Neoplasms

All Conditions

Digestive System Diseases

Ear, Nose, and Throat Diseases

Mouth and Tooth Diseases

Carcinoma

Carcinoma, Squamous Cell

Head and Neck Neoplasms

Deglutition Disorders

Esophageal Diseases

Gastrointestinal Diseases

Pharyngeal Diseases

Otorhinolaryngologic Diseases

Participants will be trained to initiate swallowing during expiration.

Participants will practice swallowing, but will not learn the key therapeutic element (i.e., initiating swallowing during expiration).

Participants will complete 6 respiratory-swallow phase training sessions that will last approximately one hour.

Respiratory-Swallow Phase Training

Participants will complete 6 "swallow practice" sessions that will last approximately one hour.

Swallow Practice

Bonnie Martin-Harris, PhD

Head and neck cancers have escalated to epidemic levels in the United States, and survivors are suffering from life-long, devastating swallowing disorders with limited therapeutic options. This clinical trial investigates a novel swallowing treatment that trains initiation of swallowing during the expiratory phase of respiration to improve swallowing safety and efficiency.

Head and neck cancers (HNC) have increased to epidemic levels in the United States. Despite good response to cancer treatment, survivors are suffering life-long toxicities that result in swallowing problems (dysphagia). Treatment options for dysphagia after HNC are extremely limited, focus on swallowing movements alone, and do not consider the importance of respiratory-swallow phase patterning. Prior evidence has demonstrated that when aberrant respiratory-swallow phase patterning is present (initiation of swallowing during inspiration) in patients with HNC, there is a higher occurrence of swallowing impairments, increased residue, and airway invasion. Further, it has been well established that the expiratory limb of the respiratory cycle provides a biomechanically advantageous set point in which to initiate safe and efficient swallowing. This randomized, controlled, Phase II clinical trial examines if respiratory-swallow phase training improves airway protection and swallowing efficiency in HNC survivors who are three or more months post-completion of first-line cancer treatment. The primary goal (Aim 1) is to determine if respiratory-swallow phase training results in increased frequency (%) of swallows initiated during expiration and improved swallowing safety. The secondary goal (Aim 2) is to examine the impact of respiratory-swallow phase training on the frequency of swallows initiated during expiration in wakeful, naturalistic swallowing environments, including eating and drinking. The investigators will recruit 88 HNC survivors with dysphagia, impaired respiratory-swallow phase patterning, and airway compromise. The investigators will deliver therapy remotely using a telehealth platform and an innovative wearable sensor that provides real-time visual feedback of respiratory-swallow movements. Endpoints will be measured from synchronized videofluoroscopic and respiratory-swallow sensor recordings at baseline, within 1-week post-treatment, and 1-month and 3-months post-treatment.

Participants and outcome assessors will be naive to experimental condition.

Training Swallowing Initiation During Expiration

Training Swallowing Initiation During Expiration: Impact on Safety and Efficiency Following Treatment for Oropharyngeal Head and Neck Cancer

Evaluates the impact of dysphagia on the quality of life of patients with head and neck cancer

Determines percent (frequency) of the target (expiratory phase) for each swallow.

Measures presence, depth and reaction to penetration and aspiration.

Quantifies pharyngeal space residue obtained in the lateral view during Modified Barium Swallow Study (MBSS)

Measures physiologic swallowing impairment from observations of MBSS recordings

Northwestern Memorial Hospital

Northwestern University

Professor

Behaviors and Mental Disorders

Quality of Life

Pre, during and pos-treatment swallowing exercises.

These patients will not receive speech pathology therapy.

pre, during and pos-treatment swallowing exercises

André L Carvalho, PHD

Luciano S Viana, PHD

Alexandre Jacinto, MD

Juliana Portas, MSC

General Objective: To evaluate the swallowing results of speech pathologist rehabilitation of advanced oropharynges, larynx and hypopharynx cancer patients during neoadjuvant chemotherapy and radiotherapy concomitant to chemotherapy.

