Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island/Brown University, Providence, RI, United States of America.
The Warren Alpert Medical School at Brown University, Providence, RI, United States of America.
Gynecol Oncol. 2022 May;165(2):323-329. doi: 10.1016/j.ygyno.2022.03.008. Epub 2022 Mar 17.
Sexual dysfunction has been reported after gynecologic cancer treatment but few studies have examined sexual function during treatment. Our objectives were to describe sexual function among women receiving systemic therapy for gynecologic cancers and to compare sexual function between women receiving upfront treatment versus treatment for cancer recurrence.
We conducted a prospective study of women 18yo and older receiving systemic therapy for gynecologic cancer in the upfront or recurrent setting. Patients receiving radiation were excluded. Participants completed a survey with questions from the Patient Reported Outcome Measurement Information System (PROMIS) SexFS and Female Sexual Function Index (FSFI). Clinical information was collected from chart review. Statistical analysis included t-test, Wilcoxon rank sum test, and Fisher's exact test.
Of 145 patients approached, 100 (69%) enrolled and 97 (67%) completed the survey. Median age was 65yo. Most patients had ovarian cancer (58%), then endometrial cancer (34%) and cervical cancer (8%). Fifty-two (54%) were receiving recurrent treatment and 45 (46%) upfront treatment. Thirty-eight (76%) in the recurrent group and 34 (75%) in the upfront group hadn't been sexually active in the last month (p = 1.0); however, 61 (67%) participants reported a desire for future sexual activity. Of the 31 patients who completed all FSFI questions, the median FSFI score was 24.0 and 21 (68%) had sexual dysfunction. Vaginal dryness was more common among patients receiving recurrent treatment (p = 0.09) while a "health condition" was a more common reason for sexual inactivity in the upfront setting (p = 0.07).
Many patients receiving systemic therapy for gynecologic cancers are willing to discuss sexual function. Most patients reported sexual dysfunction and weren't currently sexually active. Understanding patients' sexual function concerns will allow providers to intervene.
妇科癌症治疗后会出现性功能障碍，但很少有研究检查治疗期间的性功能。我们的目的是描述接受妇科癌症系统治疗的女性的性功能，并比较初治与癌症复发治疗的女性的性功能。
我们对接受初治或复发性妇科癌症系统治疗的 18 岁及以上女性进行了前瞻性研究。排除接受放疗的患者。参与者完成了来自患者报告的结局测量信息系统（PROMIS）性功能量表（SexFS）和女性性功能指数（FSFI）的调查问卷。从病历回顾中收集临床信息。统计分析包括 t 检验、Wilcoxon 秩和检验和 Fisher 精确检验。
在 145 名被接触的患者中，有 100 名（69%）入组，97 名（67%）完成了调查。中位年龄为 65 岁。大多数患者患有卵巢癌（58%），其次是子宫内膜癌（34%）和宫颈癌（8%）。52 名（54%）正在接受复发性治疗，45 名（46%）正在接受初治。在复发性组中，有 38 名（67%）患者在过去一个月没有进行过性行为，而在初治组中，有 34 名（75%）患者没有进行过性行为（p = 1.0）；然而，有 61 名（67%）参与者表示希望未来有性行为。在完成所有 FSFI 问题的 31 名患者中，FSFI 评分中位数为 24.0，21 名（68%）患者存在性功能障碍。接受复发性治疗的患者中，阴道干燥更为常见（p = 0.09），而初治时，“健康状况”是导致性行为不活跃的更常见原因（p = 0.07）。
许多接受妇科癌症系统治疗的患者愿意讨论性功能。大多数患者报告性功能障碍，且目前没有进行性行为。了解患者的性功能问题将使医务人员能够进行干预。
