Systematic review of head and neck lymphedema assessment

Fadhil, Matthew; Singh, Ravjit; Havas, Thomas; Jacobson, Ian

doi:10.1002/hed.27136

Cited by 18 publications

(29 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is just over half of the historically reported low range of 12% and a small fraction of the incidence of 90% reported in contemporary studies. [8][9][10][11][12] Our database only identi ed 521 HNC survivors who received treatment for lymphedema suggesting marked undertreatment of the disorder. The primary treatment modality for those referred was MLD (80%) with only a small percentage receiving compassion garments (13.6%) and even fewer (8.6%) receiving APCD.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 The reported prevalence of lymphedema in HNC survivors ranges from 12% to more than 90%. [8][9][10][11][12] This variation is due to methodological differences between studies with contemporary studies favoring the high range of prevalence. 8,12 HNL is not simply a cosmetic issue.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11][12] This variation is due to methodological differences between studies with contemporary studies favoring the high range of prevalence. 8,12 HNL is not simply a cosmetic issue. It is both an external and internal phenomenon with signi cant clinical sequelae.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Under recognition and treatment of lymphedema in head and neck cancer survivors – a database study

Stubblefield

Weycker

2023

Support Care Cancer

View full text Add to dashboard Cite

Purpose: Head and neck cancer (HNC) will be diagnosed in approximately 54,000 Americans in 2022 with more than 11,000 dying as a result. The treatment of HNC often involves aggressive multimodal therapy including surgery, radiotherapy, and systemic therapy. HNC and its treatments are associated with multiple painful and function-limiting neuromusculoskeletal and visceral long-term and late effects. Among these is head and neck lymphedema (HNL), the abnormal accumulation of protein rich uid, in as many as 90% of survivors. Though HNL is common and potentially contributory to other function-limiting issues in this population, it is notoriously understudied, underrecognized, underdiagnosed, and undertreated. This study seeks to determine the incidence of HNC-related lymphedema diagnosis and treatment in a large US healthcare claims repository database. Methods: A retrospective observational cohort design and data from an integrated US healthcare claims repository-the IBM MarketScan Commercial Claims and Encounters (CCAE) and Medicare Supplemental and Coordination of Bene ts (MDCR) Databases spanning the period April 1, 2012 through March 31, 2020.Results: Of the 16,654 HNC patients eligible for evaluation, 1,082 (6.5%) with a diagnosis of lymphedema were identi ed based on eligibility criteria. Of the 521 HNC patients evaluated for lymphedema treatment, 417 (80.0%) patients received 1.5 courses of MLD, 71 (13.6%) patients were prescribed compression garments, and 45 (8.6%) patients received an advanced pneumatic compression device. Conclusion: HNL in this population of HNC survivors was underdiagnosed and treated compared with contemporary assessments HNL incidence.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Under recognition and treatment of lymphedema in head and neck cancer survivors – a database study

Stubblefield

Weycker

2023

Support Care Cancer

View full text Add to dashboard Cite

show abstract

“…Only 1 observational study identified in the present review used this tool. Another recent systematic review on HNCaL assessment highlighted 2 objective measures: (1) computed tomography for external and internal HNCaL and (2) ultrasonography for external lymphedema . In the present review, 1 RCT used ultrasonography, and none used computed tomography.…”

Section: Discussionmentioning

confidence: 86%

“…In the present review, 1 RCT used ultrasonography, and none used computed tomography. For monitoring internal lymphedema, the current criterion standard is endoscopy-based measures . This review identified 6 studies (2 RCTs, 4 observational studies) of adjunct therapies that used various endoscopic measures, with none showing clear improvement.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation Interventions for Head and Neck Cancer–Associated Lymphedema

