Functional outcomes and quality of life after a 6-month early intervention program for oral cancer survivors: a single-arm clinical trial

Yueh-Hsia Chen; Wei-An Liang; Chung-Yin Hsu; Siang-Lan Guo; Shwu-Huei Lien; Hsiao-Jung Tseng; Yuan-Hung Chao

doi:10.7717/peerj.4419

Functional outcomes and quality of life after a 6-month early intervention program for oral cancer survivors: a single-arm clinical trial

PeerJ. 2018 Feb 21:6:e4419. doi: 10.7717/peerj.4419. eCollection 2018.

Authors

Yueh-Hsia Chen¹, Wei-An Liang¹, Chung-Yin Hsu², Siang-Lan Guo¹, Shwu-Huei Lien¹, Hsiao-Jung Tseng³, Yuan-Hung Chao^{2

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Affiliations

¹ Rehabilitation Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan.
² School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan.
⁴ Rehabilitation Center, National Taiwan University Hospital Chu-Tung Branch, Hsinchu County, Taiwan.
⁵ Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan.

Abstract

Background: Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. This single-arm preliminary pilot study aims to explore the effects of a six-month early intervention program following reconstructive surgery in oral cancer survivors.

Methods: A total of 65 participants were analyzed following reconstructive surgery. Outcome measurements were taken during the first visit, and at one, three and six months after reconstructive surgery.

Results: Scapular muscle strength and shoulder range of motion progressively improved during the 6-month follow-up. The mean Disability of the Arms, Shoulder and Hand (DASH) score showed significant improvement at 1 month (p < .001). Health related QoL showed significant differences between baseline and 6-months post-surgery scores on global health and on most of the function and symptom scales. The predicted return-to-work rate was 80% at one year after the operation. Return-to-work rate differs in different vocational types, with a higher rate of return in the skilled or semi-skilled (87.5%) and self-employed (86.7%).

Conclusions: We suggest that early integrated intervention program with a follow-up of at least six months following reconstructive surgery may help develop and identify intervention guidelines and goals in the initial six months of treatment following neck dissection in oral cancer survivors.

Keywords: Oral cancer; Quality of life; Return to work; Shoulder dysfunction.

Grants and funding

This study was financially supported by the Chang Gung Medical Research Program (CMPRG3E0611), Tauyuan, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.