Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A.
Department of Radiation Oncology, Stanford University, Palo Alto, California, U.S.A.
Laryngoscope. 2020 Dec;130(12):E858-E862. doi: 10.1002/lary.28549. Epub 2020 Feb 18.
This study aimed to compare outcomes in patients with head and neck lymphedema receiving either a home-based lymphedema treatment program or a hybrid approach including both home-based treatment and regular clinical visits.
Outcomes were assessed in patients receiving head and neck lymphedema rehabilitation. Baseline measures of neck, submental, and facial edema were obtained and repeated following treatment. A home program was recommended for all patients, and those receiving hybrid care received the same recommendations as well as a visit with the lymphedema therapist for additional treatment. Their outcomes were compared using standard statistical analysis.
Fifty consecutive individuals were included, 25 in each group. Adherence to at least 50% of recommended treatment was reported in 68% of those receiving home-based treatment and 84% of those receiving hybrid care. Significant improvement was demonstrated for 66% of patients. There was no statistically significant difference between treatment groups with regard to clinically significant improvement (P = .15). Patients receiving hybrid therapy demonstrated treatment advantages regarding facial edema (P = .037). Adherence to treatment was associated with clinical improvement (P = .047).
Comparable benefits were observed regardless of whether patients had a home-based or hybrid lymphedema treatment approach. These data suggest a home-based treatment approach may be appropriate for patients unable to participate in clinical sessions. However, for patients with significant facial edema, a hybrid approach may be preferable. Adherence was associated with better outcomes. Given these findings, future investigations should consider strategies to improve adherence to optimize the outcomes lymphedema treatment.
3b Laryngoscope, 2020.
本研究旨在比较接受家庭为基础的淋巴水肿治疗方案或同时包括家庭治疗和定期临床就诊的混合治疗方案的头颈部淋巴水肿患者的结局。
评估接受头颈部淋巴水肿康复治疗的患者的结局。在治疗前和治疗后均获取颈、颏下和面部水肿的基线测量值。建议所有患者进行家庭治疗，接受混合治疗的患者除了接受家庭治疗推荐方案外，还需接受淋巴水肿治疗师的额外治疗。使用标准统计学分析对其结局进行比较。
连续纳入 50 例患者，每组 25 例。报告称接受家庭治疗的患者中有 68%和接受混合治疗的患者中有 84%至少坚持了 50%的推荐治疗。66%的患者显示出显著改善。在临床显著改善方面，治疗组之间无统计学差异（P=.15）。接受混合治疗的患者在面部水肿方面显示出治疗优势（P=.037）。治疗依从性与临床改善相关（P=.047）。
无论患者采用家庭为基础的还是混合的淋巴水肿治疗方法，都观察到相似的获益。这些数据表明，对于无法参加临床就诊的患者，家庭为基础的治疗方法可能是合适的。然而，对于面部水肿显著的患者，混合治疗方法可能更为可取。治疗依从性与更好的结局相关。鉴于这些发现，未来的研究应考虑改善依从性的策略，以优化淋巴水肿治疗的结局。
3b Laryngoscope, 2020.
