Impact of a Multidisciplinary Rehabilitation Program on Quality of Life in Oral Cancer Survivors: A Randomised Controlled Trial

Abstract

Background: Oral cancer survivors often experience long-term functional impairments, including dysphagia, speech difficulties, trismus, pain, nutritional problems, and psychosocial distress, which significantly reduce HRQoL. Evidence on the effectiveness of structured rehabilitation in low- and middle-income countries is limited. This study assessed the impact of a multidisciplinary rehabilitation programme on HRQoL among Bangladeshi survivors. Methods: A randomized controlled trial at Bangabandhu Sheikh Mujib Medical University from July 2023 to July 2024 involved 80 oral squamous cell carcinoma survivors, randomly assigned to intervention (n=40) or control (n=40) groups. The intervention included a 12-week multidisciplinary rehab program with therapy, exercises, nutrition, oral hygiene, and psychosocial support, while controls received routine care. HRQoL was measured with EORTC QLQ-C30 and QLQ-H&N35. Secondary outcomes were mouth opening, weight, nutrition, adherence, satisfaction, and adverse events. Results: Baseline demographic, clinicopathological, and HRQoL characteristics were comparable between the groups (all p > 0.05). Following rehabilitation, the intervention group demonstrated significantly greater improvement in global HRQoL than the control group (+13.8 ± 6.2 vs. +3.7 ± 5.5; mean difference, 10.1; 95% CI, 7.5–12.7; p < 0.001). Significant improvements were also observed in swallowing (p < 0.001), speech (p = 0.002), pain (p = 0.004), mouth opening (p = 0.006), body weight (p = 0.031), nutritional status (p < 0.001), rehabilitation adherence (p < 0.001), and patient satisfaction (p < 0.001). No significant differences in adverse events were identified between the groups. Conclusions: A structured multidisciplinary rehabilitation program significantly improved HRQoL and multiple functional outcomes in oral cancer survivors while demonstrating excellent adherence and a favorable safety profile. These findings support the integration of multidisciplinary rehabilitation into routine survivorship care, particularly in resource-limited settings.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (1): 105-113