Impact of advanced pneumatic compression devices and usual care on psychosocial outcomes in head and neck cancer survivors with lymphedema.

Abstract

6109 Background: Head and neck cancer (HNC)-associated lymphedema impairs quality of life (QOL) in survivors, affecting body image, self-management efficacy, work productivity, and psychosocial functioning. Data supports therapist guided lymphedema therapy (TGLT) and technologies such as advanced pneumatic compression devices (APCD) reduce swelling. There is a lack of data on psychosocial and QOL outcomes. This randomized clinical trial compared psychosocial outcomes of TGLT and APCD in treatment-naïve HNC survivors with symptomatic lymphedema over 6 months. Methods: Participants (N=236) with HNC-associated lymphedema were randomized 1:1 to receive either TGLT (117) or APCD (119) for 6 months. Psychosocial outcomes were assessed at baseline, 2, 4, and 6 months using validated instruments: the Work Productivity and Activity Impairment Questionnaire (WPAIQ), Perceived Medical Condition Self-Management Scale (PMCSMS), Body Image Quality of Life Inventory (BIQLI), and Linear Analog Self-Assessment (LASA) for QOL. Longitudinal mixed-effects models evaluated within- and between-group changes over time. Results: Both treatment groups experienced improvements in psychosocial outcomes over time. Self-management efficacy improved in both arms. The APCD group demonstrated significantly greater self-efficacy managing lymphedema at 6 months (p=0.004). Work and activity impairment decreased in both groups, with no significant between-group differences. BIQLI scores improved across timepoints in both arms, reflecting enhanced body image-related QOL. LASA scores for overall QOL and emotional, physical, and spiritual well-being also improved similarly in both groups. No significant time-by-treatment interactions were observed, indicating comparable trajectories of psychosocial recovery. Conclusions: Both TGLT and APCD were associated with meaningful improvement in psychosocial outcomes, including self-management efficacy, body image, and QOL, among HNC survivors with lymphedema. APCD offers ongoing access to a convenient, home-based treatment which may enhance fidelity and self-efficacy through ongoing instrumental support. These findings underscore the value of accessible, patient-centered lymphedema interventions to enhance survivorship care. Future research should explore long-term adherence, cost-effectiveness, and integration of psychosocial support into treatment pathways. Clinical trial information: NCT04797390 .