Liang Xu, You Miaoning, Wen Cuiju, Hou Fengzhen, Kang Jingjing, Lv Zhihua, Tian Jun
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Breast Cancer Prevention and Treatment Center, Peking University Cancer Hospital & Institute, Beijing, China.
Ann Transl Med. 2022 Feb;10(3):146. doi: 10.21037/atm-21-6662.
Lymphedema is the most common complication of breast cancer patients. Complex decongestive therapy (CDT) is often recommended but the efficacy varies due to the complexity of management. This study investigated a novel model of CDT based on a mobile application with the aim of improving the management of lymphedema in China.
We developed a novel model of CDT for breast cancer survivors with lymphedema, including 5 days of CDT therapy with training provided by medical staff in the outpatient clinic and 3 weeks of self-administrated CDT with daily online instructions during phase I, and a life-long maintenance treatment with online instructions once a week for phase II, which delivered by WeChat public accounts. The breast cancer and lymphedema symptom experience index (BCLE-SEI) and the Short-Form Health Survey (SF-36) were used to assess lymphatic symptoms and quality of life. Arm volume and lymphatic symptoms were assessed at baseline, and at 5 days, 1 month, and 3 months post-treatment. The quality of life was assessed at baseline and at 3 months post-treatment.
A total of 88 patients with lymphedema were recruited, of whom, 61 followed the protocols and were further analyzed for this study. The mean relative excess arm volume (EAV) was reduced from a baseline value of 30.72% to 22.05%, 18.46%, and 16.67% at 5 days, 1 month, and 3 months post-therapy, respectively (P=0.000). The BCLE-SEI scores of lymphatic pain, heaviness, and impaired limb mobility were all significantly improved after 3 months of treatment (P<0.05). Moreover, according to the subscale of SF-36, the general health and vitality were significantly improved after 3 months of therapy (56.64 62.93, P=0.008; and 64.26 70.08, P=0.024, respectively).
The proposed model of CDT based on the mobile application WeChat achieved promising outcomes. The volume of the affected arm, the lymphedema symptoms, and the quality of life were all significantly improved.
淋巴水肿是乳腺癌患者最常见的并发症。通常推荐采用综合消肿治疗（CDT），但由于管理的复杂性，其疗效各异。本研究调查了一种基于移动应用程序的新型CDT模式，旨在改善中国淋巴水肿的管理。
我们为患有淋巴水肿的乳腺癌幸存者开发了一种新型CDT模式，包括在门诊由医务人员提供培训的5天CDT治疗，以及在第一阶段进行为期3周的自我管理CDT，期间每天提供在线指导，在第二阶段进行为期终身的维持治疗，通过微信公众号每周提供一次在线指导。采用乳腺癌和淋巴水肿症状体验指数（BCLE-SEI）和简短健康调查问卷（SF-36）来评估淋巴症状和生活质量。在基线时、治疗后5天、1个月和3个月评估手臂体积和淋巴症状。在基线时和治疗后3个月评估生活质量。
共招募了88例淋巴水肿患者，其中61例遵循方案并进一步纳入本研究分析。治疗后5天、1个月和3个月时，平均相对手臂多余体积（EAV）分别从基线值30.72%降至22.05%、18.46%和16.67%（P=0.000）。治疗3个月后，BCLE-SEI中淋巴疼痛、沉重感和肢体活动受限的评分均显著改善（P<0.05）。此外，根据SF-36的子量表，治疗3个月后总体健康和活力显著改善（分别为56.64对62.93，P=0.008；64.26对70.08，P=0.024）。
基于移动应用程序微信提出的CDT模式取得了良好的效果。患侧手臂体积、淋巴水肿症状和生活质量均得到显著改善。
