Impact of transcutaneous neuromuscular electrical stimulation on dysphagia in patients with head and neck cancer treated with definitive chemoradiation

Head Neck. 2015 Jul;37(7):1051-6. doi: 10.1002/hed.23708. Epub 2015 Apr 6.

Abstract

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.

Conclusion: 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.

Keywords: Vital Stim; chemotherapy; dysphagia; laryngectomy; radiation.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell
  • Chemoradiotherapy*
  • Combined Modality Therapy
  • Deglutition / physiology*
  • Deglutition Disorders / physiopathology*
  • Female
  • Head and Neck Neoplasms / physiopathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Retrospective Studies
  • Transcutaneous Electric Nerve Stimulation / methods*