Prophylactic exercises among head and neck cancer patients during and after swallowing sparing intensity modulated radiation: adherence and exercise performance levels of a 12-week guided home-based program

• Published in: European archives of oto-rhino-laryngology 2017-02, Vol.274 (2), p.1129-1138
• Main Authors: Cnossen, Ingrid C., van Uden-Kraan, Cornelia F., Witte, Birgit I., Aalders, Yke J., de Goede, Cees J. T., de Bree, Remco, Doornaert, Patricia, Rietveld, Derek H. F., Buter, Jan, Langendijk, Johannes A., Leemans, C. René, Verdonck-de Leeuw, Irma M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Deglutition Disorders - etiology; Deglutition Disorders - prevention & control; Exercise Therapy - methods; Female; Follow-Up Studies; Head and Neck; Head and Neck Neoplasms - radiotherapy; Head and Neck Surgery; Home Care Services; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Otorhinolaryngology; Patient Compliance - statistics & numerical data; Prospective Studies; Radiotherapy, Intensity-Modulated - adverse effects; Radiotherapy, Intensity-Modulated - methods; Treatment Outcome
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-016-4367-9

The background and purpose of this paper is to investigate adherence, exercise performance levels and associated factors in head and neck cancer (HNC) patients participating in a guided home-based prophylactic exercise program during and after treatment [swallowing sparing intensity modulated radiation therapy (SW-IMRT)]. Fifty patients were included in the study. Adherence was defined as the percentage of patients who kept up exercising; exercise performance level was categorized as low: ≤1, moderate: 1–2, and high: ≥2 time(s) per day, on average. Associations between 6- and 12-week exercise performance levels and age, gender, tumour site and stage, treatment, intervention format (online or booklet), number of coaching sessions, and baseline HNC symptoms (EORTC-QLQ-H&N35) were investigated. Adherence rate at 6 weeks was 70% and decreased to 38% at 12 weeks. In addition, exercise performance levels decreased over time (during 6 weeks: 34% moderate and 26% high; during 12 weeks: 28% moderate and 18% high). The addition of chemotherapy to SW-IMRT [(C)SW-IMRT] significantly deteriorated exercise performance level. Adherence to a guided home-based prophylactic exercise program was high during (C)SW-IMRT, but dropped afterwards. Exercise performance level was negatively affected by chemotherapy in combination with SW-IMRT.