Swallowing exercises linked with short-term improvement among patients with head and neck cancer

Among patients undergoing chemoradiation therapy (CRT) for head and neck cancer, performing targeted swallowing exercises following CRT is associated with short-term improvement in swallowing function; however, there were no significant differences in swallowing function between the intervention group and controls at nine or 12 months following treatment, according to a report in the April issue of Archives of Otolaryngology – Head & Neck Surgery.

"With improvements in swallowing function from post-treatment exercises, interest in the use of prophylactic swallowing exercises to prevent or minimize post-CRT swallowing dysfunction has grown" the authors write as background in the study. "Indeed, some cancer treatment centers recommend prophylactic swallowing exercises for all their patients undergoing CRT."

Tamar Kotz, M.S., C.C.C.-S.L.P., of the Mount Sinai Medical Center, New York, and colleagues conducted a randomized controlled trial of 26 patients with head and neck cancer who were receiving CRT. Half of the patients (n=13) were randomized to the intervention group, and performed five targeted swallowing exercises throughout their CRT and participated in weekly swallowing therapy sessions. The other half of patients (n=13) were randomized to the control group and received no swallowing exercises and were referred for swallowing treatment after completion of CRT if indicated.

The authors found that there were no statistically significant differences in swallowing scores on the Functional Oral Intake Scale (FOIS) between the intervention group and control group immediately following CRT. Additionally, there were no statistically significant differences in Eating in Public subscale scores between patients in the intervention group and those in the control group.

However, patients in the intervention group showed significantly better scores on both scales at three and six months following treatment. At nine and 12 months following treatment, however, scores on both scales between the intervention group and the control group were no longer significant. The authors note this could be due to the small sample size of the study.

"Continued study with a larger sample size is needed to expand on these findings and provide a more powerful analysis of the effect of prophylactic swallowing exercises on patients with HNC [head and neck cancer] treated with CRT," the authors conclude.