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Supportive Care in Cancer

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Open Access 01-02-2021 | Lymphedema | Original Article

Advanced pneumatic compression for treatment of lymphedema of the head and neck: a randomized wait-list controlled trial

Authors: Sheila H. Ridner, Mary S. Dietrich, Jie Deng, Sandra L. Ettema, Barbara Murphy

Published in: Supportive Care in Cancer | Issue 2/2021

Abstract

Purpose

Lymphedema associated with head and neck cancer (HNC) therapy causes adverse clinical outcomes. Standard treatment includes professionally administered complete decongestive therapy (CDT). Cost and availability of trained therapists are known barriers to therapy. Advanced pneumatic compression devices (APCD) may address these issues. A randomized, wait-list controlled trial was undertaken to evaluate an APCD in post-treatment HNC patients with lymphedema.

Material and methods

Eligible patients had completed treatment for HNC, were disease free, and had lymphedema at enrollment. Participants were randomized to wait-list lymphedema self-management (standard of care) or lymphedema self-management plus the use of the APCD bid. Safety (CTCAE V4.0) and feasibility were primary endpoints; secondary endpoints included efficacy measure by objective examination and patient reported outcomes (symptoms, quality of life, function), adherence barriers, and satisfaction. Assessments were conducted at baseline and weeks 4 and 8.

Results

Forty-nine patients were enrolled (wait-list n = 25; intervention n = 24). In total, forty-three patients completed the study. No device-related Serious Adverse Events were reported. Most patients used the APCD once per day, instead of the prescribed twice per day, citing time related factors as barriers to use. APCD use was associated with significant improvement in perceived ability to control lymphedema (p = 0.003) and visible external swelling (front view p < 0.001, right view p = 0.004, left p = 0.005), as well as less reported pain.

Conclusion

This trial supports the safety and feasibility of the APCD for the treatment of secondary lymphedema in head and neck cancer patients. In addition, preliminary data supports efficacy.

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Title: Advanced pneumatic compression for treatment of lymphedema of the head and neck: a randomized wait-list controlled trial
Authors: Sheila H. Ridner
Mary S. Dietrich
Jie Deng
Sandra L. Ettema
Barbara Murphy
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keyword: Lymphedema
Published in: Supportive Care in Cancer / Issue 2/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05540-8

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Abstract

Purpose

Material and methods

Results

Conclusion

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