Radiation tolerance of the vaginal mucosa

Hintz, Brace L.; Kagan, A. Robert; Chan, Paul Y. M.; Gilbert, Harvey A.; Nussbaum, Herman; Rao, Aroor R.; Wollin, Myron

doi:10.1016/0360-3016(80)90227-8

Cited by 91 publications

(14 citation statements)

References 11 publications

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“…Development of VS has also been attributed to the cumulative effect of radiation, which produces adhesions and circumferential fibrosis in vaginal epithelium. This could significantly diminish blood flow to the vaginal tissues, causing loss of elasticity and sensation [5, 21, 22]. Our study demonstrated adherence to VD use at 6 months was important for recovery to pre-RT vaginal size; thus, early intervention may reduce long-term consequences.…”

Section: Discussionmentioning

confidence: 92%

Prospective study of vaginal dilator use adherence and efficacy following radiotherapy

Law

Kelvin

Thom

et al. 2015

Radiotherapy and Oncology

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Background and purpose Vaginal stenosis (VS) after pelvic radiotherapy can impair long-term quality of life. We prospectively assessed adherence and efficacy of VD use as the primary and secondary objectives, respectively. Material and methods Women with gastrointestinal (n=63) and gynecologic (n=46) cancers self-reported use and VD size in monthly diaries for 12 months after radiotherapy. Adherence was measured as actual VD use out of recommended times over 12 months (3×/week × 52 weeks = 156). Results Among 109 participants, aged 28–81 years (median, 58 years), mean percent adherence over 12 months was 42% (95% confidence interval [CI], 36%–48%). Adherence was highest in the first quarter (56%), but fell to 25% by the fourth. Disease type, treatment sequence, and chemotherapy were predictors of adherence (all P<.05). Eighty-two percent maintained pre-RT VD size at 12 months; of 49% with decrease in VD size at 1 month post-RT, 71% returned to pre-RT VD size at 12 months. Disease type, younger age, and increased adherence at 6 months were associated with maintaining or returning to pre-RT size at 12 months (all P≤.05). Conclusions VD use is effective in minimizing VS, but adherence at 12 months was poor. Studies evaluating methods of improving adherence and determining the optimal frequency and duration of use are needed.

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Section: Discussionmentioning

confidence: 92%

Prospective study of vaginal dilator use adherence and efficacy following radiotherapy

Law

Kelvin

Thom

et al. 2015

Radiotherapy and Oncology

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“…Irradiation induces changes in the vagina through a direct effect on the basal layer of the mucosa and by obliteration of the small blood vessels with subsequent fibrosis of the perivaginal tissues (1,6) . The study by Hintz et al (5) suggested that the decreased radiation tolerance of the distal vagina was due to a poorer blood supply in this area. Our study shows that vaginal shortening can occur during the course of intracavitary and external irradiation.…”

Section: Discussionmentioning

confidence: 99%

Early development of vaginal shortening during radiation therapy for endometrial or cervical cancer

Katz¹,

Njuguna²,

Rakowsky³

et al. 2001

Int J Gynecol Cancer

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Vaginal necrosis can occur following radiation therapy for gynecological malignancies. The distal vaginal mucosa has a poorer radiation tolerance than the mucosa in the upper region. We examined the extent of vaginal shortening in patients treated by intravaginal brachytherapy with or without pelvic irradiation. Maximal extension of the vaginal cylinder above the pubis was measured for each insertion. We found that the difference in mean values between insertions (2.3 vs. 1.7 cm) was highly statistically significant (P < 0.0001). Our study shows that vaginal shortening can occur during the course of intracavity and external irradiation. These alterations in vaginal anatomy can have important consequences on doses received by the distal vaginal mucosa.

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“…The study by Hintz et al (5) suggested that the decreased radiation tolerance of the distal vagina was due to a poorer blood supply in this area. Our study shows that vaginal shortening can occur during the course of intracavitary and external irradiation.…”

Section: Discussionmentioning

confidence: 99%

“…The distal vagina is more susceptible to necrosis owing to the lower radiation tolerance of the mucosa in this area (5) . The extent of vaginal shortening occurring during the course of radiation therapy and its potential impact on late toxicity have not been investigated.…”

mentioning

confidence: 99%

Early development of vaginal shortening during radiation therapy for endometrial or cervical cancer

Katz,

Njuguna,

Rakowsky

et al. 2001

International Journal of Gynecological Cancer

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Vaginal necrosis can occur following radiation therapy for gynecological malignancies. The distal vaginal mucosa has a poorer radiation tolerance than the mucosa in the upper region. We examined the extent of vaginal shortening in patients treated by intravaginal brachytherapy with or without pelvic irradiation. Maximal extension of the vaginal cylinder above the pubis was measured for each insertion. We found that the difference in mean values between insertions (2.3 vs. 1.7 cm) was highly statistically significant (P< 0.0001). Our study shows that vaginal shortening can occur during the course of intracavity and external irradiation. These alterations in vaginal anatomy can have important consequences on doses received by the distal vaginal mucosa.

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Radiation tolerance of the vaginal mucosa

Cited by 91 publications

References 11 publications

Prospective study of vaginal dilator use adherence and efficacy following radiotherapy

Prospective study of vaginal dilator use adherence and efficacy following radiotherapy

Early development of vaginal shortening during radiation therapy for endometrial or cervical cancer

Early development of vaginal shortening during radiation therapy for endometrial or cervical cancer

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