Chitapanarux Imjai, Chachvarat Siriarrayapa, Sripan Patumrat, Pattarasakulchai Thienchai, Pattamapaspong Nuttaya, Kanthawang Thanat, Buntragulpoontawee Montana
Division of Radiation Oncology, Department of Radiology, Chiang Mai University, Chiang Mai, Thailand.
Nakhon Si Thammarat Cancer Hospital, Nakhon Si Thammarat, Nakhon Si Thammarat, Thailand.
Cancer Rep (Hoboken). 2025 Jan;8(1):e70109. doi: 10.1002/cnr2.70109.
Several studies have explored the advantage of treatment with hyperbaric oxygen (HBO) for upper extremity lymphedema in irradiated breast cancer patients and reported controversial results. This prospective case series aimed to document the short- and long-term efficacy of this therapy, focusing on the arm volume and functional assessment in breast cancer patients with a history of long-standing lymphedema for more than 2 years.
Six breast cancer patients with long-standing lymphedema were enrolled. All of them received breast surgery and dissection of axillary lymph nodes, chemotherapy, and postoperative radiotherapy. The average duration from the onset of lymphedema to HBO treatment was 9 ± 5.92 years (range 2-17). All patients were treated for 90 min in the HBO chamber with 100% oxygen at a higher pressure of two times the atmospheric pressure, five times a week for 30 sessions. We measured the circumference of both arms and calculated the arm volume before treatment (baseline), after 30 sessions of treatment, and after treatment at 3, 6, and 24 months. Functional assessment focused on the ability of the arm, shoulder, and hand using the Thai Quick-DASH questionnaires, which were assessed by the patients at the same periods. The change of arm volume and Thai Quick-DASH score at each time point were compared to the starting point data before HBO.
The change of arm volume and mean Quick-DASH score had decreased at 3, 6, and 24 months after treatment compared to the starting point before HBO, However, these changes were not statistically significant.
多项研究探讨了高压氧（HBO）治疗乳腺癌放疗患者上肢淋巴水肿的优势，但结果存在争议。本前瞻性病例系列旨在记录该疗法的短期和长期疗效，重点关注有超过2年长期淋巴水肿病史的乳腺癌患者的手臂体积和功能评估。
纳入6例患有长期淋巴水肿的乳腺癌患者。所有患者均接受了乳房手术及腋窝淋巴结清扫、化疗和术后放疗。从淋巴水肿开始到接受HBO治疗的平均时间为9±5.92年（范围2 - 17年）。所有患者在HBO舱内用100%氧气，在两倍大气压的较高压力下治疗90分钟，每周5次，共30次。我们在治疗前（基线）、30次治疗后、治疗后3个月、6个月和24个月测量双臂周长并计算手臂体积。功能评估使用泰国简易上肢功能障碍量表（Thai Quick-DASH）问卷，重点关注手臂、肩部和手部的功能，由患者在同一时期进行评估。将每个时间点的手臂体积变化和泰国简易上肢功能障碍量表评分与HBO治疗前的起始点数据进行比较。
与HBO治疗前的起始点相比，治疗后3个月、6个月和24个月时手臂体积变化和平均简易上肢功能障碍量表评分有所下降，但这些变化无统计学意义。
