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Multimodal Prehabilitation in Head and Neck Cancer Patients Undergoing Surgery: A Feasibility Study
Lennaert C B Groen1, Celine D de Vries2, Doriene C Mulder2
1Department of Surgery, Northwest clinics, Alkmaar, the Netherlands.
Summary
Multimodal prehabilitation shows potential for head and neck cancer surgery patients, but participation rates were limited. Future strategies like home-based programs or expanded physiotherapy networks are needed to improve feasibility.
Area of Science:
- Oncology
- Surgical Recovery
- Rehabilitation Medicine
Background:
- Head and neck cancer (HNC) incidence is rising, with surgery as a common curative treatment.
- Surgical complications and long-term functional deficits are frequent challenges in HNC patients.
- Multimodal prehabilitation has demonstrated improved outcomes in other surgical populations, such as colorectal cancer.
Purpose of the Study:
- To assess the feasibility of a multimodal prehabilitation program for patients undergoing head and neck cancer surgery.
- The program included high-intensity training, nutritional support, cessation of harmful habits, and psychological/speech therapy.
Main Methods:
- A feasibility study conducted at a teaching hospital from July 2022 to December 2023.
- Primary outcomes: participation, dropout, and adherence rates.
- Secondary outcome: functional capacity assessed 6 weeks postoperatively.
Main Results:
- Participation rate was 60%, primarily limited by travel distance to physiotherapy.
- A low dropout rate of 7% was observed.
- Significant improvements in functional tests, including the 6-minute walking test, were noted post-prehabilitation and persisted 6 weeks after surgery.
Conclusions:
- The multimodal prehabilitation program's feasibility in HNC surgery is constrained by a 60% participation rate.
- Strategies to enhance participation include expanding the network of oncologic physiotherapists or implementing home-based prehabilitation via an app.
- Further research is necessary to determine the optimal prehabilitation approach for this patient group.
