Improving dysphagia care in head and neck cancer patients treated with radiotherapy

BJMO - volume 17, issue 6, october 2023

M. Baudelet PhD, F. Duprez MD, PhD, M. De Bodt PhD, G. Van Nuffelen PhD


Dysphagia is a common and widely reported complication during and after radiotherapy (RT) for head and neck cancer (HNC), affecting quality of life (QoL). Research concerning the use of prophylactic swallowing exercises (PSE) is growing, and positive effects on muscle composition, swallowing function and QoL have already been demonstrated. However, low adherence to PSE undermines the beneficial effects. The PRESTO program, an optimised, patient-tailored and evidence-based prophylactic swallowing program augmented with adherence-improving measures was, therefore, developed. Different general but also more specific methods to increase adherence were considered. The way the PSE program was delivered depended on the treatment group (paper-, app- or therapist-supported PSE). After implementing PRESTO in 148 oropharyngeal cancer patients treated at four different hospitals in Flanders, results showed that the adherence towards PSE was the highest in the therapist-supported group. Face-to-face therapy may, thus, solve the problem of low adherence rates. In addition, it was observed that only patients practising at a high frequency (≥75% of the prescribed exercises) would achieve positive effects of the PSE on swallowing function and muscle strength. The results of this PhD research are clinically relevant and contribute to better supportive care in patients with HNC.

(Belg J Med Oncol 2023;17(6):236–8)

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De-escalation of therapy in head and neck cancer: Where are we standing now, anno 2022?

BJMO - volume 16, issue 4, june 2022

W. Lybaert MD, R. de Bree MD, PhD, J. Meulemans MD, PhD, J-F. Daisne MD, PhD, F. Duprez MD, PhD, D. Nevens MD, PhD, R. Van Hoeyweghen MD, PhD, K. Boeykens RN , J. De Ceulaer MD, W. Huvenne MD, PhD, O. Lenssen MD


The annual winter meeting of the ‘Vlaamse Werkgroep Hoofd-Hals Tumoren’ on 11 December 2021 handled the different possible de-escalation strategies in the treatment of squamous cell carcinoma of the head and neck region (SCCHN) in anno 2022. Which surgical techniques can be used nowadays to diminish long-term morbidities in SCCHN? To which extent can we lower radiotherapy doses and regions in the treatment planning of SCCHN? Are the systemic treatment options of SCCHN always radical for each patient or more personalised? Is a comprehensive geriatric assessment feasible and already used in our head and neck oncology practice? Last but not least, how can we optimally sustain our patients with nutrition before, during and after treatment of head and neck cancer?

(BELG J MED ONCOL 2022;16(4):198–208)

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