influence of individual kinesitherapy on lymphedema control during adjuvant radiotherapy after surgical treatment in women with breast cancer - a retrospective analysis

Procjenjuje se da između 20% i 60% bolesnica oboljelih od raka dojke navodi simptome limfedema. Limfedem povezan s rakom dojke karakterizira nakupljanje tekućine u intersticijskim tkivima u ruci, ramenu, vratu ili trupu i pripisuje se oštećenju limfnih čvorova tijekom tretmana karcinoma dojke koji uključuju zračenje i disekciju aksilarnih čvorova. Cilj ovog rada bio je utvrditi postoji li povezanost između kineziterapijskog programa na kontrolu limfedema tijekom adjuvantne radioterapije nakon kirurškog liječenja u žena oboljelih od karcinoma dojke. U ovo retrospektivno istraživanje uključeno je 454 bolesnice oboljelih od karcinoma dojke (prosječne životne dobi 58.01±10.66). Bolesnice su istovremeno primale adjuvantnu radioterapiju i provodile individualno planiranu kineziterapiju, te su ovisno o trajanju terapija podijeljene u četiri skupine (16, 20, 25 i 30). Prosječan broj kineziterapijskih postupaka u ovome istraživanju iznosio je 23.57±5.05. Prije početka individualne kineziterapije prosječna vrijednost indeksa ruke bila je 2.98±3.61 cm, a na kraju je iznosila 2.47±3.26 cm. Prosječna vrijednost razlike početnog i završnog indeksa ruke je iznosila -0.51±1.71 cm. Od ukupnog broja bolesnica njih 424 imalo je limfedem na početku kineziterapijskog programa (93.4%) , a njih 30 nije imalo limfedem (6.6%). Nakon završetka kineziterapijskog programa od ukupnog broja bolesnica njih 398 je imalo limfedem (87.7%), a njih 56 nije imalo (12.3%). Ovo istraživanje pokazalo je korist individualiziranog kineziterapijskog programa u smanjenju limfedema i naglašava važnost protokola multimodalne rehabilitacije kod ove skupine bolesnika.It is estimated that between 20% and 60% of breast cancer patients report symptoms of lymphedema. Lymphedema associated with breast cancer is characterized by accumulation of fluid in the interstitial tissues in the arm, shoulder, neck, or torso and is attributed to lymph node damage during breast cancer treatment involving radiation and axillary node dissection. The aim of this study was to determine whether there is an association between a kinesitherapy program on lymphedema control during adjuvant radiotherapy after surgical treatment in women with breast cancer. This retrospective study included 454 patients with breast cancer (mean age 58.01 ± 10.66). Patients received concomitant adjuvant radiotherapy and individually planned kinesitherapy, and were divided into four groups (16, 20, 25 and 30) according on the duration of therapy. The average number of kinesitherapy procedures in this study was 23.57 ± 5.05. Prior to the start of individual kinesitherapy, the mean value of the hand index was 2.98 ± 3.61 cm, and at the end it was 2.47 ± 3.26 cm. The mean value of the difference between the initial and final index of the hand was -0.51 ± 1.71 cm. Out of the total number of patients, 424 had lymphedema at the beginning of the kinesitherapy program (93.4%), and 30 of them did not have (6.6%). After the completion of the kinesitherapy program, out of the total number of patients, 398 had lymphedema (87.7%), and 56 did not (12.3%). This research showed the benefit of comprehensive kinesitherapy programme in reduction of lymphoedema and emphasizes the importance of multimodal rehabilitation protocol in this group of patients