Literature review of vaginal stenosis and dilator use in radiation oncology Journal Article

Authors: Damast, S.; Jeffery, D. D.; Son, C. H.; Hasan, Y.; Carter, J.; Lindau, S. T.; Jhingran, A.
Article Title: Literature review of vaginal stenosis and dilator use in radiation oncology
Abstract: Purpose: Guidelines for the care of women undergoing pelvic radiation therapy (RT) recommend vaginal dilator therapy (VDT) to prevent radiation-induced vaginal stenosis (VS); however, no standard protocol exists. This review seeks to update our current state of knowledge concerning VS and VDT in radiation oncology. Methods and Materials: A comprehensive literature review (1972-2017) was conducted using search terms “vaginal stenosis,” “radiation,” and “vaginal dilator.” Information was organized by key concepts including VS definition, time course, pathophysiology, risk factors, and interventions. Results: VS is a well-described consequence of pelvic RT, with early manifestations and late changes evolving over several years. Strong risk factors for VS include RT dose and volume of vagina irradiated. Resultant vaginal changes can interfere with sexual function and correlational studies support the use of preventive VDT. The complexity of factors that drive noncompliance with VDT is well recognized. There are no prospective data to guide optimal duration of VDT, and the consistency with which radiation oncologists monitor VS and manage its consequences is unknown. Conclusions: This review provides information concerning VS definition, pathophysiology, and risk factors and identifies domains of VDT practice that are understudied. Prospective efforts to monitor and measure outcomes of patients who are prescribed VDT are needed to guide practice. © 2019 American Society for Radiation Oncology
Keywords: review; treatment duration; pathophysiology; cancer radiotherapy; radiation dose; nuclear magnetic resonance imaging; pelvis; vagina disease; patient monitoring; practice guideline; radiation injury; risk factor; prescription; correlation analysis; radiation oncology; disease management; sexual function; clinical outcome; protocol compliance; vaginal stenosis; human; priority journal; radiation oncologist; pelvic radiation therapy
Journal Title: Practical Radiation Oncology
Volume: 9
Issue: 6
ISSN: 1879-8500
Publisher: Elsevier Inc.  
Date Published: 2019-11-01
Start Page: 479
End Page: 491
Language: English
DOI: 10.1016/j.prro.2019.07.001
PUBMED: 31302301
PROVIDER: scopus
Notes: Review -- Source: Scopus
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MSK Authors
  1. Jeanne Carter
    115 Carter