Vaginal stenosis and dilator use after pelvic brachytherapy
DOI:
https://doi.org/10.15649/cuidarte.3309Keywords:
Constriction, Pathologic, Genital Neoplasms, Female, Brachytherapy, Nursing, Physical Therapy Department, HospitalAbstract
Highlights
- Social and gynecological conditions interfere with the presence of vaginal stenosis and the use of vaginal dilators after pelvic brachytherapy.
- Around 25% are not sexually active and do not adhere to the use of a vaginal dilator after pelvic brachytherapy.
- Around 50% adhered to the use of a vaginal dilator after pelvic brachytherapy.
- Health education after brachytherapy contributes to adherence to the use of vaginal dilators.
Introduction: To prevent vaginal stenosis, the use of a vaginal dilator is recommended. Objective: To analyze sociodemographic data, gynecological conditions and the use of vaginal dilator after pelvic brachytherapy. Materials and Methods: Cross-sectional, retrospective study, period 2016-2020, collected between October/2020 and February /2021, from records of women with gynecological cancer treated with brachytherapy at the Centro de Pesquisa Oncológicas (Brazil). The variables included sociodemographic data and gynecological conditions in following the treatment. In the analysis, descriptive statistics, chi-squaretest, Fisher's exact test and Mann-Whitney test were applied. Results: 519 patients records were included in the investigation; the analyzes showed significant associations between the topography and staging (p<0.001), education (p=0.004) and age (p<0.001); the comparison between the distribution of the ionizing radiation dose showed a difference with the continued sexual relationship category (p=0.006); the comparison between the proportions of continued sexual relationship and using a vaginal dilator was significant (p<0.001); 49.10% (131) adhered to the use of vaginal dilator; 24.50% (127) are not sexually active and do not adhere to the use of the dilator. Discussion: It is evident that social and gynecological conditions interfere with the presence of vaginal stenosis and the use of a vaginal dilator after pelvic brachytherapy. Conclusions: The adherence found in the use of dilator affirms the contributions and the need for health education by nurses and physicaltherapists during and following the treatment.
How to cite this article: Rosa, Luciana Martins da; Hames, Maria Eduarda; Dias, Mirella; Kalinke, Luciana Puchalski; Oliveira, Claudia Manuela Siqueira de; Arzuaga-Salazar, María Angélica. Vaginal stenosis and dilator use after pelvic brachytherapy. Revista Cuidarte. 2024;15(2):e3309. https://doi.org/10.15649/cuidarte.3309
References
Morris L, Do V, Chard J, Brand AH. Radiation-induced vaginal stenosis: current perspectives. Int J Womens Health. 2017;9:273-9. https://doi.org/10.2147/IJWH.S106796
Damast S, Jeffery DD, Son CH, Hasan Y, Carter J, Lindau ST, et al. Literature review of vaginal stenosis and dilator use in radiation oncology. Pract Radiat Oncol. 2019;9(6):479-91. https://doi.org/10.1016/j.prro.2019.07.001
Conway JL, Gerber R, Han K, Jiang H, Xie J, Beiki-Ardakani A, et al. Patient-reported sexual adjustment after definitive chemoradiation and MR-guided brachytherapy for cervical cancer. Brachytherapy. 2019;18(2):133-40. https://doi.org/10.1016/j.brachy.2018.09.005
Dankulchai P, Harn-Utairasmee P, Prasartseree T, Nakkasae P, Trikhirhisthit K, Sittiwong W, et al. Vaginal 11-point and volumetric dose related to late vaginal complications in patients with cervical cancer treated with external beam radiotherapy and image-guided adaptive brachytherapy. Radiother Oncol. 2022;174:77-86. https://doi.org/10.1016/j.radonc.2022.07.009
Kpoghomou MA, Geneau M, Menard J, Stiti M, Almont T, Ghose B, et al. Assessment of an onco-sexology support and follow-up program in cervical or vaginal cancer patients undergoing brachytherapy. Support Care Cancer. 2021;29:4311-8. https://doi.org/10.1007/s00520-020-05898-9
Dias M, Roussenq SC, Rezende LF de, Lenzi J. Low level laser therapy in radiation-induced vaginal stenosis after cervical cancer treatment: case report. Braz J Dev. 2021;7(4):35230-40. https://doi.org/10.34117/bjdv7n4-133
