Management of toxicities following pelvic irradiation for gynaecological cancers

Abstract

With better understanding of the mechanisms of acute and chronic radiation-induced changes, more effective treatments are now possible. Following pelvic radiotherapy, patients should be proactively assessed for early intervention by a specialist multidisciplinary team.

Comparison of vaginal microbiota in gynecologic cancer patients pre‐ and post‐radiation therapy and healthy women

“…atrophy, and disruption in vaginal wall integrity. 9 Not surprisingly, changes in the indigenous vaginal microbial community were also observed in our samples following RT (Figure 3B). The mechanism by which pelvic RT causes vaginal microbiota alterations remains unclear, but it might be related to changes in the relative abundance (or extinction) of key species producing mucopolysaccharides as glycosaminoglycans.…”

“…Patients treated with radiotherapy for gynecologic malignancies often experience vaginal toxicity, including mucosal atrophy, and disruption in vaginal wall integrity 9 . Not surprisingly, changes in the indigenous vaginal microbial community were also observed in our samples following RT (Figure 3B).…”

“…Gynecologic cancers (GynCa) remain a major disease across the globe, with ~89 000 annual cases in the US alone, approximately 29 000 of which are terminal 8 . The cost of therapies and the management of therapy‐related toxicities are major burdens 9 . Microanatomical disruptions, gastric dysfunctions, mucosal atrophy, dyspareunia, and sexual dysfunction have been frequently reported for women undergoing treatment with radiation therapy (RT), and symptoms may persist even 2 years after the treatment 9‐11 .…”

“…8 The cost of therapies and the management of therapy-related toxicities are major burdens. 9 Microanatomical disruptions, gastric dysfunctions, mucosal atrophy, dyspareunia, and sexual dysfunction have been frequently reported for women undergoing treatment with radiation therapy (RT), and symptoms may persist even 2 years after the treatment. [9][10][11] The disturbances of the VMs in women with gynecologic malignancies undergoing anticancer therapies remain understudied, due in part to the challenges associated with recruiting patients and obtaining appropriate samples.…”

“…9 Microanatomical disruptions, gastric dysfunctions, mucosal atrophy, dyspareunia, and sexual dysfunction have been frequently reported for women undergoing treatment with radiation therapy (RT), and symptoms may persist even 2 years after the treatment. [9][10][11] The disturbances of the VMs in women with gynecologic malignancies undergoing anticancer therapies remain understudied, due in part to the challenges associated with recruiting patients and obtaining appropriate samples. Both GynCa and anticancer therapies often have a major impact on vaginal pH and/or Lactobacillus colonization, and therefore, the health of the vaginal ecosystem.…”