Adherence to physiotherapeutic guidelines in the prevention of vaginal stenosis after brachytherapy in the treatment of cervical cancer
DOI:
https://doi.org/10.33448/rsd-v10i5.14876Keywords:
Brachytherapy; Vaginal stenosis; Prysical Therapy; Treatment Adherence and Compliance; Uterine cervical neoplasms.Abstract
Introduction: Dilation exercises and sexual intercourse are preventive guidelines and vaginal stenosis. Objective: to evaluate patients' adherence to physiotherapeutic guidelines in the prevention of vaginal stenosis. Methods: retrospective study of medical records of women with cervical cancer who underwent brachytherapy between January and December 2018, and who had a one-year follow-up at the physiotherapy outpatient clinic. Continuous variables were described by mean and standard deviation and categorical variables by percentage frequency. A QCochran test was applied, considering a significance level of p≤ 0.05 to assess variations in 6 months and 1 year. Results: Medical records of 60 women with an avarage age of 49.4 years (± 11.1) were analyzed. In the first evaluation, after brachytherapy, 21 women (35%) performed vaginal dilation exercises, 26 women (43.3%) were sexually active and 13 women (21.7%) already had vaginal stenosis. After one year, 21 women (35%) performed vaginal dilation exercises and 26 women (43.3%) were sexually active. Considering those who performed at least one of the guidelines, 43 women (73.3%) adhered. There was no significant change for these parameters over 6months, or for 1year (p = 0.368). Adherence did not vary significantly for the performance of dilation exercises in the period of 6months and 1year, nor for the practice of sexual intercourse in this period (p = 0.097 and p = 0.368, respectively). Conclusion: There was good adherence by women to follow some type of preventive stenosis guidance and maintenance of the practice of these guidelines over the course of 1year.
References
Aydin, R., & yeşiltepe oskay, Ü. (2016). Sexual Experience of Women After Pelvic Radiotherapy for Cervical Cancer. Turkish Journal of Oncology/Türk Onkoloji Dergisi, 31(4).
Bae, H., & Park, H. (2016). Sexual function, depression, and quality of life in patients with cervical cancer. Supportive care in cancer, 24(3), 1277-1283.
Bakker, R. M., ter Kuile, M. M., Vermeer, W. M., Nout, R. A., Mens, J. W. M., van Doorn, L. C., & Creutzberg, C. L. (2014). Sexual rehabilitation after pelvic radiotherapy and vaginal dilator use: consensus using the Delphi method. International Journal of Gynecologic Cancer, 24(8).
Barker, C. L., Routledge, J. A., Farnell, D. J., Swindell, R., & Davidson, S. E. (2009). The impact of radiotherapy late effects on quality of life in gynaecological cancer patients. British journal of cancer, 100(10), 1558-1565.
Bernardo, B. C., Lorenzato, F. R. B., Figueiroa, J. N., & Kitoko, P. M. (2007). Disfunção sexual em pacientes com câncer do colo uterino avançado submetidas à radioterapia exclusiva. Revista Brasileira de Ginecologia e Obstetrícia, 29(2), 85-90.
Bhatla, N., Aoki, D., Sharma, D. N., & Sankaranarayanan, R. (2018). Cancer of the cervix uteri. International journal of gynecology & obstetrics, 143, 22-36.
Brand, A. H., Do, V., & Stenlake, A. (2012). Can an educational intervention improve compliance with vaginal dilator use in patients treated with radiation for a gynecological malignancy? International Journal of Gynecologic Cancer, 22(5).
Carvalho, H. A. et al. (2013). Tumores ginecológicos - Radioterapia em oncologia. (2a ed.), Atheneu.
Cullen, K., Fergus, K., DasGupta, T., Fitch, M., Doyle, C., & Adams, L. (2012). From “sex toy” to intrusive imposition: a qualitative examination of women's experiences with vaginal dilator use following treatment for gynecological cancer. The journal of sexual medicine, 9(4), 1162-1173.
da Rosa, S. Q., de Miranda, A. E. A., & de Souza, A. A. R. (2020). Tratamento do câncer de colo uterino localmente avançado: uma revisão sistemática. Brazilian Journal of Development, 6(11), 89012-89025.
Denton, A. S., & Maher, J. (2003). Interventions for the physical aspects of sexual dysfunction in women following pelvic radiotherapy. Cochrane Database of Systematic Reviews, (1).
Donovan, K. A., Taliaferro, L. A., Alvarez, E. M., Jacobsen, P. B., Roetzheim, R. G., & Wenham, R. M. (2007). Sexual health in women treated for cervical cancer: characteristics and correlates. Gynecologic oncology, 104(2), 428-434.
Flay, L. D., & Matthews, J. H. (1995). The effects of radiotherapy and surgery on the sexual function of women treated for cervical cancer. International journal of radiation oncology, biology, physics, 31(2), 399-404.
Grimm, D., Hasenburg, A., Eulenburg, C., Steinsiek, L., Mayer, S., Eltrop, S., & Woelber, L. (2015). Sexual activity and function in patients with gynecological malignancies after completed treatment. International Journal of Gynecologic Cancer, 25(6).
Grion, R. C., Baccaro, L. F., Vaz, A. F., Costa-Paiva, L., Conde, D. M., & Pinto-Neto, A. M. (2016). Sexual function and quality of life in women with cervical cancer before radiotherapy: a pilot study. Archives of gynecology and obstetrics, 293(4), 879-886.
