Secondary cancer-related head and neck lymphoedema affects internal and external structures of the head and neck. Its treatment is time and labour intensive and the burden to the health system and the patient is high without a clear understanding of the effectiveness of each therapy modality. This study aimed to investigate the feasibility of carrying out a randomised controlled trial comparing two treatment modalities for the management of head and neck lymphoedema, manual lymphatic drainage and compression. The secondary objective of the study was to evaluate the clinical effects of these treatments on internal and external head and neck lymphoedema.
This prospective, assessor blinded, two-armed randomised feasibility study investigated the management of internal and external head and neck lymphoedema comparing manual lymphatic drainage with compression therapy, delivered over six weeks. Duration of involvement in the study was 12 weeks with the intervention delivered over 6 weeks and a follow up assessment at 12 weeks post-commencement. The primary outcome was a reduction in percentage tissue water measured 12 weeks post treatment.
Recruitment rate was sub optimal with six participants recruited over 11months prior to early cessation due to restrictions imposed by the COVID19 pandemic. Eighty six percent of attendances were completed and participants reported being partially adherent to the prescribed home programme. Tissue water content showed an increase in all participants at 12 weeks. No consistent trends were identified between internal and external head and neck lymphoedema outcomes.
The feasibility of progressing this study to a full randomised controlled trial is not supported by the low recruitment rate. This finding highlights the challenges of research into head and neck lymphoedema treatment. Clinical outcomes did not show any consistent trends towards improvement in lymphoedema and therefore the study does not provide support for single modality treatment.