Shankar Abhishek, Patil Jaineet, Luther Anil, Mandrelle Kavita, Chakraborty Abhijit, Dubey Anusha, Saini Deepak, Bharat Ram Pukar, Abrol Deepak, Bharti Sachidanand Jee, Bentrad Veronika
Preventive Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India.
Radiation Oncology, Christian Medical College, Ludhiana, India.
Asian Pac J Cancer Prev. 2020 Feb 1;21(2):349-354. doi: 10.31557/APJCP.2020.21.2.349.
Treatment for cervical cancer consists of hysterectomy, radiotherapy, chemotherapy and targeted therapy in different combination based on stage at presentation. However, late consequences of such radical treatments are known but not many Indian studies have reported it. Quality of life and impact on sexual health has become an important issue in view of long survival of cervical cancer patients. LENTSOMA scale is one such scale validated for scoring radiotherapy related morbidity. However, there is need for a comprehensive scale covering all aspects of physical and psychological disruptions to provide complete recovery and rehabilitation. The study was prospective and patients who were treated for cervical cancer on follow up were included in this study. A total of 85 patients, who were treated with surgery, radiotherapy, chemotherapy alone or in combination, comprising of stage I to stage IV disease, participated in this study. Findings of this study showed that pain during intercourse and altered sexual life were reported by 32.9% and 25.9% patients respectively whereas 24.7% found it problematic and in 22.3% patients, alteration in interest in sex were reported. Vaginal stenosis was seen in 75.29% of patients after treatment with decreased frequency of intercourse after treatment was seen in 16.4 % of patients. Combination of surgery and radiotherapy in cervical cancer patients caused more sexual dysfunction and dissatisfaction, especially in lower age group. Treatment morbidity in term of sexual function was more with advanced stage disease and with the patients on longer follow up. Sexual function is an important aspect of quality of life but there is no single self-report measure in routine clinical follow up use which is brief, easy to complete and incorporates all (physical, psychological, emotional) aspects of sexual health for people affected by cancer.
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宫颈癌的治疗包括子宫切除术、放疗、化疗和靶向治疗,具体治疗方案根据就诊时的分期采用不同组合。然而,这类根治性治疗的晚期后果是已知的,但印度的相关研究报道较少。鉴于宫颈癌患者的长期生存,生活质量以及对性健康的影响已成为一个重要问题。LENTSOMA量表就是一种用于评估放疗相关发病率的有效量表。然而,需要一个全面的量表来涵盖身体和心理干扰的各个方面,以实现完全康复和康复治疗。本研究为前瞻性研究,纳入了接受宫颈癌治疗并处于随访期的患者。共有85例患者参与了本研究,他们接受了手术、放疗、化疗单独或联合治疗,疾病分期从I期到IV期。本研究结果显示,分别有32.9%和25.9%的患者报告性交时疼痛和性生活改变,而24.7%的患者认为这是个问题,22.3%的患者报告对性的兴趣发生了改变。75.29%的患者在治疗后出现阴道狭窄,16.4%的患者治疗后性交频率降低。宫颈癌患者接受手术和放疗联合治疗会导致更多性功能障碍和不满,尤其是在年龄较小的患者群体中。晚期疾病患者和随访时间较长的患者在性功能方面的治疗发病率更高。性功能是生活质量的一个重要方面,但在常规临床随访中,没有一种简单、易于完成且能涵盖癌症患者性健康所有(身体、心理、情感)方面的自我报告测量方法。