Ozge Petek Erpolat

Objective: This study investigated the efficacy of a prophylactic, home‐based exercise program administered concomitantly with radiotherapy in patients with head and neck cancer to preserve swallowing function, postural alignment, and cervical range of motion, while assessing lymphedema safety. Study Design: Randomized controlled trial. Setting: Outpatient clinics of an academic university hospital. Methods: Twenty‐four patients undergoing radiotherapy for head and neck cancer were allocated to an exercise group (n = 12; receiving a swallowing, posture, range of motion, and strengthening protocol) or a control group (n = 12; receiving standard care). Baseline and postradiotherapy outcomes were assessed using the Swallowing Quality of Life questionnaire, photogrammetric posture analysis, digital goniometry for cervical mobility, and circumference measurements for lymphedema. Results: Swallowing Quality of Life was maintained in the exercise group but deteriorated significantly in controls ( P < .001). The exercise group significantly preserved neck lateral tilt compared to controls ( P < .001). Furthermore, the intervention group demonstrated significant preservation of cervical flexion, extension, rotation, and lateral flexion ( P < .05). Facial edema metrics increased slightly in both groups with no significant inter‐group differences, confirming intervention safety ( P > .05). High adherence rates were reported. Conclusion: A prophylactic, home‐based exercise program is a safe and effective strategy to mitigate functional decline in patients undergoing radiotherapy. The intervention preserves swallowing, posture, and cervical mobility without exacerbating lymphedema, supporting early prehabilitation in oncological care. Trial Registration: ClinicalTrials.gov Identifier: NCT07376213.

Neoadjuvant stereotactic radiosurgery (SRS) has emerged as a promising strategy for managing brain metastases, offering several advantages over traditional postoperative approaches. By delivering targeted radiation prior to surgical resection, neoadjuvant SRS aims to enhance local tumor control, reduce the risk of leptomeningeal dissemination, and optimize treatment efficiency. Recent findings suggest that neoadjuvant SRS provides comparable, if not superior, local control compared to postoperative SRS, while exhibiting lower rates of radiation necrosis and leptomeningeal disease. However, uncertainties persist regarding optimal dosing regimens, treatment timing, and patient selection criteria, as factors such as tumor size, volume, and histology may significantly influence clinical outcomes. Additionally, while neoadjuvant SRS addresses challenges related to target delineation and delays associated with postoperative treatment, its long-term efficacy and integration with systemic therapies require further investigation. This review consolidates evidence from recent retrospective and prospective studies, focusing on key outcomes such as local control rates, radiation toxicity profiles, and overall survival.

Objectives/Hypothesis: To determine the effects of complex decongestive physiotherapy (CDP) and home programs on external lymphedema, staging of lymphedema, fibrosis, and three‐dimensional (3D) surface scanning and volume evaluation in head and neck lymphedema.Study Design: A prospective randomized controlled study.Methods: Twenty‐one patients were randomly divided into three groups: CDP (n:7), home program (n:7), and control (n:7). Assessment methods were applied at baseline and 4 weeks later for all groups. MD. Anderson Cancer Center Head and Neck Lymphedema Protocol was implemented to evaluate head and neck external lymphedema, staging of lymphedema, and fibrosis. A 3D scanner and a software were used to determine and calculate the volume of the head and neck region via 3D surface scanning. Head and neck external lymphedema and fibrosis assessment criteria were performed to evaluate visible soft tissue edema and the degree of stiffness.Results: The severity and volume of lymphedema decreased in the CDP program group (P < .05). Besides, external lymphedema and fibrosis at submental region were decreased in both CDP program and home program groups (P < .05).Conclusions: While the benefits of home program are limited, a CDP program may be more effective in the management of lymphedema and fibrosis in patients diagnosed with head and neck cancer.The clinical trial registration number: NCT04286698, date: 02/25/2020, retrospectively registered.Level of Evidence: 4 Laryngoscope, 131:E1550–E1557, 2021