Document Type

Article

Publication Date

3-12-2025

Comments

This article is the author's final published version in BMC Cancer, Volume 25, Issue 1, 2025, Article number 442.

The published version is available at https://doi.org/10.1186/s12885-025-13756-2.

Copyright © The Author(s) 2025

Abstract

BACKGROUND: Patients with head and neck cancer (HNC) receiving radiation therapy (RT) are at increased risk for symptoms of oral mucositis (OM), opioid use, and declines in physical function, outcomes that contribute to increased morbidity and mortality. The study objective was to determine the effects of respiratory muscle training (RMT) on OM and opioid use, as well as functional performance in patients with HNC receiving RT with or without concurrent chemotherapy (CCRT).

METHODS: Patients aged ≥ 18 years of age with stage I to IV HNC being treated with RT or CCRT receiving a home-based respiratory muscle training (RMT) (n = 20) were compared to a 5:1 matched historical group (n = 100) who did not receive RMT. RMT was delivered using the commercially available Power Lung AireStream device (Houston, TX) via a standardized home-based inspiratory and expiratory muscle-training program requiring ~ 20-30 min/day, five days per week, with a progressively increasing workload. Primary endpoints collected from all patients included changes in OM symptoms and use of opioids for pain control following start of RT. Secondary outcomes collected on RMT patients included respiratory muscle strength and functional performance (Six-Minute Walk Test, 6MWT; Short Physical Performance Battery, SPPB). All measures were assessed before and within 1-2 weeks following a standard 7-week RT regimen.

RESULTS: RMT reduced the impact of self-reported swallowing soreness (p = 0.032), eating soreness (p = 0.036), and opioid use (p = 0.015). RMT maintained inspiratory muscle strength (+ 0.6 ± 18 cmH2O, p = 0.87), expiratory muscle strength (+ 0.7 ± 12.7 cmH2O, p = 0.197), and improved the 6MWT (+ 20 ± 39.9 m, p = 0.025), with no change in the SPPB total score (p = 0.262).

CONCLUSIONS: RMT is a low-cost intervention that is easy to perform among patients undergoing RT/RTCC for HNC and is likely to reduce OM pain/symptoms and opioid, as well as to preserve respiratory muscle strength and physical function during cancer treatment.

TRIAL REGISTRATION: Not applicable. This was a matched retrospective cohort study not registered as it was a nonrandomized trial with a historical control group.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

40075332

Language

English

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