Assessment of radio(chemo)therapy-related dysphagia in head and neck cancer patients based on cough-related acoustic features: a prospective phase II national clinical trial (ACCOUGH-P/A trial)

Trials

Methodology

Jean Schoentgen¹  Marc De Bodt²  Gwen Van Nuffelen²  Dirk Van Gestel³  Sofiana Mootassim-Billah⁴ 

[1] Department of Biomechatronics, Université Libre de Bruxelles, Brussels, Belgium;Department of Otolaryngology and Head and Neck Surgery, University Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Antwerp, Belgium;Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium;Department of Logopaedics and Audiological Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium;Department of Radiation Oncology, Head and Neck Unit, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium;Department of Radiation Oncology, Speech Therapy, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium;

关键词: Head and neck cancer patients;    Radiation-associated dysphagia;    (Chemo)radiotherapy;    Cough;    Assessment;    Acoustic analysis;   

DOI  :  10.1186/s13063-023-07660-y

 received in 2023-06-29, accepted in 2023-09-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundRadiation-associated dysphagia is defined as impaired swallowing efficiency/safety following (chemo)radiotherapy in head and neck cancer patients. In a dysphagia framework, impaired coughing may lead to lung aspiration and fatal lung infection. Although cough efficacy is a predictor of the risk of aspiration, cough investigation is minimal in patients with radiation-associated dysphagia. Because cough is a transient signal, existing software for speech analysis are not appropriate. The goal of our project is to develop an assessment method using acoustic features related to voluntary and reflexive coughs as biomarkers of the risk of penetration/aspiration in patients with radiation-associated dysphagia.MethodsHealthy subjects and head and neck cancer patients with and without dysphagia will produce voluntary coughs, throat clearings and reflexive coughs. Recordings will be made using an acoustic microphone and a throat microphone. The recorded signals will be manually segmented and subsequently analysed with a software under development. Automatic final segmentation enables to measure cough duration. The first method of analysis includes temporal features: the amplitude contour, the sample entropy and the kurtosis. These features report respectively the strength, the unpredictability (turbulence noise due to the air jet) and the impulsive quality (burst) of the signal. The second method of analysis consists of a spectral decomposition of the relative cough signal energy into several frequency bands (0–400 Hz, 400–800 Hz, 800–1600 Hz, 1600–3200 Hz, > 3200 Hz). The primary outcome of this exploratory research project is the identification of a set of descriptive acoustic cough features in healthy subjects as reference data (ACCOUGH). The secondary outcome of this research in head and neck cancer patients with radiation-associated dysphagia includes the identification of (1) a set of descriptive acoustic cough features as biomarkers of penetration-aspiration (ACCOUGH-P/A), (2) swallowing scores, (3) voice features and (4) aerodynamic cough features.DiscussionThis study is expected to develop methods of acoustic cough analysis to enhance the assessment of radiation-associated dysphagia in head and neck cancer patients following (chemo)radiation.Trial registrationInternational Standard Randomized Controlled Trials Number (ISRCTN) registry ISRCTN16540497. Accepted on 23 June 2023.

【 授权许可】

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© BioMed Central Ltd., part of Springer Nature 2023