Lack of effect of coumarin in women with lymphedema after treatment for breast cancer

Charles Lawrence Loprinzi, John W. Kugler, Jeff A Sloan, Thom W Rooke, Susan K. Quella, Paul Novotny, Rex B. Mowat, John C. Michalak, Philip J. Stella, Ralph Levitt, Loren K. Tschetter, Harold Windschitl

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

Background: Lymphedema of the arms can be a serious consequence of local and regional therapy in women with breast cancer. Coumarin has been reported to be effective for the treatment of women with lymphedema; we undertook a study in which we attempted to replicate those findings. Methods: We studied 140 women with chronic lymphedema of the ipsilateral arm after treatment for breast cancer. The women received 200 mg of oral coumarin or placebo twice daily for six months and then the other treatment for the following six months. The end points of the study consisted of the volume of the arm (calculated from measurements of hand and arm circumference) and the answers on a questionnaire completed by the patient about symptoms potentially related to lymphedema. Results: The volumes of the arms at 6 and 12 months were virtually identical, regardless of whether coumarin or placebo was given first. After six months, the average volume of the affected arm increased by 21 ml during placebo treatment and 58 ml during coumarin treatment (P = 0.80). In addition, answers on the patients' questionnaires were similar in the two treatment groups. After six months, only 15 percent of the women in the coumarin group and 10 percent of those in the placebo group reported that the study medication had helped a moderate or large amount (P = 0.19). Coumarin was well tolerated, except that it resulted in serologic evidence of liver toxicity in 6 percent of the women. Conclusions: Coumarin is not effective therapy for women who have lymphedema of the arm after treatment for breast cancer.

Original languageEnglish (US)
Pages (from-to)346-350
Number of pages5
JournalNew England Journal of Medicine
Volume340
Issue number5
DOIs
StatePublished - Feb 4 1999

Fingerprint

Lymphedema
Breast Neoplasms
Arm
Placebos
Therapeutics
coumarin
Hand
Liver

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lack of effect of coumarin in women with lymphedema after treatment for breast cancer. / Loprinzi, Charles Lawrence; Kugler, John W.; Sloan, Jeff A; Rooke, Thom W; Quella, Susan K.; Novotny, Paul; Mowat, Rex B.; Michalak, John C.; Stella, Philip J.; Levitt, Ralph; Tschetter, Loren K.; Windschitl, Harold.

In: New England Journal of Medicine, Vol. 340, No. 5, 04.02.1999, p. 346-350.

Research output: Contribution to journalArticle

Loprinzi, CL, Kugler, JW, Sloan, JA, Rooke, TW, Quella, SK, Novotny, P, Mowat, RB, Michalak, JC, Stella, PJ, Levitt, R, Tschetter, LK & Windschitl, H 1999, 'Lack of effect of coumarin in women with lymphedema after treatment for breast cancer', New England Journal of Medicine, vol. 340, no. 5, pp. 346-350. https://doi.org/10.1056/NEJM199902043400503
Loprinzi, Charles Lawrence ; Kugler, John W. ; Sloan, Jeff A ; Rooke, Thom W ; Quella, Susan K. ; Novotny, Paul ; Mowat, Rex B. ; Michalak, John C. ; Stella, Philip J. ; Levitt, Ralph ; Tschetter, Loren K. ; Windschitl, Harold. / Lack of effect of coumarin in women with lymphedema after treatment for breast cancer. In: New England Journal of Medicine. 1999 ; Vol. 340, No. 5. pp. 346-350.
@article{51e24f3036264f029a1915a9a83ce7eb,
title = "Lack of effect of coumarin in women with lymphedema after treatment for breast cancer",
abstract = "Background: Lymphedema of the arms can be a serious consequence of local and regional therapy in women with breast cancer. Coumarin has been reported to be effective for the treatment of women with lymphedema; we undertook a study in which we attempted to replicate those findings. Methods: We studied 140 women with chronic lymphedema of the ipsilateral arm after treatment for breast cancer. The women received 200 mg of oral coumarin or placebo twice daily for six months and then the other treatment for the following six months. The end points of the study consisted of the volume of the arm (calculated from measurements of hand and arm circumference) and the answers on a questionnaire completed by the patient about symptoms potentially related to lymphedema. Results: The volumes of the arms at 6 and 12 months were virtually identical, regardless of whether coumarin or placebo was given first. After six months, the average volume of the affected arm increased by 21 ml during placebo treatment and 58 ml during coumarin treatment (P = 0.80). In addition, answers on the patients' questionnaires were similar in the two treatment groups. After six months, only 15 percent of the women in the coumarin group and 10 percent of those in the placebo group reported that the study medication had helped a moderate or large amount (P = 0.19). Coumarin was well tolerated, except that it resulted in serologic evidence of liver toxicity in 6 percent of the women. Conclusions: Coumarin is not effective therapy for women who have lymphedema of the arm after treatment for breast cancer.",
author = "Loprinzi, {Charles Lawrence} and Kugler, {John W.} and Sloan, {Jeff A} and Rooke, {Thom W} and Quella, {Susan K.} and Paul Novotny and Mowat, {Rex B.} and Michalak, {John C.} and Stella, {Philip J.} and Ralph Levitt and Tschetter, {Loren K.} and Harold Windschitl",
year = "1999",
month = "2",
day = "4",
doi = "10.1056/NEJM199902043400503",
language = "English (US)",
volume = "340",
pages = "346--350",
journal = "New England Journal of Medicine",
issn = "1533-4406",
publisher = "Massachussetts Medical Society",
number = "5",

