Comparison of the short-term effects of hyperbaric oxygen therapy and complex decongestive therapy on breast cancer-related lymphedema

Abstract Background Breast cancer treatment with radiotherapy can induce late radiation toxicity, characterized by pain, fibrosis, edema, impaired arm mobility, and poor cosmetic outcome. Hyperbaric oxygen therapy (HBOT) has been proposed as treatment for late radiation toxicity; however, high-level evidence of effectiveness is lacking. As HBOT is standard treatment and reimbursed by insurers, performing classic randomized controlled trials is difficult. The “Hyperbaric OxygeN therapy on brEast cancer patients with late radiation toxicity” (HONEY) trial aims to evaluate the effectiveness of HBOT on late radiation toxicity in breast cancer patients using the trial within cohorts (TwiCs) design. Methods The HONEY trial will be conducted within the Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaluation (UMBRELLA). Within UMBRELLA, breast cancer patients referred for radiotherapy to the University Medical Centre Utrecht are eligible for inclusion. Patients consent to collection of clinical data and patient-reported outcomes and provide broad consent for randomization into future intervention studies. Patients who meet the HONEY in- and exclusion criteria (participation ≥ 12 months in UMBRELLA, moderate/severe breast or chest wall pain, completed primary breast cancer treatment except hormonal treatment, no prior treatment with HBOT, no contraindications for HBOT, no clinical signs of metastatic or recurrent disease) will be randomized to HBOT or control group on a 2:1 ratio (n = 120). Patients in the control group will not be informed about participation in the trial. Patients in the intervention arm will undergo 30–40 HBOT treatment sessions in a high pressure chamber (2.4 atmospheres absolute) where they inhale 100% oxygen through a mask. Cohort outcome measures (i.e., physical outcomes, quality of life, fatigue, and cosmetic satisfaction) of the HBOT group will be compared to the control group at 3 months follow-up. Discussion This pragmatic trial within the UMBELLA cohort was designed to evaluate the effectiveness of HBOT on late radiation toxicity in breast cancer patients using the TwiCs design. Use of the TwiCs design is expected to address issues encountered in classic randomized controlled trials, such as contamination (i.e., HBOT in the control group) and disappointment bias, and generate information about acceptability of HBOT. Trial registration ClinicalTrials.gov. NCT04193722. Registered on 10 December 2019.

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The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema

Supportive Care in Cancer ◽

10.1007/s00520-010-0888-8 ◽

2010 ◽

Vol 19 (5) ◽

pp. 685-690 ◽

Cited By ~ 31

Author(s):

Abuzer Dirican ◽

Oya Andacoglu ◽

Ronald Johnson ◽

Kandace McGuire ◽

Lisa Mager ◽

...

Keyword(s):

Breast Cancer ◽

Laser Therapy ◽

Low Level Laser Therapy ◽

Short Term ◽

Low Level ◽

Low Level Laser ◽

Level Laser ◽

Breast Cancer Related Lymphedema ◽

Short Term Effects

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Efficacy of complex decongestive therapy on breast cancer-related lymphedema: A cross-sectional study

Journal of Surgery and Medicine ◽

10.28982/josam.551125 ◽

2019 ◽

Author(s):

Nehir Samancı ◽

Özlem Karataş ◽

Ayşegül Samur ◽

Ali Çipli ◽

Nilüfer Balcı

Keyword(s):

Breast Cancer ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Complex Decongestive Therapy ◽

Breast Cancer Related Lymphedema ◽

Decongestive Therapy

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Combined-complex Decongestive Therapy Reduces Volume and Improves Quality of Life and Functional Status in Patients with Breast Cancer-related Lymphedema

10.21203/rs.3.rs-20955/v1 ◽

2020 ◽

Author(s):

