Impact of transcutaneous neuromuscular electrical stimulation on dysphagia in patients with head and neck cancer treated with definitive chemoradiation.
BACKGROUND
The purpose of this study was to investigate the role of transcutaneous neuromuscular electrical stimulation (TNMES) therapy in maintaining swallowing function during chemoradiation for locally advanced head and neck cancer.


METHODS
We retrospectively compared 43 consecutive patients with locally advanced head and neck cancer treated with TNMES (treatment group) to 55 control patients. Validated swallowing scale scores were assigned.


RESULTS
All patients' swallowing scores declined post-chemoradiotherapy. A difference in mean decline in scores for the control group versus the treatment group using the Functional Oral Intake Scale (FOIS) was seen, favoring TNMES intervention (23% vs 7%; p = .015). Age, race, >10 pack-years smoking, diabetes, stage, nodal disease, accelerated fractionation, weight loss, dietary modification, no TNMES, and radiotherapy dose were all significant for poorer scores on the swallowing scales.


CONCLUSIONS
TNMES should be considered an adjunct to dysphagia reduction and possible prevention in patients with locally advanced head and neck cancer. Further studies should be conducted to define the benefit of TNMES intervention.
Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Aashish D
AD
Bhatt
Department of Speech-Language Pathology, University of Louisville, Louisville, Kentucky.
Nicole
N
Goodwin
Department of Surgery, Division of Otolaryngology-HNS, University of Louisville School of Medicine, Louisville, Kentucky.
Elizabeth
E
Cash
Department of Internal Medicine, University of Louisville, Louisville, Kentucky.
Geetika
G
Bhatt
Department of Radiation Oncology, University of Louisville, Louisville, Kentucky.
Craig L
CL
Silverman
Department of Radiation Oncology, University of Louisville, Louisville, Kentucky.
William J
WJ
Spanos
Department of Surgery, Division of Otolaryngology-HNS, University of Louisville School of Medicine, Louisville, Kentucky.
Jeffrey M
JM
Bumpous
Department of Surgery, Division of Otolaryngology-HNS, University of Louisville School of Medicine, Louisville, Kentucky.
Kevin
K
Potts
Department of Internal Medicine, Division of Hematology-Oncology, University of Louisville, Louisville, Kentucky.
Rebecca
R
Redman
Advanced ENT and Allergy, Louisville, Kentucky.
Wes A
WA
Allison
Department of Radiation Oncology, University of Louisville, Louisville, Kentucky.
Neal E
NE
Dunlap
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000503:physiopathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*
Vital Stim; chemotherapy; dysphagia; laryngectomy; radiation