This study investigated the efficacy of a vaginal dilator (VD) for the treatment of radiation-induced vaginal stenosis (VS) and the effect of a VD on sexual quality of life. Fifty three patients with endometrial or cervical cancers participated in this prospective observational study. All participants were treated with radical or adjuvant external beam radiotherapy and/or brachytherapy. They were routinely examined 4 times after radiotherapy (RT) and were also asked to complete a validated sexual function-vaginal changes questionnaire. SPSS version 20 and Minitab version 16 were used for the statistical analysis. The statistical significance was set at P < .05. The VS grading score decreased and the comfortably insertable VD size gradually increased throughout a year of VD use; all patients with initial grade 3 showed a VS of grade 2 after 12 months of VD use and 65.8% of the patients with initial grade 2 demonstrated a final VS of grade 1, while 77.8% of the participants who started with the first size of VD reached the third size after 12 months. Starting VD therapy ≤3 months after the end of RT was associated with a significant decrease in VS. A total of 60.9% of participants reported that they did not feel their vaginas were too small during intercourse after 12 months of dilation, whereas only 11.5% gave the same answer before starting dilation. Furthermore, 47.17% rated their satisfaction with their sexual life 5 out of 7 and only 3.77% gave a score of 3 after 12 months of dilation. Endometrial and cervical cancer survivors are encouraged to use VD to treat VS and for sexual rehabilitation after RT. This study recommends starting vaginal dilation no more than 3 months after treatment at least 2 to 3 times a week for 10 to 15 minutes over 12 months. However, larger, well-designed randomized clinical trials should be conducted to develop specific guidelines for VD use and efficacy in VS and sexual sexual quality of life after RT.
Background: The continuously increasing survivorship of female breast cancer makes the monitoring and improvement of patients’ quality of life ever so important. While globally there is a growing body of research on health-related quality of life one year after surgical treatment for non-metastatic breast cancer, up-to-date information regarding Greek patients is scarce.Objective: To measure the level of QoL of non-metastatic BC survivors in Greece 1 year after surgery.Methods: A sample of 200 female breast cancer survivors aged 18 to 75, who followed up as outpatients in five public hospitals were included in this cross-sectional study. All recruited patients agreed to participate in the study (100% response rate). Quality of life data were collected through the EORTC QLQ-C30 as well as BR23 questionnaires.Results: Cronbach’s alpha for all scales of the two questionnaires was from 0.551 to 0.936 indicating very good reliability. According to the Multiple Linear Regression, older patients showed a lower future perspective (p= .031), with those living in rural areas, which was associated with more financial difficulties (p= .001). Women with tertiary education and those who had been hospitalized in a university hospital recorded better on global health status (p= .003 and .000 respectively). Patients who underwent chemotherapy reported better scores in the emotional function sub-scale (p= .025). Women with reconstruction and at least one complication appeared to have significantly better scores in future perspective and social function (p= .005, .002 respectively).Conclusions: Breast cancer survivors were found to have an overall good quality of life, functioning/symptoms scores and were satisfied with the provided care.
Background: Women undergoing mastectomy choose to pursue breast reconstruction (BR) in order to reduce their body image distress. Introduction: Adjuvantchestwall irradiationis associated with a negative cosmeticoutcome.The aim of our reviewwas to identify the optimal timing of BR relating to radiotherapy delivery. Method: Using Cochrane Library, Embase, PubMed, Springer, Wanfang and CNKI, we performed a non-systematic review of articles published up to August 2021. Result: There is no hard evidence in favor of immediate, delayed or 2-stage BR when post-mastectomy radiation is indicated. Immediate and 2-stage BR seem to be valid alternatives to delayed BR. Conclusion: Further research is essential, in order to assess clinician and patient reported aesthetic outcomes and determine the optimal timing of BR in view of post-mastectomy radiotherapy,in breast cancer survivors.
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