scholarly journals Comparison Between the Effectiveness of Complex Decongestive Therapy and Stellate Ganglion Block in Patients with Breast Cancer-Related Lymphedema: A Randomized Controlled Study

2018 ◽  
Vol 3 (22;3) ◽  
pp. 255-263
Author(s):  
Kwan Sik Seo
Keyword(s):  
Breast Cancer ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Ganglion Block ◽  
Complex Decongestive Therapy ◽  
Significant Difference ◽  
Breast Cancer Related Lymphedema ◽  
Eq Vas ◽  
Decongestive Therapy

Background: Breast cancer-related lymphedema (BCRL) of the upper extremities often follows breast cancer treatment. Although complex decongestive therapy (CDT) is currently the standard treatment for BCRL, stellate ganglion block (SGB) has also been reported to be effective. Objectives: This study aimed to determine the effectiveness of SGB in the treatment of BCRL, and to assess the impact of the treatment on the quality of life (QoL) compared to CDT. Study Design: A randomized controlled trial. Setting: A single academic hospital, outpatient setting. Methods: A total of 38 patients with BCRL were recruited. Patients were randomly divided into 2 groups. Patients enrolled in the CDT group underwent 10 sessions of CDT for 2 weeks, whereas patients in the SGB group received 3 consecutive SGBs every 2 weeks. Changes in circumference, volume, and bioimpedance in the upper extremity were measured at baseline and 2 weeks after treatment and compared between the 2 groups. EuroQol-5 dimensions (EQ-5D) and EuroQol visual analog scale (EQ VAS) for QoL and subjective improvement were monitored. Results: In both groups, side-to-side difference of circumference after the treatment was decreased significantly from baseline (P < 0.05), and side-to-side difference of volume was reduced significantly in the SGB group (P < 0.05). No statistically significant difference was noted in the treatment effect between the 2 groups. Results of the EQ-5D, EQ VAS, and questionnaires regarding subjective symptoms administered at baseline and 2 weeks after each intervention revealed no statistically significant difference in the treatment effects between CDT and SGB. Limitations: Further long-term follow-up studies with a greater number of patients that include analysis according to the severity and duration of symptoms are needed. Conclusions: The results of this study suggest that SGB is an effective treatment for BCRL and may be considered as an alternative to CDT. Key words: Stellate ganglion block, complex decongestive therapy, breast cancer, lymphedema, breast cancer-related lymphedema, quality of life, bioimpedance, secondary lymphedema

scholarly journals Effects of Stellate Ganglion Block on Breast Cancer-Related Lymphedema: Comparison of Various Injectates

2015 ◽  
Vol 18;1 (1;1) ◽  
pp. 93-99
Author(s):  
Jeetinder Kaur Makkar
Keyword(s):  
Breast Cancer ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Ganglion Block ◽  
Upper Arm ◽  
Subjective Data ◽  
Arm Circumference ◽  
Significant Difference ◽  
Group A ◽  
Breast Cancer Related Lymphedema

Background: Stellate ganglion block (SGB) has been reported to be effective in the treatment of breast cancer-related lymphedema (BCRL). Objective: To determine the effects of SGB in BCRL patients and the efficacy of corticosteroids in SGB. Study Design: A double-blinded, randomized, controlled trial. Setting: A single academic hospital, outpatient setting. Methods: In total, 32 patients with BCRL were recruited. Patients were divided randomly into 3 groups (Group A: 0.5% bupivacaine 5 mL, n = 12; Group B: 0.5% bupivacaine 4.5 mL + 20 mg of triamcinolone 0.5 mL, n = 10; and Group C: 0.5% bupivacaine 4 mL + 40 mg of triamcinolone 1 mL, n = 10). All patients received 3 consecutive SGBs, every 2 weeks. The primary outcomes were changes in forearm and upper arm circumference. Circumference was measured at baseline, 2 weeks (before the second injection), 4 weeks (before the third injection), and 8 weeks (one month follow-up after 3 consecutive SGBs). Moreover, subjective data were collected using EORTC C-30 at baseline and 8 weeks. Results: After 3 consecutive SGBs, forearm and upper arm circumferences were decreased significantly from baseline in all groups (P < 0.05/3). The upper arm circumference of group C was reduced significantly more than that of group A (P < 0.05/3). The subjective data by EORTC-C30 at baseline and one month after 3 consecutive SGBs revealed no statistically significant difference. Limitations: Relatively few patients were enrolled. We did not compare SGB with any other BCRL treatment, such as complex decongestive therapy. Conclusions: This study suggests that SGB may be an effective treatment for BCRL. Furthermore, it appears that corticosteroids could have an additive effect in SGB. Key words: Stellate ganglion block, breast cancer, lymphedema:

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

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.

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

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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