Evidence map›Paper›PMID 37914083›Full record

ArticlePractical radiation oncology

Association Between Symptom Burden and Early Lymphatic Abnormalities After Regional Nodal Irradiation for Breast Cancer.

Alison K Yoder, Tianlin Xu, Peter Youssef, Sarah DeSnyder, Kathryn E Marqueen, Lynn Isales, Ruitao Lin, Benjamin D Smith, Wendy A Woodward, Michael C Stauder and 3 more

Open access · greenAbstract read
In one paragraph

Article in Practical radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Alison K YoderDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Tianlin XuDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Peter YoussefMorehouse School of Medicine, Atlanta, Georgia.
Sarah DeSnyderDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Kathryn E MarqueenDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Lynn IsalesDepartment of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ruitao LinDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Benjamin D SmithDepartment of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Wendy A WoodwardDepartment of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Michael C StauderDepartment of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Eric A StromDepartment of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Melissa B AldrichCenter for Molecular Imaging, The Brown Foundation Institute for Molecular Medicine, University of Texas Health Science Center-Houston, Houston, Texas.
Simona F ShaitelmanDepartment of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: sfshaitelman@mdanderson.org.
The University of Texas MD Anderson Cancer Center · USBrown Foundation · USMorehouse School of Medicine · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DIANE BODURKA · 1985 to 2026
$290.8M
Lymphatic and systemic immunity changes in post-radiation lymphedema developmentR01CA201487 · NCI · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI ALDRICH, MELISSA B · 2016 to 2020
$1.8M
NCI NIH HHS P30 CA016672NCI NIH HHS R01 CA201487
6 · The paper itself

Abstract

purposeDermal backflow visualized on near-infrared fluorescence lymphatic imaging (NIRF-LI) signals preclinical lymphedema that precedes the development of volumetrically defined lymphedema. We sought to evaluate whether dermal backflow correlates with patient-reported lymphedema outcomes (PRLO) surveys in breast cancer patients treated with regional nodal irradiation (RNI). METHODS AND MATERIALS: Patients with breast cancer planned for axillary dissection and RNI prospectively underwent perometry, NIRF-LI, and PRLOs (the Lymphedema Symptom Intensity and Distress Survey [LSIDS] and QuickDASH) at baseline, after surgery, and at 6, 12, and 18 months after radiation. Clinical lymphedema was defined as an arm volume increase ≥5% over baseline. Trends over time were assessed using analysis of variance testing. The association between survey responses and both dermal backflow and lymphedema was assessed using a linear mixed-effects model.

resultsSixty participants completed at least 2 sets of measurements and surveys and were eligible for analysis. Fifty-four percent of patients had cT3-T4 disease, 53% cN3 disease, and 75% had a body mass index >25. Dermal backflow and clinical lymphedema increased from 10% to 85% and from 0% to 40%, respectively, from baseline to 18 months. In the adjusted model, soft tissue sensation, neurologic sensation, and functional LSIDS subscale scores were associated with presence of dermal backflow (all P < .05). Both dermal backflow and lymphedema were associated with QuickDASH score (P < .05).

conclusionsIn this high-risk cohort, we found highly prevalent early signs of lymphedema, with increased symptom burden from baseline. Presence of dermal backflow correlated with PRLO measures, highlighting a potential NIRF-LI use to identify patients for early intervention trials after RNI.

Indexed as

Breast NeoplasmsLymphedemaAdultAgedFemaleHumansLymph NodesMiddle AgedProspective StudiesSymptom Burden

Identifiers

PMID37914083
PMCPMC11058114
OpenAlexW4388037548

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.