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Prevalence of vaginal stenosis in the physical therapy evaluation after High Dose Rate Brachytherapy at a referral center in southern Brazil

Dias, M1; Custódio, LL2Bragante, KC3; Patrício, JJS2; Roussenq, SC4; Zomkowski, K4; Sperandio, FF4

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

Objective: To verify the prevalence of vaginal stenosis in the physical evaluation in women with gynecological cancer submitted to High Dose Rate Brachytherapy (HDR) in a public institution in the South of Brazil.

Material and methods: A cross-sectional study with patients diagnosed with gynecological cancer and submitted to HDR at the Oncology Research Center (CEPON), a public referral service in cancer treatment in Santa Catarina, Brazil, from June 2016 to September 2017. To evaluate vaginal stenosis, the Common Criteria for Adverse Events version 3.0 (CTCAEv3.0) was used based on the vaginal touch test. Personal and disease data were collected in a separate form. The descriptive analysis of the continuous variables was performed through means and standard deviation. For categorical variables, a simple and relative frequency was used.

Results: A total of 75 women with a mean age of 55.61 years (± 13.22) were analyzed. The mean time to complete HDR and the physical therapy evaluation was 1.4 months (± 0.8). Cervical cancer was the most common, observed in 69.3% (n = 52) of women and endometrial cancer in 29.3% (n = 22). The most frequent staging was IIB (28.20%, n = 20) and IIIB (28.20%, n = 20). Regarding sociodemographic data, 82.1% (n = 55) of the women belonged to a group with a very low income, 97.10% (n = 68) were caucasian, and 62.5% (n = 45) had only an elementary education. Most of the women were married or were in stable union (66.2%, n = 49). All patients performed HDR, and the majority (61.3%, n = 46) received doses of 28Gy. Only 33.8% (n = 25) of the women were sexually active. The stenosis was present in 30.7% (n = 23) of the women in the moment of the physical therapy evaluation, and the majority (69.6%) presented grade 1 according to the scale used.  Conclusion: It was observed that post-HDR vaginal stenosis has a high prevalence, even in the first months after the end of the treatment. Vaginal stenosis is still one of the major sequels of gynecological cancer treatment impacting women's lives in terms of sexual activity and gynecological exams. Due to this result, there is an important necessity of interventions to prevent vaginal stenosis immediately after the completion of HDR.


Work supported by industry: no.

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