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低强度激光治疗乳腺癌后继发性淋巴水肿:系统评价

Low-level laser therapy in secondary lymphedema after breast cancer: systematic review.

作者信息

E Lima Mariana Toledo Biscaia Raposo Mourão, E Lima Januário Gomes Mourão, de Andrade Mauro Figueiredo Carvalho, Bergmann Anke

机构信息

Augusto Motta University Center-UNISUAM, Rio de Janeiro, Brazil,

出版信息

Lasers Med Sci. 2014 May;29(3):1289-95. doi: 10.1007/s10103-012-1240-y. Epub 2012 Nov 29.

Abstract

Complex physical therapy is the main treatment for the secondary lymphedema after breast cancer. The low-level laser therapy (LLLT) has been used in order to stimulate lymphangiogenesis, encourage lymphatic motility, and reduce lymphostatic fibrosis. However, these factors could also favor the development of recurrence and metastasis. The objective of this study is to discuss the use of LLLT in the treatment of lymphedema after breast cancer. This study utilized a systematic review on the use of LLLT in the treatment of lymphedema after breast cancer. Evaluating quality of articles was conducted through the PEDro scale. Of the 41 articles identified, four were considered to be of high methodological quality (score ≥ 5). The low-level laser in the axillary region was performed in all studies. The control group was not similar across studies. The results presented showed that there was a reduction in limb volume in the group subjected to low-power laser when compared with other treatments. No studies have evaluated the risk of metastasis or relapse in the irradiated areas. Because no studies have included the complex physical therapy as the comparison group, we cannot claim that laser treatment is the best efficacy or effectiveness in lymphedema treatment after breast cancer. No studies have evaluated the hypothesis that the LLLT can increase the risk of recurrence or metastasis. Therefore, the questions about the safety of this procedure in cancer patients remain.

摘要

综合物理治疗是乳腺癌术后继发性淋巴水肿的主要治疗方法。低强度激光治疗(LLLT)已被用于刺激淋巴管生成、促进淋巴运动并减少淋巴淤积性纤维化。然而,这些因素也可能有利于复发和转移的发生。本研究的目的是探讨LLLT在乳腺癌术后淋巴水肿治疗中的应用。本研究对LLLT在乳腺癌术后淋巴水肿治疗中的应用进行了系统评价。通过PEDro量表评估文章质量。在检索到的41篇文章中,有4篇被认为方法学质量较高(评分≥5分)。所有研究均对腋窝区域进行了低强度激光治疗。各研究中的对照组不尽相同。结果显示,与其他治疗方法相比,接受低功率激光治疗的组肢体体积有所减小。没有研究评估照射区域转移或复发的风险。由于没有研究将综合物理治疗作为对照组,我们不能声称激光治疗是乳腺癌术后淋巴水肿治疗中疗效最佳或效果最好的方法。没有研究评估LLLT会增加复发或转移风险这一假设。因此,该治疗方法在癌症患者中的安全性问题依然存在。

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