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• W2528445246 abstract "Considered a significant acute and long-term morbidity, lymphedema within head and neck carcinoma (HNC) patients completing high-dose radiotherapy is an under-diagnosed and under-treated concern. At risk for these patients are considerable quality of life detriments, ranging from cosmetic disfigurement to functional impairments, and may include psychosocial difficulties. Presently, composite index scoring (CIS) is used for objective determination of facial and/or neck swelling and treatment-related edema. Unfortunately, in current practice, there is limited correlation of these objective measures with subjective quality of life (QOL) assessments. Herein, we report our institutional experience of a pilot program designed to identify, assess, intervene, and quantify measures to reduce Lymphedema present within our locally advanced HNC patients. With institutional review board approval, 21 patients diagnosed and treated for HNC were identified to have treatment-related lymphedema; 5 patients were eligible for study. CIS of the face and neck were utilized to quantify facial and neck edema. In addition, a Lymphedema severity rating scale was employed for tissue quality staging. The cohort was status post multi-modality treatment, which included surgery and chemoradiation. Patients were evaluated after definitive cancer treatment, but prior to lymphedema intervention. All therapeutic intervention was carried out by a certified lymphedema therapist. Treatment included an outpatient evaluation of lymphedema severity, shoulder and cervical ROM, and upper extremity strength. Patients then received a combination of therapist administered treatment and daily self-administered home-based program. Median age was 68 years (52-96). Four of 5 patients were stage IV squamous cell carcinoma and 4 patients received either concurrent or neoadjuvant chemotherapy. A median XRT dose of 70 Gy was delivered. 4 of 5 patients had stage 2 head and neck lymphedema upon initial evaluation. Clinical response of lymphedema was seen in 100% of the patients. Treatment response ranged from 2.9% to 10% in facial/neck CIS reduction; significant minimal clinical improvement is a difference of ≥ 2%. Median lymphedema treatment duration was 68 days (20-156 days). Our preliminary data shows that with adequate screening, assessment, and intervention, symptom burden associated with lymphedema as a result of HNC treatment can be reduced. These efforts represent a grassroots effort to increase awareness of lymphedema as a HNC treatment sequelae to our referring physicians and provide an opportunity to improve the clinical outcomes and QOL of this vulnerable patient population. We will continue this paradigm to expand our outreach and improve outcomes for this underserved patient population." @default.
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• W2528445246 date "2016-10-01" @default.
• W2528445246 modified "2023-09-27" @default.
• W2528445246 title "Head and Neck Lymphedema: Reducing a Growing Problem" @default.
• W2528445246 doi "https://doi.org/10.1016/j.ijrobp.2016.06.1899" @default.
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