Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Physiotherapy and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Cancer Rep (Hoboken). 2020 Apr;3(2):e1225. doi: 10.1002/cnr2.1225. Epub 2020 Jan 3.
Lymphedema is a common complication of breast cancer or its treatment. The gold standard treatment for lymphedema is complete decongestive therapy. There are few studies about the predictive factors for the effectiveness of complete decongestive therapy.
To evaluate the results of the intensive phase of complete decongestive therapy, and to determine the predictive factors for the response to treatment in patients with breast cancer-related lymphedema.
Fifty-seven patients with breast cancer-related lymphedema (mean age: 56.2 ± 11.2 years) who underwent complete decongestive therapy between 2014 and 2016 were evaluated retrospectively. Extremity volume was calculated using circumferential measurements and the truncated cone formula technique. Response to treatment was evaluated using the percentage reduction of excess volume formula, which was obtained by calculating the extremity volume before and after treatment. The median percentage reduction of excess volume was 27.7% (IQR,13.6-50.3). The history of skin infection was related to lower percentage reduction of excess volume (P = 0.001). Although percentage reduction of excess volume was positively correlated with education level (r = 0.286, P = 0.031), percentage reduction of excess volume was negatively correlated with lymphedema duration (r = -0.361, P = 0.006), postoperative duration (r = -0.314, P = 0.018), percentage of excess volume (r = -0.398, P = 0.002), and number of complete decongestive therapy sessions (r = -0.436, P = 0.001). Univariate and multivariate analyses showed that the independent variables for percentage reduction of excess volume were percentage of excess volume (P = 0.009) and education level (P = 0.021).
Complete decongestive therapy is an effective method in patients with breast cancer related-lymphedema. The most important predictive factors for the efficacy of treatment were found as percentage of excess volume and education level. Patients with breast cancer should be followed up regularly and receive complete decongestive therapy in the early stage of lymphedema.
淋巴水肿是乳腺癌或其治疗的常见并发症。淋巴水肿的金标准治疗是完整的消肿治疗。关于完整的消肿治疗效果的预测因素的研究很少。
评估完整的消肿治疗强化阶段的结果，并确定乳腺癌相关淋巴水肿患者对治疗反应的预测因素。
回顾性评估了 2014 年至 2016 年间接受完整的消肿治疗的 57 例乳腺癌相关淋巴水肿患者（平均年龄：56.2 ± 11.2 岁）。使用周径测量和截头圆锥公式技术计算肢体体积。通过计算治疗前后肢体体积来评估治疗反应，采用过量体积百分比减少公式。过量体积的中位数减少百分比为 27.7%（IQR，13.6-50.3）。皮肤感染史与过量体积减少百分比较低相关（P = 0.001）。尽管过量体积减少百分比与教育程度呈正相关（r = 0.286，P = 0.031），但过量体积减少百分比与淋巴水肿持续时间（r = -0.361，P = 0.006）、术后持续时间（r = -0.314，P = 0.018）、过量体积百分比（r = -0.398，P = 0.002）和完整的消肿治疗次数（r = -0.436，P = 0.001）呈负相关。单变量和多变量分析显示，过量体积减少百分比的独立变量为过量体积百分比（P = 0.009）和教育程度（P = 0.021）。
完整的消肿治疗是乳腺癌相关淋巴水肿患者的有效治疗方法。治疗效果的最重要预测因素是过量体积百分比和教育程度。乳腺癌患者应定期随访，并在淋巴水肿早期接受完整的消肿治疗。
