Photobiomodulation Therapy in Head and Neck Cancer-Related Lymphedema: A Pilot Feasibility Study

Abstract

Purpose: Lymphedema is a common debilitating late effect among patients post-head and neck cancer (HNC) treatment. Head and neck lymphedema was associated with symptom burden, functional impairment, and decreased quality of life. The objective of this study was to determine the feasibility and potential efficacy of the use of photobiomodulation (PBM) therapy for head and neck lymphedema, symptom burden, and neck range of motion among HNC survivors. Methods: This was a single-arm, pre- and post-design clinical trial. Eligible patients included those with lymphedema after completion of complete decongestive therapy (CDT) and 3 to 18 months after completion of cancer therapy. The intervention included PBM therapy 2 times a week for 6 weeks for a total of 12 treatments. Lymphedema, symptom burden, and neck range of motion were measured at baseline, end-of-intervention, and 4-week post-intervention. Results: Of the 12 patients enrolled in the study, 91.7% (n = 11) completed the study intervention and assessment visits, and no adverse events were reported. When comparing the baseline to 4-week post-intervention, we found statistically significant improvements in the severity of external lymphedema, symptom burden, and neck range of motion (all P < .05). Conclusion: PBM therapy was feasible and potentially effective for the treatment of head and neck lymphedema. Future randomized controlled trials are warranted to examine the efficacy of PBM therapy for HNC-related lymphedema. Trial Registration Number and Date of Registration: ClinicalTrials.gov Identifier: NCT03738332; date of registration: November 13, 2018.

Rehabilitation Interventions for Head and Neck Cancer–Associated Lymphedema

“…Of 1642 unique citations identified by the search, 24 citations (1.5%) met the inclusion criteria, representing 23 unique studies (n = 2147 patients); 1 study produced 2 unique citations that reported different outcomes . Of the 23 studies, 6 were RCTs (26.1%) and 17 (73.9%) were observational studies (Figure).…”

“…The median number of participants was 34 (range, 7-1202). Most studies had fewer than 50 participants (12 of 17 studies). Anatomical disease sites were mixed HNC in all studies.…”

“…Anatomical disease sites were mixed HNC in all studies. Baseline lymphedema severity was not reported in most studies (13 studies). When baseline lymphedema was assessed (4 of 17 studies), all studies reported stages 1b (range, 0-3) on the MDACC-HNL Rating Scale .…”

“…When baseline lymphedema was assessed (4 of 17 studies), all studies reported stages 1b (range, 0-3) on the MDACC-HNL Rating Scale . Serious intervention-related adverse effects were either not found (7 studies) or not reported (10 studies) . The timing of interventions was mostly posttreatment except for 1 study intervention that included patients who were undergoing cancer treatment .…”

Conducting a supportive oncology clinical trial during the COVID-19 pandemic: challenges and strategies

“…Participants also reported saving time and travel expense, issues that were particularly important to participants living outside of Philadelphia. Travel time and distance are common reasons why potential participants declined to participate in the study before the pandemic [10]. The advantage of using telehealth is that it allows patients to easily access resources from wherever they are located, thus leading to more patient involvement.…”