The Evaluation of Manual Therapy for the Prevention of Radiation-Induced Fibrosis in Patients With Head and Neck Cancer

NCT ID: NCT04850170

Last Updated: 2022-03-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-01

Study Completion Date

2025-12-31

Brief Summary

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The subjects in this study are the patients with head and neck cancer after completion of the radiotherapy. Radiation-induced fibrosis is inevitable and there is no effective treatment to prevent it. Therefore, there are two parts in this study :

The first part is a pilot study. There will be 10 subjects included and manual therapy and rehabilitation will be arranged for 6 months. The manual therapy would be once a week at most, and the rehabilitation would be twice a week at most.

The second part is a randomized controlled study. 60 patients would be randomized divided into two groups. The group 1 is manual therapy(once a week at most) and rehabilitation(twice a week at most), and the group 2 is rehabilitation only(twice a week at most). Patients would be evaluated at baseline, 3rd, 6th, and 12th month. The evaluation is including the degree of superficial soft tissue fibrosis, numerical rating scale of pain, range of motion(neck), range of motion(shoulder), width of mouth opening, EORTC QLQ C30, EORTC QLQ H\&N 35, and functional oral intake scale. Besides, swallowing video fluoroscopy would be done at baseline, 6th, and 12th month.

When the subject completes the evaluation in the 12th month, the study is ended.

Because the radiation-induced fibrosis is progressed with time, we will follow up the condition of subjects at the next year and the following third year.

Detailed Description

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Conditions

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Radiation-Induced Fibrosis in Patients With Head and Neck Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The subjects in this study are the patients with head and neck cancer after completion of the radiotherapy. Radiation-induced fibrosis is inevitable and there is no effective treatment to prevent it now. Therefore, there are two parts in this study :

The first part is a pilot study. There will be 10 subjects included and manual therapy and rehabilitation will be arranged for 6 months. The manual therapy would be once a week at most, and the rehabilitation would be twice a week at most.

The second part is a randomized controlled study. 60 patients would be randomized divided into two groups. The group 1 is manual therapy(once a week at most) and rehabilitation(twice a week at most), and the group 2 is rehabilitation only(twice a week at most).
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Experimental group

The first ten subjects will be enrolled in a pilot study. The following sixty subjects will be separated randomly to experimental group and control group.

The first ten subjects and the experimental group will be arranged manual therapy and rehabilitation for six months.

Group Type EXPERIMENTAL

manual therapy

Intervention Type PROCEDURE

1. release and stretch the muscles and fascia around shoulder girdle、upper arm and forearm;
2. massage the masseter muscle and temporalis muscle;
3. mobilization of the temporomandibular joint, the thoracic and cervical spine, shoulder, and elbow.

Speech therapy

Intervention Type PROCEDURE

include the stretching of the neck, facial and oral movement training, and swallowing training

Control group

The control group will be arranged rehabilitation.

Group Type ACTIVE_COMPARATOR

Speech therapy

Intervention Type PROCEDURE

include the stretching of the neck, facial and oral movement training, and swallowing training

Interventions

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manual therapy

1. release and stretch the muscles and fascia around shoulder girdle、upper arm and forearm;
2. massage the masseter muscle and temporalis muscle;
3. mobilization of the temporomandibular joint, the thoracic and cervical spine, shoulder, and elbow.

Intervention Type PROCEDURE

Speech therapy

include the stretching of the neck, facial and oral movement training, and swallowing training

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age \> 20 years
2. Head and neck cancer
3. After Completion of radiation therapy for 4 to 6 weeks
4. Be willing to accept manual therapy and long-term follow up

Exclusion Criteria

1. Recurrence, metastatic cancer, or concurrent second cancer
2. With post-radiation dermatitis at neck or shoulder
3. Current pregnancy or lactation
4. Life expectancy of \< 12 months.
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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New Taipei Municipal Tucheng Hospital

New Taipei City, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Tsung-Hsien Yang, MD

Role: CONTACT

886-975-362-728

Facility Contacts

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TsungHsien Yang

Role: primary

886-975-362-728

References

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Wang B, Wei J, Meng L, Wang H, Qu C, Chen X, Xin Y, Jiang X. Advances in pathogenic mechanisms and management of radiation-induced fibrosis. Biomed Pharmacother. 2020 Jan;121:109560. doi: 10.1016/j.biopha.2019.109560. Epub 2019 Nov 15.

Reference Type BACKGROUND
PMID: 31739160 (View on PubMed)

Purkayastha A, Sharma N, Sarin A, Bhatnagar S, Chakravarty N, Mukundan H, Suhag V, Singh S. Radiation Fibrosis Syndrome: the Evergreen Menace of Radiation Therapy. Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):238-245. doi: 10.4103/apjon.apjon_71_18.

Reference Type BACKGROUND
PMID: 31259219 (View on PubMed)

Hojan K, Milecki P. Opportunities for rehabilitation of patients with radiation fibrosis syndrome. Rep Pract Oncol Radiother. 2013 Aug 8;19(1):1-6. doi: 10.1016/j.rpor.2013.07.007. eCollection 2014 Jan.

Reference Type BACKGROUND
PMID: 24936313 (View on PubMed)

Moloney EC, Brunner M, Alexander AJ, Clark J. Quantifying fibrosis in head and neck cancer treatment: An overview. Head Neck. 2015 Aug;37(8):1225-31. doi: 10.1002/hed.23722. Epub 2014 Jul 11.

Reference Type BACKGROUND
PMID: 24797251 (View on PubMed)

Davis AM, Dische S, Gerber L, Saunders M, Leung SF, O'Sullivan B. Measuring postirradiation subcutaneous soft-tissue fibrosis: state-of-the-art and future directions. Semin Radiat Oncol. 2003 Jul;13(3):203-13. doi: 10.1016/S1053-4296(03)00022-5.

Reference Type BACKGROUND
PMID: 12903010 (View on PubMed)

Raj VS, Pugh TM, Yaguda SI, Mitchell CH, Mullan SS, Garces NS. The Who, What, Why, When, Where, and How of Team-Based Interdisciplinary Cancer Rehabilitation. Semin Oncol Nurs. 2020 Feb;36(1):150974. doi: 10.1016/j.soncn.2019.150974. Epub 2020 Jan 16.

Reference Type BACKGROUND
PMID: 31955923 (View on PubMed)

Krisciunas GP, Vakharia A, Lazarus C, Taborda SG, Martino R, Hutcheson K, McCulloch T, Langmore SE. Application of Manual Therapy for Dysphagia in Head and Neck Cancer Patients: A Preliminary National Survey of Treatment Trends and Adverse Events. Glob Adv Health Med. 2019 Apr 24;8:2164956119844151. doi: 10.1177/2164956119844151. eCollection 2019.

Reference Type BACKGROUND
PMID: 31041144 (View on PubMed)

Krisciunas GP, Golan H, Marinko LN, Pearson W, Jalisi S, Langmore SE. A novel manual therapy programme during radiation therapy for head and neck cancer - our clinical experience with five patients. Clin Otolaryngol. 2016 Aug;41(4):425-31. doi: 10.1111/coa.12535. Epub 2016 Feb 8. No abstract available.

Reference Type BACKGROUND
PMID: 26381894 (View on PubMed)

Other Identifiers

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CMRPVVL0081

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

202002052A3

Identifier Type: -

Identifier Source: org_study_id

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