Self-care for head and neck cancer survivors with lymphedema and fibrosis: A pilot randomized clinical trial.

Authors

null

Jie Deng

University of Pennsylvania School of Nursing, Philadelphia, PA

Jie Deng , Alexander Lin , Subhash Aryal , John Nicholas Lukens , Erin McMenamin , Ryan Quinn , Joy Cohn , Bryan Spinelli , Barbara A. Murphy

Organizations

University of Pennsylvania School of Nursing, Philadelphia, PA, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, University of Pennsylvania, Philadelphia, PA, Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA, Hospital of University of Pennsylvania, Philadelphia, PA, Thomas Jefferson University, Jefferson College of Rehabilitation Sciences, Philadelphia, PA, Vanderbilt University Medical Center, Nashville, TN

Research Funding

Other Foundation

Background: Lymphedema and fibrosis (LEF) are debilitating late effects in head and neck cancer survivors (HNCS). Initial therapy is usually directed by therapists following which patients undertake a LEF self-care program (SCP). No evidence based LEF-SCP are available. We report on the feasibility and preliminary efficacy data of a multifaceted LEF-SCP. Methods: 59 HNCS with LEF were randomized to: Usual care (n = 20), usual care + LEF-SCP (n = 20), and usual care + LEF-SCP + routine follow-up with a lymphedema therapist (n = 19). Assessments were conducted at baseline, 3-, 6-, 9-, and 12-months. Outcome measures include feasibility and preliminary efficacy (LEF progression, symptom burden, and jaw range of motion [ROM]). Multivariate covariance pattern model analysis was used to test for difference between arms. Results: 1) Feasibility: LEF-SCP training sessions - 80% completion rate; 90% satisfaction with the LEF-SCP; self-care adherence was similar between arms; no adverse event. 2) Preliminary Efficacy: Compared to usual care, participants randomized to LEF-SCP (+/- follow-up) showed a decrease in LEF severity (p < 0.05), reduction in symptom burden (p < 0.05), without significant improvement in jaw ROM. No significant differences were noted between the patients +/- follow-up with a lymphedema therapist. There was a trend to improved self-efficacy in patients participating in the LEF-SCP. Conclusions: The LEF-SCP is feasible and potentially efficacious for HNCS. Further testing is warranted. Clinical trial information: NCT03030859.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Head and Neck Cancer

Track

Head and Neck Cancer

Sub Track

Other Head and Neck Cancer (Salivary, Thyroid)

Clinical Trial Registration Number

NCT03030859

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 6094)

DOI

10.1200/JCO.2022.40.16_suppl.6094

Abstract #

6094

Poster Bd #

85

Abstract Disclosures

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