomized clinical controlled trials published until 30 April 2020. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 251 records were retrieved, and 10 met the inclusion criteria. Interventions whose parameters focus on a 12-week exercise programs of aerobic activity (walking) or Progressive Resistance Training (PRT) for the whole body are effective and safe modalities improving QoL in HNC survivors. Electrophysical agents did not show significant results between groups. As for the assessment of methodological quality, 4 of the 10 articles included had a high risk of overall bias. Only five articles provided sufficient information to conduct a meta-analysis for exercise program intervention on QoL, showing a tendency in favor of intervention group, even when the global results did not show statistically significant improvements (pooled Cohen’s d 0.15; 95% CI: −0.25 to 0.54; I2 45.87%; p heterogeneity = 0.10). The present review and meta-analysis identified meaningful benefits of exercise on QoL of HNC survivors; this has been confirmed in a meta-analysis. This review adds evidence supporting exercise interventions on Head and Neck Cancer population whose opportunities for successful recovery after medical treatment are more limited.

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“…Patients were invited to take part in an interview at two timepoints: (1) in-hospital, 7-14 days after surgery, and (2) 6 ± 2 weeks post-surgery, during the follow-up assessment. Interviews were optional and patients were able to decline if they were not feeling well.…”

Section: Interviews With Patientsmentioning

confidence: 99%

“…Globally, over 550,000 people are diagnosed with head and neck cancer (HNC) each year [1,2]. Due to the location of these tumours, HNC surgical patients often experience high symptom burden from treatment, which can negatively impact their physical functioning (e.g., impaired neck and shoulder mobility, difficulties with speech and swallowing) [3,4], and psychosocial functioning (e.g., depression, anxiety, impaired quality of life) [3,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the view of HCPs is critical for understanding the logistics of clinical workflow to support exercise prehabilitation implementation [19,20]. The purpose of this study was thus to obtain qualitative feedback on (1) adding patient assessments across the HNC surgical timeline and (2) the logistics and potential benefits of an exercise prehabilitation intervention.…”

Section: Introductionmentioning

confidence: 99%

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Adding exercise to a care pathway for patients undergoing surgery for head and neck cancer

Daun¹,

Twomey²,

Dort³

et al. 2020

Preprint

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Head and neck cancer (HNC) surgical patients experience high symptom burden. Exercise prehabilitation has the potential to improve patient outcomes, but the perspectives of patients and healthcare providers (HCPs) must be considered to facilitate implementation. The purpose of this study was to obtain qualitative feedback from HNC surgical patients and HCPs regarding: (1) adding patient assessments across the HNC surgical timeline, and (2) the logistics and potential benefits of a future exercise prehabilitation intervention. Semi-structured interviews took place with patients and HCPs. Interview questions included satisfaction with study recruitment, measurement completion, impact on clinical workflow (HCPs), and perceptions of a future prehabilitation program. Transcripts were analyzed using a constructivist philosophy and interpretive description methodology. Ten patients and ten HCPs participated in this study. Four themes were identified: (1) the value of exercise and its importance in clinical care, (2) acceptability and necessity of assessments, (3) factors to support implementation, and (4) the components of an ideal prehabilitation program. Overall, these findings highlight the importance and value of exercise across the HNC surgical timeline from both the patient and HCPs’ perspective. These findings will inform the future implementation of a multiphasic exercise prehabilitation trial in HNC surgical patients.

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Identifying Gaps in Research on Rehabilitation for Patients With Head and Neck Cancer: A Scoping Review

Cited by 13 publications

References 26 publications

Head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma

Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis

Adding exercise to a care pathway for patients undergoing surgery for head and neck cancer

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