Faculty of Medicine and Life Sciences, LCRC, Hasselt University, Hasselt, Belgium.
Limburg Oncology Center, Jessa Hospital - Campus Virga Jesse, Hasselt, Belgium.
J Obstet Gynaecol. 2022 Aug;42(6):2156-2163. doi: 10.1080/01443615.2022.2035329. Epub 2022 Feb 16.
The objective of this retrospective analysis was to determine the incidence and extent of vaginal mucositis (VM) in women with gynaecological cancer undergoing external (chemo)radiation therapy (CRT). A retrospective analysis was set up to collect data on the incidence and severity of VM in women treated with external pelvic RT for gynaecological cancer at the Jessa Hospital, Hasselt and ZOL, Genk, BE between January 2017 and June 2018. At the start and end of their external (C)RT, they rated the frequency and intensity of five common symptoms of VM. Thirty-three patients treated with RT for gynaecological cancer met the inclusion criteria. A non-negligible proportion of patients already experienced at least one VM symptom to any degree before the start of RT, a proportion that further increased towards the end of the RT (73%). At the end of RT, on average, about 25% of these patients reported moderate-to-severe symptoms (against about 7% before the (C)RT). These results suggest that VM is a rather frequent side effect in gynaecological cancer patients that aggravates during treatment up to a moderate severity level. Although the small sample size, these data highlight the need for attention to VM.Impact Statement Radiotherapy plays an important role in the treatment of gynaecological malignancies. A debilitating complication in patients undergoing pelvic radiotherapy is vaginal mucositis, an inflammation of the vaginal mucosal lining. To date, the incidence of vaginal mucositis is still not well documented. A non-negligible proportion of patients already experienced at least one symptom related to vaginal mucositis before the start of radiotherapy. Most patients presented mild to moderate vaginal mucositis symptoms at the end of external pelvic radiotherapy. Burning sensation, pruritus, and pain were the most frequently documented radiotherapy-induced complications. Vaginal mucositis is an underrated side effect of pelvic radiotherapy that needs to be tackled multidisciplinary by a team of nurses, radiotherapists, oncologists, and gynaecologists. The team should tackle the complication from the start of radiotherapy by using the most appropriate measures. Due to a possible link between acute vaginal mucositis and late vaginal toxicity, the team needs to follow-up patient's post-radiotherapy to support patients in late complications and advise/encourage patients in performing vaginal dilatation to prevent vaginal stenosis.
本回顾性分析的目的是确定接受妇科癌症外照射（放化疗）治疗的女性阴道粘膜炎（VM）的发生率和程度。本回顾性分析旨在收集 2017 年 1 月至 2018 年 6 月在比利时哈塞尔特 Jessa 医院和根特 ZOL 接受盆腔外照射治疗妇科癌症的女性 VM 发生率和严重程度的数据。在开始和结束外照射（放化疗）时，她们评估了五种常见 VM 症状的频率和强度。33 名接受妇科癌症放化疗的患者符合纳入标准。相当一部分患者在开始放疗前已经出现至少一种 VM 症状，且该比例在放疗结束时进一步增加（73%）。在放疗结束时，这些患者中约有 25%报告有中度至重度症状（而在（放化疗）前约有 7%）。这些结果表明 VM 是妇科癌症患者相当常见的副作用，在治疗过程中加重至中度严重程度。尽管样本量较小，但这些数据强调了需要关注 VM。
放疗在妇科恶性肿瘤的治疗中起着重要作用。接受盆腔放疗的患者出现的一种使人虚弱的并发症是阴道粘膜炎，即阴道黏膜内层的炎症。迄今为止，阴道粘膜炎的发生率仍未得到很好的记录。相当一部分患者在开始放疗前已经出现至少一种与阴道粘膜炎相关的症状。大多数患者在接受盆腔外照射放疗结束时出现轻度至中度阴道粘膜炎症状。烧灼感、瘙痒和疼痛是最常记录的放疗相关并发症。阴道粘膜炎是盆腔放疗被低估的副作用，需要由护士、放射治疗师、肿瘤学家和妇科医生组成的多学科团队共同处理。该团队应从放疗开始就通过使用最合适的措施来处理该并发症。由于急性阴道粘膜炎和晚期阴道毒性之间可能存在关联，该团队需要在放疗后对患者进行随访，以支持患者处理晚期并发症，并建议/鼓励患者进行阴道扩张以预防阴道狭窄。
