University Clinical Centre Tuzla, Department of Gynaecology and Obstetrics, Univerzitetska, Tuzla, Bosnia and Herzegovina.
Bosn J Basic Med Sci. 2011 Feb;11(1):62-4. doi: 10.17305/bjbms.2011.2628.
The opinion regarding sexual and vaginal function of patients with advanced cervical cancer treated primarily by chemoradiotherapy has still not been formed, mainly due to inappropriate methodology as the control group was comprised of healthy women. The aim of this study is to, by means of interview, evaluate vaginal and sexual function of patients with advanced cervical cancer before and after chemoradiotherapy and compare the results. A number of 35 patients were irradiated by teleradiotherapy dose of 45 Gy in 25 fractions over 5 weeks to the pelvis and additional 20-24 Gy in 4-6 fractions were given by intracavitary HDR brachytherapy. Patients received 40 mg/m(2) of cisplatin once a week, which is a total of 4-6 cycles of cisplatin. Patients answered the questions in a form of a questionnaire specifically created for cervical cancer (EORTC-QLQ-Cx 24), for the period immediately before diagnosed cervical cancer (thus being a control group). They also answered the same questions for the period starting 12 months after the completion of concomitant chemoradiotherapy, and were an experimental group at the time. For the testing of statistical significance of differences among the examined groups parameter and non-parameter tests were used (the Wilcoxon signed ranks test and Student's t-test). The difference p<0.05 was considered statistically significant. Vaginal problems of patients after chemoradiotherapy were statistically reduced (44 versus 0; p<0.0001). There is no statistical significance in the vaginal function among the analyzed groups but weaker pain during intercourse was registered after chemoradiotherapy (p=0.009). After chemoradiotherapy, patients' vaginal function is extremely improved whereas there is no difference in the sexual function. Pain during intercourse is statistically reduced after chemoradiotherapy.
关于接受放化疗为主的中晚期宫颈癌患者的性及阴道功能的观点尚未形成,主要是因为对照组由健康女性组成,方法不当。本研究旨在通过访谈评估中晚期宫颈癌患者放化疗前后的阴道和性功能,并比较结果。35 例患者接受盆腔外照射 45 Gy/25 次,5 周;腔内后装放疗 20-24 Gy/4-6 次。同期每周给予顺铂 40mg/m2,共 4-6 个周期。患者填写了专门为宫颈癌设计的问卷(EORTC-QLQ-Cx24),填写时间分别为宫颈癌确诊前(作为对照组)和放化疗结束后 12 个月(作为实验组)。统计分析采用参数检验和非参数检验(Wilcoxon 符号秩检验和 Student's t 检验),检验水准为 P<0.05。放化疗后患者的阴道问题显著减少(44 例 vs 0 例;P<0.0001)。但各组阴道功能差异无统计学意义,但放化疗后性交疼痛减轻(p=0.009)。放化疗后患者阴道功能显著改善,性功能无差异,性交疼痛减轻。