IADR Abstract Archives
Interventions for fibrosis in patients with head and neck cancer
Objectives: To determine the effectiveness of available interventions in the prevention and treatment of soft tissue fibrosis secondary to radiotherapy to the head and neck.
Methods: Electronic searches were performed in MEDLINE, Embase, up to the end of February 2016. We included prospective controlled studies of preventive and therapeutic interventions intended for use in adults at risk of or who developed radiotherapy-induced trismus and/or dysphagia. The primary subjective outcome measure of this review was the change in maximum interincisal opening for trismus and the swallowing function for dysphagia. Secondary endpoints included quality of life of head and neck survivors. There was no dedicated funding source for this study.
Results: Fourteen studies were included in the systematic review. Three preventive studies (two RCTs) found that masticatory muscles exercises during radiotherapy could not prevent or reduce trismus. In four therapeutic studies of individuals with established trismus (one RCT), there was an increase in mouth opening following a structured exercise program. Two preventive studies found that swallowing exercise during radiotherapy could not prevent or reduce dysphagia. Two therapeutic RCTs showed that a rehabilitation programme of tongue, pharynx and larynx exercises did not reduce established dysphagia. Similar results were reported in two therapeutic RCTs of neuromuscular electrical stimulation. One RCT to evaluate the therapeutic effect of combination therapy of neuromuscular electrical stimulation and balloon dilatation in the treatment of established radiation-induced dysphagia showed a significant improvement in swallowing function when compared with the control group (tongue exercise). The overall quality of the studies was low and there was a high risk of performance bias.
Conclusions: There was a large variation in research methodology, type and duration of the interventions. Based on the results of this systematic review, clinical guidelines cannot be established.
Methods: Electronic searches were performed in MEDLINE, Embase, up to the end of February 2016. We included prospective controlled studies of preventive and therapeutic interventions intended for use in adults at risk of or who developed radiotherapy-induced trismus and/or dysphagia. The primary subjective outcome measure of this review was the change in maximum interincisal opening for trismus and the swallowing function for dysphagia. Secondary endpoints included quality of life of head and neck survivors. There was no dedicated funding source for this study.
Results: Fourteen studies were included in the systematic review. Three preventive studies (two RCTs) found that masticatory muscles exercises during radiotherapy could not prevent or reduce trismus. In four therapeutic studies of individuals with established trismus (one RCT), there was an increase in mouth opening following a structured exercise program. Two preventive studies found that swallowing exercise during radiotherapy could not prevent or reduce dysphagia. Two therapeutic RCTs showed that a rehabilitation programme of tongue, pharynx and larynx exercises did not reduce established dysphagia. Similar results were reported in two therapeutic RCTs of neuromuscular electrical stimulation. One RCT to evaluate the therapeutic effect of combination therapy of neuromuscular electrical stimulation and balloon dilatation in the treatment of established radiation-induced dysphagia showed a significant improvement in swallowing function when compared with the control group (tongue exercise). The overall quality of the studies was low and there was a high risk of performance bias.
Conclusions: There was a large variation in research methodology, type and duration of the interventions. Based on the results of this systematic review, clinical guidelines cannot be established.