Efficacy of laser CO2 treatment for refractory lymphedema secondary to cancer treatments

Abstract

Lymphedema is a frequent debilitating condition among cancer patients. Daily supportive treatment may be necessary without long-term improvement. We describe two cases with chronic refractory lymphedema treated with fractional 10,600 nm CO₂ laser. A 61-year-old female with locally advanced cervical cancer presented with postsurgical edematous swelling of the vulva and mons pubis and recurring cellulitis due to chronic lymphangiectasia. After six treatments of fractional CO₂ laser, she noticed an 80% reduction of lymphorrea, swelling, and frequency of cellulitis. A 32-year old melanoma patient presented with refractory right lower leg lymphedema post right inguinal lymph node dissection and radiation. After fractional CO₂ laser, she noted increased softness of her inguinal scar and a decrease of the lower leg edema. Fractional CO₂ laser may be useful in addressing chronic refractory lymphedema. Further research should confirm our findings to consider fractional laser as a standard method in the treatment of chronic lymphedema.

Keywords: chronic lymphedema; female genital cancer; fractional CO2 laser therapy; lower limb lymphedema; quality of life (QoL); vulvar lymphedema.