Pôle Centre de Psychiatrie générale, Unité d'hospitalisation Adulte "L'Odyssée", Centre Hospitalier Henri Guérin Pierrefeu-du-var, Toulon, France.
Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France.
Support Care Cancer. 2021 Aug;29(8):4311-4318. doi: 10.1007/s00520-020-05898-9. Epub 2021 Jan 7.
Women's sexual health and wellbeing with cervical or vaginal cancer may be largely affected by complications from external beam radiotherapy (EBRT) and utero-vaginal brachytherapy (BT), of which vaginal stenosis is the main complication. The objective of this study was to assess the impact of support by a nurse sexologist on sexuality, vaginal side-effects, and the quality of clinical follow-up in patients treated with brachytherapy for cervical or vaginal cancer.
We performed a retrospective study of the sexuality of women treated for cervical or vaginal cancer. Data from patients with cervical or vaginal cancer who underwent brachytherapy between 2013 and 2017 were collected at Institut Universitaire de Cancer de Toulouse-Oncopôle (IUCT-Oncopôle). Patients were divided into two groups: group A (intervention group) received support from a nurse sexologist and group B (control group) did not. The chi-square test and a logistic multivariate model were used for data analysis.
A total of 156 patients were included in this study, including 57.7% who were followed by a nurse sexologist. We observed low compliance in using vaginal dilators after brachytherapy and/or radiotherapy over time regardless of the group, and patients' sexual activity was inadequately addressed. Information regarding the resumption of sexuality 2 months after treatment was missing in 1.1% of patients in group A and in 36.4% of patients in group B. Multivariate analysis showed that patients in group A had a lower risk of developing vaginal stenosis with OR = 0.5 (95% CI = 0.25-0.92) and OR . = 0.5 (95% CI = 0.26-1.09) compared with those in group B.
This retrospective study highlights the lack of information collected by physicians during follow-up concerning the sexuality of patients with cervical or vaginal cancer treated by EBRT and BT. The support offered by nurse sexologists in improving patients' sexual activity and reducing their physical side-effects such as vaginal stenosis is likely to be beneficial. A prospective study is currently being conducted to validate the present findings.
宫颈癌或阴道癌患者的女性性健康和幸福感可能会受到外照射放疗（EBRT）和子宫阴道近距离放疗（BT）的并发症的极大影响，其中阴道狭窄是主要并发症。本研究的目的是评估护士性治疗师对接受宫颈癌或阴道癌 BT 治疗的患者的性行为、阴道副作用和临床随访质量的支持的影响。
我们对接受宫颈癌或阴道癌治疗的女性的性行为进行了回顾性研究。在图卢兹癌症研究所-Oncopôle（IUCT-Oncopôle）收集了 2013 年至 2017 年间接受 BT 治疗的宫颈癌或阴道癌患者的数据。患者分为两组：A 组（干预组）接受护士性治疗师的支持，B 组（对照组）不接受。数据采用卡方检验和逻辑多元模型进行分析。
本研究共纳入 156 例患者，其中 57.7%的患者接受了护士性治疗师的随访。我们观察到，无论分组如何，BT 和/或放疗后使用阴道扩张器的依从性随时间逐渐降低，且患者的性行为未得到充分关注。A 组中有 1.1%的患者和 B 组中有 36.4%的患者在治疗后 2 个月时缺少关于恢复性行为的信息。多因素分析显示，A 组患者发生阴道狭窄的风险较低，OR=0.5（95%CI=0.25-0.92）和 OR=0.5（95%CI=0.26-1.09）与 B 组相比。
本回顾性研究强调了在 EBRT 和 BT 治疗宫颈癌或阴道癌患者的随访过程中，医生对患者性行为的信息收集不足。护士性治疗师提供的支持可能有助于改善患者的性行为，并减少阴道狭窄等身体副作用。目前正在进行一项前瞻性研究来验证本研究结果。
