Samaie Nouroozi Atefeh, Alyasin Ashraf, Malek Mohammadi Ashraf, Mehrdad Nili, Mousavi Seyed Asadollah, Vaezi Mohammad, Gharib Atoosa, Ghavamzadeh Ardeshir, Mohammadi Saeed
Department of Gynecology and Obstetrics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Asian Pac J Cancer Prev. 2019 Mar 26;20(3):817-823. doi: 10.31557/APJCP.2019.20.3.817.
Sexual dysfunction (SDF) is a common sequel to cancer treatment which affects the quality of life in women treated with pelvic radiotherapy. The aim of this study was to evaluate the safety, symptom resolution and objective improvement the injection of autologous platelet released growth factor (APRGF) for treatment of SDF in cited patients. This prospective pilot study enrolled 10 cancer-free patients with SDF who underwent pelvic radiotherapy at least 5 years ago, randomly. Each patient was received 1-2 cc APRGF within four weeks and all patients were re-evaluated at eight weeks and six months. CD34 immuno histochemistry and Masson’s trichrome staining were performed on vaginal biopsy section for angiogenesis and fibrosis assay respectively. Sexual satisfaction after the injection of APRFG was clinically difference and the entire patient had sexual satisfaction. In the patient’s follow-up, none of them needs to repeat the treatment. Our results declared that APRGF injection was effective and symptoms were disappeared in the entire patients. Significant objective improvements in vaginal diameter (mean before injection, 6.5 cm vs 7.1 cm after injection) (p-value = 0.001) and vaginal flexibility (mean before treatment, 0.72 cm vs 1.85 cm after injection) (P-value = 0.026) were observed. Characteristics of discharge before the injection in 60% of patients were included dry vagina and 40% had mild discharge but after injection 40% of patients had moderate and also 60% had mild and sufficient discharge (P-value= 0.190). Overally, our patients reported better sexual function and showed better vaginal function indexes, after APRFG injection.
性功能障碍(SDF)是癌症治疗后的常见后遗症,会影响接受盆腔放疗的女性的生活质量。本研究的目的是评估注射自体血小板释放生长因子(APRGF)治疗上述患者SDF的安全性、症状缓解情况和客观改善情况。这项前瞻性试点研究随机招募了10名无癌症的SDF患者,这些患者至少在5年前接受过盆腔放疗。每位患者在四周内接受1 - 2毫升APRGF注射,所有患者在八周和六个月时进行重新评估。分别对阴道活检切片进行CD34免疫组织化学和Masson三色染色,以进行血管生成和纤维化分析。注射APRFG后的性满意度在临床上存在差异,所有患者都有性满意度。在患者随访中,没有人需要重复治疗。我们的结果表明,注射APRGF是有效的,所有患者的症状都消失了。观察到阴道直径有显著的客观改善(注射前平均为6.5厘米,注射后为7.1厘米)(p值 = 0.001)和阴道柔韧性(治疗前平均为0.72厘米,注射后为1.85厘米)(P值 = 0.026)。60%的患者注射前的分泌物特征为阴道干燥,40%有轻度分泌物,但注射后40%的患者有中度分泌物,60%有轻度且充足的分泌物(P值 = 0.190)。总体而言,我们的患者在注射APRFG后报告性功能更好,阴道功能指标也更好。