Jahan Rifat, Bhuiyan A K M Motiur Rahman, Alam Afroja, Chowdhury Mostofa Kamal, Hassan Romena, Aktar Nisha Mortuja
Bangladesh Medical University (BMU), Dhaka, Bangladesh.
New Cross Hospital, The Royal Wolverhampton Trust, United Kingdom.
PLoS One. 2025 Jun 20;20(6):e0326040. doi: 10.1371/journal.pone.0326040. eCollection 2025.
Lymphedema is a chronic condition that significantly affects both physical function and quality of life of breast cancer patients. Although there is no definitive cure, various treatment options exist to alleviate its symptoms. Among these, Complex Decongestive Therapy (CDT) is widely regarded as a primary approach. This study seeks to evaluate the effectiveness of CDT for breast cancer patients with upper limb lymphedema and aims to assess the benefits of this treatment despite the challenges and constraints in resource-limited settings.
This observational study was conducted among 42 female breast cancer patients with unilateral upper limb lymphedema attending the Lymphedema Clinic of the Department of Palliative Medicine at Bangladesh Medical University in Dhaka, Bangladesh. Limb volume, skin condition, and clinical signs and symptoms were assessed at baseline. All patients received the intensive phase of Complex Decongestive Therapy (CDT) for 6 weeks, with follow-up assessments conducted at the 3rd week and the 6th week.
A significant reduction in the volume of the affected limbs was observed from baseline to the 6th week, as well as from the 3rd week to the 6th week. Although no statistically significant improvement in skin edema was recorded during this period, visible clinical improvement in skin texture was noted. After receiving CDT and proper skin care, 59.5% of patients regained normal skin on the affected limb. Additionally, there was a significant reduction in self-reported symptoms such as tightness, heaviness, and pain in the affected limb from baseline to the 6th week.
Lymphedema management using all components of Complex Decongestive Therapy (CDT) was found to be effective in reducing limb volume and alleviating the distressing symptoms of patients. Timely referral of lymphedema patients to specialized clinics and initiation of CDT can significantly reduce their ongoing suffering in Bangladesh.
淋巴水肿是一种慢性疾病，严重影响乳腺癌患者的身体功能和生活质量。尽管尚无根治方法，但有多种治疗方案可缓解其症状。其中，综合消肿治疗（CDT）被广泛视为主要治疗方法。本研究旨在评估CDT对上肢淋巴水肿乳腺癌患者的有效性，并评估在资源有限的环境中尽管存在挑战和限制，但该治疗的益处。
本观察性研究在孟加拉国达卡孟加拉国医科大学姑息医学系淋巴水肿诊所就诊的42例单侧上肢淋巴水肿女性乳腺癌患者中进行。在基线时评估肢体体积、皮肤状况以及临床体征和症状。所有患者接受为期6周的综合消肿治疗（CDT）强化阶段，在第3周和第6周进行随访评估。
从基线到第6周，以及从第3周到第6周，观察到患侧肢体体积显著减小。尽管在此期间皮肤水肿无统计学显著改善，但皮肤质地有明显的临床改善。接受CDT和适当的皮肤护理后，59.5%的患者患侧肢体皮肤恢复正常。此外，从基线到第6周，患侧肢体自我报告的紧绷、沉重和疼痛等症状显著减轻。
发现使用综合消肿治疗（CDT）的所有组成部分进行淋巴水肿管理可有效减少肢体体积并减轻患者的痛苦症状。在孟加拉国，将淋巴水肿患者及时转诊至专科诊所并启动CDT可显著减轻他们持续的痛苦。
