Long-Term Effects of Complex Decongestive Therapy in Breast Cancer Patients With Arm Lymphedema After Axillary Dissection
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Objective To investigate the long-term effects of complex decongestive therapy (CDT) on edema reduction in breast cancer-related lymphedema patients after axillary dissection, according to the initial volume of edema.Methods A retrospective review of 57 patients with unilateral arm after an axillary dissection for breast cancer was performed. The patients, treated with two weeks of CDT and self-administered home therapy, were followed for 24 months. Arm volume was serially measured by using an optoelectronic volumeter prior to and immediately after CDT; and there were follow-up visits at 3, 6, 12, and 24 months. Patients were divided into two groups according to the percent excess volume (PEV) prior to CDT: group 1, PEV<20% and group 2, PEV≥20%. Results In group 1, mean PEV before CDT was 11.4±5.0% and 14.1±10.6% at 24 months after CDT with no significant difference. At the end of CDT, PEV was 28.8±15.7% in group 2, which was significantly lower than the baseline (41.9±19.6%). The reduction of PEV was maintained for 24 months in group 2. Conclusion The long-term effects of CDT were well-maintained for 24 months, but there was a difference in progression of PEV between the two groups. The patients with more initial PEV showed significant volume-reducing effects of CDT. In patients with less initial PEV, the severity of lymphedema did not progress to higher grades.
Abstract
Objective To investigate the long-term effects of complex decongestive therapy (CDT) on edema reduction in breast cancer-related lymphedema patients after axillary dissection, according to the initial volume of edema.Methods A retrospective review of 57 patients with unilateral arm after an axillary dissection for breast cancer was performed. The patients, treated with two weeks of CDT and self-administered home therapy, were followed for 24 months. Arm volume was serially measured by using an optoelectronic volumeter prior to and immediately after CDT; and there were follow-up visits at 3, 6, 12, and 24 months. Patients were divided into two groups according to the percent excess volume (PEV) prior to CDT: group 1, PEV<20% and group 2, PEV≥20%. Results In group 1, mean PEV before CDT was 11.4±5.0% and 14.1±10.6% at 24 months after CDT with no significant difference. At the end of CDT, PEV was 28.8±15.7% in group 2, which was significantly lower than the baseline (41.9±19.6%). The reduction of PEV was maintained for 24 months in group 2. Conclusion The long-term effects of CDT were well-maintained for 24 months, but there was a difference in progression of PEV between the two groups. The patients with more initial PEV showed significant volume-reducing effects of CDT. In patients with less initial PEV, the severity of lymphedema did not progress to higher grades.
참고문헌 (38)
- Ahmed RL., "Lymphedema and quality of life in breast cancer survivors : the Iowa Women’s Health Study", J Clin Oncol, 26, pp.5689~5696 (2008)
- Pusic AL., "Quality of life among breast cancer patients with lymphedema : a systematic review of patient-reported outcome instruments and outcomes", J Cancer Surviv, 7, pp.83~92 (2013)
- Shah C., "Breast cancer-related arm lymphedema : incidence rates, diagnostic techniques, optimal management and risk reduction strategies", Int J Radiat Oncol Biol Phys, 81, pp.907~914 (2011)
- Gartner R., "Self-reported arm-lymphedema and functional impairment after breast cancer treatment : a nationwide study of prevalence and associated factors", Breast, 19, pp.506~515 (2010)
- Ashikaga T., "Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection", J Surg Oncol, 102, pp.111~118 (2010)
- Mouridsen HT., "Improvement of prognosis in breast cancer in Denmark 1977-2006, based on the nationwide reporting to the DBCG Registry", Acta Oncol, 47, pp.525~536 (2008)
- Miller CL., "Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema : implications for prophylactic surgery", Breast Cancer Res Treat, 135, pp.781~789 (2012)
- Foldi E., "The lymphedema chaos : a lancet", Ann Plast Surg, 22, pp.505~515 (1989)
- Vignes S., "Long-term management of breast cancer-related lymphedema after intensive decongestive physiotherapy", Breast Cancer Res Treat, 101, pp.285~290 (2007)
