Efficacy of intermittent pneumatic compression on breast cancer-related upper limb lymphedema: a systematic review and meta-analysis in clinical studies.

BACKGROUND

Complete decongestive therapy (CDT) and intermittent pneumatic compression (IPC) are the most common combination of treatments in breast cancer-related upper limb lymphedema. The effects of IPC as an addition to CDT are inconsistent in different studies. This meta-analysis aimed to explore whether IPC could bring additional benefits to CDT.

METHODS

Literatures were retrieved from databases with full-text publications ranging from January 1995 to March 2024. Fixed-effect models were applied to subsequent analysis if no heterogeneity was detected by using the Inverse formula. Publication bias was assessed using the Begg's test and Eagger's test.

RESULTS

Twelve studies were finally included for further analysis. Results showed that additional application of IPC to CDT could further improve lymphedema within 4 weeks after the treatment period [standard mean difference (SMD) =-0.2 mL, 95% confidence interval (CI): -0.33 to -0.07 mL]. However, this additional benefit was weakened within about 9.4±2.6 weeks' follow-up duration after ceasing physical therapy (SMD =-0.15 mL, 95% CI: -0.33 to 0.04 mL).

CONCLUSIONS

Periodically continuous treatment should be suggested to maintain the effect of CDT + IPC to promote lymph drainage and lymphedema improvement. Nonetheless, the treatment involved in the studies ranged from 4 to 12 weeks, therefore potential bias might exist.