Radiation-induced vaginal stenosis: current perspectives

Morris, Lloyd; Do, Viet; Chard, Jennifer; Brand, Alison

doi:10.2147/ijwh.s106796

Cited by 69 publications

(79 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One of the long-term side effects after irradiation is vaginal stenosis defined as vaginal narrowing and shortening. Vaginal stenosis can have adverse effects on sexual functioning, making gynecological examination difficult and sometimes painful, and may even impede cytological studies from detecting cancer recurrence [ 5 ]. The few studies in this respect indicate that the use of a vaginal dilator can prevent vaginal strictures.…”

Section: Introductionmentioning

confidence: 99%

EQD2 Analyses of Vaginal Complications in Exclusive Brachytherapy for Postoperative Endometrial Carcinoma

Zhang

Fornes

Gomez

et al. 2020

Cancers

View full text Add to dashboard Cite

Background: To evaluate whether EQD2(α/β = 3Gy) at 2 cm3 of the most exposed area of the vagina is related to late vaginal toxicity in postoperative endometrial cancer (PEC) patients (p) treated with exclusive brachytherapy (BT). Methods: From 2014 to 2017, 43p were included in this study. BT was administered: 3-fractions of 6Gy in 37p and 2-fractions of 7.5Gy in 6p. The dose was prescribed at a depth of 5 mm from the applicator surface with dose-point optimization based on distance. The active treatment length was 2.5 cm. CTV-D90 and the dose to the most exposed 2 cm3 of the vagina was calculated for each patient. Late toxicity of the bladder and rectum was assessed using Radiation Therapy Oncology Group (RTOG) criteria, and vaginal toxicity by objective Late Effects Normal Tissue Task Force (LENT)-Subjective, Objective, Management, Analytic (SOMA) (LENT-SOMA) criteria. Statistics: frequency tables, mean, median, range, standard deviation, and box plot. Results: The median follow-up was 51 months (12–68). 20 p (46.5%) and 2 p (4.7%) developed G1 and G2 vaginal complications, respectively. Only 1/2 p-G2 receiving EQD2(α/β = 3Gy) at 2 cm3 >68Gy presented vaginal shortening and 18/20 p-G1 received doses < 68Gy. Conclusions: PECp receiving exclusive brachytherapy with doses < 68Gy EQD2(α/β = 3Gy) at 2 cm2 of the vagina presented only G0–G1 vaginal toxicity, except for one with bleeding telangiectasias. Larger prospective studies are necessary to confirm the present results.

show abstract

Section: Introductionmentioning

confidence: 99%

EQD2 Analyses of Vaginal Complications in Exclusive Brachytherapy for Postoperative Endometrial Carcinoma

Zhang

Fornes

Gomez

et al. 2020

Cancers

View full text Add to dashboard Cite

show abstract

“…A dilatação também deve ser realizada para desfazer aderências e manter a patência vaginal. Uma estratégia concorrente ou alternativa é estimular a relação sexual regular (MORRIS et al, 2017).…”

Section: Estenose Vaginalunclassified

“…Há uma falta de consenso sobre múltiplos aspectos do uso do dilatador, incluindo a frequência, duração, intervalo de tempo apropriado para iniciar o uso após a realização da RT pélvica, o tamanho do dilatador, a técnicade inserção e a real necessidade de dilatadores em pacientes sexualmente ativas. Não há evidências para apoiar o uso de dilatadores durante a RT, o que de fato pode ser prejudicial (MORRIS et al, 2017).…”

Section: Estenose Vaginalunclassified

See 1 more Smart Citation

Qualidade De Vida Após O Câncer Ginecológico

Ramalho¹,

Pinheiro²,

Paula³

et al. 2019

Rev. Bras. Sex. Hum.

