VICTOR FIGUEIREDO LEITE
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- Rehabilitation Interventions for Head and Neck Cancer-Associated Lymphedema A Systematic Review(2023) CHENG, Jessica T.; LEITE, Victor F.; TENNISON, Jegy M.; GUTIERREZ, Carolina; KLINE-QUIROZ, Cristina; CAPOZZI, Lauren C.; YU, Shui; KRAUSE, Kate J.; LANGELIER, David; PARKE, Sara C.IMPORTANCE Head and neck cancer-associated lymphedema (HNCaL) affects up to 90% of survivors of head and neck cancer and is a substantial contributor to disability following head and neck cancer treatment. Despite the prevalence and morbidity associated with HNCaL, rehabilitation interventions are not well studied.OBJECTIVE To identify and appraise the current evidence for rehabilitation interventions in HNCaL.EVIDENCE REVIEW Five electronic databases were searched systematically from inception to January 3, 2023, for studies on HNCaL rehabilitation interventions. Study screening, data extraction, quality rating, and risk of bias assessment were performed by 2 independent reviewers.FINDINGS Of 1642 citations identified, 23 studies (1.4%; n = 2147 patients) were eligible for inclusion. Six studies (26.1%) were randomized clinical trials (RCTs) and 17 (73.9%) were observational studies. Five of the 6 RCTs were published during 2020 to 2022. Most studies had fewer than 50 participants (5 of 6 RCTs; 13 of 17 observational studies). Studies were categorized by intervention type, including standard lymphedema therapy (11 studies [47.8%]) and adjunct therapy (12 studies [52.2%]). Lymphedema therapy interventions included standard complete decongestive therapy (CDT) (2 RCTs, 5 observational studies), modified CDT (3 observational studies), therapy setting (1 RCT, 2 observational studies), adherence (2 observational studies), early manual lymphatic drainage (1 RCT), and inclusion of focused exercise (1 RCT). Adjunct therapy interventions included advanced pneumatic compression devices (APCDs) (1 RCT, 5 observational studies), kinesio taping (1 RCT), photobiomodulation (1 observational study), acupuncture/moxibustion (1 observational study), and sodium selenite (1 RCT, 2 observational studies). Serious adverse events were either not found (9 [39.1%]) or not reported (14 [60.9%]). Low-quality evidence suggested the benefit of standard lymphedema therapy, particularly in the outpatient setting and with at least partial adherence. High-quality evidence was found for adjunct therapy with kinesio taping. Low-quality evidence also suggested that APCDs may be beneficial.CONCLUSIONS AND RELEVANCE The results of this systematic review suggest that rehabilitation interventions for HNCaL, including standard lymphedema therapy with kinesio taping and APCDs, appear to be safe and beneficial. However, more prospective, controlled, and adequately powered studies are needed to clarify the ideal type, timing, duration, and intensity of lymphedema therapy components before treatment guidelines can be established.
- Current Status of Cancer Rehabilitation in Latin America(2024) VILLALOBOS, Vanessa Ucles; SILVA, Ana Carolina Mendez; BELMONTE, Gema Herrera; RUIZ, Judith del Rosario Bermudez; MOJICA, Yudi Milena Rodriguez; BRITO, Christina May Moran de; FIGUEIREDO, Victor; MERIDA, Patricia Rosales; SANTANDER, Blanca Irene Acuna; FLORES, Jonathan Ortiz; LUCIANI, Monica; SIERRA, Leonardo; TAGLE, Maritza Martinez; MONCHEZ, Georgina Granados; MARTINEZ, Licellot; JIMENEZ, Merly Monica Rivero; FLORES, Every Nataly Casas; SATO, Koyi; LEON, Erika Lissette Perez De; GOMEZ, Juan Carlos Leal; SINCAL, Edin Geovanny Xicay; PONCE, Flor de Maria Perez; QUAN, Martha Lolany Perez Ramirez de; DUARTE, Claudia Morales; RAMIREZ, Jose Emilio Albizures; CHAVEZ, Sigrid Yerena LemusPurpose of ReviewThis article provides an overview of access, advancements, and obstacles in the field of cancer rehabilitation in Latin America.Recent FindingsSince cancer rehabilitation is a relatively new service for Latin American countries, there is a noticeable lack of economic, human, and other resources available to carry out the optimal program. This study aims to highlight the current state in order to find solutions to the identified challenges.SummaryCancer and its treatment contribute to significant patient morbidity and mortality with physical and mental late effects. Cancer rehabilitation provides care and interventions to mitigate these functional impairments and improve quality of life. There are significant increases in global cancer incidence and number of survivors, which necessitates an increase in cancer rehabilitation services. Currently, in our countries, there are substantial political, economic, and educational challenges that are barriers to growth in these services.
- Establishing a Cancer Rehabilitation Service in a Middle-Income Country: an Experience from Brazil(2022) LEITE, Victor F.; CECATTO, Rebeca Boltes; BATTISTELLA, Linamara Rizzo; BRITO, Christina May Moran dePurpose of Review Our aim is to provide a historical review of the implementation of a cancer rehabilitation center in Brazil, active since 2008. We expect this data to support the implementation of other centers both in Brazil and worldwide. Recent Findings Cancer rehabilitation delivery is fragmented and punctuated in most cases, and cancer rehabilitation centers are rare. Data on how to establish rehabilitation centers could facilitate the implementation of new centers. We provide data on what was our strategy for hiring, establishing treatment protocols, barriers, and facilitators. We also provide figures on the number of each rehabilitation specialist, as well as the general standard operating procedures of our rehabilitation center, among other features. Establishing cancer rehabilitation centers in a middle-income country is feasible. We expect that our experience may facilitate the establishment of new cancer rehabilitation services and the improvement of current ones.
- Rehabilitation Interventions in Head and Neck Cancer(2024) CHENG, Jessica T.; EMOS, Marc Ramos; LEITE, Victor; CAPOZZI, Lauren; WOODROW, Lindsey E.; GUTIERREZ, Carolina; NGO-HUANG, An; KRAUSE, Kate J.; PARKE, Sara C.; LANGELIER, David MichaelObjective: The aim of the study is to identify and appraise current evidence for rehabilitation interventions in head and neck cancer. Design: A previously published scoping review spanning 1990 through April 2017 was updated through January 11, 2023 and narrowed to include only interventional studies (Arch Phys Med Rehabil. 2019;100(12):2381-2388). Included studies had a majority head and neck cancer population and rehabilitation-specific interventions. Pairs of authors extracted data and evaluated study quality using the PEDro tool. Results were organized by intervention type. Results: Of 1338 unique citations, 83 studies with 87 citations met inclusion criteria. The median study sample size was 49 (range = 9-399). The most common interventions focused on swallow (16 studies), jaw (11), or both (6), followed by whole-body exercise (14) and voice (10). Most interventions took place in the outpatient setting (77) and were restorative in intent (65 articles). The overall study quality was fair (median PEDro score 5, range 0-8); none were of excellent quality (PEDro >9). Conclusions: Most head and neck cancer rehabilitation interventions have focused on restorative swallow and jaw exercises and whole-body exercise to address dysphagia, trismus, and deconditioning. More high-quality evidence for head and neck cancer rehabilitation interventions that address a wider range of impairments and activity and social participation limitations during various cancer care phases is urgently needed to reduce head and neck cancer-associated morbidity.