Impact of chemoradiotherapy on vaginal and sexual function of patients with FIGO IIb cervical cancer

Abstract

Th e opinion regarding sexual and vaginal function of patients with advanced cervical cancer treated primarily by chemoradiotherapy has still not been formed, mainly due to inappropriate methodology as the control group was comprised of healthy women. Th e aim of this study is to, by means of interview, evaluate vaginal and sexual function of patients with advanced cervical cancer before and after chemoradiotherapy and compare the results. A number of  patients were irradiated by teleradiotherapy dose of  Gy in  fractions over  weeks to the pelvis and additional - Gy in - fractions were given by intracavitary HDR brachytherapy. Patients received  mg/m  of cisplatin once a week, which is a total of - cycles of cisplatin. Patients answered the questions in a form of a questionnaire specifi cally created for cervical cancer (EORTC-QLQ-Cx ), for the period immediately before diagnosed cervical cancer (thus being a control group). Th ey also answered the same questions for the period starting  months after the completion of concomitant chemoradiotherapy, and were an experimental group at the time. For the testing of statistical signifi cance of diff erences among the examined groups parameter and non-parameter tests were used (the Wilcoxon signed ranks test and Student' s t-test). Th e diff erence p<. was considered statistically signifi cant. Vaginal problems of patients after chemoradiotherapy were statistically reduced ( versus ; p<.). Th ere is no statistical signifi cance in the vaginal function among the analyzed groups but weaker pain during intercourse was registered after chemoradiotherapy (p=.). After chemoradiotherapy, patients' vaginal function is extremely improved whereas there is no diff erence in the sexual function. Pain during intercourse is statistically reduced after chemoradiotherapy.

Quality of Life among Survivors of Locally Advanced Cervical Cancer Treated with Definitive Chemoradiotherapy in a Decade of Transition

“…Three studies reported QoL assessments that were specific to age ( Table 2 ). 21 22 26 Conway et al 21 noted that more problems were encountered by older patients compared with younger patients, signifying that age may be an important determinant of both distress and overall QoL. Furthermore, Nunes de Arruda et al 22 noted that age affected scores on body image, sexual activity, and menopausal symptoms.…”

“…37 In our review, the EORTC QLQ-C30 and CX24 were the most commonly used tools in evaluating health-related and disease-specific QoL. 19,22,23,[25][26][27] Two papers characterized the temporal evolution of health-related QoL among LACC survivors. 19,21 One reported improvement at 12, 24, and 36 months.…”

“…The number and quality of studies included in our review reflect the relative paucity of high-quality literature on longterm QoL among LACC survivors. Of the nine papers included in this review, one 19 is a multinational study; six [20][21][22][25][26][27] come from upper-middle or high income countries, namely, Brazil, Canada, Italy, Bosnia and Herzegovina, and Thailand; and two 23,31 come from a lower-middle income country, India. 56 The studies include three small (<50) cross-sectional studies, 20,27,31 one (n ¼ 67) retrospective study, 21 and three small (<60) prospective studies.…”

“…56 The studies include three small (<50) cross-sectional studies, 20,27,31 one (n ¼ 67) retrospective study, 21 and three small (<60) prospective studies. 23,25,26 Only the multinational study 19 reported multiple QoL assessments beyond the first year after completion of therapy, while only two cross-sectional studies from Thailand 20,27 provide QoL data beyond 3 years of survivorship.…”

Psychosexual health in gynecological cancer

“…Following radical hysterectomy for locally advanced cervical cancer, there was no significant difference in sexual activity and enjoyment between women with benign or malignant disease; however, the cancer group had worse problems than healthy controls with body image and vaginal functioning [15]. In women with advanced cervical cancer given chemoradiotherapy, pain during intercourse was in fact reduced after treatment [16]. This may have been a result of the resolution of bleeding, discharge, and pelvic pain.…”