Selenium in the treatment of radiation-associated secondary lymphedema.
OBJECTIVE
The aim of this explorative study was to evaluate the impact of selenium in the treatment of lymphedema after radiotherapy.


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.
Micke
Oliver
O
Department of Radiotherapy, Münster University Hospital, Münster, Germany. omicke@trace-elements.de
Bruns
Frank
F
Mücke
Ralph
R
Schäfer
Ulrich
U
Glatzel
Michael
M
DeVries
Alexander F
AF
Schönekaes
Klaus
K
Kisters
Klaus
K
Büntzel
Jens
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D007819:Laryngeal Edema / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D008197:Lymph Node Excision / Q000009:adverse effects; D008209:Lymphedema / Q000188:drug therapy* / Q000209:etiology; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D037981:Neck Dissection; D010147:Pain Measurement; D011832:Radiation Injuries / Q000188:drug therapy* / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D018038:Sodium Selenite / Q000627:therapeutic use*; D014139:Tracheostomy; D016896:Treatment Outcome
D003037:Cobalt Radioisotopes; D018038:Sodium Selenite; D002945:Cisplatin; D005472:Fluorouracil