Fatores preditivos de resposta ao complexo descongestivo fisioterápico para linfedema secundário ao câncer de mama: análise de prontuários
DOI:
https://doi.org/10.33233/fb.v16i3.82Abstract
Objetivo: Identificar fatores preditivos de resposta ao Complexo Descongestivo Fisioterápico (CDF) no linfedema secundário ao câncer de mama. Método: Estudo observacional com 82 mulheres de janeiro de 2003 a junho de 2012. Foi realizada perimetria de membros superiores, antes e após o tratamento. Os fatores preditivos investigados foram: idade, índice de massa corporal, sessões de tratamento, tipo de cirurgia, estadiamento do câncer, quimioterapia, hormonioterapia, radioterapia, hipertensão, diabetes, doenças osteoarticulares. O teste de Wilcoxon foi empregado para comparação das médias da perimetria dos membros superiores e os testes de Mann-Whitney e Kruskal-Wallis para avaliar a influência dos fatores clínicos e do tratamento para câncer de mama na diferença média entre as circunferências do membro acometido e do membro contralateral antes e após o tratamento com CDF. Resultados: A quimioterapia esteve associada í menor resposta ao tratamento do linfedema, enquanto as demais variáveis não apresentaram interferências. A diferença média inicial entre as circunferências do membro acometido e contralateral foi 11,9 ± 9,12 cm; e a final foi 8,12 ± 7,45 cm (p < 0.0001). Houve redução significativa em todos os pontos avaliados. Conclusão: O CDF conduziu a redução significativa da circunferência em todos os pontos avaliados. Somente a quimioterapia esteve relacionada í menor resposta do linfedema ao CDF.
Palavras-chave: câncer de mama, linfedema, Fisioterapia, saúde da mulher.
References
Omar MTA, Ebid AAEG, Morsy AME. Treatment of post-mastectomy lymphedema with laser therapy: double blind placebo control randomized study. J Surg Res 2011;165(1):82-90.
Fu MR. Breast cancer-related lymphedema: Symptoms, diagnosis, risk reduction, and management. World J Clin Oncol 2014;5(3):241-7.
Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol 2008;26(21):3536-42.
Zhu YQ, Xie YH, Liu FH, Guo Q, Shen PP, Tian Y. Systemic analysis on risk factors for breast cancer related lymphedema. Asian Pac J Cancer Prev 2014; 15(16): 6535-41.
Forner-Cordero I, Munõz-Langa J, Forner-Cordero A, DeMiguel-Jimeno JM. Predictive factors of response to decongestive therapy in patients with breast-cancer-related lymphedema. Ann Surg Oncol 2010;17(3):744-51.
Paiva DMF, Leite ICG, Rodrigues VO, Cesca MG. Fatores associados ao linfedema em pacientes com câncer de mama. Rev Bras Ginecol Obstet 2011;33(2):75-80.
Togawa K, Ma H, Sullivan-Halley J, Neuhouser ML, Imayama I, Baumgartner KB, et al. Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study. Breast Cancer Res 2014;22;16(4):414.
Internacional Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2013 consensus document of the International Society of Lymphology. Lymphology 2013;46(1):1-11.
Meirelles MCCC, Mamede MV, Souza L, Panobianco MS. Avaliação de técnicas fisioterapêuticas no tratamento do linfedema pós-cirurgia de mama em mulheres. Rev Bras Fisioter 2006;10(4):393-99.
Vignes S, Porcher R, Champagne A, Dupuy A. Predictive factors of response to intensive decongestive physiotherapy in upper limb lymphedema after breast cancer treatment: a cohort study. Breast Cancer Res Treat 2006;98(1):1-6.
Marconi, MA e Lakatos, EM. Técnicas de Pesquisa. In: Marconi, MA e Lakatos, EM. Fundamentos de metodologia cientÃfica. 6ª ed. São Paulo: Atlas; 2005.p.186-7.
Ibrahim AO, Alawad AA. Risk factors and management of breast cancer-related lymphedema. Int J Med 2015;3(1):38-40.
