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Vester, Sarah ; Muhr, Anna ; Meier, Johannes ; Süß, Christoph ; Kummer, Peter ; Künzel, Julian

Prehabilitation of dysphagia in the therapy of head and neck cancer- a systematic review of the literature and evidence evaluation

Vester, Sarah, Muhr, Anna, Meier, Johannes, Süß, Christoph, Kummer, Peter und Künzel, Julian (2023) Prehabilitation of dysphagia in the therapy of head and neck cancer- a systematic review of the literature and evidence evaluation. Frontiers in Oncology 13.

Veröffentlichungsdatum dieses Volltextes: 19 Dez 2023 08:31
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.55243


Zusammenfassung

BackgroundPrehabilitation is becoming increasingly important in oncology because of the significant survival benefits that the reduction of malnutrition provide. Specifically, tumor- and therapy-related dysphagia leads to malnutrition in more than half of head and neck tumor patients. Studies describe the positive effects of an early onset of swallow-specific prehabilitation on the protection of ...

BackgroundPrehabilitation is becoming increasingly important in oncology because of the significant survival benefits that the reduction of malnutrition provide. Specifically, tumor- and therapy-related dysphagia leads to malnutrition in more than half of head and neck tumor patients. Studies describe the positive effects of an early onset of swallow-specific prehabilitation on the protection of the swallowing function. This paper intents to evaluate the existing evidence on the efficacy of preventive forms of swallowing therapy.MethodsA systematic literature search was performed in February 2022 in the Cochrane Library, MEDLINE via PubMed, and ClinicalTrials.gov databases for randomized controlled trials investigating preventive swallowing therapy in head and neck tumor patients. This Procedure complies with the PRISMA statement. The RCTs were evaluated by using the PEDro Scale and the Cochrane Risk of Bias tool RoB2.ResultsFive randomized-controlled trials with 423 participants were identified. Four Studies showed moderate to high quality in the PEDro analysis, one showed less. The risk of bias was high in all studies because there was no possibility for blinding and there were high dropout rates. Heterogeneity in interventions, measurement instruments, measurement time points, and outcomes limits a general statement about which swallowing exercises are suitable for the prevention of dysphagia in head and neck tumor patients. Evidence is provided for short-term effects (<= 24 months) on functional aspects of swallowing and quality of life. Overall, a decreasing adherence over time was observed in the intervention groups.DiscussionInitial studies describe swallowing-specific prehabilitation programs in head and neck tumor patients as effective, at least in the short term, whereas long-term effects need to be further investigated. At the current time the evidence base for clear recommendations does not appear to be sufficiently high and studies share a high risk of bias. Further well-designed research, especially considering the conditions in the national health care system, is needed.OtherThere was no funding and no registration.



Beteiligte Einrichtungen


Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftFrontiers in Oncology
Verlag:FRONTIERS MEDIA SA
Ort der Veröffentlichung:LAUSANNE
Band:13
Datum18 Dezember 2023
InstitutionenMedizin > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde
Medizin > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie
Medizin > Lehrstuhl für Strahlentherapie
Identifikationsnummer
WertTyp
10.3389/fonc.2023.1273430DOI
Stichwörter / KeywordsPROPHYLACTIC SWALLOWING EXERCISES; CONCURRENT CHEMORADIOTHERAPY; SPEECH-THERAPY; QUALITY; REHABILITATION; CHEMORADIATION; RADIOTHERAPY; PROGRAM; TRIAL; COSTS; prehabilitation; dysphagia; aspiration; speech therapy; head and neck squamous cell carcinoma; flexible endoscopic evaluation of swallowing
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-552438
Dokumenten-ID55243

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