- Ko DS., "Effective treatment of lymphedema of the extremities", Arch Surg, 133, pp.452~458 (1998)
- Vignes S., "Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy", Support Care Cancer, 19, pp.935~940 (2011)
- Vignes S., "Predictive factors of response to intensive decongestive physiotherapy in upper limb lymphedema after breast cancer treatment : a cohort study", Breast Cancer Res Treat, 98, pp.1~6 (2006)
- Kim YB., "Would complex decongestive therapy reveal long term effect and lymphoscintigraphy predict the outcome of lower-limb lymphedema related to gynecologic cancer treatment?", Gynecol Oncol, 127, pp.638~642 (2012)
- Ramos SM., "Edema volume, not timing, is the key to success in lymphedema treatment", Am J Surg, 178, pp.311~315 (1999)
- Forner-Cordero I., "Predictive factors of re-sponse to decongestive therapy in patients with breast-cancer-related lymphedema", Ann Surg Oncol, 17, pp.744~751 (2010)
- Bernas MJ., "The diagnosis and treatment of peripheral lymphedema : draft revision of the 1995 Consensus Document of the International Society of Lymphology Executive Committee for discussion at the September 3-7, 2001, XVIII International Congress of Lymphology in Genoa, Italy", Lymphology, 34, pp.84~91 (2001)
- Szuba A., "Decongestive lymphatic therapy for patients with cancer-related or primary lymphedema", Am J Med, 109, pp.296~300 (2000)
- Piller N., "The diagnosis and treatment of peripheral lymphedema", Lymphology, 42, pp.146~147 (2009)
- Stillwell GK., "Treatment of postmastectomy lymphedema", Mod Treat, 6, pp.396~412 (1969)
- Lasinski BB., "A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011", PM R, 4, pp.580~601 (2012)
- Stanton AW., "Validation of an optoelectronic limb volumeter(Perometer)", Lymphology, 30, pp.77~97 (1997)
- Tierney S., "Infrared optoelectronic volumetry, the ideal way to measure limb volume", Eur J Vasc Endovasc Surg, 12, pp.412~417 (1996)
- Ancukiewicz M., "Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema : the flaws in current studies and need for universal methodology", Breast Cancer Res Treat, 135, pp.145~152 (2012)
- Johansson K., "Arm lymphoedema in a cohort of breast cancer survivors 10 years after diagnosis", Acta Oncol, 49, pp.166~173 (2010)
- "Lymphedema following treatment for breast cancer: a new approach to an old problem" (2013)[URL]
- Helyer LK., "Obesity is a risk factor for developing postoperative lymphedema in breast cancer patients", Breast J, 16, pp.48~54 (2010)
- Sitzia J., "A review of outcome indicators in the treatment of chronic limb oedema", Clin Rehabil, 11, pp.181~191 (1997)
- Gebruers N., "Volumetric evaluation of upper extremities in 250 healthy persons", Clin Physiol Funct Imaging, 27, pp.17~22 (2007)
- Liao SF., "Complex decongestive physiotherapy for patients with chronic cancer-associated lymphedema", J Formos Med Assoc, 103, pp.344~348 (2004)
- Yamamoto R., "Effectiveness of the treatment-phase of two-phase complex decongestive physiotherapy for the treatment of extremity lymphedema", Int J Clin Oncol, 12, pp.463~468 (2007)
- Casley-Smith JR., "Alterations of untreated lymphedema and it’s grades over time", Lymphology, 28, pp.174~185 (1995)
- Bar Ad V., "Time-course of arm lymphedema and potential risk factors for progression of lymphedema after breast conservation treatment for early stage breast cancer", Breast J, 18, pp.219~225 (2012)
- Liao SF., "The efficacy of complex decongestive physiotherapy(CDP)and predictive factors of lymphedema severity and response to CDP in breast cancer-related lymphedema(BCRL)", Breast, 22, pp.703~706 (2013)
- Cheifetz O., "Management of secondary lymphedema related to breast cancer", Can Fam Physician, 56, pp.1277~1284 (2010)
- Hamner JB., "Lymphedema therapy reduces the volume of edema and pain in patients with breast cancer", Ann Surg Oncol, 14, pp.1904~1908 (2007)
- Korpan MI., "Lymphedema: a therapeutic approach in the treatment and rehabilitation of cancer patients", Am J Phys Med Rehabil, 90, pp.S69~S75 (2011)
- Jeffs E., "Treating breast cancer-related lymphoedema at the London Haven : clinical audit results", Eur J Oncol Nurs, 10, pp.71~79 (2006)
- Williams AF., "A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema", Eur J Cancer Care(Engl), 11, pp.254~261 (2002)