Comparison Between the Effectiveness of Complex Decongestive Therapy and Stellate Ganglion Block in Patients with Breast Cancer-Related Lymphedema: A Randomized Controlled Study

摘要

Background: Breast cancer-related lymphedema (BCRL) of the upper extremities oftenfollows breast cancer treatment. Although complex decongestive therapy (CDT) is currentlythe standard treatment for BCRL, stellate ganglion block (SGB) has also been reported to beeffective.Objectives: This study aimed to determine the effectiveness of SGB in the treatment ofBCRL, and to assess the impact of the treatment on the quality of life (QoL) compared toCDT.Study Design: A randomized controlled trial.Setting: A single academic hospital, outpatient setting.Methods: A total of 38 patients with BCRL were recruited. Patients were randomly dividedinto 2 groups. Patients enrolled in the CDT group underwent 10 sessions of CDT for 2 weeks,whereas patients in the SGB group received 3 consecutive SGBs every 2 weeks. Changes incircumference, volume, and bioimpedance in the upper extremity were measured at baselineand 2 weeks after treatment and compared between the 2 groups. EuroQol-5 dimensions(EQ-5D) and EuroQol visual analog scale (EQ VAS) for QoL and subjective improvement weremonitored.Results: In both groups, side-to-side difference of circumference after the treatment wasdecreased significantly from baseline (P < 0.05), and side-to-side difference of volume wasreduced significantly in the SGB group (P < 0.05). No statistically significant difference wasnoted in the treatment effect between the 2 groups. Results of the EQ-5D, EQ VAS, andquestionnaires regarding subjective symptoms administered at baseline and 2 weeks aftereach intervention revealed no statistically significant difference in the treatment effectsbetween CDT and SGB.Limitations: Further long-term follow-up studies with a greater number of patients thatinclude analysis according to the severity and duration of symptoms are needed.Conclusions: The results of this study suggest that SGB is an effective treatment for BCRLand may be considered as an alternative to CDT.