終末期の悪性軟部腫瘍症例に生じたリンパ浮腫に対し症状緩和を得られた2例

概要

論文の詳細を見る
Limb lymphedema is a serious complication following surgery or radiation therapy for malignant soft tissue tumors. We have recently experienced two cases where we provided symptomatic relief for lymphedema as part of palliative care for patients with sarcoma in the advanced stage. For the treatment of lymphedema, complex physical therapy (manual lymphatic drainage, compression, and exercise therapy), elevation of the affected limb, and skin care were carried out after ruling out the presence of deep venous thrombosis. Inelastic bandaging provides containment and effectively arrests the progression of swelling that stretches the skin. Since obstructive masses interrupt the entire lymphatic quadrants, lymphatic drainage is focused on creating a collateral flow in the truncal territories and in the limb. No complications associated with treatment were observed. In spite of refractory edema due to disease progression in both cases, the swelling of the affected limb or patients' subjective symptoms were temporarily improved by the treatment. While aiming to reduce swelling, the provision of comfort, relief from pain or other swelling-related symptoms, and maintenance or restoration of function are desirable and beneficial outcomes. Palliative therapy for lymphedema may lead to an improvement of the quality of life (QOL) of patients with sarcoma in the advanced stage.