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Erschienen in: Supportive Care in Cancer 4/2019

20.10.2018 | Original Article

Effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy on management of breast cancer-related lymphedema

verfasst von: Angelo Cacchio, Rosa Prencipe, Marina Bertone, Luciana De Benedictis, Luciano Taglieri, Erika D’Elia, Cesidia Centoletti, Giancarlo Di Carlo

Erschienen in: Supportive Care in Cancer | Ausgabe 4/2019

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Abstract

Purpose

To assess the effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy (CDT) on the management of patients with a breast cancer-related lymphedema (BCRL).

Methods

Fifty outpatients (average age of 56.2 ± 2.7 years, range 28–71) with a BCRL were enrolled for this study. Patients were randomly assigned (1:1 ratio) to receive either CDT consisting of skin care, manual lymphatic drainage, remedial exercises, and elastic compression garment (control group, n = 25) or CDT plus Linfadren® (study group, n = 25). Patients were evaluated before and after treatment and 3 months after the end of treatment. Primary outcomes were reduction of upper limb excess volume (EV) and percentage reduction of excess volume (%REV). Secondary outcomes were improvement in Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, and patient’s perception of treatment effectiveness (PPTE).

Results

Addition of Linfadren® to CDT yielded an additional reduction of primary outcomes both after treatment (EV, − 521 ml vs. − 256 ml, P < 0.0001; %REV, − 66.4% vs. − 34%, P = 0.02) and at 3-month follow-up (EV, − 59 ml vs. + 24 ml, P < 0.0001; %REV, − 73.6% vs. − 31.4%, P = 0.004). Moreover, statistically significant differences were found between the two groups for the secondary outcomes after treatment (QuickDASH, P = 0.006; PPTE, P = 0.03) and at 3-month follow-up (QuickDASH, P = 0.006; PPTE, P = 0.02). No patient showed adverse events.

