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Randomized Controlled Trial
. 2020 May;42(5):873-885.
doi: 10.1002/hed.26060. Epub 2020 Jan 6.

Prophylactic swallowing therapy for patients with head and neck cancer: A three-arm randomized parallel-group trial

Laurelie R Wall  1   2   3   4 , Elizabeth C Ward  1   3   4 , Bena Cartmill  1   2 , Anne J Hill  3   4 , Elizabeth Isenring  5 , Joshua Byrnes  6 , Sandro V Porceddu  7   8
Affiliations
Randomized Controlled Trial

Prophylactic swallowing therapy for patients with head and neck cancer: A three-arm randomized parallel-group trial

Laurelie R Wall et al. Head Neck. 2020 May.

Abstract

Background: Intensive prophylactic swallowing therapy can mitigate dysphagia in patients with oropharyngeal (OP) SCC, however, presents service challenges. This trial investigated the clinical efficacy of three service models delivering prophylactic swallowing therapy during (chemo)radiotherapy ([C]RT).

Methods: Patients (n = 79) with OPSCC receiving (C)RT were were randomized to: (a) clinician-directed face-to-face therapy (n = 26); (b) telepractice therapy via "SwallowIT" (n = 26); or (c) patient self-directed therapy (n = 27). Swallowing, nutritional, and functional status were compared at baseline, 6-weeks, and 3-months post-(C)RT. Patients' perceptions/preferences for service-delivery were collated posttreatment.

Results: Service-delivery mode did not affect clinical outcomes, with no significant (P > .05) between-group differences or group-by-time interactions observed for swallowing, nutrition, or functional measures. Therapy adherence declined during (C)RT in all groups. SwallowIT and clinician-directed models were preferred by significantly (P = .002) more patients than patient-directed.

Conclusions: SwallowIT provided clinically equivalent outcomes to traditional service models. SwallowIT and clinician-directed therapy were preferred by patients, likely due to higher levels of therapy support.

Keywords: dysphagia; head and neck cancer; prophylactic swallowing therapy; randomized controlled trial; service-delivery; telehealth.

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