Haddad NC, Brollo LCS, Oliveira MAP, Bernardo-Filho M. Diagnostic methods for vaginal stenosis and compliance to vaginal dilator use: a systematic review. J Sex Med. 2021;18(3):493-514. https://doi.org/10.1016/j.jsxm.2020.12.013
Rosa LM, Hames ME, Días M, Kalinke LP, Oliveira CMS, Arzuaga-Salazar MA. Planilha quantitativa - ID 3309–2021. Mendeley Data V1, 2023. https://doi.org/10.17632/8jdm9scwxc.1
National Cancer Institute. National Institutes of Health, Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0: 2009. USA: National Cancer Institute; [Internet] 2009 [Cited: Jun, 10, 2022]. Available from: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/Archive/CTCAE_4.0_2009-05-29_QuickReference_8.5x11.pdf
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49. https://doi.org/10.3322/caac.21660
Vu M, Yu J, Awolude OA, Chuang L. Cervical cancer worldwide. Current problems in câncer. Curr Probl Cancer. 2018;42(5):457-65. https://doi.org/10.1016/j.currproblcancer.2018.06.003
Tallon B, Monteiro D, Soares L, Rodrigues N, Morgado F. Tendências da mortalidade por câncer de colo no Brasil em 5 anos (2012-2016). Saúde debate. 2020;44(125):362-71. https://doi.org/10.1590/0103-1104202012506
Santana EO, Marcondes L, Silva LAA da, Sawada NO, Rosa LM da, Kalinke LP. Imagem guiada para qualidade de vida de mulheres com câncer cervical: estudo quase experimental. Rev cuid. 2023;14(1):e2358. http://dx.doi.org/10.15649/cuidarte.2358
Suneja G, Viswanathan A. Gynecologic Malignancies. Hematol Oncol Clin North Am. 2020;34(1):71-89. https://doi.org/10.1016/j.hoc.2019.08.018
Yang J, Delara R, Magrina J, Magtibay P, Langstraat C, Dinh T, et al. Management and outcomes of primary vaginal Cancer. Gynecol Oncol. 2020;159(2):456-63. https://doi.org/10.1016/j.ygyno.2020.08.036
Instituto Nacional do Câncer. Registro hospitalar de Câncer. Rio de Janeiro, Brasil: INCA; 2024. [Cited: Maio, 23, 2024]. Disponível em: https://irhc.inca.gov.br/RHCNet/
Westerveld H, Nesvacil N, Fokdal L, Chargari C, Schmid MP, Milosevic M, et al. Definitive radiotherapy with image-guided adaptive brachytherapy for primary vaginal cancer. Lancet Oncol. 2020;21(3):e157-67. https://doi.org/10.1016/S1470-2045(19)30855-1
Westerveld H, Kirchheiner K, Nout RA, Tanderup K, Lindegaard JC, Spampinato S, et al. Dose-effect relationship between vaginal dose points and vaginal stenosis in cervical cancer: An EMBRACE-I sub-study. Radiother Oncol. 2022;168:8-15. https://doi.org/10.1016/j.radonc.2021.12.034
Romano KD, Hill C, Trifiletti D, Peach MS, Horton BJ, Shah N, et al. High dose-rate tandem and ovoid brachytherapy in cervical cancer: dosimetric predictors of adverse events. Radiat Oncol. 2018;13(129):1-10. https://doi.org/10.1186/s13014-018-1074-2
Cerentini TM, Schlöttgen J, da Rosa PV, La Rosa VL, Vitale SG, Giampaolino P, et al. Clinical and psychological outcomes of the use of vaginal dilators after gynaecological brachytherapy: a randomized clinical trial. Advances in therapy. 2019;36(8):1936-49. https://doi.org/10.1007/s12325-019-01006-4
Stahl JM, Qian JM, Tien CJ, Carlson DJ, Chen Z, Ratner ES, et al. Extended duration of dilator use beyond 1 year may reduce vaginal stenosis after intravaginal high-dose-rate brachytherapy. Support Care Cancer. 2019;27(4):1425-33. https://doi.org/10.1007/s00520-018-4441-5
Akbaba S, Oelmann-Avendano JT, Krug D, Arians N, Bostel T, Hoerner-Rieber J, et al. The impact of vaginal dilator use on vaginal stenosis and sexual quality of life in women treated with adjuvant radiotherapy for endometrial cancer. Strahlenther Onkol. 2019;195(10):902-12. https://doi.org/10.1007/s00066-019-01466-1
Araya-Castro P, Sacomori C, Diaz-Guerrero P, Gayán P, Román D, Sperandio FF. Vaginal dilator and pelvic floor exercises for vaginal stenosis, sexual health and quality of life among cervical cancer patients treated with radiation: clinical report. J Sex Marital Ther. 2020;46(6):513-27. https://doi.org/10.1080/0092623X.2020.1760981
de Morais Siqueira T, Derchain S, Juliato CRT, Pinto E Silva MP, Machado HC, Brito LGO. Vaginal stenosis in women with cervical or endometrial cancer after pelvic radiotherapy: a cross-sectional study of vaginal measurements, risk for sexual dysfunction and quality of life. Int Urogynecol J. 2022;33(3):637-49. https://doi.org/10.1007/s00192-021-04798-8
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