The experiences of women receiving brachytherapy for cervical cancer: A systematic literature review

Humphrey, Pauline; Bennett, Claire; Cramp, Fiona

doi:10.1016/j.radi.2018.06.002

Cited by 35 publications

(29 citation statements)

References 31 publications

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“…MRI-based BT is a complex, time-constrained, and resource-intensive procedure, which can be challenging. Generally, the BT procedure comprises anesthesia, applicator insertion, image acquisition, patient transport, waiting for treatment, dose delivery, applicator removal and removed processes, whereas the acute side effects include anesthesia-related side effects and operative injury, pain, bleeding as well as infection ( 10 – 12 ). To the best of our knowledge, the present study is the first report describing acute side effects in BT procedure for cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Applicator Insertion Related Acute Side Effects for Cervical Cancer Treated With Brachytherapy

et al. 2021

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PurposeTo report applicator insertion-related acute side effects during brachytherapy (BT) procedure for cervical cancer patients.Materials and MethodsBetween November 2017 and December 2019, 407 BT fractions were performed in 125 patients with locally advanced cervical cancer. Acute side effects recorded comprised anesthesia-related side effects, mechanical-related side effects and infection, whose frequency and degree were recorded. Pain was assessed using numeric rating scale; vaginal bleeding volume was counted by weighing gauze pieces used in packing. The BT procedure comprised eight stages: anesthesia, applicator insertion, image acquisition, transport, waiting for treatment, dose delivery, applicator removal, and removed which denoted 0.5–12.0 h period after removal, with time of each stage recorded. Factors influencing acute side effects were assessed by Spearman correlation and Mann–Whitney U test.ResultsThe most common acute side effect was pain, followed by vaginal bleeding. The mean scores for pain were highest during removal time, 4.9 ± 1.6 points. The mean vaginal bleeding volume was 44.4 ml during removal time. Mean total procedure time was 218.8 (175–336) min, having positive relationship with frequency of acute side effects. The total procedure time with acute side effects was longer than that without acute side effects. The longest procedure time was waiting time, 113.0 (91.0–132.0) min. More needles generated higher pain scores and larger volume of vaginal bleeding.ConclusionPain and vaginal bleeding were the most common acute side effects, especially during removal time, which physicians should focus on. Shortening patients’ waiting time helps to reduce the total procedure time, thus, reduce acute side effects. While meeting dose requirement, less needles are helpful to reduce acute side effects.

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Section: Discussionmentioning

confidence: 99%

Analysis of Applicator Insertion Related Acute Side Effects for Cervical Cancer Treated With Brachytherapy

et al. 2021

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“…There was no evidence of patient input into individual treatment plans or service design, although this was not explicitly asked in the survey. Brachytherapy for cervical cancer causes patients varying levels of pain, anxiety and distress, and it has been proposed that the duration of the procedure and repetition of the procedure will impact on women's experiences [1]. Interstitial or hybrid techniques and use of MRI planning has been recommended and widely implemented, with the aim of improving local tumour control [2,4,[8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…A cross-sectional survey was developed to gather information from UK centres carrying out gynaecological brachytherapy for locally advanced cervical cancer. Survey questions were informed by research literature [1][2][3][4] and discussion with the study team, The survey was piloted by four brachytherapy radiographers resulting in rewording of some questions, to minimise misinterpretation and improve consistency of responses. The final survey consisted of 30 questions covering brachytherapy techniques and scheduling, anaesthetic/analgesia protocols, inpatient/day case treatment and non-pharmacological support such as psychologist input.…”

Section: Methodsmentioning

confidence: 99%

“…A systematic literature review has shown that brachytherapy for gynaecological cancer causes patients varying levels of pain, anxiety and distress and that there is a need for better pain management, patient information and support and the development of non-pharmacological interventions to improve experiences [1]. To date, previous research has not explored non-pharmacological support services (such as psychological support or use of complementary therapies) or the impact of treatment schedules on women's experiences of brachytherapy.…”

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confidence: 99%

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Brachytherapy for locally advanced cervical cancer: A survey of UK provision of care and support