Methods and Casuistic: Randomized clinical trial phase II. 80 patients with advanced oropharynges, larynx and hypopharynx cancer diagnoses from Barretos Cancer Hospital, which had the proposal of neoadjuvant chemotherapy followed by radiotherapy combined with chemotherapy. Patients are randomized on two groups: control group and speech pathology therapy group

To evaluate and compare the swallowing and life quality swallowing on a group undergoing to speech pathology therapy (intervention) and a control group (no intervention).

Swallowing Intervention During Radiochemotherapy on Head and Neck Cancer

Randomized Phase II Trial: Swallowing Speech Pathology Intervention During Radiochemotherapy on Patients With Head and Neck Cancer

Self-reporting swallowing questionnaire, clinical swallowing examination and modified barium swallow (MBS), and the MD Anderson Dysphagia Inventory (MDADI).

Barretos Cancer Hospital

Control (Usual care) group in which patients will receive swallowing and prescribed dietary intervention during the radiotherapy period prescribed by the attending physician.

Patients receive twice daily swallowing intervention by a speech language pathologist, consisting of the battery of isometric / isotonic exercises.

Patients will receive a one time only swallowing intervention session by a speech language pathologist, instructing them in the battery of isometric / isotonic exercises plus a home practice instruction digital video tape to support self directed practice of this program at home.

swallowing intervention by a speech language pathologist, consisting of the battery of isometric / isotonic exercises

Pharyngocise

Giselle Carnaby-Mann, PhD

In this study supported by an American Cancer Society grant, the investigators are evaluating two levels of swallowing exercise intensity on the maintenance of swallowing muscles and their function in Head/Neck cancer patients undergoing radiotherapy. Patients in this study are randomly placed into different exercise groups and provided with exercises to perform daily during their radiation treatment. Their progress, diet management and swallowing ability are monitored throughout the treatment period and followed up until 3 months after radiation treatment. In addition to the daily treatment details, the patients perception of their swallowing ability and concerns about their health and treatment are also measured. This clinical trial will help to refine a previously investigated simple exercise package and provide a program of intervention that can help prevent medically related complications of swallowing difficulty (e.g. pneumonia, dehydration, prolonged tube feeding), and improve the ability to eat for patients with head / neck cancer. Ultimately it is hoped that this form of exercise therapy will help reduce the costs (personal and financial) to the patient, caregivers and community.

In an earlier pilot study, a regime of simple swallowing exercises was identified as useful in maintaining oropharyngeal muscle characteristics as measured by T2 weighted Magnetic Resonance Imaging (MRI) and produced a trend toward improved function for swallowing in patients undergoing radiotherapy for head and neck cancer. The purpose of this current study is to evaluate the dose response of two levels of swallowing exercise intensity on the maintenance of muscle composition and function for swallowing in Head/Neck cancer patients undergoing radiotherapy.

HYPOTHESIS: A program of intensive swallowing exercise (Pharyngocise) will maintain muscle function in the oral cavity and pharynx during radiotherapy, preserving or supporting swallowing function in Head/Neck cancer patients.

STUDY DESIGN: 130 patients with Head/Neck cancer, confirmed by clinical history and exam, will be recruited over a 4 year period. All subjects will undergo an initial baseline work up, including a standardized clinical and instrumental swallowing evaluation, psychosocial scales, nutritional exam, and T2 weighted MRI prior to the first radiation therapy. Subjects will be randomized into 1 of 3 groups:

Group A: Usual care (control) group - patients will receive swallowing and prescribed dietary intervention during the radiotherapy period prescribed by the attending physician.

Group B: High intensity pharyngocise treatment group - patients will receive twice daily swallowing intervention by a speech language pathologist, consisting of the battery of isometric/isotonic exercises.

Group C: Low intensity pharyngocise treatment group - patients will receive a single instructional exercise session on the isometric/isotonic exercises from a Speech Language Pathologist and a practice tape to support home practice of the exercises.