Cheng

Leite

Tennison

et al. 2023

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

ImportanceHead and neck cancer–associated lymphedema (HNCaL) affects up to 90% of survivors of head and neck cancer and is a substantial contributor to disability following head and neck cancer treatment. Despite the prevalence and morbidity associated with HNCaL, rehabilitation interventions are not well studied.ObjectiveTo identify and appraise the current evidence for rehabilitation interventions in HNCaL.Evidence ReviewFive electronic databases were searched systematically from inception to January 3, 2023, for studies on HNCaL rehabilitation interventions. Study screening, data extraction, quality rating, and risk of bias assessment were performed by 2 independent reviewers.FindingsOf 1642 citations identified, 23 studies (1.4%; n = 2147 patients) were eligible for inclusion. Six studies (26.1%) were randomized clinical trials (RCTs) and 17 (73.9%) were observational studies. Five of the 6 RCTs were published during 2020 to 2022. Most studies had fewer than 50 participants (5 of 6 RCTs; 13 of 17 observational studies). Studies were categorized by intervention type, including standard lymphedema therapy (11 studies [47.8%]) and adjunct therapy (12 studies [52.2%]). Lymphedema therapy interventions included standard complete decongestive therapy (CDT) (2 RCTs, 5 observational studies), modified CDT (3 observational studies), therapy setting (1 RCT, 2 observational studies), adherence (2 observational studies), early manual lymphatic drainage (1 RCT), and inclusion of focused exercise (1 RCT). Adjunct therapy interventions included advanced pneumatic compression devices (APCDs) (1 RCT, 5 observational studies), kinesio taping (1 RCT), photobiomodulation (1 observational study), acupuncture/moxibustion (1 observational study), and sodium selenite (1 RCT, 2 observational studies). Serious adverse events were either not found (9 [39.1%]) or not reported (14 [60.9%]). Low-quality evidence suggested the benefit of standard lymphedema therapy, particularly in the outpatient setting and with at least partial adherence. High-quality evidence was found for adjunct therapy with kinesio taping. Low-quality evidence also suggested that APCDs may be beneficial.Conclusions and RelevanceThe results of this systematic review suggest that rehabilitation interventions for HNCaL, including standard lymphedema therapy with kinesio taping and APCDs, appear to be safe and beneficial. However, more prospective, controlled, and adequately powered studies are needed to clarify the ideal type, timing, duration, and intensity of lymphedema therapy components before treatment guidelines can be established.

show abstract

Effect of Complex Decongestive Therapy on Quality of Life and Physical Parameters in Head and Neck Lymphedema

Keskin Kavak,

Duran,

Ünsal Delialioğlu

et al. 2024

The Laryngoscope

View full text Add to dashboard Cite

ObjectiveTo assess the effect of complex decongestive therapy treatment (CDT) on quality of life, neck disability, cervical range of motion, and facial and neck lymphedema size using specific anatomical landmark points.MethodsThis prospective study was conducted in a tertiary cancer center in Turkey. Thirty patients included in the study were treated with CDT for 21 days. The patients were evaluated before and after CDT with MD Anderson Cancer Center Head and Neck Lymphedema (MDACC HNC) staging system, The Neck Disability Index, European Organization for Research and Treatment of Cancer Quality of Life 30 (EORTC‐QLOC30), Facial Composite score and Neck Circumferences, cervical range of motion.ResultsMedian follow‐up was 7.2 months. After treatment of 30 patients significant cognitive function, emotional function, and social function (p < 0.001). After CDT treatment, the quality of life sub‐parameters of EORTC QLQ‐C30 showed significant improvement (p < 0.001). The facial composite score and neck circumferences indices showed significant improvement (p < 0.001). A decrease of 2% or more in the facial composite score and neck circumferences was observed in all patients participating in the study.ConclusionThere have been few studies on the effectiveness of CDT on the EORTC QLQ‐C30, facial composite score, and neck circumferences in head and neck lymphedema. In patients with head and neck lymphedema following head and neck cancer, our study demonstrated the positive effects of complex decongestive therapy (CDT) on neck disability, range of motion, quality of life, and facial and neck lymphedema tissue size.Level of Evidence4 Laryngoscope, 2024

show abstract

Systematic review of head and neck lymphedema assessment

Cited by 18 publications

References 64 publications

Under recognition and treatment of lymphedema in head and neck cancer survivors – a database study

Under recognition and treatment of lymphedema in head and neck cancer survivors – a database study

Rehabilitation Interventions for Head and Neck Cancer–Associated Lymphedema

Effect of Complex Decongestive Therapy on Quality of Life and Physical Parameters in Head and Neck Lymphedema

Contact Info

Product

Resources

About