Hanlon, A., Small Jr, W., Strauss, J., Lin, L. L., Hanisch, L., Huang, L., & Bruner, D. W. (2018). Dilator Use following Vaginal Brachytherapy for Endometrial Cancer: A Randomized Feasibility and Adherence Study. Cancer nursing, 41(3), 200.
Heijkoop, S. T., Nout, R. A., Quint, S., Mens, J. W. M., Heijmen, B. J. M., & Hoogeman, M. S. (2017). Dynamics of patient reported quality of life and symptoms in the acute phase of online adaptive external beam radiation therapy for locally advanced cervical cancer. Gynecologic oncology, 147(2), 439-449.
Law, E., Kelvin, J. F., Thom, B., Riedel, E., Tom, A., Carter, J., & Goodman, K. A. (2015). Prospective study of vaginal dilator use adherence and efficacy following radiotherapy. Radiotherapy and Oncology, 116(1), 149-155.
Madeiro, A., Rufino, A. C., Brandão, N. D. S., & Santos, I. D. S. (2016). Tendências da mortalidade por câncer do colo do útero no Piauí, 2000-2011. Cadernos Saúde Coletiva, 24(3), 282-285.
Marques, A. D. A., Silva, M. P. P. D., & Amaral, M. T. P. D. (2011). Tratado de fisioterapia em saúde da mulher. Roca, 27.
Matos, S. R. D. L., Lucas Rocha Cunha, M., Podgaec, S., Weltman, E., Yamazaki Centrone, A. F., & Cintra Nunes Mafra, A. C. (2019). Consensus for vaginal stenosis prevention in patients submitted to pelvic radiotherapy. PloS one, 14(8), e0221054.
Miles, T. (2012). International guidelines on vaginal dilation after pelvic radiotherapy. Brook Hill, Woodstock, Oxon: Owen Mumford Ltd.
Ministério da Saúde. (2019). Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: Incidência de Câncer no Brasil. https://www.inca.gov.br/sites/ufu.sti. inca.local/files//media/document//estimativa-2020-incidencia-de-cancer-no-brasil.pdf
Novaes, P. E. (2011). Colo uterino. Sociedade Brasileira de Radioterapia. Radioterapia baseada em evidências: recomendações da Sociedade Brasileira de Radioterapia (SBRT). Lemar, 273-83.
Panobianco, M. S., Pimentel, A. V., de Almeida, A. M., & Oliveira, I. S. B. (2012). Mulheres com diagnóstico avançado do câncer do colo do útero: enfrentando a doença e o tratamento. Revista Brasileira de Cancerologia, 58(3), 517-523.
Pimentel, N. B. L., Modesto, F. C., Lima, V. C. G. S., de Andrade, K. B. S., de Oliveira, A. M., Fuly, P. D. S. C., & dos Santos, M. L. S. C. (2020). O câncer do colo uterino e o impacto psicossocial da radioterapia pélvica: revisão integrativa. Research, Society and Development, 9(10), e6489109052-e6489109052.
Robinson, J. W., Faris, P. D., & Scott, C. B. (1999). Psychoeducational group increases vaginal dilation for younger women and reduces sexual fears for women of all ages with gynecological carcinoma treated with radiotherapy. International Journal of Radiation Oncology* Biology* Physics, 44(3), 497-506.
Salvajoli, J. V., Souhami, L., & Faria, S. L. (1999). Radioterapia em oncologia (pp. 852-855). Medsi.
Silveira, C. F., Regino, P. A., Soares, M. B. O., Mendes, L. C., Elias, T. C., & Silva, S. R. D. (2016). Quality of life and radiation toxicity in patients with gynecological and breast cancer. Escola Anna Nery, 20(4).
Soares, M. L. C. A., Trezza, M. C. S. F., Oliveira, S. M. B. D., Melo, G. C. D., Lima, K. R. D. S., & Leite, J. L. (2016). O custo da cura: vivências de conforto e desconforto de mulheres submetidas à braquiterapia. Escola Anna Nery, 20(2), 317-323.
Stabile, C., Goldfarb, S., Baser, R. E., Goldfrank, D. J., Abu-Rustum, N. R., Barakat, R. R., & Carter, J. (2017). Sexual health needs and educational intervention preferences for women with cancer. Breast cancer research and treatment, 165(1), 77-84.
Thuler, L. C. S., Aguiar, S. S. D., & Bergmann, A. (2014). Determinantes do diagnóstico em estadio avançado do câncer do colo do útero no Brasil. Revista Brasileira de Ginecologia e Obstetrícia, 36(6), 237-243.Yoshida, K., Yamazaki, H., Nakamura, S., Masui, K., Kotsuma, T., Baek, S. J., & Yoshioka, Y. (2013). Comparisons of late vaginal mucosal reactions between interstitial and conventional intracavitary brachytherapy in patients with gynecological cancer: Speculation on the relation between pallor reaction and stenosis. Anticancer research, 33(9), 3963-3968.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Kelley Cristian do Nascimento; Felipe Cardozo Modesto; Raquel Boechat de Moura Carvalho; Kamila Rodrigues Ferreira; Patrícia Lopes Souza; Gustavo Telles da Silva
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.