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)