ADHERENCE TO VAGINAL DILATION FOLLOWING HIGH DOSE RATE BRACHYTHERAPY FOR ENDOMETRIAL CANCER
ADHERENCE TO VAGINAL DILATION FOLLOWING HIGH DOSE RATE BRACHYTHERAPY FOR ENDOMETRIAL CANCER
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DOI：
10.1016/j.ijrobp.2010.02.058
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发表时间：
2011-07-01
影响因子：
7
通讯作者：
Kunos, Charles A.
中科院分区：
文献类型：
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作者：
Friedman, Lois C.;Abdallah, Rita;Kunos, Charles A.
目的：我们报告了与坚持阴道扩张相关的人口统计学、临床和心理社会因素，并描述了子宫内膜癌高剂量率（HDR）近距离放射治疗后妇女的性和婚姻或非婚姻双重功能。我们回顾性评估了18岁或以上的早期子宫内膜异位症患者，（IAgr 3-IIB）癌症在过去3.5年内接受了HDR阴道内近距离放射治疗。有或没有性伴侣的妇女都有资格参加。患者通过邮件或电话完成问卷调查，评估人口统计学和临床变量，坚持阴道扩张，dyadic satisfaction，性功能，和health beliefs.Results：78的89（88%）符合条件的妇女早期子宫内膜癌HDR近距离放射治疗完成问卷。只有33%的患者是粘附者，根据报告，在放疗后的第一个月内每周使用扩张器超过两次。报告放疗后阴道尺寸感知变化的非依从者报告称，近距离放射治疗后阴道主观较小（p = 0.013）。与不遵守者相比，遵守者报告了更多关于性生活或缺乏性生活的担忧（p = 0.047）。患者报告相当多的性功能障碍后完成HDR brachytherapy.Conclusions：坚持阴道扩张器使用的建议，HDR近距离放射治疗子宫内膜癌是穷人。旨在教育女性扩张器使用益处的干预措施可能会增加依从性。虽然性功能受到损害，但在我们的研究中，许多女性在患癌症之前就存在这种情况。(C)2011 Elsevier Inc.
Purpose: We report demographic, clinical, and psychosocial factors associated with adherence to vaginal dilation and describe the sexual and marital or nonmarital dyadic functioning of women following high dose rate (HDR) brachytherapy for endometrial cancer.Methods and Materials: We retrospectively evaluated women aged 18 years or older in whom early-stage endometrial (IAgr3-IIB) cancers were treated by HDR intravaginal brachytherapy within the past 3.5 years. Women with or without a sexual partner were eligible. Patients completed questionnaires by mail or by telephone assessing demographic and clinical variables, adherence to vaginal dilation, dyadic satisfaction, sexual functioning, and health beliefs.Results: Seventy-eight of 89 (88%) eligible women with early-stage endometrial cancer treated with HDR brachytherapy completed questionnaires. Only 33% of patients were adherers, based on reporting having used a dilator more than two times per week in the first month following radiation. Nonadherers who reported a perceived change in vaginal dimension following radiation reported that their vaginas were subjectively smaller after brachytherapy (p = 0.013). Adherers reported more worry about their sex lives or lack thereof than nonadherers (p = 0.047). Patients reported considerable sexual dysfunction following completion of HDR brachytherapy.Conclusions: Adherence to recommendations for vaginal dilator use following HDR brachytherapy for endometrial cancer is poor. Interventions designed to educate women about dilator use benefit may increase adherence. Although sexual functioning was compromised, it is likely that this existed before having cancer for many women in our study. (C) 2011 Elsevier Inc.