}

TY - JOUR

T1 - Lack of effect of coumarin in women with lymphedema after treatment for breast cancer

AU - Loprinzi, Charles Lawrence

AU - Kugler, John W.

AU - Sloan, Jeff A

AU - Rooke, Thom W

AU - Quella, Susan K.

AU - Novotny, Paul

AU - Mowat, Rex B.

AU - Michalak, John C.

AU - Stella, Philip J.

AU - Levitt, Ralph

AU - Tschetter, Loren K.

AU - Windschitl, Harold

PY - 1999/2/4

Y1 - 1999/2/4

N2 - Background: Lymphedema of the arms can be a serious consequence of local and regional therapy in women with breast cancer. Coumarin has been reported to be effective for the treatment of women with lymphedema; we undertook a study in which we attempted to replicate those findings. Methods: We studied 140 women with chronic lymphedema of the ipsilateral arm after treatment for breast cancer. The women received 200 mg of oral coumarin or placebo twice daily for six months and then the other treatment for the following six months. The end points of the study consisted of the volume of the arm (calculated from measurements of hand and arm circumference) and the answers on a questionnaire completed by the patient about symptoms potentially related to lymphedema. Results: The volumes of the arms at 6 and 12 months were virtually identical, regardless of whether coumarin or placebo was given first. After six months, the average volume of the affected arm increased by 21 ml during placebo treatment and 58 ml during coumarin treatment (P = 0.80). In addition, answers on the patients' questionnaires were similar in the two treatment groups. After six months, only 15 percent of the women in the coumarin group and 10 percent of those in the placebo group reported that the study medication had helped a moderate or large amount (P = 0.19). Coumarin was well tolerated, except that it resulted in serologic evidence of liver toxicity in 6 percent of the women. Conclusions: Coumarin is not effective therapy for women who have lymphedema of the arm after treatment for breast cancer.

AB - Background: Lymphedema of the arms can be a serious consequence of local and regional therapy in women with breast cancer. Coumarin has been reported to be effective for the treatment of women with lymphedema; we undertook a study in which we attempted to replicate those findings. Methods: We studied 140 women with chronic lymphedema of the ipsilateral arm after treatment for breast cancer. The women received 200 mg of oral coumarin or placebo twice daily for six months and then the other treatment for the following six months. The end points of the study consisted of the volume of the arm (calculated from measurements of hand and arm circumference) and the answers on a questionnaire completed by the patient about symptoms potentially related to lymphedema. Results: The volumes of the arms at 6 and 12 months were virtually identical, regardless of whether coumarin or placebo was given first. After six months, the average volume of the affected arm increased by 21 ml during placebo treatment and 58 ml during coumarin treatment (P = 0.80). In addition, answers on the patients' questionnaires were similar in the two treatment groups. After six months, only 15 percent of the women in the coumarin group and 10 percent of those in the placebo group reported that the study medication had helped a moderate or large amount (P = 0.19). Coumarin was well tolerated, except that it resulted in serologic evidence of liver toxicity in 6 percent of the women. Conclusions: Coumarin is not effective therapy for women who have lymphedema of the arm after treatment for breast cancer.

UR - http://www.scopus.com/inward/record.url?scp=0033521964&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033521964&partnerID=8YFLogxK

U2 - 10.1056/NEJM199902043400503

DO - 10.1056/NEJM199902043400503

M3 - Article

C2 - 9929524

AN - SCOPUS:0033521964

VL - 340

SP - 346

EP - 350

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 1533-4406

IS - 5

ER -