Aashish D Bhatt1, Nicole Goodwin2, Elizabeth Cash3, Geetika Bhatt4, Craig L Silverman5, William J Spanos5, Jeffrey M Bumpous3, Kevin Potts3, Rebecca Redman6, Wes A Allison7, Neal E Dunlap5. 1. Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts. 2. Department of Speech-Language Pathology, University of Louisville, Louisville, Kentucky. 3. Department of Surgery, Division of Otolaryngology-HNS, University of Louisville School of Medicine, Louisville, Kentucky. 4. Department of Internal Medicine, University of Louisville, Louisville, Kentucky. 5. Department of Radiation Oncology, University of Louisville, Louisville, Kentucky. 6. Department of Internal Medicine, Division of Hematology-Oncology, University of Louisville, Louisville, Kentucky. 7. Advanced ENT and Allergy, Louisville, Kentucky.
Abstract
BACKGROUND: The purpose of this study was to investigate the role of transcutaneous neuromuscular electrical stimulation (TNMES) therapy in maintaining swallowing function during chemoradiation for locally advanced head and neck cancer. METHODS: We retrospectively compared 43 consecutive patients with locally advanced head and neck cancer treated with TNMES (treatment group) to 55 control patients. Validated swallowing scale scores were assigned. RESULTS: All patients' swallowing scores declined post-chemoradiotherapy. A difference in mean decline in scores for the control group versus the treatment group using the Functional Oral Intake Scale (FOIS) was seen, favoring TNMES intervention (23% vs 7%; p = .015). Age, race, >10 pack-years smoking, diabetes, stage, nodal disease, accelerated fractionation, weight loss, dietary modification, no TNMES, and radiotherapy dose were all significant for poorer scores on the swallowing scales. CONCLUSION: TNMES should be considered an adjunct to dysphagia reduction and possible prevention in patients with locally advanced head and neck cancer. Further studies should be conducted to define the benefit of TNMES intervention.
BACKGROUND: The purpose of this study was to investigate the role of transcutaneous neuromuscular electrical stimulation (TNMES) therapy in maintaining swallowing function during chemoradiation for locally advanced head and neck cancer. METHODS: We retrospectively compared 43 consecutive patients with locally advanced head and neck cancer treated with TNMES (treatment group) to 55 control patients. Validated swallowing scale scores were assigned. RESULTS: All patients' swallowing scores declined post-chemoradiotherapy. A difference in mean decline in scores for the control group versus the treatment group using the Functional Oral Intake Scale (FOIS) was seen, favoring TNMES intervention (23% vs 7%; p = .015). Age, race, >10 pack-years smoking, diabetes, stage, nodal disease, accelerated fractionation, weight loss, dietary modification, no TNMES, and radiotherapy dose were all significant for poorer scores on the swallowing scales. CONCLUSION: TNMES should be considered an adjunct to dysphagia reduction and possible prevention in patients with locally advanced head and neck cancer. Further studies should be conducted to define the benefit of TNMES intervention.
Authors: Danila Rodrigues Costa; Paulo Sérgio da Silva Santos; Cássia Maria Fischer Rubira; Giédre Berretin-Felix Journal: SAGE Open Med Date: 2020-12-14