Prospective study of vaginal dilator use adherence and efficacy following radiotherapy

Law, Ethel; Kelvin, Joanne Frankel; Thom, Bridgette; Riedel, Elyn; Tom, Ashlyn; Carter, Jeanne; Alektiar, Kaled M.; Goodman, Karyn A.

doi:10.1016/j.radonc.2015.06.018

Cited by 73 publications

(58 citation statements)

References 25 publications

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“…However, observational data indicate that regular use of dilator following RT is associated with lower rates of self-reported VS 34–36. Further clinical trials are ideally needed; however, the difficulties of designing appropriate trials to establish a causal relationship are widely acknowledged 1,22.…”

Section: Prevention Strategies and Outcomesmentioning

confidence: 99%

Radiation-induced vaginal stenosis: current perspectives

Morris¹,

Do²,

Chard³

et al. 2017

IJWH

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Treatment of gynecological cancer commonly involves pelvic radiation therapy (RT) and/or brachytherapy. A commonly observed side effect of such treatment is radiation-induced vaginal stenosis (VS). This review analyzed the incidence, pathogenesis, clinical manifestation(s) and assessment and grading of radiation-induced VS. In addition, risk factors, prevention and treatment options and follow-up schedules are also discussed. The limited available literature on many of these aspects suggests that additional studies are required to more precisely determine the best management strategy of this prevalent group after RT.

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Section: Prevention Strategies and Outcomesmentioning

confidence: 99%

Radiation-induced vaginal stenosis: current perspectives

Morris¹,

Do²,

Chard³

et al. 2017

IJWH

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“…Bahng et al reported that patient use of a vaginal dilator significantly reduces incidence of vaginal atrophy [71]. In a prospective study of vaginal dilator adherence, continued use of a vaginal dilator 6 months after pelvic radiotherapy decreased the rate of vaginal stenosis [79]. Patients with higher mean vaginal doses may benefit the most from use of a vaginal dilator [80].…”

Section: Toxicitymentioning

confidence: 99%

“…The study admits that observational studies suggest that regular vaginal dilation may improve rates of patient-reported vaginal stenosis [81]. Low rates of adherence to use of a vaginal dilator result in difficulty interpreting data on this topic however [71,79,80]. The use of a vaginal dilator following VBT may be a controversial topic, but many investigators, including the authors recommend routine use for patients that are not sexually active.…”

Section: Toxicitymentioning

confidence: 99%

American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review

et al. 2017

Self Cite

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This article aims to review the risk stratification of endometrial cancer, treatment rationale, outcomes, treatment planning, and treatment recommendations of vaginal brachytherapy (VBT) in the post-operative management of endometrial cancer patients. The authors performed a thorough review of the literature and reference pertinent articles pertaining to the aims of this review. Adjuvant VBT for early stage endometrial cancer patients results in very low rates of vaginal recurrence (0–3.1%) with low rates of late toxicity which are primarily vaginal in nature. PORTEC-2 supports that VBT results in non-inferior rates of vaginal recurrence compared to external beam radiotherapy (EBRT) for the treatment of high-intermediate risk patients. VBT as a boost following EBRT, in combination with chemotherapy, and for high-risk histologies have shown excellent results as well though randomized data do not exist supporting VBT boost. There are many different applicators, dose-fractionation schedules, and treatment planning techniques which all result in favorable clinical outcomes and low rates of toxicity. Recommendations have been published by the American Brachytherapy Society and the American Society of Radiation Oncology to help guide practitioners in the use of VBT. Data support that patients and physicians both prefer joint decision-making regarding the use of VBT, and patients often desire additional treatment for a marginal benefit in risk of recurrence. Discussions regarding adjuvant therapy for endometrial cancer are best performed in a multi-disciplinary setting and patients should be counseled properly regarding the risks and benefits of adjuvant therapy.

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“…Research into the acceptability and efficacy of vaginal dilation, as a prophylactic or as a treatment for vaginal stenosis, has yielded inconsistent results (Bakker et al, 2014;Law et al, 2015;Miles & Johnson, 2014) and adherence to vaginal dilation protocols tends to be poor (Huffman et al, 2016;Law et al, 2015;Miles & Johnson, 2014). Little evidence exists within the literature to support the use of vaginal dilation during active RT, when inflammatory activity and psychological strain is in a more acute phase (Bakker et al, 2014;Johnson, Miles, & Cornes, 2010;Miles & Johnson, 2014).…”

Section: Vaginal Dilationmentioning

confidence: 99%

A comprehensive review of sexual health concerns after cancer treatment and the biopsychosocial treatment options available to female patients

2017

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The repercussions of cancer diagnosis and treatment profoundly impact the sexual wellbeing of women prior to, during, and following cancer treatment. Sexual health concerns are often under-addressed within clinical and research settings, and information tends to be limited to women with breast or gynecological cancers. In this narrative literature review, the authors critically evaluate research published between 1990 and 2016, pertaining to sexual health concerns of women diagnosed with cancer, of any type or stage, and to the psychosocial and biomedical interventions that currently exist for the treatment of sexual health-related side-effects (e.g. vaginal dryness, dyspareunia and vulvo-vaginal atrophy). The findings of 109 published articles are discussed and summarised according to four central themes: how cancer affects female sexual wellbeing; physical impacts of cancer diagnosis and treatment; emotional impacts of cancer diagnosis and treatment; and interventions for sexual dysfunction. Suggestions to enhance research and clinical practice in relation to the sexual health concerns of women following cancer treatments are also presented. Concerns pertaining to women's sexual health are diverse, multiple, and pervade all types and stages of cancer. Several evidence-based psychosocial and biomedical interventions exist to help women manage physical and psychosocial ramifications of cancer diagnosis and treatment.

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Prospective study of vaginal dilator use adherence and efficacy following radiotherapy

Cited by 73 publications

References 25 publications

Radiation-induced vaginal stenosis: current perspectives

Radiation-induced vaginal stenosis: current perspectives

American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review

A comprehensive review of sexual health concerns after cancer treatment and the biopsychosocial treatment options available to female patients

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