Comparing the prevalence, location, and severity of head and neck lymphedema after postoperative radiotherapy for oral cavity cancers and definitive chemoradiotherapy for oropharyngeal, laryngeal, and hypopharyngeal cancers

Claire Jeans; Bena Brown; Elizabeth C Ward; Anne E Vertigan; Amanda E Pigott; Jodie L Nixon; Chris Wratten

doi:10.1002/hed.26394

Comparing the prevalence, location, and severity of head and neck lymphedema after postoperative radiotherapy for oral cavity cancers and definitive chemoradiotherapy for oropharyngeal, laryngeal, and hypopharyngeal cancers

Head Neck. 2020 Nov;42(11):3364-3374. doi: 10.1002/hed.26394. Epub 2020 Jul 31.

Authors

Claire Jeans^{1

2}, Bena Brown^{1

3

4}, Elizabeth C Ward^{1

3}, Anne E Vertigan^{5

6

7}, Amanda E Pigott^{3

8

9}, Jodie L Nixon^{8

9}, Chris Wratten¹⁰

Affiliations

¹ Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
² Speech Pathology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia.
³ Centre for Functioning and Health Research, Metro South Health Services District, Queensland Health, Buranda, Brisbane, Queensland, Australia.
⁴ Speech Pathology Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
⁵ Speech Pathology Department, John Hunter Hospital and Belmont Hospital, New Lambton Heights, New South Wales, Australia.
⁶ School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.
⁷ Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
⁸ Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
⁹ Occupational Therapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
¹⁰ Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia.

PMID: 32735033
DOI: 10.1002/hed.26394

Abstract

Background: This study aimed to examine the prevalence, location, and severity of chronic internal, external, and combined head and neck lymphedema (HNL) in patients with head and neck (HNC) who were treated with definitive chemoradiotherapy (CRT) or postoperative radiotherapy (PORT).

Methods: Sixty-two participants between 1 and 3 years post-treatment were recruited. Internal HNL was rated with Patterson's Scale. External HNL was graded with the MD Anderson Cancer Center Lymphedema Rating Scale.

Results: Ninety-eight percent of participants presented with some form of chronic HNL. Sixty-one percent had internal HNL only, 35% had combined HNL, and 2% had external HNL only. Participants treated with PORT were more likely to experience combined HNL (69% vs 24%, P = .001), whereas those treated with CRT were more likely to have internal HNL only (74% vs 25%, P = .001).

Conclusions: Chronic HNL is highly prevalent following multimodal treatment, and differences in HNL presentations exist between treatment modalities.

Keywords: head and neck cancer; lymphedema; prevalence; radiotherapy; surgery.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Chemoradiotherapy / adverse effects
Head and Neck Neoplasms* / therapy
Humans
Hypopharyngeal Neoplasms* / therapy
Lymphedema* / epidemiology
Lymphedema* / etiology
Lymphedema* / therapy
Mouth
Prevalence