Treatment for lymphedema following head and neck cancer therapy: A systematic review

Tyker, Albina; Franco, Joel; Desai, Shaun C.; Walen, Scott

doi:10.1016/j.amjoto.2019.05.024

Cited by 46 publications

(86 citation statements)

References 40 publications

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“…It can be associated with functional deterioration and poor quality of life [5,27]. Clinical interest in lymphoedema in head and neck cancer has increased in the last decade and recent reviews have attempted to examine the evidence and management of the condition, but there is still limited information about the evaluation and effectiveness of treatments [26,28].…”

Section: Discussionmentioning

confidence: 99%

“…MLD is relatively straightforward to teach and is not associated with any significant side effects. Other treatments may involve selenium, liposuction and lymphaticovenular anastomosis and while there are some studies suggesting these treatments are effective in a small number of patients, there are limited large randomised controlled trials [28].…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review evaluated all established treatment modalities for lymphoedema associated with head and neck cancer [28]. Twenty-six articles were included in the review, totalling 1018 study subjects.…”

Section: Discussionmentioning

confidence: 99%

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Using the Glasgow Benefit Inventory questionnaire to quantify the health benefits of lymphoedema treatment in patients with head and neck cancer

Halliday

Gittins²,

Ahsan

2020

Appl Cancer Res

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Background Lymphoedema is a common side effect after treatment for head and neck cancer. Our treatment protocol involves staging the degree of lymphoedema and then offering treatment comprising skin care, manual lymphatic drainage, simple lymphatic drainage, compression and elastic therapeutic tape. The Glasgow Benefit Inventory is a validated post-interventional questionnaire applicable to otorhinolaryngology interventions which measures changes in health status. The aim of this study was to quantify the health benefits of lymphoedema treatment using the Glasgow Inventory Benefit questionnaire, in patients with a history of treated head and neck cancer. Methods Any patient who had undergone treatment with curative intent of a primary head and neck malignancy who had been referred for lymphoedema treatment within a 6 month period was eligible for inclusion. Patients completed a questionnaire after finishing the course of lymphoedema treatment. Results A total of 15 patients completed the questionnaire. Ten patients (67%) demonstrated some level of improvement in quality of life, while two (13%) reported no benefit and three (20%) reported negative improvements. The average score for the total Glasgow Benefit Inventory scale was + 7.2. The greatest benefit was demonstrated with the physical benefit subscale (+ 13.1). The average general benefit score was + 9.0. Conclusions Lymphoedema treatment involves techniques which can fairly easily be taught to patients to complete at home. In this study, there were mild improvements in patient reported quality of life using the Glasgow Benefit Inventory in the majority of patients. Clinical interest has increased in lymphoedema recently, but there is still limited information about the effectiveness of treatments and future research should look to address these issues.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Using the Glasgow Benefit Inventory questionnaire to quantify the health benefits of lymphoedema treatment in patients with head and neck cancer

Halliday

Gittins²,

Ahsan

2020

Appl Cancer Res

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“…Most HNC patients undergo brief professional therapy followed by self-care. While this approach may prove efficacious for some patients, lymphedema fails to respond adequately to standard therapies in others [9][10][11][12][13]. Many patients experience barriers to lymphedema care including cost or insurance obstacles, lack of certified and experienced lymphedema therapists, and self-limitations (e.g., physical or cognitive impairments).…”

Section: Purposementioning

confidence: 99%

Advanced pneumatic compression for treatment of lymphedema of the head and neck: a randomized wait-list controlled trial