All patients will be treated for approximately 6 weeks and followed for 3 months post treatment. Baseline assessments will be repeated. In addition, daily treatment details, patients perception of current swallowing ability and progress in therapy will be recorded by the Speech Pathologist. Participants will be independently monitored throughout the treatment period by researcher blind to the treatment group assigned, via weekly phone interview sessions. Compliance with the treatment techniques, and the occurrence of any negative endpoints such as occurrence of aspiration pneumonia will be recorded.

Pharyngocise Dose Response Study

Muscle Preservation and Swallow Function Following Radiotherapy: A Dose Response Study

T2 Weighted Magnetic Resonance Imaging (MRI) to quantify baseline muscle parameters in the oral cavity and pharynx. The regions of interest will be identified on images using axial and coronal planes. Information regarding the muscle volume, composition (fat Vs muscle Vs edema) as reflected by the signal intensity.

Swallowing ability and method/ type of dietary intake, e.g. Functional Oral Intake Scale score \[F.O.I.S\] over the study period

Weight and Body Mass Index will be calculated.

Domain assessments for, quality of life, pain,and fatigue using the Functional Assessment of Cancer Therapy - Head and Neck (FACT-H/N), Pain Disability Index (PDI), Functional Assessment of Cancer Therapy - Anemia (FACT-An) scale, Multidimensional Fatigue Symptom Inventory (MFSI), Profiles of Mood Scale (POMS) and Center for Epidemiologic Studies Depression Scale(CESD).

Range of swallowing biomechanics measured from endoscopic and fluorographic evaluations.

Patient perception of effect of swallowing disability - Swallowing Quality of Life (SWAL QOL) score during the study period.

American Cancer Society, Inc.

University of Florida

LE NEINDRE Aymeric, PhD

DIAZ LOPEZ Carlos, PhD st

Aymeric Le Neindre, PhD

Carlos DIAZ LOPEZ, MSc

Medina i Mirapeix Francesc

Radiotherapy for head and neck cancers (H\&NC) heightens the risk of swallowing disorders (SD), impacting nutrition, quality of life, and overall health, leading to increased hospitalization and mortality. Dietary plans hinge on patients' nutritional status, swallowing ability, and prognosis. Early interventions are crucial, emphasizing the need for precise assessments guiding prognosis, specifying structures for intervention, and facilitating targeted rehabilitation.

Clinical examinations lack precision, while existing complementary methods like videofluoroscopy or Fiberoptic Endoscopic Evaluation of Swallowing are invasive, irradiating, resource-intensive, and challenging to access, with uncertain prognostic values.

Ultrasound imaging emerges as a non-invasive alternative, offering morphological and dynamic evaluation of swallowing-related structures. It enables qualitative and quantitative analyses, improving precision in targeting structures for rehabilitation. Researchers propose an ultrasound predictive model to anticipate SD risk during H\&NC radiotherapy, assessing its reliability and accuracy.

Over eighteen months, 124 outpatients beginning H\&NC radiotherapy at Forcilles's Hospital will undergo weekly clinical and water-swallow tests by a speech language therapist, with videofluoroscopy when SD is suspected. Ultrasound evaluations pre-treatment and at seven and fourteen days will be conducted by blinded ultrasonographers. Cox models will test ultrasound measurement thresholds for SD prediction, estimating sensitivity, specificity, and prediction values. A global ultrasound predictive model will be developed via logistic multivariable regression.

The study aims to establish an association between ultrasound markers and SD, improving early detection for tailored management. This non-invasive alternative to videofluoroscopy offers potential for enhancing patient outcomes in H\&NC radiotherapy.

Radiotherapy for head and neck cancers increases the risk of Swallowing Disorders (SD), which can have serious consequences for nutrition, quality of life, and overall health.

Early intervention strategies could greatly benefit, highlighting the importance of assessments offering insights into patients' prognosis, identifying which specific structures require intervention and enabling a targeted rehabilitation approach.

