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

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

Cristina Kline-Quiroz, Sheila H. Ridner, Derek Smith and Barbara Murphy
Journal of clinical oncology, Vol.44(16_suppl), pp.6109-6109
06/01/2026
DOI: 10.1200/JCO.2026.44.16_suppl.6109

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Abstract

6109Background: 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.

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