Effectiveness of physical activity interventions in improving objective and patient-reported outcomes in head and neck cancer survivors: A systematic review


Author: Patrick T Lynch1, Sami Horani1, Rebecca Lee1, Baran D Sumer2, Simon C Lee3, Helen G Mayo4, Chad Rethorst5, Andrew T Day6

Affiliation: <sup>1</sup> Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, United States.

<sup>2</sup> Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, United States; Population Science & Cancer Control, UT Southwestern Simmons Comprehensive Cancer Center, Dallas, TX, United States.

<sup>3</sup> Population Science & Cancer Control, UT Southwestern Simmons Comprehensive Cancer Center, Dallas, TX, United States.

<sup>4</sup> Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, United States; UT Southwestern Medical Center Library, Dallas, TX, United States.

<sup>5</sup> Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States.

<sup>6</sup> Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, United States; Population Science & Cancer Control, UT Southwestern Simmons Comprehensive Cancer Center, Dallas, TX, United States. Electronic address: andrew.day@utsouthwestern.edu.
Conference/Journal: Oral Oncol
Date published: 2021 Apr 23
Other:
 Volume ID: 117   ,  Pages: 105253   ,  Special Notes: doi: 10.1016/j.oraloncology.2021.105253.   ,  Word Count: 269  
    Objective:

To assess the effectiveness of physical activity interventions in improving objective and patient-reported outcomes in HNC survivors.



Introduction:

Multiple guidelines recommend that head and neck cancer (HNC) survivors participate in regular physical activity. Physical activity is associated with improved outcomes and mortality in healthy individuals as well as in certain cancer populations. However, the effectiveness of physical activity interventions in HNC survivors is inadequately understood.



Methods and results:

Our literature search through December 2018 identified 2,392 articles. After de-duplication, title and abstract review, full-text review and bibliographic search, 20 studies met all inclusion criteria. Inclusion criteria included any full-body physical activity intervention in HNC survivors that did not target discrete organ sites or functions (e.g. swallowing). Study cohorts included 749 predominantly male participants with a mean age range of 48-63 years. At their conclusion, physical activity interventions were associated with at least one significant improvement in an objective or patient-reported outcome in 75% of studies. Aerobic capacity and fatigue were the most commonly improved outcomes. None of the included studies evaluated associations with survival or recurrence. Although traditional aerobic and resistance interventions were more common, a greater proportion of alternative physical activity (yoga and Tai Chi) interventions demonstrated improved objective and patient-reported outcomes.



Conclusion:

Physical activity interventions in HNC survivors often conferred some improvement in objective and patient-reported outcomes. Additional highly-powered, randomized controlled studies are needed to establish the optimal type, intensity, and timing of physical activity interventions as well as their impact on oncologic outcomes.



Keywords: Cancer survivors; Exercise interventions; Head and neck cancer; Outcomes; Physical activity interventions; Quality of life; Recurrence; Squamous cell carcinoma; Survival; Survivorship.



PMID: 33901767 DOI: 10.1016/j.oraloncology.2021.105253