Abstract:
bstract
PURPOSE Evaluate the effectiveness of compression while receiving chemotherapy compared with chemo therapy alone in the treatment of HIV-associated Kaposi sarcoma (KS) lymphedema.
METHODS A randomized controlled trial was conducted in a single oncology clinic in western Kenya
(NCT03404297). A computer-generated randomization schedule was used to allocate treatment arms.
Randomized block design was used for stratification by lymphedema stage. Participants were HIV positive adults
age ≥ 18 years on antiretroviral therapy with biopsy-proven KS associated with leg lymphedema and being
initiated on chemotherapy. The intervention was 10 weeks of weekly clinic-based application of two-component
paste compression bandages. The primary outcome was change in the Lower Extremity Lymphedema Index
(LELI) score from week 0 to week 14. The secondary outcomes were change in the Lymphedema Quality of Life
measure (LYMQOL) and change in the European Organisation for Research and Treatment of Cancer (EORTC)
QLQ-C30 score from week 0 to week 14. Blinded outcome assessments were conducted.
RESULTS Of 30 participants randomly assigned, 25 eligible patients (chemotherapy [control], n = 13; com pression plus chemotherapy [intervention], n = 12) returned at week 14. Change in LELI, LYMQOL, and EORTC
QLQ-C30 scores between week 14 and week 0 did not significantly differ by arm. The mean (standard deviation)
change in LELI score was –25.9 (34.6) for the control arm compared with –13.3 (29.5) for the intervention arm,
P = .340. The difference (95% CI) in the change in LELI score was –12.6 (–39.3 to 14.1).
CONCLUSION Future studies evaluating a 14-week change in LELI for KS lymphedema should assume a standard
deviation of approximately 30. Lessons learned from this pilot trial should inform the development of a larger,
multicenter trial to evaluate the effectiveness of compression for KS lymphedema