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- W2166965440 abstract "Lymphedema treatment is based on Decongestive Lymphedema Therapy (DLT) with an intensive phase followed by a long-term maintenance phase. This study aimed to observe volume variation over the intensive phase and 6 months later. Prospective multicentre observational study of patients with unilateral lymphedema. The primary objective was to assess lymphedema volume variation between baseline, the end of intensive phase and 6 months later. Secondary objectives were to assess the frequency of heaviness limiting limb function and treatments safety predictors for volume reduction. Three hundred and six patients (89.9% women; 59.9 ± 14.3 years old) with upper/lower (n = 184/122) limb lymphedema were included. At the end of the intensive phase, median excess lymphedema volume reduction was 31.0% (41.7–19.9) followed by a 16.5% (5.9–42.3) median increase over the 6-month maintenance period phase. Previous intensive treatment was the only significant predictor of this response. As compared to baseline, heaviness limiting limb use was much less frequently reported at the end of the reductive phase (75.5% versus 42.3% respectively), and was more frequent at the end of the maintenance phase (62.6%). The most frequent adverse events reported were skin redness and compression marks (18.4 and 15.7% of patients, respectively). Blisters requiring treatment stoppage were rare (1.4%). Intensive phase decreases lymphedema volume and heaviness limiting limb function. The benefit is partially abolished after the first 6 months of maintenance. There is a need to consider how to provide optimal patient care for the long-term control of lymphedema. Le traitement du lymphœdème repose sur la thérapie décongestive qui associe une phase initiale de traitement décongestif intensif (TDI) suivie d’un traitement d’entretien. L’objectif de l’étude POLIT était de décrire l’efficacité et la tolérance des traitements pendant la phase initiale et six mois après la phase de TDI. Étude d’observation prospective multicentrique de patients présentant un lymphœdème unilatéral de membre. Évaluer la variation de volume du lymphœdème entre l’inclusion, la fin du TDI et après six mois de traitement d’entretien. Évaluer la fréquence des lourdeurs handicapantes de membre et la tolérance des traitements ; déterminer des facteurs prédictifs de la variation de volume. Trois cent six patients présentant un lymphœdème du membre supérieur/inférieur (n = 184/122) ont été inclus. Pendant le TDI, la réduction médiane du volume du lymphœdème était de 31,0 % (41,7–19,9) suivie d’une réaugmentation de volume médian de 16,5 % (5,9–42,3) après six mois de traitement d’entretien. Un TDI antérieur était le seul facteur prédictif de cette réponse. Parmi les patients, 75,5 % rapportaient des lourdeurs de membre à l’inclusion contre 42,3 % à la fin du TDI et 62,6 % à la fin du suivi. Pendant le TDI, rougeurs de peau et marques de compression étaient fréquentes (10,5 et 8,2 % des patients), les lésions de frottement nécessitant l’arrêt du traitement étaient rares (1,4 %). Le TDI diminue le volume du lymphœdème et les lourdeurs handicapantes de membre. Ce bénéfice s’atténue lors des six premiers mois du traitement d’entretien. L’amélioration du traitement d’entretien est indispensable à la persistance à long terme du bénéfice du TDI." @default.
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- W2166965440 date "2014-07-01" @default.
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- W2166965440 title "Prospective multicentre observational study of lymphedema therapy: POLIT study" @default.
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- W2166965440 doi "https://doi.org/10.1016/j.jmv.2014.05.004" @default.
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