However, the clinical examination lacks precision. Complementary examinations, such as videofluoroscopy or Fiberoptic Endoscopic Evaluation of Swallowing (FEES), are irradiating or invasive, consume numerous resources and are difficult to access. What's more, their prognostic values are not known.

In this context, ultrasound imaging has garnered increased interest for assessing swallowing disorders. Recognised for its non-invasive nature and its ability to overcome conventional constraints, ultrasound holds promise in integrating morphological and dynamically swallowing-related structures evaluation. This approach, enabling both qualitative and quantitative analysis of multiple structures, would enhance the precision in targeting structures for rehabilitation.

The researchers intend to create an ultrasound predictive model to anticipate the risk of developing swallowing disorders during head and neck cancer radiotherapy.

Hypothesis : The investigators hypothesize that one or more ultrasound variables are independently associated with swallowing disorder development and worsening nutritional status during radiotherapy treatment for head and neck cancer.

Objectives Main objective : The main objective of this study is to evaluate the predictive capacity of different ultrasound markers of the VADS on the incidence of TD during radiotherapy treatment for CTC

Secondary objectives :

In a population of patients treated with radiotherapy for CTC :

* Assessing the reliability of ultrasound measurements ;
* Evaluate the feasibility of ultrasound measurements;
* To evaluate the predictive ability of the change in ultrasound markers after 1 and 2 weeks of radiotherapy on the incidence of TD ;
* To determine whether ultrasound markers associated with the onset of TD improve a predictive model including known predictors ;
* Assessing the association between ultrasound markers and the incidence of undernutrition;
* To evaluate the predictive ability of the change in ultrasound markers after 1 and 2 weeks of radiotherapy on the incidence of undernutrition ;
* Evaluate the association between ultrasound markers and quality of life in relation to TD.

Study design :

Prospective, observational single-centre study will be performed per the ethical standards of the Declaration of Helsinki and will be reported following the standards for the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis guidelines (TRIPOD)

Population :

One hundred and twenty-four outpatients starting a radiotherapy treatment for head and neck cancer will be enrolled at Radiotherapy Services at Forcilles's Hospital, during a eighteen-months period. All consecutive patients will be screened at admission, and will be included if they satisfy the eligibility criteria. All patients will provide oral consent to participate, by the clinical research French laws. The patient's participation will be equivalent to the duration of their radiotherapy treatment. The maximum additional time needed for research interventions is 40 minutes.

Data collection : Data will be recorded using an online case report form (Datacapt). Demographic data, comorbidities, medical and surgical history will be recorded at inclusion. Clinical, videoflyoroscopy and ultrasound measurements will also be recorded. On-site monitoring is planned every month.

The ultrasound examination will be conducted initially, on the seventh and fourteenth days of radiotherapy, always preceding other swallowing evaluations.

Ultrasound examination :

Ultrasonography will be performed using a Sonosite E2 Expert ultrasound device (Digital Color Doppler Ultrasound System ; Sonoscape medical corp. China) with a 7-10 MHz linear and a 3-5 MHz probes. Detailed information for ultrasound procedure is described in the research protocol. Ultrasonography will be performed with the patients in near-to-supine position (30°).

To assess the value of variation in these examinations during radiotherapy as a predictive factor, a total of three ultrasound examinations will be performed prior to the first radiotherapy treatment and after seven and fourteen days. Ultrasonographers will be blinded from all patients' status and previous examination.

Ultrasound evaluation will focus on the movements or morphology of structures such as the tongue, laryngeal movement, or suprahyoid muscles.

In order to assess inter-examiner reliability, and only during the first ultrasound evaluation, the tests will be carried out by two different operators on a consecutive sample of patients. To limit the examination time for each patient, the investigators will use another consecutive sample of patients for intra-examiner reliability. For the patients making up the samples used for reliability assessment, only 10' extra will be added.

Clinical evaluation All patients will undergo a standardized weekly clinical assessment conducted by a speech language therapist. This assessment will involve an analytical evaluation of various structures (tongue movement and strength, laryngeal movement, etc.) and swallowing tests following the volume-viscosity swallow test.

