Can Hyperbaric Oxygen Therapy Reduce Breast Cancer Treatment-Related Lymphedema? A Pilot Study
| Autor: | Senthil K. Raghavan, Lindsie Cone, Dawen Xie, Kel Jansen, Joan E. Cunningham, Daniela Nitcheva, William M. Butler, Jane Teas |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Vascular Endothelial Growth Factor A
medicine.medical_specialty Time Factors medicine.medical_treatment Vascular Endothelial Growth Factor C Breast Neoplasms Pilot Projects chemistry.chemical_compound Breast cancer Confidence Intervals Odds Ratio Humans Medicine Lymphedema Mastectomy Aged Hyperbaric Oxygenation Chemotherapy business.industry General Medicine Odds ratio Middle Aged medicine.disease Confidence interval Surgery Clinical trial Radiation therapy Vascular endothelial growth factor Treatment Outcome chemistry Arm Lymph Node Excision Female Radiotherapy Adjuvant business |
| Zdroj: | Journal of Women's Health. 13:1008-1018 |
| ISSN: | 1931-843X 1540-9996 |
| Popis: | Arm lymphedema after surgery or radiation for breast cancer is common, causing pain and limitation of activities. Previous reports of hyperbaric oxygen (HBO) therapy for breast edema led us to consider the use of HBO therapy for arm lymphedema.Ten healthy postmenopausal women (age 58 +/- 5.7 years) with persistent (9.4 years +/- 9.1 years) arm lymphedema following breast cancer surgery and radiation (n = 10) plus chemotherapy (n = 7) received 20 HBO treatments (90 minutes at 2.0 ATA five times a week for 4 weeks). End points included changes in upper extremity volume, platelet counts, plasma levels of vascular endothelial growth factor (VEGF), and lymph angiogenic-associated vascular endothelial growth factor-C (VEGF-C). Lymphedema volume (LV) was defined as the volume of the unaffected arm subtracted from the volume of the affected arm.We observed a 38% average reduction in hand lymphedema (-7.4 ml, 11.6 SD, range -30-+8 ml, p = 0.076, 95% confidence interval -15.7-0.9 ml) at the end of HBO, which was independent of changes in body weight. For those who benefited (n = 8), the reduction was persistent from the end of treatment to a final measurement an average of 14.2 months after the last HBO treatment. However, total LV did not change significantly. VEGF-C increased from baseline (p = 0.004) before treatment 20, suggesting HBO had begun to stimulate this growth factor.Future studies should explore the effects of a greater number of HBO treatments on lymphedema, with more patients. |
| Databáze: | OpenAIRE |
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