Document Type : Systematic Review and Meta-analysis
Authors
School of Nursing, University of Jordan, Amman, Jordan.
Abstract
Purpose: To review and analyze critically the available evidence for Complete Decongestive Therapy Effect on Breast Cancer Related to Lymphedema. Data Sources: Publications were retrieved from the major database search engines, included Google scholar, EBSCO host, and PubMed database. The search terms including: “Complete decongestive therapy (CDT)”, “breast cancer”, “Breast cancer related to lymphedema (BCRL)” “breast surgery” and “mastectomy”. Study Selection: The studies were initially selected based on keywords associated with inclusion criteria. Then, articles were chosen based on their titles. Then, based on the fill text and design, randomized control with a comprehensive description of the outcomes. The authors analyzed 3,181 articles, of which 15 randomized controlled trials met inclusion criteria with no publication date constraint. Data Extraction: Each article’s authors, nations, participants, outcomes variables, measuring instruments, intervention technique and follow-up, outcomes, and results were retrieved. After reaching consensus among authors, study quality was evaluated using the Jadad scale, and risk of bias was determined using the Cochrane Rob2 tool. Data Synthesis: The levels of evidence were of excellent quality. The retrieved articles were of “high” methodological caliber. The major outcome variables were in QOL, pain, ROM and edema. The effect size of CDT on QOL was 2.347 (95% CI: -1.41, 6.11) (p=0.22). Pain was -0.068 (95% CI: -35.21) (p=0.64). ROM was 0.324 (95% CI: -0.44,0.09) (p=0.41) and edema was -2.9 (95% -1.53,1.11) (p=0.76). Conclusions: The CDT is still recommended as the primary therapy for BCRL and is regarded the most practical and cost-effective treatment for BCRL. This result recommends patients to perform CDT to improve their QOL, ROM, and to lessen pain and edema volume. To improve the body of evidence supporting the effectiveness of the CDT on BCRL, additional trials with bigger sample sizes, longer follow-ups, blindness outcomes, and patient compliance evaluations are required.
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