Shaimaa shamoun

University of Jordan, Jordan

Title: Complete decongestive therapy effect on breast cancer related to lymphedema: A systemic review and meta-analysis of randomized controlled trials


Purpose: To analyze critically the available evidence for Complete Decongestive Therapy Effect on Breast Cancer Related to Lymphedema. Data Sources: Publications were retrieved from the database search engines, included Google scholar, EBSCO host, and PubMed database. The search terms including: “Complete decongestive therapy (CDT)”,“Breast cancer related to lymphedema (BCRL)” “breast surgery” and “mastectomy”. Study Selection: The studies were initially selected based on keywords associated with inclusion criteria. Then, articles were chosen based on their titles. Then, based on the fill text and design, randomized control with a comprehensive description of the outcomes. The authors analyzed 3,181 articles, of which 15 randomized controlled trials met inclusion criteria with no publication date constraint. Data Extraction: Each article’s authors, nations, participants, outcomes variables, measuring instruments, intervention technique and follow-up, outcomes, and results were retrieved. After reaching consensus among authors, study quality was evaluated using the Jadad scale, and risk of bias was determined using the Cochrane Rob2 tool. Data Synthesis: The levels of evidence were of excellent quality. The retrieved articles were of “high” methodological caliber. 
The major outcome variables were in QOL, pain, ROM and edema. The effect size of CDT on QOL was 2.347 (95% CI: -1.41, 6.11) (p=0.22). Pain was -0.068 (95% CI: -35.21) (p=0.64). ROM was 0.324 (95% CI: -0.44,0.09) (p=0.41) and edema was -2.9 (95% -1.53,1.11) (p=0.76). Conclusions: The CDT is still recommended as the primary therapy for BCRL. This result recommends patients to perform CDT to improve their QOL, ROM, and to lessen pain and edema volume. To improve the body of evidence supporting the effectiveness of the CDT on BCRL, additional trials with bigger sample sizes, longer follow-ups, blindness outcomes, and patient compliance evaluations are required. 
Keywords: Complete decongestive therapy (CDT)- breast cancer- Breast Cancer Related to Lymphedema (BCRL) 


Shaimaa Shamoun has completed her PHD at the age of 38 years from University of Jordan. She is Director of Nursing at the Oncology and Radiology Hospital in Al-Basheer hospitals, Jordan. She has over 11 publications in Scopus index journals. She obtained Oncology Nurse Specialist Certification from Jordanian Nursing counseling on 8/3/2015. She presented her research articles as a speaker at six different conferences. She prepared with Jordanian nursing council the oncology exam for oncology nurses’ recruitment at ministry of health on September/2020. She prepared lectures about oncology course for new oncology nurse staff as an orientation program annually. She has a certificate as a lecturer to present and prepare Chemotherapy administration course, held at radiation and chemotherapy department in Al Basheer hospital: 8 CPD hours from Jordanian nursing council from 24 /9/2023 to 19/11/2023 and 2 CPD hours as a lecturer. She presented lectures to female students and their mothers at schools, staff and community annually (October) about breast self-examination, screening and early detection of breast cancer at pink October.