Conclusions

Linfadren® in addition to CDT was a safe and effective therapy for reducing BCRL and was better than CDT alone.
Literatur
10.
16.
Zurück zum Zitat Casley-Smith JR, Casley-Smith JR (1996) Treatment of lymphedema by complex physical therapy with and without oral and topical benzopyrones: what should therapists and patients expect. Lymphology 29:76–82PubMed Casley-Smith JR, Casley-Smith JR (1996) Treatment of lymphedema by complex physical therapy with and without oral and topical benzopyrones: what should therapists and patients expect. Lymphology 29:76–82PubMed
17.
Zurück zum Zitat Chang TS, Gan JL, Fu KD, Huang WY (1996) The use of 5,6 benzo-[alpha]-pyrone (coumarin) and heating by microwaves in the treatment of chronic lymphedema of the legs. Lymphology 29:106–111PubMed Chang TS, Gan JL, Fu KD, Huang WY (1996) The use of 5,6 benzo-[alpha]-pyrone (coumarin) and heating by microwaves in the treatment of chronic lymphedema of the legs. Lymphology 29:106–111PubMed
18.
Zurück zum Zitat Casley-Smith JR, Boris M, Weindorf S, Lasinski B (1998) Treatment for lymphedema of the arm--the Casley-Smith method: a noninvasive method produces continued reduction. Cancer 83(suppl 12):2843–2860CrossRefPubMed Casley-Smith JR, Boris M, Weindorf S, Lasinski B (1998) Treatment for lymphedema of the arm--the Casley-Smith method: a noninvasive method produces continued reduction. Cancer 83(suppl 12):2843–2860CrossRefPubMed
20.
Zurück zum Zitat Pecking AP (1995) Evaluation by lymphoscintigraphy of the effect of a micronized flavonoid fraction (Daflon 500 mg) in the treatment of upper limb lymphedema. Int Angiology 14:39–43 Pecking AP (1995) Evaluation by lymphoscintigraphy of the effect of a micronized flavonoid fraction (Daflon 500 mg) in the treatment of upper limb lymphedema. Int Angiology 14:39–43
21.
Zurück zum Zitat Bollinger A, Herrig I, Fischer M, Hoffmann U, Franzeck UK (1995) Intravital capillaroscpy in patients with chronic venous insufficiency and lymphedema: relevance to Daflon 500 mg. Int J Microcirc Clin Exp 15(Suppl 1):41–44CrossRefPubMed Bollinger A, Herrig I, Fischer M, Hoffmann U, Franzeck UK (1995) Intravital capillaroscpy in patients with chronic venous insufficiency and lymphedema: relevance to Daflon 500 mg. Int J Microcirc Clin Exp 15(Suppl 1):41–44CrossRefPubMed
22.
Zurück zum Zitat Casley-Smith JR (2000) Changes in the microcirculation at the superficial and deeper levels in lymphoedema: the effects and results of massage, compression, exercise and benzopyrones on these levels during treatment. Clin Hemorheol Microcirc 23:335–343PubMed Casley-Smith JR (2000) Changes in the microcirculation at the superficial and deeper levels in lymphoedema: the effects and results of massage, compression, exercise and benzopyrones on these levels during treatment. Clin Hemorheol Microcirc 23:335–343PubMed
25.
Zurück zum Zitat International Society of Lymphology (2013) The diagnosis and treatment of peripheral lymphedema: 2013 consensus document of the International Society of Lymphology. Lymphology 46:1–11 International Society of Lymphology (2013) The diagnosis and treatment of peripheral lymphedema: 2013 consensus document of the International Society of Lymphology. Lymphology 46:1–11
26.
Zurück zum Zitat Framework L (2006) Best practice for the management of lymphoedema. In: International consensus. MEP Ltd, London Framework L (2006) Best practice for the management of lymphoedema. In: International consensus. MEP Ltd, London
28.
Zurück zum Zitat Rabe E, Partsch H, Hafner J, Lattimer C, Mosti G, Neumann M, Urbanek T, Huebner M, Gaillard S, Carpentier P (2017) Indications for medical compression stockings in venous and lymphatic disorders: an evidence-based consensus statement. Phlebology [Epub ahead of print] 33:163–184. https://doi.org/10.1177/0268355516689631 CrossRef Rabe E, Partsch H, Hafner J, Lattimer C, Mosti G, Neumann M, Urbanek T, Huebner M, Gaillard S, Carpentier P (2017) Indications for medical compression stockings in venous and lymphatic disorders: an evidence-based consensus statement. Phlebology [Epub ahead of print] 33:163–184. https://​doi.​org/​10.​1177/​0268355516689631​ CrossRef
30.
Zurück zum Zitat Mahran SA, Moshref SS (2011) The effectiveness of a modified complete decongestive therapy program in the treatment of lymphedema cases. JKAU Med Sci 18:37–51 Mahran SA, Moshref SS (2011) The effectiveness of a modified complete decongestive therapy program in the treatment of lymphedema cases. JKAU Med Sci 18:37–51
31.
Zurück zum Zitat Cohen SR, Payne DK, Tunkel RS (2001) Lymphedema: strategies for management. Cancer 92:980–987CrossRefPubMed Cohen SR, Payne DK, Tunkel RS (2001) Lymphedema: strategies for management. Cancer 92:980–987CrossRefPubMed
32.
Zurück zum Zitat Kasseroller RG (1998) The Vodder school. the Vodder method Cancer 83(suppl 12):2840–2842PubMed Kasseroller RG (1998) The Vodder school. the Vodder method Cancer 83(suppl 12):2840–2842PubMed
35.
Zurück zum Zitat Taylor R, Jayasinghe UW, Koelmeyer L, Ung O, Boyages J (2006) Reliability and validity of arm volume measurements for assessment of lymphedema. Phys Ther 86:205–214PubMed Taylor R, Jayasinghe UW, Koelmeyer L, Ung O, Boyages J (2006) Reliability and validity of arm volume measurements for assessment of lymphedema. Phys Ther 86:205–214PubMed
40.
Zurück zum Zitat Burgos A, Alcaide A, Alcoba C, Azcona JM, Garrido J, Lorente C, Moreno E, Murillo E, Olsina-Pavia J, Olsina-Kissler J, Samaniego E, Serra M (1999) Comparative study of the clinical efficacy of two different coumarin dosages in the management of arm lymphedema after treatment for breast cancer. Lymphology 32:3–10PubMed Burgos A, Alcaide A, Alcoba C, Azcona JM, Garrido J, Lorente C, Moreno E, Murillo E, Olsina-Pavia J, Olsina-Kissler J, Samaniego E, Serra M (1999) Comparative study of the clinical efficacy of two different coumarin dosages in the management of arm lymphedema after treatment for breast cancer. Lymphology 32:3–10PubMed
41.
Zurück zum Zitat Saeed F, Mehjabeen SSK, Noor-Jahan AM (2015) Diuretic & anti-urolithic activity of some crude extracts. Int J Pharm Phyto Pharmacol Res 7:128–131 Saeed F, Mehjabeen SSK, Noor-Jahan AM (2015) Diuretic & anti-urolithic activity of some crude extracts. Int J Pharm Phyto Pharmacol Res 7:128–131
Metadaten
Titel
Effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy on management of breast cancer-related lymphedema
verfasst von
Angelo Cacchio
Rosa Prencipe
Marina Bertone
Luciana De Benedictis
Luciano Taglieri
Erika D’Elia
Cesidia Centoletti
Giancarlo Di Carlo
Publikationsdatum
20.10.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 4/2019
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4514-5

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