Head and Neck Cancer Clinical Trial
Official title:
To Investigate the Effectiveness of Two Different Physiotherapy Programs in Lymphedema Following Head and Neck Cancer Treatment
The aim of this study was to determine the effects of complex decongestive physiotherapy (CDP) and home programs on internal/external lymphedema, staging, fibrosis, and three-dimensional (3D) surface scanning and volume evaluation in head and neck lymphedema. Twenty-one patients were randomly divided into three groups: CDP; home program including self manual lymph drainage (MLD) and exercises; and control. CDP included MLD drainage, compression, exercise, and skin care. Self-MLD and exercises were performed by home program group patients. Assessment methods were applied at baseline and 4 weeks later for all groups. MD. Anderson Cancer Center Head and Neck Lymphedema Protocol was implemented to evaluate head and neck external lymphedema, staging, and fibrosis. An Artec Eva 3D scanner and the Autodesk ReCap Photo Studio software were used to determine and calculate the volume of the head and neck region via 3D surface scanning. Head and neck external lymphedema and fibrosis assessment criteria were performed to evaluate visible soft tissue edema and the degree of stiffness. To assess internal lymphedema, Patterson's scale was applied using fiber-optic endoscopic imaging.
Head and neck cancer (HNC) have been seen in 13.3/100,000 males and 2.8/100,000 in females in
Turkey. HNC related treatments such as lymph node dissection, tumor excision, chemotherapy,
radiotherapy, and cancer itself can cause head and neck lymphedema (HNL). The incidence of
HNL due to HNC treatments (surgery, chemotherapy and chemoradiation) has been reported to be
between 48% and 90%.
A recognition of HNL has been growing in recent years, but HNL is still much less recognized
than upper and lower limb lymphedema and is easily ignored by both patients and health care
providers. Therefore, in many cases, the diagnosis and treatment of HNL may be delayed, or
patients cannot access treatment. In routine practice, after HNC, the self-absorption of HNL
is generally expected. Clinical experiences have confirmed that HNL develops 2-6 months after
cancer treatment and regresses in some patients over time.
A variety of physiotherapy approaches have been shown to prevent and minimize physical,
functional, emotional, and social disorders resulting from HNL. However, complex decongestive
physiotherapy (CDP) is considered a gold standard treatment method for lymphedema. This
method consists of manual lymph drainage (MLD), skin care, compression therapy, and
therapeutic exercises. Although there are many studies about the effects of CDP on upper and
lower limbs, there is only a limited number of studies about HNL and CDP in the literature.
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