Pinar Borman ◽

Aysegul Yaman ◽

Sina Yasrebi ◽

Adeviye Pinar Inanli

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Functional Status ◽

Excess Volumes ◽

Complex Decongestive Therapy ◽

Eortc Qlq C30 ◽

Breast Cancer Related Lymphedema ◽

Eortc Qlq ◽

Decongestive Therapy

Abstract Background: The aim of this study was to evaluate the effects of complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL), in regard to volume reduction, functional status and quality of life (QoL).Methods: Fifty patients with unilateral BCRL were included. The demographic variables focusing on lymphedema were recorded. All patients received combined phase 1 CDT including skin care, manual lymphatic drainage, multilayer bandaging and supervised exercises, five times a week for three weeks, as a total of 15 sessions. Patients were assessed by limb volumes and excess volumes according to geometric approximation derived from serial circumference-measurements of the limb, prior and at the end of third week. The functional disability was evaluated by quick disability of arm, shoulder and hand questionnaire (DASH). Quality of life was assessed by the European Organization forResearch and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and its breast cancer module (EORTC-QLQ-BR23).Results: Fifty females with mean age of 53.22±11.2 years were included. The median duration of lymphedema was 12 months. There were 22 patients in stage1, 26 in stage2 and 2 patients in stage3. The mean baseline limb and excess volumes were significantly decreased at the end of therapies (3262±753cm³ vs 2943±646.6cm³ and 31.36±16.5% vs 19.12±10.4%, p=0.000,respectively). The DASH and EORTC-QLQ-C30 and BR23 scores were also decreased significantly (p<0.05). The improvements in volumes were related negatively with the duration of lymphedema,and the stage of lymphedema. Conclusion: In conclusion phase 1CDT in a combined manner performed daily for 3 weeks, greatly reduces the volumes as well as improves the disability and QoL, especially when performed earlier.

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Combıned-Complex Decongestıve Therapy Reduces Volume And Improves Quality Of Lıfe And Functıonal Status In Patıents Wıth Breast Cancer-Related Lymphedema

10.21203/rs.3.rs-20955/v2 ◽

2020 ◽

Author(s):

Pinar Borman ◽

Aysegul Yaman ◽

Sina Yasrebi ◽

Adeviye Pinar Inanli

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Functional Status ◽

Excess Volumes ◽

Complex Decongestive Therapy ◽

Eortc Qlq C30 ◽

Breast Cancer Related Lymphedema ◽

Eortc Qlq ◽

Decongestive Therapy

Abstract Background: The aim of this study was to evaluate the effects of complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL), in regard to volume reduction, functional status and quality of life (QoL).Methods: Fifty patients with unilateral BCRL were included. The demographic variables focusing on lymphedema were recorded. All patients received combined phase 1 CDT including skin-care, manual lymphatic drainage, multilayer bandaging and supervised exercises, five times a week for three weeks, as a total of 15 sessions. Patients were assessed by limb volumes and excess volumes according to geometric approximation derived from serial circumference-measurements of the limb, prior and at the end of third week. The functional disability was evaluated by quick disability of arm, shoulder and hand questionnaire (DASH). Quality of life was assessed by the European Organization for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and its breast cancer module (EORTC-QLQ-BR23).Results: Fifty females with mean age of 53.22±11.2 years were included. The median duration of lymphedema was 12 months. There were 22 patients in stage1, 26 in stage2 and 2 patients in stage3. The mean baseline limb and excess volumes were significantly decreased at the end of therapies (3262±753cm³ vs 2943±646.6cm³ and 31.36±16.5% vs 19.12±10.4%, p=0.000,respectively). The DASH and EORTC-QLQ-C30 and BR23 scores were also decreased significantly (p<0.05). The improvements in volumes were related negatively with the duration of lymphedema,and the stage of lymphedema. Conclusion: In conclusion phase 1CDT in a combined manner performed daily for 3 weeks, greatly reduces the volumes as well as improves the disability and QoL, especially when performed earlier.Trial Registration: 'retrospectively registered’

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Recurrent Breast Cancer – Hyperbaric Oxygen Therapy

Medical & Clinical Research ◽

10.33140/mcr.05.05.04 ◽

2020 ◽

Vol 5 (5) ◽

Keyword(s):

Breast Cancer ◽

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Recurrent Breast Cancer ◽

Primary Diagnosis ◽

Current Medical ◽

Er Positive ◽

Recurrent Breast ◽

Positive Recurrent

Primary Diagnosis: Breast Cancer (2005). Past Treatment included Chemotherapy, Radiation Therapy. Current Medical: Recurrent Breast Cancer, Metastatic ER positive, Recurrent HER2 negative breast cancer, Oesophageal stricture. Currently taking Tamoxifen. * Referred for Hyperbaric Oxygen Therapy to assist her current medical management.

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