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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 and 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.
Date of publication of this fulltext: 19 Dec 2023 08:31
Article
DOI to cite this document: 10.5283/epub.55243
Abstract
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.
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| Item type | Article | ||||
| Journal or Publication Title | Frontiers in Oncology | ||||
| Publisher: | FRONTIERS MEDIA SA | ||||
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| Open Access Type: | Gold (with APC) | ||||
| Place of Publication: | LAUSANNE | ||||
| Volume: | 13 | ||||
| Date | 18 December 2023 | ||||
| Institutions | Medicine > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie Medicine > Lehrstuhl für Strahlentherapie | ||||
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| Keywords | PROPHYLACTIC 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 Decimal Classification | 600 Technology > 610 Medical sciences Medicine | ||||
| Status | Published | ||||
| Refereed | Yes, this version has been refereed | ||||
| Created at the University of Regensburg | Yes | ||||
| URN of the UB Regensburg | urn:nbn:de:bvb:355-epub-552438 | ||||
| Item ID | 55243 |
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