Videofluoroscopy :

VFSS is a radiographic procedure offering a dynamic view of oral, pharyngeal, and upper esophageal function during swallowing. The radiologist and speech-language therapist collaborate to realise these evaluations. Barium-mixed food and fluid aid visibility via videofluoroscopy. The examiner must evaluate the broadest range of the patient's feeding options, starting with the safest quantity and texture. VFSS assesses swallow characteristics, bolus movement patterns, initiation, nasopharyngeal reflux, pharyngeal clearance, laryngeal penetration, and aspiration. At any time, examiners may halt the evaluation if deemed harmful, with reasons recorded. In instances of penetration or aspiration, the speech-language therapist employs the 'Penetration-Aspiration Scale.'

Statistical plan :

The study aims to assess the prognostic value of swallowing ultrasound in predicting the occurrence of swallowing disorders (TDs) during radiotherapy for CTC treatment. The event under consideration is the development of TDs between patient inclusion and the completion of radiotherapy. The analysis involves investigating the relationship between variables and TD occurrence. Quantitative variables in multivariate models will be studied using restricted cubic splines and fractional polynomial methods for accurate assessment.

Variable selection for the TD predictive model includes testing the prognostic values of ultrasound variables and adjustment variables through univariate Cox models. Significant variables (p ≤ 0.10) or those with known prognostic impact will be included in a multivariate Cox model. Model calibration, discrimination, and internal validation will be evaluated using the c-index, graphical calibration at 30 days, and the bootstrap method.

The estimation of TD onset times will utilize the Kaplan-Meier method, comparing survival curves between groups defined by ultrasound variable thresholds with the log-rank test. A prognostic score will be constructed from multivariate model results, categorizing patients into low-risk, intermediate-risk, and high-risk groups. Thresholds for categorization will be determined using Cox's method.

Handling missing data involves either deleting observations with missing data or using data imputation methods depending on the origin and type of missing data. Reproducibility assessment of ultrasound measurements includes inter-operator and intra-operator evaluations. To assess inter-operator reproducibility, measurements by two different operators will be compared, while intra-operator reproducibility will be evaluated from measurements performed by the same operator 30 minutes apart. A sample size of 40 patients is deemed necessary for reproducibility assessment based on Walter et al.'s methodology.

The tests will be performed at a significance level of 5%. 95% confidence intervals will be provided for each estimate.

Calculations will be performed using SPSS v21 IBM and R software (version 3.6.1, www.R-project.org).

Sample size calculation :

According to Harrell's recommendations on the construction of multivariate models, a maximum of 1 variable per 10 events should be included. The investigators estimates the incidence of swallowing disorders in our patient population at 45% according to the literature. The investigators aims to include a maximum of 5 variables in the multivariate model, i.e. 112 patients required.

Among the eligible patient population, taking into account a 10% loss-of-sight rate, it is necessary to include 124 patients

Radiation-Related Dysphagia Development Prediction Using a Two-Step Ultrasonographic Model (R-2D-2)

Evaluation of the Prognostic Value of Aerodigestive Tract Ultrasound in the Occurrence of Radiotherapy-related Swallowing Disorders in Head and Neck Cancer Patients

Ultrasound evaluation will be performed at inclusion and 7 and 14 days afterward to evaluate the predictive capacity of observed changes in ultrasound to anticipate the development of swallowing disorders during radiotherapy treatment

Ultrasound evaluation will be performed on the day of the initial radiotherapy session, preceding the treatment.

Incidence is defined as the proportion of new cases of undernutrition during radiotherapy

Ultrasound evaluation will be performed at inclusion and 7 and 14 days afterward to evaluate the predictive capacity of observed changes in ultrasound to anticipate new cases of undernutrition during radiotherapy Incidence is defined as the proportion of new cases of undernutrition during radiotherapy

Predictive capacity of morphology and/or movement of the tongue, hyoid bone and suprahyoid muscles measured by ultrasound and quality of life at 30 days of radiotherapy treatment assessed by the MD Anderson Dysphagia Inventory questionnaire

Ratio of morphology and/or movement of the tongue, hyoid bone and suprahyoid muscles markers successfully conducted by ultrasound performed. Reasons for non-interpretation where applicable

Swallowing disorders will be diagnosed by videofluoroscopy wich will be performed when swallowing disorder is suspected or at the end of radiotherapy treatment.

