A randomized controlled trail of combination therapy of neuromuscular electrical stimulation and balloon dilatation in the treatment of radiation-induced dysphagia in nasopharyngeal carcinoma patients

Dysphagia is a most common complication induced by radiotherapy in nasopharyngeal carcinoma (NPC) patients. This randomized controlled trail (RCT) was performed to evaluate the therapeutic effect of combination therapy of neuromuscular electrical stimulation (NMES) and balloon dilatation in the treatment of radiation-induced dysphagia in NPC patients. Sixty NPC patients with radiation-induced dysphagia were assigned to either the combination rehabilitation group (treatment group) or the routine rehabilitation group (control group) at random. Both groups were subjected to routine rehabilitation treatment, while the combination rehabilitation group also received combination therapy of NMES and balloon dilatation for 4 months. The water swallow test (WST) and videofluoroscopic swallowing study (VFSS) were used to evaluate the severity of dysphagia. The treatment group showed a significant improvement in swallowing function when compared with the control group. When the WST was used, the efficacy rate (percentage of patients with excellent and effective results) of treatment group was higher than that of control group (90.1 vs. 76.3%), and the difference was statistically significant (χ² = 8.55, p = 0.036). When the VFSS was used, the videofluoroscopy results in our study showed that the values of oral transit time (OTT), swallow reaction time (SRT), pharyngeal transit time (PTT) and laryngeal closure duration (LCD) in treatment group were notably improved when compared with those in control group. In conclusion, combination rehabilitation treatment can improve swallow function in the treatment of radiation-induced dysphagia in NPC patients.

Implications for Rehabilitation

• Dysphagia is also a most important complication associated with radiotherapy and may result in serious complications, such as aspiration pneumonia, and permanent or long-term feeding tube dependence which significantly decrease the quality of life of nasopharyngeal carcinoma patients (NPC).

• Rehabilitation treatment is the most important therapy scheme for radiation-induced dysphagia, and neuromuscular electrical stimulation and balloon dilatation are useful therapy method for dysphagia.

• Combination rehabilitation treatment can improve swallow function in the treatment of radiation-induced dysphagia in NPC.