Effect of Swallowing Rehabilitative Therapies on Functional Outcomes and Quality of Life in Head and Neck Cancer Patients: A Meta-analysis of Randomized Controlled Trials.

Swallowing rehabilitative therapies are widely used to manage impairments in head and neck cancer (HNC), but their pooled effects outcomes have not been established. This study aimed to evaluate the effects of swallowing rehabilitative therapies on functional outcomes and quality of life (QoL) in HNC patients. We searched six databases from inception through December 2024, with no restrictions on date, region, or language. Only randomized controlled trials (RCTs) were eligible. Functional outcomes comprised swallowing function, aspiration/penetration, oral intake, mouth opening, and pain, whereas QoL was assessed overall and across its domains. Pooled effect sizes were estimated using Hedges' g with 95% confidence intervals (CIs) under a random-effects model, where values of approximately 0.20, 0.50, and 0.80 denoted small, moderate, and large effects, respectively. Heterogeneity, publication bias, and moderator analyses were performed. Thirty-one RCTs involving 2,038 HNC patients (men: 68.11%) were included. The therapies exerted moderate to small effects on swallowing function (g: 0.69; 95% CI: 0.30, 1.08), aspiration/penetration (g: -0.21; -0.40, -0.02), oral intake (g: 0.39; 0.07 to 0.71), and mouth opening (g: 0.44; 0.30, 0.58), a large effect on pain (g: -0.93; -1.48, -0.38), and a moderate to small effect on overall QoL (g: 0.43; 0.15, 0.72). Moderator analyses among subgroup comparisons only oral intake showed significantly larger effects with longer (>8 weeks; p = 0.038) and more frequent (>70 sessions; p = 0.025) programs. HNC patients may benefit from tailored, sustained, and frequent swallowing rehabilitation as part of long-term supportive care.