Page 112 - Functional impairment and cues for rehabilitation of head and neck cancer patients -

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Chapter 5
ABSTRACT
Objective: The objective was to assess swallowing, mouth opening and speech function during the first year after radiation-based treatment (RT(+)) combined with a dedicated preventive rehabilitation program for stage III-IV oropharyngeal carcinoma (OPC).
Methods: Swallowing, mouth opening and speech function were collected before and at six- and twelve-month follow-up after RT(+) for OPC as part of ongoing prospective assessments by speech-language pathologists.
Results: Objective and patient-perceived function deteriorated until six months and improved until twelve months after treatment, but did not return to baseline levels with 25%, 20% and 58% of the patients with objective dysphagia, trismus and speech problems, respectively. Feeding tube dependency and pneumonia prevalence was low.
Conclusion: A substantial proportion of patients experience functional limitations after RT(+) for OPC, suggesting room for improvement of the current rehabilitation program. Pretreatment sarcopenia seems to be associated with worse functional outcomes and might be a relevant target for rehabilitation strategies.