Long-Term Follow-Up of Fractional CO2 Laser Therapy for Genitourinary Syndrome of Menopause in Breast Cancer Survivors

Abstract

(1) Background: The objective of this study was to determine the long-term efficacy of fractional CO2 laser therapy in breast cancer survivors. (2) Methods: This was a single-arm study of breast cancer survivors. Participants received three treatments of fractional CO2 laser therapy and returned for a 4 week follow-up. Participants were contacted for follow-up at annual intervals. The Vaginal Assessment Scale (VAS), the Female Sexual Function Index (FSFI), the Female Sexual Distress Scare Revised (FSDS-R), the Urinary Distress Inventory (UDI), and adverse events were collected and reported for the two-year follow-up. The changes in scores were compared between the four-week and two-year and the one-year and two-year follow-ups using paired t-tests. (3) Results: In total, 67 BC survivors were enrolled, 59 completed treatments and the four week follow-up, 39 participated in the one-year follow-up, and 33 participated in the two-year follow-up. After initial improvement in the VAS from baseline to the four week follow-up, there was no statistically significant difference in the VAS score (mean Δ 0.23; 95% CI [−0.05, 0.51], p = 0.150) between the four week follow-up and the two-year follow-up. At the two-year follow-up, the FSFI and FSDS-R scores remained improved from baseline and there was no statistically significant change in the FSFI score (mean Δ −0.83; 95% CI [−3.07, 2.38] p = 0.794) or the FSDS-R score (mean Δ −2.85; 95% CI [−1.88, 7.59] p = 0.227) from the one to two-year follow-up. The UDI scores approached baseline at the two-year follow-up; however, the change between the one- and two-year follow-ups was not statistically significant (mean Δ 4.76; 95% CI [−1.89, 11.41], p = 0.15). (4) Conclusions: Breast cancer survivors treated with fractional CO2 laser therapy have sustained improvement in sexual function two years after treatment completion, suggesting potential long-term benefit.

Emerging Use of Vaginal Laser to Treat Genitourinary Syndrome of Menopause for Breast Cancer Survivors: A Review

“…In total, 502 breast cancer survivors participated in the studies. The majority of studies [ 14 , 15 , 16 , 19 , 20 , 21 , 24 , 25 ] administered three cycles of vaginal laser treatment every 30 days; however, other approaches of laser administration were also used as the optimal number of cycles has yet to be defined.…”

“…Four studies [ 16 , 23 , 24 , 25 ] evaluated the long-term sustainability of the improvement of GSM symptoms in breast cancer survivors, and the results are promising. Gambacciani et al [ 16 ] reported a maintained effect of laser therapy for at least 12 to 18 months.…”

“…It showed maintained improvement in sexual and urinary function, although the observed effect decreased after 6 months. Quick et al [ 25 ] suggested the potential long-term benefit of laser therapy as sexual function remained improved two years after treatment completion. There was a slight increase in the mean VAS score from the 4 week follow-up to the 2 year follow-up, but it was not statistically significant.…”

“…Fortunately, currently emerging vaginal laser therapy shows similar improvement in GSM symptoms compared to local estrogen treatment in healthy women after natural menopause [ 13 ]. In addition, there is an increasing number of studies demonstrating the feasibility of vaginal laser to treat GSM for breast cancer survivors [ 11 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Unfortunately, a survey of oncology health professionals reveals that only 3% of respondents recommend vaginal laser for treating GSM, while the main concerns of laser therapy are cost, efficacy, safety, availability, and a lack of knowledge [ 26 ].…”

Study of the laser radiation effect in combination with doxorubicin on the survival of MCF7 and MCF7DOX culture cells

“…Researchers are studying the biological effects of laser radiation with different wavelengths and using different biological objects of study [14,15]. The ability of light energy at different parameters of irradiation to either promote cell regeneration or initiate in them the occurrence of pathological changes due to the modulation of metabolic processes is of great interest [16,17].…”