Repeated measurements by the same ultrasonographer and by a second ultrasonographer on a concurrent sample

Hopital Forcilles

Rare Diseases

Chronic Graft Versus Host Disease

The experimental arm corresponds to the patient benefiting from a monthly telephone follow-up during the first 6 months of their discharge from the reeducation center : "CRIL" (from M1 to M6). They will be contacted each month by CRIL's speech therapist for a telephone interview (20 to 30 minutes).

The comparison group will follow the standard follow-up protocol. A technician will contact the patients in the control arm to obtain the TIMES score each month. No further telephone follow-up will be carried out.

Monthly follow-up by telephone from M1 to M6. The interview will unroll in 2 stages, a first stage of discussion during which the speech therapist will take news of the patient. The second, more formal phase will be the opportunity to collect the data necessary for the validation of the primary and secondary outcomes. To do this, the speech therapist will use the Functional Oral Intake Scale (FOIS) score, the DHI and an interview grid.

The interview will be conducted using an interview sheet previously written by the project team. The following elements will be discussed: the description of oral food intakes (TIMES), the perceived swallowing handicap (DHI), the instructions related to the diet and their daily application, ongoing rehabilitation follow-ups, notable events as well, then his emotional and psychological experience in relation to the disorder.

Telephone follow-up

Anais Galtier

Prospective, open-label, randomized, single-center study evaluating the benefit of a months long monthly telephone follow-up for patients with chronic disorders following the after-effects of anti-cancer treatments after an intensive rehabilitation stay versus standard follow-up.

Upper aerodigestive tract (UAT) cancer is a malignant tumor in the hypopharynx, larynx, oropharynx and oral cavity. In 2017, 15,000 new cases of cancers of the upper aero-digestive tract were identified: which in France places them among the most frequent cancers.

The treatments used to treat UAT cancers are of three types: surgery, radiotherapy and radio chemotherapy and can have significant functional consequences, in particular on swallowing and phonation.

This therapeutic management is routinely associated with supportive care, in order to ensure the functional rehabilitation that will allow the maintenance of the quality of life of these patients as well as their entourage by reducing the side effects of the treatments and the effects of disease.

Intensive rehabilitation is offered to patients who have been treated for UAT cancer in order to speed up the learning of new behaviors and improve their memorization. Thus, these patients benefit from intensive multidisciplinary rehabilitation within the Intensive Reeducation Center for Laryngectomees.

However, it is not uncommon to see patients return for a second stay following a loss of the benefits learned, in particular on the swallowing function, omissions of food safety instructions or an interruption of local rehabilitation.

Studies have shown that remote monitoring can have a positive impact on the health of these patients. However, no study has assessed the impact of such monitoring on functional swallowing abilities.

This study will asses the impact of a monthly phone call during 6 months on patients with chronic swallowing disorders compared to the routine follow up. The telephone interviews will mainly consist of questionnaires.

Single-center, open-label, prospective study

Follow-up After a Stay in Intensive Rehabilitation for Patients With Swallowing Disorders

Benefit of an at Home Telephone Follow-up After a Stay in an Intensive Rehabilitation Center for Patients With Chronic Swallowing Disorders Following a Upper Aero-digestive Tract Cancer Treatment : Open, Controlled, Randomized Study

Assessed by establishing the FOIS (Functional Oral Intake Scale) score :

Level from 1 to 7, (1 being the worse functional oral intake, 7 being the best functional oral intake possible)

TUBE DEPENDENT (levels 1-3)

