Lymphedema management in patients with head and neck cancer: a systematic review of randomized controlled trials on physical therapy interventions

Abstract

Purpose: Lymphedema is one of the most common side effects following oncological treatment. This systematic review analyzed the latest literature concerning the efficacy of physical therapy interventions in treating secondary lymphedema in patients with head and neck cancer. Methods: Medline, Web of Science, Scopus, and Cochrane Library were searched for studies published before August 2023. Randomized controlled trials in which physical therapy was applied to treat lymphedema in head and neck cancer were included. Reviewers blinded screened the articles retrieved, scored methodological quality, and extracted data. The review was conducted according to the PRISMA statement and registered in PROSPERO (CRD42023439643). Risk of bias assessment was performed using the Cochrane tools. Results: A total of four randomized controlled trials were included. They comprise 167 patients, and only one of the studies achieved a low risk of bias. Interventions were kinesio taping, compression therapy, manual lymphatic drainage and/or exercise applied in combination with skin care and self-management. Some adverse effects related to intervention were mild and transitory. Conclusion: The findings shown by this review were that an exercise program plus manual lymphatic drainage supplemented with kinesio taping or compression therapy could be beneficial for external lymphedema. Neither therapy achieved an improvement in internal lymphedema.