Choi Eunjoo, Nahm Francis Sahngun, Lee Pyung-Bok
Department of Anesthesiology and Pain Medicine., Seoul National University Bundang Hospital, Seongnam-si, Bundang-gu Korea.
Pain Physician. 2015 Jul-Aug;18(4):365-72.
Breast cancer-related lymphedema (BCRL) not only has physical implications, but also affects the quality of life in breast cancer survivors. Despite numerous studies of various therapies, the optimal treatment for BCRL is unknown.
In this study, we investigated the efficacy of sympathetic blockade (thoracic sympathetic ganglion block, [TSGB]) in treating BCRL.
Retrospective study.
Tertiary referral center/teaching hospital.
TSGB was performed in 35 patients under fluoroscopic guidance. First, arm circumference and Lymphedema and Breast Cancer Questionnaire [LBCQ] score were assessed before TSGB and 2 weeks and 2 months after the procedure. Efficacy was defined as a ≥ 50% reduction in the LBCQ score and a ≥ 50% decrease in the circumference difference between the unaffected and affected arms 2 months after TSGB. Second, TSGB efficacy according to the lymphedema stage and the period between BCRL onset and TSGB (< 6 months vs. > 6 months) was evaluated.
The arm circumference and LBCQ score significantly decreased at 2 months (P < 0.001), and 65.7% of patients showed good efficacy. Patients with high stage lymphedema showed improved efficacy after TSGB compared to those with low stage disease (P = 0.045). The TSGB efficacy did not differ according to the period between BCRL onset and TSGB.
This study was not a randomized prospective controlled study and did not compare the therapeutic outcomes to those in a conservative treatment group.
TSGB in BCRL patients appears to be effective in decreasing the affected arm circumference. TSGB may be an alternative option in BCRL patients who do not respond to conservative therapy.
乳腺癌相关淋巴水肿（BCRL）不仅会对身体产生影响，还会影响乳腺癌幸存者的生活质量。尽管对各种治疗方法进行了大量研究，但BCRL的最佳治疗方法仍不明确。
在本研究中，我们调查了交感神经阻滞（胸交感神经节阻滞，[TSGB]）治疗BCRL的疗效。
回顾性研究。
三级转诊中心/教学医院。
在透视引导下对35例患者进行TSGB。首先，在TSGB前、术后2周和2个月评估臂围和淋巴水肿与乳腺癌问卷[LBCQ]评分。疗效定义为TSGB术后2个月LBCQ评分降低≥50%，患侧与未患侧手臂周长差减少≥50%。其次，根据淋巴水肿分期以及BCRL发病至TSGB的时间（<6个月与>6个月）评估TSGB疗效。
2个月时臂围和LBCQ评分显著降低（P<0.001），65.7%的患者显示出良好疗效。与低分期疾病患者相比，高分期淋巴水肿患者TSGB术后疗效改善（P=0.045）。TSGB疗效在BCRL发病至TSGB的时间方面无差异。
本研究不是随机前瞻性对照研究，未将治疗结果与保守治疗组进行比较。
BCRL患者的TSGB似乎能有效减小患侧手臂周长。TSGB可能是对保守治疗无反应的BCRL患者的一种替代选择。
