Association Between Symptom Burden and Early Lymphatic Abnormalities After Regional Nodal Irradiation for Breast Cancer.

Autor:	Yoder AK; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Xu T; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas., Youssef P; Morehouse School of Medicine, Atlanta, Georgia., DeSnyder S; Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Marqueen KE; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Isales L; Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Lin R; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas., Smith BD; Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Woodward WA; Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Stauder MC; Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Strom EA; Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Aldrich MB; Center for Molecular Imaging, The Brown Foundation Institute for Molecular Medicine, University of Texas Health Science Center-Houston, Houston, Texas., Shaitelman SF; Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: sfshaitelman@mdanderson.org.
Jazyk:	angličtina
Zdroj:	Practical radiation oncology [Pract Radiat Oncol] 2024 May-Jun; Vol. 14 (3), pp. e180-e189. Date of Electronic Publication: 2023 Oct 31.
DOI:	10.1016/j.prro.2023.10.008
Abstrakt:	Purpose: Dermal backflow visualized on near-infrared fluorescence lymphatic imaging (NIRF-LI) signals preclinical lymphedema that precedes the development of volumetrically defined lymphedema. We sought to evaluate whether dermal backflow correlates with patient-reported lymphedema outcomes (PRLO) surveys in breast cancer patients treated with regional nodal irradiation (RNI). Methods and Materials: Patients with breast cancer planned for axillary dissection and RNI prospectively underwent perometry, NIRF-LI, and PRLOs (the Lymphedema Symptom Intensity and Distress Survey [LSIDS] and QuickDASH) at baseline, after surgery, and at 6, 12, and 18 months after radiation. Clinical lymphedema was defined as an arm volume increase ≥5% over baseline. Trends over time were assessed using analysis of variance testing. The association between survey responses and both dermal backflow and lymphedema was assessed using a linear mixed-effects model. Results: Sixty participants completed at least 2 sets of measurements and surveys and were eligible for analysis. Fifty-four percent of patients had cT3-T4 disease, 53% cN3 disease, and 75% had a body mass index >25. Dermal backflow and clinical lymphedema increased from 10% to 85% and from 0% to 40%, respectively, from baseline to 18 months. In the adjusted model, soft tissue sensation, neurologic sensation, and functional LSIDS subscale scores were associated with presence of dermal backflow (all P < .05). Both dermal backflow and lymphedema were associated with QuickDASH score (P < .05). Conclusions: In this high-risk cohort, we found highly prevalent early signs of lymphedema, with increased symptom burden from baseline. Presence of dermal backflow correlated with PRLO measures, highlighting a potential NIRF-LI use to identify patients for early intervention trials after RNI. Competing Interests: Disclosures Simona F. Shaitelman reports contracted research support from ExactSciences, Alpha Tau, Artios, and TAE Life Sciences during the study period. (Copyright © 2023 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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