The ReDyor study: Effects of prophylactic swallowing exercises on dysphagia and quality of life in patients with head and neck cancer receiving chemoradiation therapy, a randomized clinical trial

Abstract

Objective

To determine the best time to start rehabilitation to preserve swallowing function and enhance health-related quality of life in patients with head and neck cancer (HNC) undergoing chemoradiation therapy (CRT).

Material and methods

Randomized single-blind controlled trial study conducted at a tertiary university hospital. Fifty-two HNC patients treated with CRT were randomized into early intervention (EIG, at diagnosis) and late intervention groups (LIG, post-radiotherapy). Interventions included Inspiratory and Expiratory Muscle Strength Training and standard swallowing exercises for 21 weeks, starting 2 weeks before RT in EIG and immediately after RT in LIG. Functional parameters, dysphagia severity, and HRQoL were assessed at baseline, RT completion, and post-RT follow-ups (3, 6, 12 months).

Results

No significant differences were observed between groups, except for mouth interincisor opening at RT completion in EIG. At final assessment, PEmax% values recovered in EIG but deteriorated in LIG (p = 0.028). Speech problems decreased in EIG (p = 0.019) compared to baseline. PImax showed a positive trend in both groups. Both groups had isolated improvements in quality of life.

Conclusion

The effectiveness of rehabilitation was similar regardless of initiation timing, suggesting both early and late interventions are viable for preserving swallowing function and improving quality of life in HNC patients undergoing CRT.