Pre-rehabilitation Interventions for Patients With Head and Neck Cancers: A Systematic Review and Meta-Analysis

Head & Neck

Seth, I., Bulloch, G., et al. (2023).

Head & Neck, 46(1), 86-117.

This systematic review and meta-analysis investigates the effects of pre-habilitative interventions delivered prior to cancer treatment (e.g., chemotherapy, radiation therapy) for patients with head and neck cancer. This article summary contains findings related to speech-language pathology (SLP) scope of practice (i.e., prophylactic swallowing therapy).

Not stated

From database inception to December 2022

Randomized controled trials, non-randomized controlled trials, and observational studies

31 (29 within SLP scope of practice)

<div>In adults with HNC, prehabilitative dysphagia exercises improved:</div> <ul> <li><span style="color: #333333;"><strong>length of stay</strong> (MD = -20.6 days; 1 study); </span></li> <li><span style="color: #333333;"><strong>dysphagia incidence </strong>(risk ratio [RR] = 0.55; 3 studies); and</span></li> <li><span style="color: #333333;"><strong>pain</strong> (MD = -11.5) as measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30; 1 study).</span></li> </ul> <div><span style="color: #333333;">Prehabilitative dysphagia exercises had no significant effect on:</span></div> <ul> <li><span style="color: #333333;"><strong>weight loss </strong>(2 studies);</span></li> <li><span style="color: #333333;"><strong>maximum mouth opening</strong> (3 studies);</span></li> <li><span style="color: #333333;"><strong>incidence of mucositis</strong> (1 study);</span></li> <li><span style="color: #333333;"><strong>incidence of serious complications</strong> (5 studies); and</span></li> <li><span style="color: #333333;"><strong>EORTC QLQ-C30 scores</strong> for swallowing symptoms (2 studies), trouble with social eating (2 studies), and overall physical functioning (1 study).</span></li> </ul> <div><span style="color: #333333;">Limitations to this review include heterogeneity between studies, unclear methodology of included studies, limited sample sizes within sub-analyses, and a homogenous population (i.e., predominately European or Caucasian). Additional, high-quality research is indicated.</span></div>