Ridner

Dietrich

Deng

et al. 2020

Support Care Cancer

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Purpose Lymphedema associated with head and neck cancer (HNC) therapy causes adverse clinical outcomes. Standard treatment includes professionally administered complete decongestive therapy (CDT). Cost and availability of trained therapists are known barriers to therapy. Advanced pneumatic compression devices (APCD) may address these issues. A randomized, wait-list controlled trial was undertaken to evaluate an APCD in post-treatment HNC patients with lymphedema. Material and methods Eligible patients had completed treatment for HNC, were disease free, and had lymphedema at enrollment. Participants were randomized to wait-list lymphedema self-management (standard of care) or lymphedema self-management plus the use of the APCD bid. Safety (CTCAE V4.0) and feasibility were primary endpoints; secondary endpoints included efficacy measure by objective examination and patient reported outcomes (symptoms, quality of life, function), adherence barriers, and satisfaction. Assessments were conducted at baseline and weeks 4 and 8. Results Forty-nine patients were enrolled (wait-list n = 25; intervention n = 24). In total, forty-three patients completed the study. No device-related Serious Adverse Events were reported. Most patients used the APCD once per day, instead of the prescribed twice per day, citing time related factors as barriers to use. APCD use was associated with significant improvement in perceived ability to control lymphedema (p = 0.003) and visible external swelling (front view p < 0.001, right view p = 0.004, left p = 0.005), as well as less reported pain. Conclusion This trial supports the safety and feasibility of the APCD for the treatment of secondary lymphedema in head and neck cancer patients. In addition, preliminary data supports efficacy.

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“…(13,14) About one third of these patients present with low stage disease (T1-2, N0), therefore radiation or surgery protocols are available for treatment. Higher stage disease in HNC requires postoperative chemoradiotherapy (13) resulting in treatment sequelae like a cosmetic burden (15), trismus, radiotherapy-induced neck fibrosis (16) and radiodermatitis, further skin irregularities, and lymphedema (17). AFG can address these complications after successful treatment.…”

Section: Introductionmentioning

confidence: 99%

Autologous fat grafting in the face and neck-Multinational trends and knowledge of the safety, applications and indications considering oncologic risk potential

Fiedler¹,

Saleh²,

Mukrowsky³

2021

Preprint

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Introduction Autologous fat grafting (AFG) has both aesthetic and reconstructive applications. Described by Neuber in 1893 there are numerous applications of AFG as the body of evidence for its use has expanded. The earliest controversies were evident in lipofilling for breast defects post-oncological treatment, and to this day some countries do not allow it for fear of inducing tumourogenesis in an oncologically ablated field. Adipose-derived stem cells (ASCs) have been shown pro-oncologic behaviour in xenografts, however, this has not been reproduced in clinical observations thus far. Material and Methods We sought to review contemporary harvesting and processing techniques for AFG in the craniofacial region, therefore distributed a survey to evaluate the opinion and clinical impact of oncological risk across four European countries with possibly differing clinical attitudes. Results In the craniofacial region AFG is mostly used for aesthetic indications, cannula hand-held aspiration and centrifugation seem to be the predominant harvesting and processing techniques. Half of our respondents tell patients about the possibility of pro-oncologic behaviour of AFG. We found no significant geographical differences between the German-speaking and the English groups concerning their harvesting and processing technique. German participants seem to perform AFG more often and mostly use it for cosmetic and post-cancer treatment sequelae, English participants homogenically use AFG for cosmetic reasons. Conclusion Theoretical pro-oncologic behaviour of craniofacial AFG does not deter surgeons. Perhaps, we shouldn’t consider discussing this complex area of oncogenesis with patients as there is no elevated risk from what we know.

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Treatment for lymphedema following head and neck cancer therapy: A systematic review

Cited by 46 publications

References 40 publications

Using the Glasgow Benefit Inventory questionnaire to quantify the health benefits of lymphoedema treatment in patients with head and neck cancer

Using the Glasgow Benefit Inventory questionnaire to quantify the health benefits of lymphoedema treatment in patients with head and neck cancer

Advanced pneumatic compression for treatment of lymphedema of the head and neck: a randomized wait-list controlled trial

Autologous fat grafting in the face and neck-Multinational trends and knowledge of the safety, applications and indications considering oncologic risk potential

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