How do you prevent and treat lymphedema following head and neck XRT?

I have had success over many years using sodium selenite 250 mcg, 2 capsules daily, for patients with subacute supraglottic edema after head/neck radiotherapy. The majority of patients report a moderate improvement in symptoms of raspy voice and mild dysphagia. This is clearly not appropriate to manage patients with significant airway compromise. Therapy can usually be discontinued after several months and I haven't seen noticeable side effects. The capsules are available online, but typically n...

I've found that lymphedema of the neck can occur after radiation in many settings, but the worst seems to be oral cavity cases, where they have neck dissection followed by RT (chemoRT) and the RT fields include level I.

One thing I'd recommend is to let your patients know to expect some lymphedema of the neck and under the chin. If you don't, patients often think it's recurrence of cancer and worry constantly about it until they see you again.

I've also been pleasantly surprised by how effectiv...

To help prevent lymphedema of the sublingual/submandibular region for oropharynx primaries where level IA +/- level IB are not treated, or for lateralized oral cavity cases where the contralateral neck is not prophylactically treated, I contour my lip/oral cavity avoidance structure and then bring a small portion of that contour down to the hyoid. Having an area of minimally dosed skin will likely help the lymphatics drain and it is similar to what we recommend for sarcoma IMRT, with the strip o...