Trial Outcomes & Findings for Investigation of Two Swallowing Therapy Models During Radiation Therapy for Head and Neck Cancer (NCT NCT03832686)

NCT ID: NCT03832686

Last Updated: 2024-04-10

Results Overview

Measure of overall adherence to prescribed exercise protocol, by treatment group and radiation week.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

98 participants

Primary outcome timeframe

7 weeks

Results posted on

2024-04-10

Participant Flow

98 participants were screened, 91 participants were randomized to a study arm.

Participant milestones

Participant milestones
Measure
Virtual Coach App
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Overall Study
STARTED
44
47
Overall Study
COMPLETED
33
34
Overall Study
NOT COMPLETED
11
13

Reasons for withdrawal

Reasons for withdrawal
Measure
Virtual Coach App
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Overall Study
Lost to Follow-up
6
9
Overall Study
Discontinued Intervention
5
4

Baseline Characteristics

Investigation of Two Swallowing Therapy Models During Radiation Therapy for Head and Neck Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Virtual Coach App
n=44 Participants
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
n=47 Participants
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Total
n=91 Participants
Total of all reporting groups
Age, Continuous
61 years
n=99 Participants
62 years
n=107 Participants
62 years
n=206 Participants
Sex/Gender, Customized
Female
5 Participants
n=99 Participants
6 Participants
n=107 Participants
11 Participants
n=206 Participants
Sex/Gender, Customized
Male
39 Participants
n=99 Participants
40 Participants
n=107 Participants
79 Participants
n=206 Participants
Sex/Gender, Customized
Unknown/Not Reported
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=99 Participants
0 Participants
n=107 Participants
3 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
40 Participants
n=99 Participants
46 Participants
n=107 Participants
86 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
2 Participants
n=99 Participants
1 Participants
n=107 Participants
3 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
Race (NIH/OMB)
White
38 Participants
n=99 Participants
44 Participants
n=107 Participants
82 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=99 Participants
1 Participants
n=107 Participants
4 Participants
n=206 Participants
Region of Enrollment
United States
44 Participants
n=99 Participants
47 Participants
n=107 Participants
91 Participants
n=206 Participants

PRIMARY outcome

Timeframe: 7 weeks

Population: Participants with available data at each respective timepoint.

Measure of overall adherence to prescribed exercise protocol, by treatment group and radiation week.

Outcome measures

Outcome measures
Measure
Virtual Coach App
n=38 Participants
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
n=40 Participants
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Number of Participants Achieving at Least 50% Adherence to Swallowing Exercises
Week 1
18 Participants
17 Participants
Number of Participants Achieving at Least 50% Adherence to Swallowing Exercises
Week 2
19 Participants
16 Participants
Number of Participants Achieving at Least 50% Adherence to Swallowing Exercises
Week 3
15 Participants
13 Participants
Number of Participants Achieving at Least 50% Adherence to Swallowing Exercises
Week 4
15 Participants
12 Participants
Number of Participants Achieving at Least 50% Adherence to Swallowing Exercises
Week 5
9 Participants
9 Participants
Number of Participants Achieving at Least 50% Adherence to Swallowing Exercises
Week 6
9 Participants
10 Participants
Number of Participants Achieving at Least 50% Adherence to Swallowing Exercises
Week 7
6 Participants
4 Participants

SECONDARY outcome

Timeframe: 19 weeks

Population: Participants who completed the intervention and were blinded at consent.

The MD Anderson Dysphagia Inventory (MDADI) was selected to capture and quantify the patient perception of swallowing dysfunction. It is a 20-item patient reported survey that measures the impact of dysphagia on patients with HNC. Each item is scored on a 5 point scale with 1=lower function and 5=higher function. Possible scores range from 20-100 with higher scores indicating more normal swallowing function.

Outcome measures

Outcome measures
Measure
Virtual Coach App
n=32 Participants
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
n=34 Participants
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Patient Perceived Swallowing Impairment as Measured by the MD Anderson Dysphagia Inventory (MDADI)
75.66 score on a scale
Standard Deviation 13.6
76.35 score on a scale
Standard Deviation 17.1

SECONDARY outcome

Timeframe: 19 weeks

Population: Participants who completed the intervention and were blinded at consent.

