A randomized study to prevent lymphedema in women treated for breast cancer: CALGB 70305 (Alliance)
| Autor: | Gini F. Fleming, Heshan Liu, Jeff A. Sloan, Charles L. Loprinzi, Michelle J. Naughton, Jane M. Armer, Jill M. Oliveri, Gary Unzeitig, Marianne Melnik, Lisa D. Yee, Karen Hock, John R. Taylor, Drew K. Seisler, Electra D. Paskett, Michael Schwartz, Jennifer Le-Rademacher |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Breast Neoplasms Article law.invention Poor adherence Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Breast cancer Randomized controlled trial law Early Medical Intervention Humans Medicine Cooperative group Lymphedema 030212 general & internal medicine Range of Motion Articular Mastectomy Aged Aged 80 and over business.industry Incidence Incidence (epidemiology) Middle Aged Hand medicine.disease humanities Exercise Therapy body regions Treatment Outcome Oncology 030220 oncology & carcinogenesis Arm Physical therapy Lymph Node Excision Female Self Report business Range of motion Healthcare providers Follow-Up Studies |
| Zdroj: | Cancer |
| ISSN: | 1097-0142 0008-543X |
| DOI: | 10.1002/cncr.33183 |
| Popis: | Background Lymphedema affects many women who are treated for breast cancer. We examined the effectiveness of an education-only (EO) versus education plus sleeve compression/exercise intervention (lymphedema education and prevention [LEAP]) on lymphedema incidence and range of motion (ROM) in a group-randomized trial across 38 cooperative group sites. Methods The treating institution was randomly assigned to either EO or LEAP by a study statistician. All patients at a treating institution participated in the same intervention (EO or LEAP) to minimize contamination bias. Participants completed surveys, arm volume measurements, and self-reported ROM assessments before surgery and at 12 and 18 months after surgery. Lymphedema was defined as a ≥10% difference in limb volume at any time post-surgery up to 18 months after surgery or diagnosis by a health provider. Cochran-Mantel-Haenszel tests were used to compare lymphedema-free rates between groups, stratified by lymph node surgery type. Self-reported ROM differences were compared between groups. Results A total of 554 participants (56% LEAP) were included in the analyses. At 18 months, lymphedema-free rates were 58% (EO) versus 55% (LEAP) (P = .37). ROM for both arms was greater in LEAP versus EO at 12 months; by 18 months, most women reported full ROM, regardless of group. In LEAP, only one-third wore a sleeve ≥75% of the time; 50% performed lymphedema exercises at least weekly. Conclusion Lymphedema incidence did not differ by intervention group at 18 months. Poor adherence in the LEAP group may have contributed. However, physical therapy may speed recovery of ROM. Further research is needed to effectively reduce the incidence and severity of lymphedema in patients who have breast cancer. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text