Prospective study of vaginal dilator use adherence and efficacy following radiotherapy. Issue 1 (July 2015)

• Record Type: Journal Article
• Authors: Law, Ethel; Kelvin, Joanne F.; Thom, Bridgette; Riedel, Elyn; Tom, Ashlyn; Carter, Jeanne; Alektiar, Kaled M.; Goodman, Karyn A.
• Is Part Of: Radiotherapy and oncology. Volume 116:Issue 1(2015:Jul.)
• Page Start: 149
• Page End: 155
• Publication Date: 2015-07
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.06.018
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Background and purpose</title> <p id="sp0005">Vaginal stenosis (VS) after pelvic radiotherapy (RT) can impair long-term quality of life. We prospectively assessed adherence and efficacy of vaginal dilator (VD) use in women after pelvic RT.</p> </sec> <sec> <title id="st015">Material and methods</title> <p id="sp0010">Women with gastrointestinal (<italic>n</italic> = 63) and gynecologic (<italic>n</italic> = 46) cancers self-reported use and VD size in monthly diaries for 12 months after radiotherapy. Adherence was measured as actual VD use out of recommended times over 12 months (3×/week × 52 weeks = 156).</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">Among 109 participants, aged 28–81 years (median, 58 years), mean percent adherence over 12 months was 42% (95% confidence interval [CI], 36–48%). Adherence was highest in the first quarter (56%), but fell to 25% by the fourth. Disease type, treatment sequence, and chemotherapy were predictors of adherence (all <italic>P</italic> < .05). Eighty-two percent maintained pre-RT VD size at 12 months; of 49% with a decrease in VD size at 1 month post-RT, 71% returned to pre-RT VD size at 12 months. Disease type, younger age, and increased adherence at 6 months were associated with maintaining or returning to pre-RT size at 12 months (all <italic>P</italic> ⩽ .05).</p> </sec> <sec> <title id="st025">Conclusion</title> <p id="sp0020">VD use is effective in minimizing VS, but adherence at 12 months was poor. Studies evaluating methods of improving adherence and determining the optimal frequency and duration of use are needed.</p> </sec> </abstract>