Pretreatment Swallowing Exercises Improve Swallow Function After Chemoradiation

Carroll, William R.; Locher, Julie L.; Canon, Cheri L.; Bohannon, Isaac A.; McColloch, Nancy L.; Magnuson, J. Scott

doi:10.1097/mlg.0b013e31815659b0

Cited by 232 publications

(170 citation statements)

References 34 publications

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“…After the designated period of this systematic search had ended, several additional papers were published, three of which (Carroll et al [97], Logemann et al [103] and Langerman et al [104]) warrant a brief review. Carroll et al and Logemann et al suggested that (early) rehabilitation might be beneWcial.…”

Section: Generalmentioning

confidence: 99%

See 1 more Smart Citation

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Molen

Rossum

Burkhead

et al. 2008

Eur Arch Otorhinolaryngol

110

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Organ preservation with radiotherapy and concomitant chemotherapy has become an accepted treatment modality in advanced head and neck cancer. Unfortunately, organ preservation is not synonymous with function preservation. The aim of this review was to systematically assess the eVects of the disease and chemoradiotherapy (CRT) on functions such as swallowing, mouth opening, nutrition, pain and quality of life in patients with head and neck cancer. Another aim was to search for (evidence-based) techniques or strategies known to alleviate or rehabilitate the loss of function(s) associated with CRT. Two databases were searched (time period, January 1997 to August 2007) for the terms head and neck cancer, chemotherapy or cisplatin and radiotherapy, and the functional outcomes swallowing, trismus, nutrition, pain and quality of life or a variation of those words. In total, 15 relevant articles were identiWed that met the inclusion criteria. The majority of the studies that met the criteria focused on the outcomes swallowing, quality of life, and nutrition. Two studies reported on the outcome pain, but no paper reported on the outcome trismus. Only two papers mentioned rehabilitation options, but speciWc information was lacking. Further long-term prospective research is essential, not only to determine the function impairment caused by the tumor and CRT, but also to assess the eVects of known and newly developed rehabilitation measures. Therefore, in September 2006, the Netherlands Cancer Institute started a randomised clinical trial (RCT): Prevention of trismus, swallowing and speech problems in patients treated with chemoradiotherapy for advanced head and neck cancer. This systematic review was carried out to collect the baseline information for the future outcomes of this RCT.

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Section: Generalmentioning

confidence: 99%

“…Many tongue and swallowing exercises, such as tongue function therapy and swallowing maneuvres, are described in the literature [17,21,48,[97][98][99][100][101][102]. Furthermore, the eVectiveness of these swallowing exercises has not yet been assessed systematically in the CRT patient population.…”

Section: Generalmentioning

confidence: 99%

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Molen

Rossum

Burkhead

et al. 2008

Eur Arch Otorhinolaryngol

110

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“…This method was pioneered by Ogilvie et al [50] and more recently utilised by Crowther et al [51] to provide a visual display of synthesised evidence, where lack of homogeneity between studies has precluded the traditional use of a forest plot. The average TREND score was 13.8 (range, [10][11][12][13][14][15][16][17][18]. Despite the variable scorings, studies were deemed to have sufficiently comparable quality in their methodology and reported findings, hence none warranted exclusion from the final cohort.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…Historically, treatment approaches have been reactive, with rehabilitation administered after medical intervention (either surgical or non-surgical). However, emerging evidence [15][16][17][18][19] has instigated a shift towards the use of preventative dysphagia rehabilitation, based on the premise that proactively exercising swallowing structures known to be negatively impacted by radiation may limit the extent of (C)RT-induced dysfunction [20].…”

Section: Introductionmentioning

confidence: 99%

Physiological Changes to the Swallowing Mechanism Following (Chemo)radiotherapy for Head and Neck Cancer: A Systematic Review

et al. 2013

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Emerging research suggests that preventative swallowing rehabilitation, undertaken pre-or during (chemo)radiotherapy ([C]RT), can significantly improve early swallowing outcomes for head and neck cancer (HNC) patients. However, these treatment protocols are highly variable. Determining specific physiological swallowing parameters which are most likely to be impacted post-(C)RT would assist in refining clear targets for preventative rehabilitation.Therefore, this systematic review (1) examined the frequency and prevalence of physiological swallowing deficits observed post-(C)RT for HNC, and (2) determined the patterns of prevalence of these key physiological deficits over time post-treatment. Online databases were searched for relevant papers published between January 1998 and March 2013. In total, 153 papers were identified and appraised for methodological quality and suitability based on exclusionary criteria. Ultimately, nineteen publications met the study's inclusion criteria.Collation of reported prevalence of physiological swallowing deficits revealed reduced laryngeal excursion, base of tongue (BOT) dysfunction, reduced pharyngeal contraction and impaired epiglottic movement as most frequently reported. BOT dysfunction and impaired epiglottic movement showed a collective prevalence of over 75% in the majority of patient cohorts, whilst reduced laryngeal elevation and pharyngeal contraction had a prevalence of over 50%. Sub-analysis suggested a trend that the prevalence of key deficits is dynamic although persistent over time. These findings can be used by clinicians to inform preventative intervention, and support the use of specific, evidence-based therapy tasks explicitly selected to target the highly prevalent deficits post-(C)RT for HNC.

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“…24 Pretreatment swallowing exercises produces measurable improvements in post-treatment swallowing function in patients who undergo organ-preservation chemoradiation (CT/RT) for head and neck cancer and might reduce dependence on PEG. 25 With rising interest in organ preservation, more and more radical radiotherapy and intensive multimodal treatment would be pursued. Whilst deciding the need for tube enterostomies in patients for radiotherapy alone consideration should be given to absolute dose, volume, time-frame and whether brachytherapy is added or not.…”

Section: Head and Neck Cancer-clinical Considerationsmentioning

confidence: 99%

Feeding Tube Enterostomies in Upper Aerodigestive Tract Cancers

Saha¹,

Bose²,

Pankaj³

2010

International Journal of Head and Neck Surgery

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Establishment and maintenance of safe access is crucial for long-term enteral nutrition in patients with head-neck and esophagogastric cancers. Tube enterostomies such as gastrostomy and jejunostomy are being increasingly used with wider use of chemoradiation and adjuvant therapy following surgery. This article reviews the currently available enteral access techniques by the open and percutaneous route and their indications, safety, effectiveness and role in modern oncological practice.

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Pretreatment Swallowing Exercises Improve Swallow Function After Chemoradiation

Cited by 232 publications

References 34 publications

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Physiological Changes to the Swallowing Mechanism Following (Chemo)radiotherapy for Head and Neck Cancer: A Systematic Review

Feeding Tube Enterostomies in Upper Aerodigestive Tract Cancers

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