Sexual dysfunctions after high dose rate brachytherapy for gynaecolofical cancer treatment
Dias, M1; Custódio, LL2; Patrício, JJS2; Bragante, KC3; Zomkovski, K4; Sperandio, FF4; Souza, CPF1; Mozzini, CB5
1: Oncology Research Centre CEPON, Brazil; 2: University of Southern Santa Catarina, Brazil; 3: Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; 4: University of the State of Santa Catarina, Brazil; 5: Hospital of the City of Passo Fundo, Brazil
Objective: To verify the main sexual dysfunctions in women with gynaecological cancer submitted to High Dose Rate Brachytherapy (HDR) in a public institution in the South of Brazil.
Materials and Methods: A retrospective analysis of the medical records of women diagnosed with gynaecological cancer was performed at a physiotherapy service, after HDR, at a Cancer Centre in Southern Brazil, between July 2016 and September of 2017. The Common Criteria for Adverse Events version 3.0 (CTCAEv3.0) was used to evaluate the vaginal stenosis and an own form was used to evaluate the sexual dysfunctions, complemented by a gynaecological examination. The descriptive analysis of the continuous variables was performed through means and standard deviation. For categorical variables, a simple and relative frequency was used. Student's t-test for independent samples and Spearman's correlation were performed. A significance level was set at p <0.05.
Results: A total of 84 women with an average of 54.77 years old (± 13.06) were analysed. Cervical cancer was the most common, observed in 72.6% (n = 61) of the women, with the most frequent staging being IIB (31.60%, n = 25) and IIIB (27.80%; n = 22). Regarding the sociodemographic data, 84% (n = 63) of the women belonged to a group with a low income, 97.20% (n = 77) were Caucasian and 61.70% (n= 50) had only an elementary education. The majorities of women were married or were in stable union (60,30%, n= 55). All patients performed HDR, and the majority (63.1%, n = 53) received doses of 28Gy. Subsequently, sexual activity was present in 36.10% (n = 30) of the women after HDR, and of these, 53.1% (n = 17) presented some type of sexual dysfunction, the most common was dyspareunia (83, 30%, n = 15) followed by stenosis, which was present in 16.70% of the women (n = 3). It was observed in the study that younger women, mean age of 47.80 years (± 12.17) are more sexually active when compared to women with higher age 58.50 years (± 12.00), p ≤ 0.01.
Conclusions: HDR interferes with the sexual activity of women, more frequently in women over 50 years of age, and can progress with important sexual dysfunctions, especially dyspareunia and vaginal stenosis. In this way interventions and guidelines are necessary soon after HDR ends, seeking to promote the sexual quality of women and to reduce the chronicity of sexual dysfunctions in this population.
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