Jaber Sireen, Levin Gabriel, Ram-Weiner Maya, Lev-Sagie Ahinoam
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9765422, Israel.
The Department of Gynecologic Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel.
Cancers (Basel). 2025 Apr 6;17(7):1241. doi: 10.3390/cancers17071241.
We aimed to study the efficacy of fractional CO laser for genitourinary syndrome of menopause (GSM) symptoms in breast cancer (BC) survivors through a randomized, sham-controlled study, followed by an open-phase study assessing the impact of additional treatments.
BC survivors with GSM were randomized to receive either three sessions of intravaginal CO laser or sham treatment every 3-4 weeks. The laser's energy was 45-60 mJ/pixel. Outcomes were compared one month following the last session. Participants initially receiving laser treatment were offered three more sessions, while those receiving sham had six laser sessions in an open-label study.
Thirty-four BC survivors were randomized to laser (n = 19) or sham (n = 15) treatments. Dyspareunia and intercourse dryness scores improved in both groups one month post-treatment, without a significant advantage of laser over sham. The laser treatment resulted in a reduction in daily dryness (-1.30 ± 0.55, = 0.017), an increase in vaginal hydration (3.24 ± 1.13, = 0.004), and an increase in Vaginal Health Index (VHI) (2.26 ± 0.50, < 0.001). Most participants (18/19 and 9/15, respectively) opted to continue laser treatments after unblinding, resulting in 27 patients receiving six laser treatments. Increasing the number of laser treatments was associated with a constant improvement in Visual Analogue Score (VAS) scores for dyspareunia, intercourse dryness, daily dryness, burning, discomfort, itch, and average VAS, as well as pH, VHI, and hydration. Conclusions Three fractional CO laser treatments for BC survivors reduced daily dryness but did not improve dyspareunia and sexual dryness when compared to sham in this randomized trial. Increasing the number of treatment sessions seemed to improve outcomes; however, it remained clinically insufficient, even after six treatments.
我们旨在通过一项随机、假对照研究，研究分次二氧化碳激光治疗乳腺癌（BC）幸存者绝经后泌尿生殖综合征（GSM）症状的疗效，随后进行一项开放阶段研究，评估额外治疗的影响。
患有GSM的BC幸存者被随机分为每3 - 4周接受三次阴道内二氧化碳激光治疗或假治疗。激光能量为45 - 60 mJ/像素。在最后一次治疗后一个月比较结果。最初接受激光治疗的参与者又接受了三次治疗，而接受假治疗的参与者在一项开放标签研究中接受了六次激光治疗。
34名BC幸存者被随机分为激光治疗组（n = 19）或假治疗组（n = 15）。两组在治疗后一个月性交困难和性交干涩评分均有所改善，激光治疗组与假治疗组相比无显著优势。激光治疗使每日干涩程度降低（-1.30±0.55，P = 0.017），阴道湿润度增加（3.24±1.13，P = 0.004），阴道健康指数（VHI）增加（2.26±0.50，P < 0.001）。大多数参与者（分别为18/19和9/15）在揭盲后选择继续激光治疗，导致27名患者接受了六次激光治疗。增加激光治疗次数与性交困难、性交干涩、每日干涩、灼烧感、不适感、瘙痒的视觉模拟评分（VAS）以及平均VAS评分持续改善相关，同时与pH值、VHI和湿润度也相关。结论 在这项随机试验中，与假治疗相比，三次分次二氧化碳激光治疗可减轻BC幸存者的每日干涩程度，但并未改善性交困难和性交干涩。增加治疗次数似乎可改善结局；然而，即使经过六次治疗，在临床上仍显不足。