Functional Oral Intake Scale (measure of diet restriction). Scores range from 1-7 where lower scores reflect more limited oral intake and higher scores reflect more normal diet levels.

Outcome measures

Outcome measures
Measure
Virtual Coach App
n=32 Participants
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
n=34 Participants
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Diet Level as Defined by the Functional Oral Intake Scale (FOIS)
6.06 score on a scale
Standard Deviation 1.0
5.94 score on a scale
Standard Deviation 1.5

SECONDARY outcome

Timeframe: 7 weeks

Population: Participants who completed the intervention and were blinded at consent.

Performance Status Scale Head and Neck measures eating in public (range 0-100; higher number is indicative of better function), and normalcy of diet (range 0-100, higher number is indicative of more normal function)

Outcome measures

Outcome measures
Measure
Virtual Coach App
n=32 Participants
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
n=34 Participants
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Diet Restrictions as Measured by the Performance Status Scale Head and Neck
Eating in Public
90.15 score on a scale
Standard Deviation 19.4
86.12 score on a scale
Standard Deviation 25.9
Diet Restrictions as Measured by the Performance Status Scale Head and Neck
Normalcy of Diet
79.12 score on a scale
Standard Deviation 7.2
76.94 score on a scale
Standard Deviation 7.1

SECONDARY outcome

Timeframe: 19 weeks

Population: Participants who completed the intervention and were blinded at consent.

The Modified Barium Swallow Impairment Profile is a tool designed to quantify degree of impairment on 13 individual physiologic components visualized during a modified barium swallow where higher numbers reflect greater dysfunction. Score range: 0-4 for each physiologic component. The maximum possible Oral score is 22 and the maximum possible pharyngeal score is 29.

Outcome measures

Outcome measures
Measure
Virtual Coach App
n=32 Participants
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
n=34 Participants
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Physiological Oropharyngeal Swallowing Impairment as Measured by the Modified Barium Swallow Impairment Profile (MBS-ImP)
MBSImP Oral
3.9 score on a scale
Standard Deviation 2.9
4.21 score on a scale
Standard Deviation 2.5
Physiological Oropharyngeal Swallowing Impairment as Measured by the Modified Barium Swallow Impairment Profile (MBS-ImP)
MBSImP Pharyngeal
9.33 score on a scale
Standard Deviation 3.8
8.18 score on a scale
Standard Deviation 3.9

SECONDARY outcome

Timeframe: 19 weeks

Population: Participants who completed the intervention and were blinded at consent.

The Penetration Aspiration Scale measures the presence and depth of food/liquid material entering the airway and patient response to that material. This scale ranges from 1-8 with higher numbers indicating more abnormal function.

Outcome measures

Outcome measures
Measure
Virtual Coach App
n=32 Participants
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
n=34 Participants
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Depth of Bolus Entry Into the Laryngeal Vestibule as Measured Using the Penetration-Aspiration Scale (PAS)
2.76 score on a scale
Standard Deviation 2.1
2.42 score on a scale
Standard Deviation 1.7

SECONDARY outcome

Timeframe: 7 weeks

Population: Participants who completed the intervention and were blinded at consent.

Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) rates the safety and efficiency of the swallow. Safety and efficiency are rated on a scale of 0-4 with higher numbers indicating more abnormality. This scale also includes an overall impairment score which takes into consideration the safety and efficiency grade.

Outcome measures

Outcome measures
Measure
Virtual Coach App
n=32 Participants
Participants use a comprehensive swallowing rehabilitation app to determine if a mobile application may enhance adherence to swallowing therapy.
Standard of Care
n=34 Participants
Participants are educated regarding potential radiation-related side effects and trained in the same series of swallowing exercises by the SLP and complete paper exercise logs.
Severity of Impairment of Swallowing Safety and Efficiency as Measured Using the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) Scale
0.97 score on a scale
Standard Deviation 1.0
0.82 score on a scale
Standard Deviation 0.8

Adverse Events

Virtual Coach App

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Standard of Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Heather Starmer, MD

Stanford University

Phone: 650-529-5903

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place