Oliveira MMF, Rezende LF. Linfedema. In: Marques AA, Pinto e Silva MP, Amaral MTP (orgs.). Tratado de Fisioterapia em Saúde da Mulher. São Paulo: Roca; 2011. p.118-20.
Vignes S, Porcher R, Arrault M, Dupuy A. Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy. Support Care Cancer 2011;19(7):935-40.
Warren LE, Miller CL, Horick N, Skolny MN, Jammallo LS, Sadek BT et al. The impact of radiation therapy on the risk of lymphedema after treatment for breast cancer: a prospective cohort study. Int J Radiat Oncol Biol Phys 2014;88(3):565-71.
Rebegea L, Firescu D, Dumitru M, Anghel R. The incidence and risk factors for occurrence of arm lymphedema after treatment of breast cancer. Chirurgia (Bucur) 2015;110(1):33-7.
Vignes S, Blanchard M, Arrault M, Porcher R. Intensive complete decongestive physiotherapy for cancer-related upper-limb lymphedema: 11 days achieved greater volume reduction than 4. Gynecol Oncol 2013;131(1):127-30.
Haghighat S, Lotfi-Tokalday M, Yunesian M, Akbari ME, Nazemi F, Weiss J. Comparing two treatment methods for post mastectomy lymphedema: complex decongestive therapy alone and in combination with intermittent pneumatic compression. Lymphology 2010;43(1):25-33.
Uzkeser H, Karatay S, Erdemci B, Koc M, Senel K. Efficacy of manual lymphatic drainage and intermittent pneumatic compression pump use in the treatment of lymphedema after mastectomy: a randomized controlled trial. Breast Cancer 2015;22(3):300-7.
Lee JH, Shin BW, Jeong HJ, Kim GC, Kim DK, Sim YJ. Ultrasonographic evaluation of therapeutic effects of complex decongestive therapy in breast cancer-related lymphedema. Ann Rehabil Med 2013;37(5):683-9.
Koul R, Dufan T, Russell C, Guenther W, Nugent Z, Sun X, Cooke AL. Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer. Int J Radiat Oncol Biol Phys 2007;67(3):841-6.
Haghighat S, Lotfi-Tokaldany M, Maboudi AA, Karami M, Bahadori A, Weiss J. Predictive factors of response to phase I complete decongestive therapy in upper extremity lymphedema following breast carcinoma in Iran. Lymphology 2013; 46(2):97-104.
Liao SF, Li SH, Huang HY, Chen ST, Kuo SJ, Chen DR, Wei TS. The efficacy of complex decongestive physiotherapy (CDP) and predictive factors of lymphedema severity and response to CDP in breast cancer- related lymphedema (BCRL). Breast 2013;22(5):703-6.
Kang Y, Jang DH, Jeon JY, Lee SJ, Jeong SY, Shin DI, Kim HJ. Pressure monitoring of multilayer inelastic bandaging and the effect of padding in breast cancer -relatedlymphedema patients. Am J Phys Med Rehabil 2012;91(9):768-73.
Paiva DMF, Rodrigues VO, Cesca MG, Palma PV, Leite IC. Prevalence of lymphedema in women undergoing treatment for breast cancer in a referral center in southeastern Brazil. BMC Women's Health 2013;13:6.
Godoy JM, Silva SH, Godoy MF. Sensitivity and specificity of combined perimetric and volumetric evaluations in the diagnosis of arm lymphedema. Prague Med Rep 2007;108(3):243-7.
Kim L, Jeon JY, Sung IY, Jeong SY, Do JH, Kim HJ. Prediction of treatment outcome with bioimpedance measurements in breast cancer related lymphedema patients. Ann Rehabil Med 2011;35(5):687-93.
Dylke ES, Ward LC, Meerkin JD, Nery L, Kilbreath SL. Tissue composition changes and secondary lymphedema. Lymphat Res Biol 2013;11(4):211-8.
Paskett ED, Dean JA, Oliveri JM, Harrop JP. Cancer-related lymphedema risk factors, diagnosis, treatment, and impact: a review. J Clin Oncol 2012;30(30):3726.
Downloads
Published
Issue
Section
License
Authors are authorized for non-exclusive distribution of the version of the work published in this journal (eg, publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
