Theresa Yao1, Beth Beadle2, C Floyd Holsinger1, Heather M Starmer1. 1. Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A. 2. Department of Radiation Oncology, Stanford University, Palo Alto, California, U.S.A.
Abstract
OBJECTIVE: This study aimed to compare outcomes in patients with head and neck lymphedema receiving either a home-based lymphedema treatment program or a hybrid approach including both home-based treatment and regular clinical visits. METHODS: Outcomes were assessed in patients receiving head and neck lymphedema rehabilitation. Baseline measures of neck, submental, and facial edema were obtained and repeated following treatment. A home program was recommended for all patients, and those receiving hybrid care received the same recommendations as well as a visit with the lymphedema therapist for additional treatment. Their outcomes were compared using standard statistical analysis. RESULTS: Fifty consecutive individuals were included, 25 in each group. Adherence to at least 50% of recommended treatment was reported in 68% of those receiving home-based treatment and 84% of those receiving hybrid care. Significant improvement was demonstrated for 66% of patients. There was no statistically significant difference between treatment groups with regard to clinically significant improvement (P = .15). Patients receiving hybrid therapy demonstrated treatment advantages regarding facial edema (P = .037). Adherence to treatment was associated with clinical improvement (P = .047). CONCLUSIONS: Comparable benefits were observed regardless of whether patients had a home-based or hybrid lymphedema treatment approach. These data suggest a home-based treatment approach may be appropriate for patients unable to participate in clinical sessions. However, for patients with significant facial edema, a hybrid approach may be preferable. Adherence was associated with better outcomes. Given these findings, future investigations should consider strategies to improve adherence to optimize the outcomes lymphedema treatment. LEVEL OF EVIDENCE: 3b Laryngoscope, 2020.
OBJECTIVE: This study aimed to compare outcomes in patients with head and neck lymphedema receiving either a home-based lymphedema treatment program or a hybrid approach including both home-based treatment and regular clinical visits. METHODS: Outcomes were assessed in patients receiving head and neck lymphedema rehabilitation. Baseline measures of neck, submental, and facial edema were obtained and repeated following treatment. A home program was recommended for all patients, and those receiving hybrid care received the same recommendations as well as a visit with the lymphedema therapist for additional treatment. Their outcomes were compared using standard statistical analysis. RESULTS: Fifty consecutive individuals were included, 25 in each group. Adherence to at least 50% of recommended treatment was reported in 68% of those receiving home-based treatment and 84% of those receiving hybrid care. Significant improvement was demonstrated for 66% of patients. There was no statistically significant difference between treatment groups with regard to clinically significant improvement (P = .15). Patients receiving hybrid therapy demonstrated treatment advantages regarding facial edema (P = .037). Adherence to treatment was associated with clinical improvement (P = .047). CONCLUSIONS: Comparable benefits were observed regardless of whether patients had a home-based or hybrid lymphedema treatment approach. These data suggest a home-based treatment approach may be appropriate for patients unable to participate in clinical sessions. However, for patients with significant facial edema, a hybrid approach may be preferable. Adherence was associated with better outcomes. Given these findings, future investigations should consider strategies to improve adherence to optimize the outcomes lymphedema treatment. LEVEL OF EVIDENCE: 3b Laryngoscope, 2020.
Authors: Jie Deng; Mary S Dietrich; Kenneth J Niermann; Robert J Sinard; Anthony J Cmelak; Sheila H Ridner; Jill Gilbert; Barbara A Murphy Journal: Int J Radiat Oncol Biol Phys Date: 2020-10-14 Impact factor: 8.013
Authors: Neerav Goyal; Andrew Day; Joel Epstein; Joseph Goodman; Evan Graboyes; Scharukh Jalisi; Ana P Kiess; Jamie A Ku; Matthew C Miller; Aru Panwar; Vijay A Patel; Assuntina Sacco; Vlad Sandulache; Amy M Williams; Daniel Deschler; D Gregory Farwell; Cherie-Ann Nathan; Carole Fakhry; Nishant Agrawal Journal: Laryngoscope Investig Otolaryngol Date: 2021-11-30
Authors: Sheila H Ridner; Mary S Dietrich; Jie Deng; Sandra L Ettema; Barbara Murphy Journal: Support Care Cancer Date: 2020-06-02 Impact factor: 3.603