View full text Add to dashboard Cite

Muitas mulheres com malignidades ginecológicas serão curadas ou tornar-se-ão sobreviventesde longo prazo. Diferentes tratamentos (cirurgia, radioterapia, quimioterapia) para cânceres ginecológicospodem causar insuficiência ovariana ou aumento dos sintomas da menopausa, além de efeitos negativos acurto e longo prazo sobre a saúde sexual e qualidade de vida (QV). O manejo dos sintomas menopausais eda disfunção sexual é importante nos esforços para otimizar a QV dessas mulheres. O objetivo deste artigoé apresentar uma visão abrangente da saúde sexual das sobreviventes de câncer ginecológico e discutir asopções de tratamento baseadas em evidências. Método: Trata-se de estudo descritivo com abordagemqualitativa para verificação do benefício e da segurança do uso de terapia hormonal nessas pacientes, bemcomo os problemas de saúde sexual comumente encontrados e as opções para seu manejo. Resultados:Dados disponíveis sugerem que o uso de terapia hormonal em pacientes com cânceres ginecológicos nãotem um impacto negativo no resultado oncológico e resulta em melhora dos sintomas vasomotores e geniturinários da menopausa. Evidências quanto à segurança do uso de terapia hormonal em mulheres comneoplasias dependentes de estrogênio são escassas. A disfunção sexual é prevalente entre as sobreviventesde câncer ginecológico como resultado de seu tratamento, impactando negativamente a QV. Muitas pacientes esperam que os profissionais de saúde iniciem uma discussão sobre sexualidade, mas a maioria nunca discutiu questões relacionadas à saúde sexual com seu médico. Conclusões: Profissionais da oncologia podem ter um impacto significativo na QV das sobreviventes de câncer ginecológico abordando os sintomas menopausais e as preocupações de saúde sexual. As candidatas à terapia hormonal em oncologia ginecológica incluem mulheres com menopausa induzida ou sintomas menopausais diagnosticadas com câncer endometrial de baixo grau, em estágio inicial, e cânceres de colo uterino, vulva, vagina e ovário. Estratégias simples podem ser implementadas na prática clínica para tratar as questões sexuais. O encaminhamento para provedores especializados em saúde sexual pode ser necessário nos casosmais complexos.

show abstract

“…In addition to ovarian effects, pelvic irradiation causes persistent endometrial and myometrial atrophy and myometrial fibrosis 16 . Radiation damage to the vaginal mucosa may result in adhesions, ulceration, atrophy and fibrosis, causing shortening and tightening of the vaginal canal (vaginal stenosis) in about a third of patients, with a range of 1.25–88% depending on the dose and site of radiation and concomitant therapy 17 …”

Section: Mechanisms Of Cancer‐related Menopausementioning

confidence: 99%

Managing menopausal symptoms after cancer: an evidence‐based approach for primary care

Marino

McNamara

Hickey

2018

Medical Journal of Australia

View full text Add to dashboard Cite

Summary Impaired ovarian function and menopausal symptoms are common after cancer treatment. Menopausal symptoms often occur at an earlier age in women with cancer, and may be more severe than in natural menopause; they may be the most persistent and troubling sequelae of cancer. A third of female patients with cancer report dissatisfaction with the quality and length of physician–patient discussions about reproductive health, including menopause. Systemic menopausal hormone therapy is the most effective treatment for menopausal symptoms, but it is not suitable for all patients after cancer — where it is unsuitable, alternative effective non‐hormonal treatments are available. Effective pharmacological agents available to treat vasomotor symptoms include selective serotonin reuptake inhibitors, serotonin–noradrenaline reuptake inhibitors, clonidine and gabapentin. There is increasing evidence supporting cognitive behavioural therapy for the treatment of vasomotor symptoms, in self‐help or group settings. Vaginal atrophy can be treated with vaginal (topical) oestrogen with minimal systemic absorption; topical vaginal lubricants may help with vaginal dryness and dyspareunia, with some evidence suggesting that silicone‐based products may be more effective than water‐based ones. Bone health may be impaired in post‐menopausal women with cancer or in cancer survivors, particularly in women with treatment‐related menopause or in women receiving anti‐oestrogen therapies; this should be managed in addition to menopausal symptoms. Primary care physicians should be aware of the troublesome and ongoing nature of menopausal symptoms after cancer, should discuss them with all patients after cancer treatment, and should consider treatment or referral to a specialist for appropriate management.

show abstract

Radiation-induced vaginal stenosis: current perspectives

Cited by 69 publications

References 43 publications

EQD2 Analyses of Vaginal Complications in Exclusive Brachytherapy for Postoperative Endometrial Carcinoma

EQD2 Analyses of Vaginal Complications in Exclusive Brachytherapy for Postoperative Endometrial Carcinoma

Qualidade De Vida Após O Câncer Ginecológico

Managing menopausal symptoms after cancer: an evidence‐based approach for primary care

Contact Info

Product

Resources

About