Treatment approaches and outcomes of a head and neck lymphedema service at an Australian comprehensive cancer center

Rebecca Louise Venchiarutti; Sandra Templeton; Lara Mathers; Emma Charters; Jonathan Robert Clark

doi:10.1002/hed.27369

Treatment approaches and outcomes of a head and neck lymphedema service at an Australian comprehensive cancer center

Head Neck. 2023 Jun;45(6):1539-1548. doi: 10.1002/hed.27369. Epub 2023 Apr 17.

Authors

Rebecca Louise Venchiarutti^{1

2}, Sandra Templeton³, Lara Mathers¹, Emma Charters^{1

4}, Jonathan Robert Clark^{1

5

6}

Affiliations

¹ Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
² Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
³ Department of Integrative Oncology and Supportive Care, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
⁴ Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
⁵ Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
⁶ Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, New South Wales, Australia.

PMID: 37067075
DOI: 10.1002/hed.27369

Abstract

Background: Patients treated for head and neck cancer are at high risk of developing head and neck lymphedema (HNL). We describe outcomes of HNL management at an Australian institution from 2018 to 2020.

Methods: Electronic records from Chris O'Brien Lifehouse were retrospectively reviewed from January 1, 2018 to December 31, 2020. Objective changes in HNL were assessed using The M. D. Anderson Cancer Center (MDACC) HNL rating scale and Assessment of Lymphedema of the Head and Neck (ALOHA).

Results: Among the 100 patients referred for management of HNL, surgery was the most frequent treatment modality (80%; 70% with neck dissection) and 69% underwent radiotherapy. Manual lymphatic drainage (MLD) was most often prescribed (96%), followed by self-MLD (93%). Small but significant improvements in ALOHA measurements were observed for 50 patients (50%). Only 5/29 (17%) patients had post-treatment improvements on the MDACC scale.

Conclusions: Standardized, prospective measurement of treatment approaches and outcomes is needed to further evaluate the service.

Keywords: exercise; head and neck cancer; lymphedema; self-management; supportive care.

Publication types

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

MeSH terms

Australia
Head and Neck Neoplasms* / therapy
Humans
Lymphedema* / etiology
Lymphedema* / therapy
Prospective Studies
Retrospective Studies