Effect of radiation therapy in conjunction with chemotherapy on neck and shoulder muscles in head and neck cancer patients: a pilot study

Background: Head and neck cancer are emerging as a major health problem. The management of head and neck cancers involves a variety of options like surgery, radiation therapy, chemotherapy or targeted/immunotherapy & palliative care. Radiation Therapy is the most common form of treatment in operated as well as non- operated cases. The various side effects of radiation therapy involve xerostomia, fatigue, skin changes/reactions, dysphagia, damage to the nerve, muscle, tendons and ligaments which causes conditions like dropped neck syndrome, muscle atrophy, etc. The aim of the study was to find the effect of radiation therapy in conjunction with chemotherapy on neck and shoulder muscles in head and neck cancer patients. Methods: It was a pilot study & 4 samples were taken. Range of Motion & Manual Muscle Testing were administered on patients and the result were analysed. Results: The study found that there was an incidence of neck muscle weakness among patients receiving radiation therapy with chemotherapy for head and neck cancer with the mean of Grade 4 of Manual Muscle Testing. Also, there was incidence of shoulder muscle weakness in one of the patients with the mean of 4.75. Due to a smaller number of subjects, the effect of on shoulder muscles couldn’t be clearly found out. Conclusion: The study concluded that there is an effect of radiation therapyin conjunctionwith chemotherapy on both neck and shoulder muscles in head and neck cancer patients. Thus, physiotherapy intervention is necessary to maintain the mobility & strength of neck and shoulder in such patients.