INTERVENTIONS USED IN THE TREATMENT OF RADIOTHERAPY INDUCED TRISMUS: A SYSTEMATIC REVIEW

Abstract

Abstract Introduction: Trismus is a chronic debilitating complication of radiotherapy to the head and neck highly prevalent among head and neck cancer survivors. Affected patients may experience a marked restriction of jaw movements causing difficulties with daily activities, such as eating, chewing and swallowing, all of which have a direct impact on the quality of life of patients. Objectives: To assess the effects of available intervention to manage radiotherapy-induced trismus. Methods: We have included controlled trials involving adults with a diagnosis of radiotherapy-induced trismus. Four main databases were included in our search (MEDLINE OVID, EMBASE, OVID, the COCHRANE library, and Web of Science core collection) with a throughout, comprehensive search conducted in all databases. Search was carried out in June 2024 for randomized controlled trials (RCTs) and non-randomized controlled studies incorporating trismus treatments for head and neck cancer. Results: In total 9 studies were included, 7 RCT, and two non-randomized controlled studies, with a total of 530 patients who received radiotherapy alone, or combined chemoradiotherapy. Most of the studies were focusing on the range of motion exercise, one study focused on low-intensity ultrasound, and low-level laser therapy, other study focused on photobiomodulation (FTBM) and conventional speech therapy. However, others focused on Myofascial Release (MFR) technique, Therabite System, Engstrom jaw device and Matrix Rhythm Therapy. Conclusion: The results of this systematic review showed that there is no high-level evidence for the effectiveness of one type of management interventions over another. Further RCTs are required to draw reliable and generalizable conclusions on the treatment of trismus in head and neck cancer survivors.