Humphrey

Dures

Hoskin

et al. 2021

Radiotherapy and Oncology

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Background and purpose: Gynaecological brachytherapy can cause anxiety, distress and discomfort. It is not known how variation in delivery impacts women's experiences. To inform future research an online survey was carried out to identify variations in brachytherapy and support available to women receiving treatment for locally advanced cervical cancer (LACC). Materials and methods: An online survey was sent to 44 UK brachytherapy centres using the Qualtrics Ò survey platform. It included questions about brachytherapy scheduling, inpatient/day case treatment, anaesthetic/analgesia, non-pharmacological support and health professionals' opinions regarding holistic care. A mixture of closed questions with pre-specified options and open questions were employed. Descriptive statistics were generated to identify variance in UK practice. Free text responses were analysed using inductive content analysis. Results: Responses were received from 39/43 eligible centres (91% response rate). Brachytherapy was predominantly given on an inpatient basis at 65% and day case at 35% of centres. Eleven scheduling regimes were reported with typical duration of brachytherapy ranging from three to 52 h. The main categories identified in response to what worked well were: 'consistency of staff'; 'good information provision' and 'experienced/skilled/senior staff'. The main categories identified as needing improvement were: 'training of different staff groups' and 'follow up and support' with many suggestions for service improvements. Conclusion:The survey provided a comprehensive overview of brachytherapy services for LACC demonstrating wide variability in scheduling regimes, duration of treatment and holistic care. The findings support the need to explore women's experiences with a range of treatment regimes and anaesthesia and analgesia techniques to inform improvements to future clinical care.

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“…Pain and anxiety have been reported as primary concerns for patients with gynecologic cancers undergoing HDR brachytherapy [3]. However, almost no research has been published on the degree to which these symptoms are experienced by cervical cancer patients during HDR brachytherapy [4].…”

Section: Introductionmentioning

confidence: 99%

The Experience of Pain and Anxiety in Cervical Cancer Patients Undergoing Multiple Fraction High-Dose Rate Brachytherapy: A Prospective Observational Study

Benali¹,

Tazi²,

Kietga³

et al. 2022

JCT

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Purpose: To evaluate the anxiety and pain levels of cervical cancer patients undergoing intracavitary multifraction high-dose rate (HDR) brachytherapy, as part of a process to develop guidelines for quality patient-centered care. Methods: Cervical cancer patients (n = 31) undergoingmultiple fraction HDR brachytherapy treatment at the National Institute of Oncology in Rabat (Morocco) completed ratings of pain and anxiety intensity using 11-point verbal analog scales, at 6 key time points over 2 brachytherapy insertion procedures and 4 brachytherapy fractions. Women were evaluated for psychological status at baseline before starting the brachytherapy process using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0 -7 = normal, 8 -10 = borderline, 11 -21 = abnormal. Factors that could affect anxiety levels such as education level, relationship status, number of pregnancies and prior surgical history were documented. Results: Between July and August 2020, 31 women with a median age of 49.6 years were evaluated (range: 27 -70). The HADS score identified depression in 5 patients (16.1%) and anxiety in 12 patients (38.7%). Throughout both treatment procedures, anticipatory anxiety was reported, with a maximum intensity in the operating room during spinal anesthesia (3.23 ± 1.7) and during applicator insertion (2.97 ± 2.4). Moderate-to-severe anxiety scores were reported in 25.8% and 22.6% of patients respectively. Level of education showed a significant correlation with anxiety scores (p = 0.027). Pain increased significantly during the procedure (p < 0.001). Bed-rest restriction applicator in situ (4.

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The experiences of women receiving brachytherapy for cervical cancer: A systematic literature review

Cited by 35 publications

References 31 publications

Analysis of Applicator Insertion Related Acute Side Effects for Cervical Cancer Treated With Brachytherapy

Analysis of Applicator Insertion Related Acute Side Effects for Cervical Cancer Treated With Brachytherapy

Brachytherapy for locally advanced cervical cancer: A survey of UK provision of care and support

The Experience of Pain and Anxiety in Cervical Cancer Patients Undergoing Multiple Fraction High-Dose Rate Brachytherapy: A Prospective Observational Study

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