1. No oral intake
2. Tube dependent with minimal/inconsistent oral intake
3. Tube supplements with consistent oral intake TOTAL ORAL INTAKE (levels 4-7)
4. Total oral intake of a single consistency
5. Total oral intake of multiple consistencies requiring special preparation
6. Total oral intake with no special preparation, but must avoid specific foods or liquid items
7. Total oral intake with no restrictions

Assessed by establishing the FOIS (Functional Oral Intake Scale) score :

Level from 1 to 7 :

TUBE DEPENDENT (levels 1-3)

1. No oral intake
2. Tube dependent with minimal/inconsistent oral intake
3. Tube supplements with consistent oral intake TOTAL ORAL INTAKE (levels 4-7)
4. Total oral intake of a single consistency
5. Total oral intake of multiple consistencies requiring special preparation
6. Total oral intake with no special preparation, but must avoid specific foods or liquid items
7. Total oral intake with no restrictions

Assessed by establishing the FOIS (Functional Oral Intake Scale) score:

Level from 1 to 7 :

TUBE DEPENDENT (levels 1-3)

1. No oral intake
2. Tube dependent with minimal/inconsistent oral intake
3. Tube supplements with consistent oral intake TOTAL ORAL INTAKE (levels 4-7)
4. Total oral intake of a single consistency
5. Total oral intake of multiple consistencies requiring special preparation
6. Total oral intake with no special preparation, but must avoid specific foods or liquid items
7. Total oral intake with no restrictions

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Training Swallowing Initiation During Expiration	NCT05278039	Head and Neck C... Dysphagia Oropharyngeal D... Oropharynx Squa...	Respiratory-Swa... Swallow Practic...	18 Years -	Northwestern University
Swallowing Intervention During Radiochemotherapy on Head and Neck Cancer	NCT02075385	Head Neck Cance... Swallowing Diso...	pre, during and...	18 Years -	Barretos Cancer Hospital
Pharyngocise Dose Response Study	NCT01279837	Dysphagia	Pharyngocise	21 Years - 90 Years	University of Florida
Radiation-Related Dysphagia Development Prediction Using a Two-Step Ultrasonographic Model (R-2D-2)	NCT06387004	Swallowing Diso...		18 Years -	Hopital Forcilles
Swallowing Intervention During Radiochemotherapy on Head and Neck Cancer	NCT02075385	Head Neck Cance... Swallowing Diso...	pre, during and...	18 Years -	Barretos Cancer Hospital
Training Swallowing Initiation During Expiration	NCT05278039	Head and Neck C... Dysphagia Oropharyngeal D... Oropharynx Squa...	Respiratory-Swa... Swallow Practic...	18 Years -	Northwestern University
Follow-up After a Stay in Intensive Rehabilitation for Patients With Swallowing Disorders	NCT04859595	Swallowing Diso...	Telephone follo...	18 Years - 100 Years	University Hospital, Toulouse
Radiation-Related Dysphagia Development Prediction Using a Two-Step Ultrasonographic Model (R-2D-2)	NCT06387004	Swallowing Diso...		18 Years -	Hopital Forcilles
Radiation-Related Dysphagia Development Prediction Using a Two-Step Ultrasonographic Model (R-2D-2)	NCT06387004	Swallowing Diso...		18 Years -	Hopital Forcilles
Training Swallowing Initiation During Expiration	NCT05278039	Head and Neck C... Dysphagia Oropharyngeal D... Oropharynx Squa...	Respiratory-Swa... Swallow Practic...	18 Years -	Northwestern University
Radiation-Related Dysphagia Development Prediction Using a Two-Step Ultrasonographic Model (R-2D-2)	NCT06387004	Swallowing Diso...		18 Years -	Hopital Forcilles
Follow-up After a Stay in Intensive Rehabilitation for Patients With Swallowing Disorders	NCT04859595	Swallowing Diso...	Telephone follo...	18 Years - 100 Years	University Hospital, Toulouse
Pharyngocise Dose Response Study	NCT01279837	Dysphagia	Pharyngocise	21 Years - 90 Years	University of Florida

Spots Global Cancer Trial Database for swallowing disorders