Improving Functional Oral Intake in Head and Neck Cancer Survivors with Chronic Radiation-Associated Dysphagia - The Multicenter Randomized Controlled HIT-CRAD Trial.

Authors

Hanne Massonet, Ann Goeleven, Leen Van Den Steen, Alice Vergauwen, Margot Baudelet, Fréderic Duprez, Peter Tomassen, Olivier Vanderveken, Sandra Nuyts, Gwen Van Nuffelen

Published in

Dysphagia. Aug 14, 2026. Epub Aug 14, 2026.

Abstract

This randomized controlled trial evaluated the efficacy of home-based treatment programs for chronic radiation associated dysphagia (CRAD) in head and neck cancer (HNC) patients, comparing high-volume strength training to combined strength-skill training with either real or sham High-Definition transcranial Direct Current Stimulation (HD-tDCS). 54 HNC survivors with CRAD were randomized in 3 groups, each performing exercises 4 times per week over 8 weeks. Group 1 (n = 18) received strength training only, consisting of tongue strengthening exercises, chin tuck against resistance exercises with effortful swallowing and expiratory muscle strength training. Group 2 (n = 18) completed the same regimen for 4 weeks, followed by 4 weeks of skill training according to the McNeill Dysphagia Therapy Program. Group 3 (n = 18) completed this combined therapy program while receiving HD-tDCS over the swallowing motor cortex during each therapy session. To examine the additional effect of HD-tDCS, group 2 received sham stimulation. All groups showed significant improvements in functional oral intake (p < .001), swallowing function (p < .05) and muscle strength (p < .001). Participants receiving combined strength and skill training (group 2 + 3) had significantly greater odds of better oral intake outcomes after 8 weeks of training (OR 13.47, 95%CI 5.95 - 30.49, p < .001) compared to the strength-only group (group 1) (OR 3.04, 95%CI 1.44 - 6.44, p = .004). There was no additional benefit of HD-tDCS when comparing group 2 and 3. High-volume strength and skill-based training is an effective intervention for CRAD in HNC survivors. Combining strength and skill training is the most efficient choice to improve functional oral intake.

PMID:
42595809
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.

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