Skin/Soft Tissue Elasticity in Head and Neck Cancer Survivors With Lymphedema and Fibrosis

PRIMARY OBJECTIVES:

I. To obtain pilot data of the elasticity of skin/soft tissues using shear wave elasticity at the defined anatomical sites in head and neck cancer survivors with lymphedema and fibrosis (LEF).

II. To explore the correlation between elasticity of skin/soft tissues and the following: 1) symptoms as measured by the Lymphedema Symptom Intensity and Distress Survey-Head and Neck (LSIDS-HN); 2) functional impact as measured by Cervical Range of Motion Device and the Vanderbilt Head and Neck Symptom Survey; and 3) physical exam findings as measured by Head and Neck LEF Grading Criteria.

OUTLINE:

Participants will be evaluated for LEF status using the Head and Neck External Lymphedema - Fibrosis (HN-LEF) Grading Criteria and neck range of motion using the Cervical Range of Motion Device. Participants also complete study questionnaires, including Vanderbilt Head and Neck Symptom Survey (VHNSS) and Lymphedema Symptom Intensity and Distress Survey - Head and Neck (LSIDS-H\&N). Participants undergo ultrasound shear wave elastography over 20-25 minutes. Participants' cancer disease and treatment information will be gathered from their medical records.

• Medical Examination (Procedure), also known as Exam, Examination, Medical Assessment, Medical Exam, Medical Inspection: Evaluation of secondary lymphedema and fibrosis (LEF) status
• Questionnaire Administration (Other): Completion of questionnaires
• Shear Wave Elastography (Procedure), also known as Transient Elastography: Undergo ultrasound shear wave elastrography

Primary outcomes

• Elasticity values [Within 2 weeks of initial study visit]: Descriptive statistics will be used to describe data from elasticity measure. Of particular interest will be the measures of central tendency and variability at the multiple sites. Sites with higher variability (coefficient of variation) that others may be indicative of less reliable assessment.

Secondary outcomes

• Strength of associations of tissue elasticity and current conventional methods [Within 2 weeks of initial study visit]: Correlation coefficients will be used to assess the strength of the associations of the elasticity values with the respective LEF grades (HN-LEF) for the respective sites. Those values will also be correlated with Vanderbilt Head and Neck Symptom Survey and HN-LSIDS symptom and Cervical Range of Motion scores. Due to the large number of correlations proposed in this study, effect sizes (strength of the associations) and clinically significant patterns will be of much greater importance than statistical significance.

Sex: All, ages: 22 Years to any

Inclusion Criteria:

* Histologically confirmed cancer involving the head and neck
* Completed all therapy
* No evidence of cancer (NED)
* Ability to understand English in order to complete questionnaires
* Able to provide informed consent

Exclusion Criteria:

* Have medical record documentation of significant cognitive impairment that would preclude the ability to provide informed consent
* Are unwilling to undergo the study assessment
* Have recurrent and/or metastatic cancer

• Kenneth Niermann, Principal investigator, Vanderbilt University/Ingram Cancer Center

NIH grants: P30CA068485