Lymphovenous Canada: Modest benefits found with combined decongestive therapy in the DELTA study

Dr. Ian Dayes, radiologist with McMaster University and the Juravinski Cancer Centre (in Hamilton), received funding from the Canadian Breast Cancer Research Alliance (CBCRA) and support from the Ontario Clinical Oncology Group (OCOG) to determine the effectiveness of combined decompressive therapy in DELTA - A Randomized Trial of Decongestive Lymphatic Therapy for Lymphedema in Women With Breast Cancer.

The study started in 2003 with final data collected in February 2009 - however analysis of data from the study is still being reviewed. Preliminary results from the study found that modest benefits were seen in patients who used combined decompressive therapy (CDT) and wrapping of arms with bandages compared to patients who were immediately fitted in sleeves.

Initial results from the study were reported at the International Congress of Lymphology in Sydney, Australia and the American Society for Radiation Oncology in Chicago in 2009. (See: Dayes I, et al "DELTA: a randomized trial of decongestive lymphatic therapy for women with lymphedema following treatment for breast cancer" ASTRO 2009; Abstract 112.)

A total of 103 patients from six clinics across Canada participated in the study. Preliminary data found that patients who underwent CDT lost an average of 256 ml of excess fluid versus those who were immediately fitted with a sleeve who lost an average of 143 ml. The percentage difference between the two groups was statistically not considered to be significant. Women with lymphedema for a year or longer, however, had a mean volume reduction of 320 to 330 mL with decongestive therapy compared to little more than 100 mL with the compression devices alone.

Further analysis is underway to identify long-term benefits to patients enrolled in study after the treatment phase, and to determine which individuals appear to benefit from CDT versus use of a sleeve. Data from the study may also be pooled with data from other studies to identify benefits that could not be identified in the small sample from this study.

Note to readers: The Juravinski Cancer Centre (formerly known as the Hamilton Regional Cancer Centre), has re-opened their lymphedema clinic. Patients must be referred by their oncologist. For information please contact Margaret Forbes, RN at (905) 387-9495 ext. 64176.