A Prospective Study of the Lymphedema and Fibrosis Continuum in Patients with Head and Neck Cancer
A Prospective Study of the Lymphedema and Fibrosis Continuum in Patients with Head and Neck Cancer
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DOI：
10.1089/lrb.2016.0001
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发表时间：
2016-12-01
影响因子：
1.4
通讯作者：
Murphy, Barbara
中科院分区：
文献类型：
--
作者：
Ridner, Sheila H.;Dietrich, Mary S.;Murphy, Barbara
背景：本研究的目的是确定头颈癌（HNC）患者内部、外部和合并淋巴水肿和纤维化的患病率和性质。材料和方法：我们获得了100名新诊断为头颈部癌症的患者的同意，进行了一项为期4年的前瞻性纵向描述性研究。2010年8月23日开始招募，2014年4月24日完成研究。83名患者在放疗前至治疗后18个月定期接受评估。确定发生外部、内部或两种类型淋巴水肿和/或纤维化的百分比，以及外部、内部或两种类型淋巴水肿和/或纤维化的严重程度轨迹。结果：治疗前淋巴水肿发生率为：外源性：62.7%，内源性：41.7%，或合并：29.2%，纤维化：42.2%。淋巴水肿迟发率范围更大：外源性：81.9% ~ 90.1%，内源性：80.4% ~ 89.4%，合并：70.6% ~ 80.9%，纤维化：66.7% ~ 77.4%。大约75%的患者有以中度至重度外部或内部淋巴水肿为特征的晚期效应轨迹；47%的患者有中度至重度纤维化。结论：HNC的淋巴及软组织并发症不仅发生在治疗后，也发生在治疗前。它们在治疗后的前18个月普遍存在，在我们的研究中，超过90%的患者经历某种形式的内部、外部或联合淋巴水肿，其中一半以上的患者发展为纤维化。指出了对这些条件的进一步研究。
Background: The purpose of this study was to determine the prevalence and nature of internal, external, and combined lymphedema and fibrosis in patients with head and neck cancer (HNC).Materials and Methods: We obtained consent from 100 patients newly diagnosed with having cancer of the head and neck for a 4-year, prospective, longitudinal descriptive study. Recruitment began in August 23, 2010, and the study was completed in April 24, 2014. Eighty-three were evaluated at regular intervals from preradiation therapy to 18 months post-treatment. Percentage developing external, internal, or both types of lymphedema and/or fibrosis and trajectories of the severity of external, internal, or both types of lymphedema and/or fibrosis were determined.Results: Before treatment, lymphedema rates were the following: external: 62.7%, internal: 41.7%, or combined: 29.2%, and/or fibrosis: 42.2%. Ranges of lymphedema late-effect rates were even higher: external: 81.9%-90.1%, internal: 80.4%-89.4%, combined: 70.6%-80.9%, and fibrosis: 66.7%-77.4%. Approximately 75% had a late-effect trajectory characterized by moderate to severe external or internal lymphedema; similar to 47% had moderate to severe fibrosis.Conclusion: Lymphatic and soft tissue complications of HNC occur not only post-treatment but also before treatment. They are ubiquitous throughout the first 18 months post-treatment, with greater than 90% of patients in our study experiencing some form of internal, external, or combined lymphedema, and over half of those patients developing fibrosis. Further research regarding these conditions is indicated.