Sexual Function After Intracavitary Vaginal Brachytherapy for Early-Stage Endometrial Carcinoma

Abstract

Objective To describe the effects of intracavitary brachytherapy (IVB) on sexual function and quality of life of women with early-stage endometrial cancer. Methods Women with International Federation of Gynecology and Obstetrics stage I to stage II endometrial cancer treated surgically with or without IVB were identified and mailed questionnaires. Quality of life and sexual function were measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the cervical cancer disease-specific module. Pertinent data from prior surgery and radiation treatments were abstracted retrospectively. Linear transformation of the survey subscale scores was conducted per European Organization for Research and Treatment of Cancer guidelines. Results Sixteen women in the IVB arm and 53 in the surgery-alone group completed the survey. Of the sexually active patients, 33% of the IVB patients and 42% of the surgery-alone patients felt their vagina was dry during sexual activity (P = 0.804) and 17% versus 20% felt their vagina was short (P = 0.884). Seventeen percent of patients in the IVB group felt their vagina was tight compared to 29% in the surgery-alone group (P = 0.891) and 0% versus 14% of patients reported pain during intercourse (P = 0.808). There was no statistically significant difference in sexual/vaginal functioning, sexual worry, or sexual enjoyment between the 2 groups. Conclusions Although both groups report vaginal changes that may affect sexual function, the patients treated with IVB reported similar outcomes on a sexual function questionnaire compared to patients treated with surgery alone.

External Pelvic and Vaginal Irradiation Versus Vaginal Irradiation Alone as Postoperative Therapy in Medium-Risk Endometrial Carcinoma: A Prospective, Randomized Study—Quality-of-Life Analysis

“…From the quality-of-life analysis of the PORTEC-2 study, it was reported that only 15% of the women were sexually active at baseline and no difference was noted for external beam therapy and vaginal brachytherapy with regard to sexual functioning and symptoms. 20 In a study by Quick et al, 22 the outcome on sexual function was similar after adjuvant vaginal brachytherapy and surgery alone. In future studies on quality-of-life in endometrial carcinoma, the new EORTC QLQ-EN24 cancer module should be used.…”

Prospective study of vaginal dilator use adherence and efficacy following radiotherapy

“…Patients with rectal cancer who needed postoperative chemotherapy were less likely to adhere, most likely due to treatment-related side effects, such as bowel dysfunction, fatigue, and neutropenia related to surgery and adjuvant chemotherapy. Their longer treatment course [24] with more acute side effects may have lessened the priority of long-term health maintenance.…”

Maintaining sexual health throughout gynecologic cancer survivorship: A comprehensive review and clinical guide

“…Several small cross-sectional studies have not shown a difference in sexual function in endometrial patients undergoing hysterectomy and VBT compared to women who received hysterectomy alone [20, 21] or compared to a healthy postmenopausal control [22]. Nonetheless, Quick et al showed that compared to before the diagnosis of cancer, the majority of patients felt their vagina was smaller and reported increased vaginal dryness, more pain with intercourse, and less interest in sex [21].…”

“…Nonetheless, Quick et al showed that compared to before the diagnosis of cancer, the majority of patients felt their vagina was smaller and reported increased vaginal dryness, more pain with intercourse, and less interest in sex [21]. In a study by Damast et al, 81% of patients who underwent hysterectomy with adjuvant VBT reported sexual dysfunction.…”