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Rehabilitation Interventions for Head and Neck Cancer-Associated Lymphedema: A Systematic Review
Jessica T Cheng1, Victor F Leite2, Jegy M Tennison3
1Department of Supportive Care Medicine, City of Hope Orange County, Irvine, California.
JAMA Otolaryngology-- Head & Neck Surgery
|June 29, 2023
Summary
Head and neck cancer-associated lymphedema (HNCaL) rehabilitation interventions show promise, with kinesio taping and advanced pneumatic compression devices (APCDs) appearing safe and beneficial. Further research is needed to establish definitive treatment guidelines for HNCaL survivors.
Area of Science:
- Oncology
- Rehabilitation Medicine
- Lymphedema Management
Background:
- Head and neck cancer-associated lymphedema (HNCaL) significantly impacts up to 90% of survivors, causing substantial disability.
- Despite its prevalence and morbidity, evidence-based rehabilitation interventions for HNCaL remain understudied.
Approach:
- A systematic review of five electronic databases was conducted from inception to January 3, 2023, to identify HNCaL rehabilitation studies.
- 23 studies, including 6 randomized clinical trials (RCTs) and 17 observational studies, were eligible for inclusion.
- Interventions were categorized into standard lymphedema therapy and adjunct therapies, with data extraction and quality assessment performed by two independent reviewers.
Key Points:
- Standard lymphedema therapy, particularly in outpatient settings with adherence, showed low-quality evidence of benefit.
- Adjunct therapies, including kinesio taping (high-quality evidence) and advanced pneumatic compression devices (APCDs) (low-quality evidence), also suggested potential benefits.
- Most studies were small, and serious adverse events were rarely reported or not found.
Conclusions:
- Rehabilitation interventions for HNCaL, such as standard therapy, kinesio taping, and APCDs, appear safe and beneficial.
- High-quality, prospective, and adequately powered studies are essential to establish optimal treatment guidelines for HNCaL.
