A Pilot Randomized Prospective Study of Exercise Rehabilitation Program and Neuromuscular Electrical Stimulation as Adjuvant Treatment for Nasopharyngeal Carcinoma Patients with Postradiotherapy Dysphagia

Objectives: The primary treatment for nasopharyngeal carcinoma (NPC) is radiotherapy, with or without concurrent chemotherapy.Dysphagia is a common complication induced by radiotherapy in NPC patients.Neuromuscular electrical stimulation (NMES) is an emerging therapy that complements existing treatment protocols for dysphagia.This pilot study was performed to evaluate the therapeutic effect of a combination therapy of NMES and an exercise rehabilitation program for radiation-induced dysphagia in NPC patients.Materials and methods: This pilot prospective randomized controlled interventional study included six NPC patients with chronic postradiotherapy dysphagia, who were assigned to either a routine therapy or a combined therapy group.Both groups were subjected to a routine swallowing rehabilitation program, while subjects in the combined therapy group also received NMES for 8 weeks.The Eating Assessment Tool-10 (EAT-10) was used to evaluate symptom severity, while the Functional Oral Intake Scale (FOIS) was utilized to document the functional level of oral intake.All subjects underwent videofluoroscopic swallowing study before and after completing the 8-week intervention program.Results: The median percentage of improvement in FOIS and EAT-10 was higher in the combination therapy group.Median percentage of improvement in penetration-aspiration scale score with fluid and paste bolus; oral transit time with paste and semi-solid bolus; and pharyngeal transit time with all bolus consistencies were higher in the combination therapy group.Conclusion: Combination therapy using an exercise rehabilitation program and NMES has more positive effects in the treatment of postradiotherapy dysphagia in NPC patients.These two techniques should be implemented in all postradiation NPC patients with significant dysphagia.Further research is warranted.