Department of Surgery, Division of Surgical Oncology, Magee-Womens Hospital University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Support Care Cancer. 2011 May;19(5):685-90. doi: 10.1007/s00520-010-0888-8. Epub 2010 May 6.
Breast-cancer-related lymphedema (BCRL) is a chronic disease, and currently there is no definitive treatment for it. There are some therapeutic interventions targeted to decrease the limb swelling and the associated problems. Low-level laser therapy (LLLT) has been used in the treatment of post-mastectomy lymphedema since 2007 in the US. The aim of this study is to review our short-term experience with LLLT in the treatment of BCRL.
Seventeen BCRL patients referred to our lymphedema program between 2007 and 2009 were enrolled in this study. All patients had experienced at least one conventional treatment modality such as complex physical therapy, manual lymphatic drainage, and/or pneumatic pump therapy. LLLT was added to patients' ongoing therapeutic regimen. All patients completed the full course of LLLT consisting of two cycles. The difference between sums of the circumferences of both affected and unaffected arms (ΔC), pain score, scar mobility, and range of motion were measured before and after first and second cycles of LLLT sequentially.
All patients were female with a median age of 51.8 (44-64) years. ΔC decreased 54% (15-85%) and 73% (33-100%), after the first and second cycles of LLLT, respectively. Fourteen out of seventeen experienced decreased pain with motion by an average of 40% (0-85%) and 62.7% (0-100%) after the first and second cycle of LLLT, respectively. Three patients had no improvement in pain after LLLT. Scar mobility increased in 13 (76.4%) and shoulder range of motion improved in 14 (82.3%) patients after LLLT. One patient developed cellulitis during LLLT.
Patients with BCRL received additional benefits from LLLT when used in conjunction with standard lymphedema treatment. These benefits include reduction in limb circumference, pain, increase in range of motion and scar mobility. Additionally, two cycles of LLLT were found to be superior to one in this study.
乳腺癌相关性淋巴水肿（BCRL）是一种慢性疾病，目前尚无明确的治疗方法。有一些治疗干预措施旨在减少肢体肿胀和相关问题。低水平激光疗法（LLLT）自 2007 年以来一直在美国用于治疗乳腺癌根治术后淋巴水肿。本研究旨在回顾我们在治疗 BCRL 中使用 LLLT 的短期经验。
2007 年至 2009 年间，我们的淋巴水肿计划收治了 17 例 BCRL 患者。所有患者均至少接受过一种常规治疗方法，如复杂物理治疗、手动淋巴引流和/或气压泵治疗。LLLT 被添加到患者正在进行的治疗方案中。所有患者均完成了包括两个周期的完整 LLLT 疗程。在 LLLT 第一和第二周期前后，分别测量双侧受累和未受累手臂周长之和的差值（ΔC）、疼痛评分、瘢痕活动度和运动范围。
所有患者均为女性，中位年龄为 51.8（44-64）岁。LLLT 第一和第二周期后，ΔC 分别减少了 54%（15-85%）和 73%（33-100%）。17 例中有 14 例在 LLLT 第一和第二周期后运动时疼痛减轻，平均分别减少 40%（0-85%）和 62.7%（0-100%）。3 例患者在 LLLT 后疼痛无改善。13 例（76.4%）瘢痕活动度增加，14 例（82.3%）肩部运动范围改善。1 例患者在 LLLT 期间发生蜂窝织炎。
当与标准淋巴水肿治疗联合使用时，BCRL 患者从 LLLT 中获得了额外的益处。这些益处包括肢体周长、疼痛、运动范围和瘢痕活动度的减少。此外，本研究发现，两个周期的 LLLT 优于一个周期。
