Selenium in the treatment of radiation-associated secondary lymphedema

Int J Radiat Oncol Biol Phys. 2003 May 1;56(1):40-9. doi: 10.1016/s0360-3016(02)04390-0.

Abstract

Purpose: The aim of this explorative study was to evaluate the impact of selenium in the treatment of lymphedema after radiotherapy.

Materials and methods: Between June 1996 and June 2001, 12 patients with edema of the arm and 36 patients with edema of the head-and-neck region were treated with selenium for therapy-related lymphedema. Of these 36 patients, 20 had interstitial endolaryngeal edema associated with stridor and dyspnea. All patients received sodium selenite over 4 to 6 weeks.

Results: Self-assessment using a visual analog scale (n = 48) showed a reduction of 4.3 points when comparing pre- and posttreatment values (p < 0.05). Of 20 patients with endolaryngeal edema, 13 underwent no tracheostomy, 5 underwent a temporary tracheostomy, and only 2 underwent a permanent tracheostomy. Ten of 12 patients with arm edema showed a circumference reduction of the edematous limb and improvement in the Skin-Fold Index by 23.3 points. An improvement of one stage or more was shown by the Földi or the Miller score (n = 28) in 22 (Földi score) and in 24 (Miller score) patients.

Conclusions: Treatment with sodium selenite is well tolerated and easy to deliver. Additionally, our results suggest that sodium selenite has a positive effect on secondary-developing lymphedema caused by radiation therapy alone or by irradiation after surgery.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Cisplatin / administration & dosage
  • Cisplatin / therapeutic use
  • Cobalt Radioisotopes / therapeutic use
  • Combined Modality Therapy
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Hypopharyngeal Neoplasms / complications
  • Hypopharyngeal Neoplasms / drug therapy
  • Hypopharyngeal Neoplasms / radiotherapy
  • Hypopharyngeal Neoplasms / surgery
  • Laryngeal Edema / drug therapy
  • Laryngeal Edema / etiology
  • Laryngeal Edema / surgery
  • Lymph Node Excision / adverse effects
  • Lymphedema / drug therapy*
  • Lymphedema / etiology
  • Mastectomy
  • Mastectomy, Segmental
  • Middle Aged
  • Neck Dissection
  • Pain Measurement
  • Radiation Injuries / drug therapy*
  • Radiation Injuries / etiology
  • Radiotherapy / adverse effects*
  • Radiotherapy, Adjuvant / adverse effects
  • Radiotherapy, High-Energy / adverse effects
  • Sodium Selenite / therapeutic use*
  • Tracheostomy
  • Treatment Outcome

Substances

  • Cobalt Radioisotopes
  • Sodium Selenite
  • Cisplatin
  • Fluorouracil