Effects of Adjuvant Respiratory Therapy on Secretion Expectoration and Treatment Adherence in Patients with Head and Neck Cancer Receiving Concurrent Chemo-Radiotherapy

Purpose: Common complaints of head and neck cancer patients receiving concurrent chemo-radiotherapy (CCRT) are dry mouth, dysphagia, trismus, hoarseness, sore throat, and oral mucosal damage, which result in retained secretions and difficult expectoration. We aimed to investigate the effect of adjuvant respiratory therapy on secretion expectoration and treatment completion in patients with head and neck cancer receiving CCRT. Materials and Methods: From November 2016 to May 2018, 56 head and neck cancer patients were recruited retrospectively, and according to their respiratory therapy in medical record, were divided into control group (CG, n=27) or the research group (RG, n=29). In the CG, the patients were treated via teaching of routine breathing exercises and expel techniques, while patients in the RG were treated with inhalation of a ß-agonist bronchodilator agent, 5 times each week, in addition to the standard treatment administered in the CG. Results: The total completion rate of treatment was significantly higher in the RG (21 patients) compared with the CG (12 patients) (72.4% vs 44.4%, p< 0.05). After therapy, the rates of clinical symptoms were significantly increased in the RG compared with the CG, including smooth expectoration (76.2% vs 75.0%), decreased secretions (61.9% vs 58.3%), reduced viscosity of secretions (66.7% vs 58.3%), lower cough frequency (71.4% vs 50.0%), improved sore throat (52.4% vs 41.7%) and swallowing function (52.4% vs 50.0%). The continuation of chemo-radiotherapy without disruption was higher in the RG than it was in the CG (66.7% vs 50.0%). There was no significant difference in adverse effects between the two groups. Conclusions: Adjuvant respiratory therapy not only improves secretion expectoration, but also reduces side effects, thus promoting completion of the CCRT schedule in patients with head and neck cancer.