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Swallowing Rehabilitation in Patients With Head and Neck Cancer Receiving Radiotherapy

Not Applicable
Completed
Conditions
Cancer of Head and Neck
Interventions
Other: Late rehabilitation
Other: Early rehabilitation
Registration Number
NCT02900911
Lead Sponsor
Parc de Salut Mar
Brief Summary

Head and neck cancer has a negative impact in swallowing function and quality of life. Rehabilitation has proven its usefulness after radiation therapy (RT), but some studies suggest that interventions should be initiated prior to RT sessions. This study aims to evaluate the effects of prophylactic rehabilitation on swallowing and quality of life. The study pretends to establish a preventive rehabilitative program with the target of reducing RT side effects and improve patients' quality of life.

Detailed Description

Head and neck cancer has a negative impact in swallowing function and quality of life. Although current diagnostic and therapeutic protocols try to preserve swallowing and speaking, acute or late dysphagia as well as a poor quality of life are frequent in these patients.

Some studies have reported an improvement in swallowing function after an exercise based intervention following radiation therapy (RT), regardless the need of concomitant chemotherapy (RT-QT). Other studies focus the interest in the use of prophylactic exercises to prevent or minimize post-swallowing dysfunction.

Patients receiving RT or RT-QT refer worsening of their quality of life, especially during the first days after treatment. One study suggests that rehabilitation prior to cancer treatment could potentially improve quality of life. However, this observation should be contrasted with a randomized study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
52
Inclusion Criteria
  • Patients with advanced head and neck cancer receiving radiotherapy
Exclusion Criteria
  • Candidates to surgical treatment
  • Previous head and neck cancer
  • Dysphagia due to causes other than cancer
  • Previous head or neck radiation therapy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Later rehabilitationLate rehabilitationLate intervention consists of standard swallow therapy and instructions to train respiratory muscles starting after completing Radiotherapy
Early rehabilitationEarly rehabilitationEarly intervention consisting in standard swallow therapy and instructions to train respiratory muscles starting 2 weeks before Radiotherapy during 6 months
Primary Outcome Measures
NameTimeMethod
Change in dysphagia severity at three months post radiotherapy2 weeks before beginning radiotherapy, and 3 months after completing radiotherapy

8-point Penetration Aspiration Scale: scores of 1-2 indicate normal swallowing, 3-5 reflect penetration, and \>6, aspiration

Change in quality of life at three months post radiotherapy2 weeks before beginning radiotherapy and 3 months after completing radiotherapy

Head \& Neck Cancer 35 (HN35)

Secondary Outcome Measures
NameTimeMethod
Change in dysphagia security signs at three months post radiotherapy2 weeks before beginning radiotherapy and 3 months after completing radiotherapy

Security signs (tone of voice, coughing during or after eating, or desaturation of more than 3% compared to baseline pulse oximetry) assessed with the Volume Viscosity Swallow Test

Change in lingual Force at three months post radiotherapy2 weeks before beginning radiotherapy and 3 months after completing radiotherapy

Lingual Force: maximum isometric tongue pressure of three peak isometric tongue pressure scores assessed with the IOPI system.

Trial Locations

Locations (1)

Hospital de l'Esperança

🇪🇸

Barcelona, Spain

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