Wearable Technologies in Head and Neck Oncology: Scoping Review.

Abstract

Background: Head and neck cancer (HNC) survivors face profound functional and quality-of-life deficits due to disease- and treatment-related sequelae, ranging from mild fatigue to debilitating dysphagia. Wearable technology, by monitoring biometric data such as step counts or providing swallowing biofeedback, offers a unique method for tracking and monitoring the negative effects of HNC.

Objective: The aim of this study was to explore the current applications of wearable technology in HNC.

Methods: A scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A search strategy was built, and a literature search was performed across 5 databases. The initial search yielded 5256 studies, which underwent a 2-phase screening process: title and abstract review followed by full-text review. Inclusion criteria included peer-reviewed, English-language articles published between January 2002 and April 2024 that used wearable technology in HNC care. After full-text review, 9 studies met the inclusion criteria. Data were manually extracted and synthesized narratively.

Results: The included studies examined 3 main types of wearable devices: radioactivity (2 studies), physical activity (4 studies), and throat physiology monitors (3 studies). Radioactivity monitors detected residual radioactivity and thyroidal radioiodine uptake. They demonstrated potential to reduce radioactivity exposure risk and personalize radiation doses for patients with thyroid cancer. Physical activity monitors tracked step counts, heart rate, and sleep habits. Low step counts were significantly associated with increased anxiety, radiation-related toxicity, hospital admission rates, and feeding tube placement. One study also linked poor sleep patterns to declines in quality of life. Throat physiology monitors measured pharyngeal electromyography data as well as extrinsic laryngeal muscle movements. Throat sensors achieved high accuracy in classifying swallowing events and translating muscle movements into speech. While earliest in the development continuum, they are promising tools for swallowing and vocal rehabilitation therapy. Barriers to wearable adoption included wearable discomfort, technical difficulties, and patient withdrawal due to treatment side effects. As the definition of wearable adherence varied widely, we propose that future studies report wearable adherence as "percentage of prescribed wear time achieved" to facilitate cross-study comparisons.

Conclusions: Wearable technology may enhance treatment monitoring, prognostication, and rehabilitation in head and neck oncology. Radioactivity and physical activity monitors provide actionable insights for clinical decision-making, while throat physiology monitors offer innovative solutions for speech and swallowing therapy. However, challenges such as device adherence, data integration, and patient comfort must be addressed to realize their full potential. Future research should prioritize larger, longitudinal studies, standardized adherence metrics, and consider the integration of artificial intelligence to refine predictive capabilities. By overcoming these barriers, wearable technology could transform survivorship care, improving functional outcomes and quality of life for patients with HNC.