Quantitative clinical outcomes of therapy for head and neck lymphedema
Purpose: Head and neck surgery and radiation cause tissue fibrosis that leads to functional limitations and lymphedema. The objective of this study was to determine whether lymphedema therapy after surgery and radiation for head and neck cancer decreases neck circumference, increases cervical range...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-07-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109418300708 |
| _version_ | 1819099982256406528 |
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| author | Kaleigh N. Doke, MD Laine Bowman, MA, OTR Yelizaveta Shnayder, MD Xinglei Shen, MD Mindi TenNapel, PhD Sufi Mary Thomas, PhD Prakash Neupane, MD Hung-Wen Yeh, PhD Chris E. Lominska, MD |
| author_facet | Kaleigh N. Doke, MD Laine Bowman, MA, OTR Yelizaveta Shnayder, MD Xinglei Shen, MD Mindi TenNapel, PhD Sufi Mary Thomas, PhD Prakash Neupane, MD Hung-Wen Yeh, PhD Chris E. Lominska, MD |
| author_sort | Kaleigh N. Doke, MD |
| collection | DOAJ |
| description | Purpose: Head and neck surgery and radiation cause tissue fibrosis that leads to functional limitations and lymphedema. The objective of this study was to determine whether lymphedema therapy after surgery and radiation for head and neck cancer decreases neck circumference, increases cervical range of motion, and improves pain scores. Methods and materials: A retrospective review of all patients with squamous cell carcinoma of the oral cavity, oropharynx, or larynx who were treated with high-dose radiation therapy at a single center between 2011 and 2012 was performed. Patients received definitive or postoperative radiation for squamous cell carcinoma of the oral cavity, oropharynx, or larynx. Patients were referred to a single, certified, lymphedema therapist with specialty training in head and neck cancer after completion of radiation treatment and healing of acute toxicity (typically 1-3 months). Patients underwent at least 3 months of manual lymphatic decongestion and skilled fibrotic techniques. Circumferential neck measurements and cervical range of motion were measured clinically at 1, 3, 6, 9, and 12 months after completion of radiation therapy. Pain scores were also recorded. Results: Thirty-four consecutive patients were eligible and underwent a median of 6 months of lymphedema therapy (Range, 3-12 months). Clinically measured total neck circumference decreased in all patients with 1 month of treatment. Cervical rotation increased by 30.2% on the left and 27.9% on the right at 1 month and continued to improve up to 44.6% and 55.3%, respectively, at 12 months. Patients undergoing therapy had improved pain scores from 4.3 at baseline to 2.0 after 1 month. Conclusions: Lymphedema therapy is associated with objective improvements in range of motion, neck circumference, and pain scores in the majority of patients. |
| first_indexed | 2024-12-22T00:55:32Z |
| format | Article |
| id | doaj.art-7f256fe317094cc58309faaf1eda01df |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-12-22T00:55:32Z |
| publishDate | 2018-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-7f256fe317094cc58309faaf1eda01df2022-12-21T18:44:20ZengElsevierAdvances in Radiation Oncology2452-10942018-07-0133366371Quantitative clinical outcomes of therapy for head and neck lymphedemaKaleigh N. Doke, MD0Laine Bowman, MA, OTR1Yelizaveta Shnayder, MD2Xinglei Shen, MD3Mindi TenNapel, PhD4Sufi Mary Thomas, PhD5Prakash Neupane, MD6Hung-Wen Yeh, PhD7Chris E. Lominska, MD8Department of Radiation Oncology, The University of Kansas Health System, Kansas City, Kansas; Corresponding author. Kansas University Medical Center, Department of Radiation Oncology, 3901 Rainbow Boulevard, Kansas City, KS 66160.Overland Park Regional Medical Center, Overland Park, KansasDepartment of Otolaryngology, The University of Kansas Health System, Kansas City, KansasDepartment of Radiation Oncology, The University of Kansas Health System, Kansas City, KansasDepartment of Radiation Oncology, The University of Kansas Health System, Kansas City, KansasDepartment of Otolaryngology, The University of Kansas Health System, Kansas City, KansasDepartment of Medical Oncology, The University of Kansas Health System, Kansas City, KansasDepartment of Biostatistics, The University of Kansas Health System, Kansas City, KansasDepartment of Radiation Oncology, The University of Kansas Health System, Kansas City, KansasPurpose: Head and neck surgery and radiation cause tissue fibrosis that leads to functional limitations and lymphedema. The objective of this study was to determine whether lymphedema therapy after surgery and radiation for head and neck cancer decreases neck circumference, increases cervical range of motion, and improves pain scores. Methods and materials: A retrospective review of all patients with squamous cell carcinoma of the oral cavity, oropharynx, or larynx who were treated with high-dose radiation therapy at a single center between 2011 and 2012 was performed. Patients received definitive or postoperative radiation for squamous cell carcinoma of the oral cavity, oropharynx, or larynx. Patients were referred to a single, certified, lymphedema therapist with specialty training in head and neck cancer after completion of radiation treatment and healing of acute toxicity (typically 1-3 months). Patients underwent at least 3 months of manual lymphatic decongestion and skilled fibrotic techniques. Circumferential neck measurements and cervical range of motion were measured clinically at 1, 3, 6, 9, and 12 months after completion of radiation therapy. Pain scores were also recorded. Results: Thirty-four consecutive patients were eligible and underwent a median of 6 months of lymphedema therapy (Range, 3-12 months). Clinically measured total neck circumference decreased in all patients with 1 month of treatment. Cervical rotation increased by 30.2% on the left and 27.9% on the right at 1 month and continued to improve up to 44.6% and 55.3%, respectively, at 12 months. Patients undergoing therapy had improved pain scores from 4.3 at baseline to 2.0 after 1 month. Conclusions: Lymphedema therapy is associated with objective improvements in range of motion, neck circumference, and pain scores in the majority of patients.http://www.sciencedirect.com/science/article/pii/S2452109418300708 |
| spellingShingle | Kaleigh N. Doke, MD Laine Bowman, MA, OTR Yelizaveta Shnayder, MD Xinglei Shen, MD Mindi TenNapel, PhD Sufi Mary Thomas, PhD Prakash Neupane, MD Hung-Wen Yeh, PhD Chris E. Lominska, MD Quantitative clinical outcomes of therapy for head and neck lymphedema Advances in Radiation Oncology |
| title | Quantitative clinical outcomes of therapy for head and neck lymphedema |
| title_full | Quantitative clinical outcomes of therapy for head and neck lymphedema |
| title_fullStr | Quantitative clinical outcomes of therapy for head and neck lymphedema |
| title_full_unstemmed | Quantitative clinical outcomes of therapy for head and neck lymphedema |
| title_short | Quantitative clinical outcomes of therapy for head and neck lymphedema |
| title_sort | quantitative clinical outcomes of therapy for head and neck lymphedema |
| url | http://www.sciencedirect.com/science/article/pii/S2452109418300708 |
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