Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Physical Medicine and Rehabilitation, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Pain Physician. 2019 May;22(3):255-263.
Breast cancer-related lymphedema (BCRL) of the upper extremities often follows breast cancer treatment. Although complex decongestive therapy (CDT) is currently the standard treatment for BCRL, stellate ganglion block (SGB) has also been reported to be effective.
This study aimed to determine the effectiveness of SGB in the treatment of BCRL, and to assess the impact of the treatment on the quality of life (QoL) compared to CDT.
A randomized controlled trial.
A single academic hospital, outpatient setting.
A total of 38 patients with BCRL were recruited. Patients were randomly divided into 2 groups. Patients enrolled in the CDT group underwent 10 sessions of CDT for 2 weeks, whereas patients in the SGB group received 3 consecutive SGBs every 2 weeks. Changes in circumference, volume, and bioimpedance in the upper extremity were measured at baseline and 2 weeks after treatment and compared between the 2 groups. EuroQol-5 dimensions (EQ-5D) and EuroQol visual analog scale (EQ VAS) for QoL and subjective improvement were monitored.
In both groups, side-to-side difference of circumference after the treatment was decreased significantly from baseline (P < 0.05), and side-to-side difference of volume was reduced significantly in the SGB group (P < 0.05). No statistically significant difference was noted in the treatment effect between the 2 groups. Results of the EQ-5D, EQ VAS, and questionnaires regarding subjective symptoms administered at baseline and 2 weeks after each intervention revealed no statistically significant difference in the treatment effects between CDT and SGB.
Further long-term follow-up studies with a greater number of patients that include analysis according to the severity and duration of symptoms are needed.
The results of this study suggest that SGB is an effective treatment for BCRL and may be considered as an alternative to CDT.
Stellate ganglion block, complex decongestive therapy, breast cancer, lymphedema, breast cancer-related lymphedema, quality of life, bioimpedance, secondary lymphedema.
乳腺癌相关上肢淋巴水肿（BCRL）常继发于乳腺癌治疗后。虽然复杂消肿治疗（CDT）目前是 BCRL 的标准治疗方法，但星状神经节阻滞（SGB）也被报道是有效的。
本研究旨在确定 SGB 治疗 BCRL 的有效性，并评估与 CDT 相比，SGB 对生活质量（QoL）的影响。
随机对照试验。
一家单学术医院，门诊环境。
共招募了 38 例 BCRL 患者。患者随机分为 2 组。CDT 组接受 10 次 CDT 治疗，为期 2 周；SGB 组则每 2 周接受 3 次连续 SGB。在基线和治疗后 2 周时测量上肢周径、体积和生物阻抗的变化，并比较 2 组之间的差异。监测 EuroQol-5 维度（EQ-5D）和 EuroQol 视觉模拟量表（EQ VAS）用于 QoL 和主观改善。
两组治疗后患侧与健侧周径的差异均显著减小（P < 0.05），SGB 组患侧与健侧体积的差异显著减小（P < 0.05）。2 组之间的治疗效果无统计学差异。在基线和每次干预后 2 周时进行的 EQ-5D、EQ VAS 和主观症状问卷的结果显示，CDT 和 SGB 之间的治疗效果无统计学差异。
需要进一步进行更多患者的长期随访研究，包括根据症状的严重程度和持续时间进行分析。
本研究结果表明，SGB 是治疗 BCRL 的有效方法，可作为 CDT 的替代方法。
星状神经节阻滞，复杂消肿治疗，乳腺癌，淋巴水肿，乳腺癌相关淋巴水肿，生活质量，生物阻抗，继发性淋巴水肿。
