Respiratory muscle function and exercise capacity in a stage 4 head-and-neck cancer patient receiving chemoradiotherapy

Abstract

Background: Reduced physical and functional capacity is one of the main treatment-related side effects of chemoradiation therapy in head-and-neck cancer patients. We evaluated a case of a head-and-neck cancer patient who was undergoing chemoradiation and was assessed for various components of cardiopulmonary function that plays a vital role in the treatment prognosis. The aim of this case report was to evaluate the respiratory muscle function and exercise capacity of a head-and-neck cancer patient receiving chemoradiation therapy. Settings and Design: From among the newly diagnosed admitted to the hospital care, a 60-year-old male with supraglottic carcinoma, who was undergoing concomitant chemoradiation for 7 weeks, was evaluated for various components of cardiopulmonary function. Subjects and Methods: Outcomes assessed were diaphragm function (mobility and thickness), maximal inspiratory pressure and maximal expiratory pressure, and 6-min walk test at baseline (pre), after 3 weeks, and after 7 weeks of chemoradiation therapy. The data were quantitatively analyzed to interpret the difference of respiratory muscle function and exercise capacity. Results: Evaluation of these outcomes showed a significant decrease from the baseline till the end of the 7 th week. Conclusions: Therefore, concomitant chemoradiation therapy substantially decreased the respiratory muscle function and exercise capacity in the head-and-neck cancer patient.

Effect of exercise across the head and neck cancer continuum: a systematic review of randomized controlled trials

“…The general characteristics of the included studies are presented in Table 1 . Briefly, two trials were conducted in the US [ 26 , 27 ], two in India [ 28 , 29 ], two in Taiwan [ 30 , 31 ], and one each in Canada [ 32 ], Germany [ 33 ] and Denmark [ 34 ]. Overall, seven trials applied a randomized controlled trial design [ 26 – 31 ] [ 33 ], whereas two performed a cross-over randomized controlled trial [ 32 ] [ 34 ].…”

“…The sample size across the studies varied from 15 to 148 patients. Six research articles specified the cancer sites across the head and neck district [ 26 , 27 , 29 , 31 , 32 , 34 ], and the disease stage varied from stage I to IV, with two trials that did not report it [ 28 , 30 ]. Overall, the risk of bias assessment revealed some concerns for eight trials, whereas, in one investigation, the risk of bias was high (Supplementary Information).…”

“…Two studies did not report the exercise intensity [ 26 , 32 , 33 ], whereas four investigations declared to have performed a progressive exercise prescription [ 26 , 31 – 33 ]. Concerning supervision, three studies stated to start the exercise intervention with a supervised phase followed by an unsupervised period [ 26 , 27 , 29 ], three proposed a supervised program [ 28 , 31 , 33 ], and one a mixed program with supervised and unsupervised sessions in the same week [ 32 ].…”

“…Feasibility was the primary aim in three trials [ 26 , 27 , 33 ], assessed through recruitment rate, adherence rate to the exercise intervention, and withdrawals. Six out of eight trials reported a recruitment rate ranging from 20 to 32.3% [ 26 , 28 , 29 , 32 , 33 , 35 ]. Adherence to the exercise intervention was provided by five studies and varied from 45.2% to 93.1% [ 26 , 27 , 31 – 33 ].…”

“…Dropout rates among the patients allocated in the intervention group ranged from 0 to 38.7%, whereas for controls varied between 0 and 28.6% [ 26 – 32 ]. Regarding safety, only three studies reported the safety profile of exercise [ 26 , 28 , 33 ]. Samuel and colleagues stated that no adverse events occurred during the study [ 28 ], whereas in the investigations of Grote et al [ 33 ] and Rogers et al [ 26 ], non-exercise-related adverse events were reported ( Table 2 ).…”