Selenium in the treatment of head and neck lymphedema.
OBJECTIVE
To investigate the impact of selenium in the treatment of lymphedema of the head and neck region after radiotherapy alone or in combination with surgery.


METHODS
Between June 1996 and June 2001 a total of 36 cancer patients (29 male, 7 female; median age 61 years) were treated with selenium for persistent, extensive or progressive lymphedema of the head and neck region. Twenty had interstitial endolaryngeal edema associated with stridor and dyspnea. All patients received 350 microg/m(2) body surface sodium selenite medication p.o. daily (total dose 50 microg per day) for a period of 4-6 weeks after radiotherapy. The optimal effect of the selenium treatment was assessed after 4 weeks of therapy using the Miller score system. A visual analogue scale on a scale of 0-10 was used to assess the patient's quality of life prior to and after selenium.


RESULTS
75% of the patients had an improvement of the Miller score of one stage or more. The self-assessment of quality of life using the visual analogue scale improved significantly after selenium treatment with a reduction of 4.4 points (p < 0.05). Of the 20 patients with endolaryngeal edema tracheostomy was not necessary in 13 patients (65%), but 5 and 2 received a temporary or permanent tracheostomy, respectively. No episode of erysipelas was observed in all study patients.


CONCLUSIONS
Our results suggest a short positive effect of sodium selenite on secondary head and neck lymphedema caused by radiotherapy alone or in combination with surgery.
Bruns
F
F
Department of Radiotherapy, Medical School Hannover, Hannover, Germany.
Büntzel
J
J
Mücke
R
R
Schönekaes
K
K
Kisters
K
K
Micke
O
O
D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000523:psychology / Q000532:radiotherapy; D006801:Humans; D008209:Lymphedema / Q000188:drug therapy* / Q000523:psychology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018038:Sodium Selenite / Q000627:therapeutic use*
D018038:Sodium Selenite