The impact of radiation on lymphedema: a review of the literature

Allam, Omar; Park, Kitae E; Chandler, Ludmila; Mozaffari, Mohammad Ali; Ahmad, Maham; Lu, Xiaona; Alperovich, Michael

doi:10.21037/gs.2020.03.20

Cited by 54 publications

(47 citation statements)

References 64 publications

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“…Lymphedema is a chronic, potentially progressive disorder which is characterized by the pathological accumulation of lymphatic fluid and fibrosis of subcutaneous tissue somewhere in the body. In BC survivors, this tissue is in the ipsilateral arm of BC and most often appears after axillary lymph node dissection and axillary radiotherapy [ 7 , 8 ]. This secondary lymphedema often causes functional problems, adversely affects quality of life, and may be accompanied by recurrent infections [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Determination of the Minimum Detectable Change in the Total and Segmental Volumes of the Upper Limb, Evaluated by Perimeter Measurements

et al. 2020

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Among female breast cancer survivors, there is a high prevalence of lymphedema subsequent to axillary lymph node dissection and axillary radiation therapy. There are many methodologies available for the screening, diagnosis and follow-up of breast cancer survivors with or without lymphedema, the most common of which is the measurement of patients’ arm circumference. The purpose of this study was to determine the intra-rater minimal detectable change (MDC) in the volume of the upper limb, both segmentally and globally, using circumference measurements for the evaluation of upper limb volume. In this study, 25 women who had received a unilateral mastectomy for breast cancer stage II or III participated. On two occasions separated by 15 min, the same researcher determined 11 perimeters for each arm at 4 cm intervals from the distal crease of the wrist in the direction of the armpit. The MDC at the segmental level ranged from 3.37% to 7.57% (2.7 to 14.6 mL, respectively) and was 2.39% (42.9 mL) at the global level of the arm; thus, minor changes in this value result in a high level of uncertainty in the interpretation of the results associated with the diagnosis of lymphedema and follow-up for presenting patients.

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Section: Introductionmentioning

confidence: 99%

Determination of the Minimum Detectable Change in the Total and Segmental Volumes of the Upper Limb, Evaluated by Perimeter Measurements

et al. 2020

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“…Our data suggest that this decline might be moderated with HIT, particularly in regard to depression and anxiety outcomes, activity and function 87 and activities of daily living 88 . Most of the negative side effects of cancer and its treatments are related to reduced physical functioning, reduced mobility due to surgery or chemotherapy 89 , lymphedema 90 , negative body composition changes as sarcopenia 91 , or osteoporosis 92 . Providing opportunities to increase independence through HIT is highly important since more than half of all cancer patients develop a mobility disability because of the disease and its treatments' adverse side-effects 93 .…”

Section: Discussionmentioning

confidence: 99%

Effects of High-Intensity Training on the Quality of Life of Cancer Patients and Survivors: A Systematic Review With Meta-Analysis

Lavín-Pérez

Collado‐Mateo

Mayo

et al. 2021

Preprint

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Cancer and associated medical treatments affect patients' health-related quality of life (HRQoL) by decreasing functional dimensions of physical, social, cognitive, and emotional well-being, while increasing short and late-term symptoms. Exercise, however, is demonstrated to be a useful therapy to improve cancer patients and survivors’ HRQoL, yet the effectiveness of high-intensity training (HIT) exercise is uncertain. This systematic-review and meta-analysis aimed to analyse the effects of HIT on HRQoL dimensions in cancer patients and survivors as well as evaluate the optimal prescription of HIT. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and examined Web of Science and PubMed (Medline) databases. Data was analysed utilizing Review Manager Software. Twenty-two articles were included in the systematic review and seventeen in the meta-analysis. Results showed HIT improved global quality of life, physical functioning, role functioning, social functioning, cognitive functioning, fatigue, pain, dyspnoea, and insomnia, compared to an inactive control group. Whereas no differences were found in contrast to low to moderate-intensity exercise compared to inactive controls. Particular improvements in HRQoL were observed during the cancer treatment and with the following prescription: a training duration of more than eight weeks, a frequency of 2 days/week, a volume of at least 120 minutes/week including 15 minutes or more of HIT. Our findings whilst encouraging, highlight the infancy of the extant evidence base for the role of HIT in the HRQoL of cancer patients and survivors.

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“…Bar Ad et al (2010) reported that 16% of all patients undergoing treatment with a combination of lymph node resection and radiation therapy developed clinical signs of lymphedema [ 56 ], whereas radiation therapy led to the highest incidences at 31% [ 55 ]. Radiation therapy can lead to the reduction of proliferative potential of the lymphatic tissue, fibrosis of the lymph nodes or to a mechanical insufficiency of the lymphatic vasculature [ 57 ]. Additional co-factors in the development of secondary lymphedema can be congestive heart failure or renal diseases [ 58 ].…”

Section: Overview Of Lymphedemamentioning

confidence: 99%

Biology of Lymphedema

Brix

Šerý

Onorato³

et al. 2021

Biology

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This narrative review portrays the lymphatic system, a poorly understood but important physiological system. While several reviews have been published that are related to the biology of the lymphatic system and lymphedema, the physiological alternations, which arise due to disturbances of this system, and during lymphedema therapy, are poorly understood and, consequently, not widely reported. We present an inclusive collection of evidence from the scientific literature reflecting important developments in lymphedema research over the last few decades. This review aims at advancing the knowledge on the area of lymphatic system function as well as how system dysfunction, as seen in lymphedema, affects physiological systems and how lymphedema therapy modulates these mechanisms. We propose that future studies should aim at investigating, in-detail, aspects that are related to fluid regulation, hemodynamic responses, and endothelial and/or vascular changes due to lymphedema and lymphedema therapy.

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The impact of radiation on lymphedema: a review of the literature

Cited by 54 publications

References 64 publications

Determination of the Minimum Detectable Change in the Total and Segmental Volumes of the Upper Limb, Evaluated by Perimeter Measurements

Determination of the Minimum Detectable Change in the Total and Segmental Volumes of the Upper Limb, Evaluated by Perimeter Measurements

Effects of High-Intensity Training on the Quality of Life of Cancer Patients and Survivors: A Systematic Review With Meta-Analysis

Biology of Lymphedema

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