Sexual functioning among endometrial cancer patients treated with adjuvant high-dose-rate intra-vaginal radiation therapy Journal Article


Authors: Damast, S.; Alektiar, K. M.; Goldfarb, S.; Eaton, A.; Patil, S.; Mosenkis, J.; Bennett, A.; Atkinson, T.; Jewell, E.; Leitao, M.; Barakat, R.; Carter, J.; Basch, E.
Article Title: Sexual functioning among endometrial cancer patients treated with adjuvant high-dose-rate intra-vaginal radiation therapy
Abstract: Purpose: We used the Female Sexual Function Index (FSFI) to investigate the prevalence of sexual dysfunction (SD) and factors associated with diminished sexual functioning in early stage endometrial cancer (EC) patients treated with simple hysterectomy and adjuvant brachytherapy. Methods and Materials: A cohort of 104 patients followed in a radiation oncology clinic completed questionnaires to quantify current levels of sexual functioning. The time interval between hysterectomy and questionnaire completion ranged from <6 months to >5 years. Multivariate regression was performed using the FSFI as a continuous variable (score range, 1.2-35.4). SD was defined as an FSFI score of <26, based on the published validation study. Results: SD was reported by 81% of respondents. The mean (± standard deviation) domain scores in order of highest-to-lowest functioning were: satisfaction, 2.9 (±2.0); orgasm, 2.5 (±2.4); desire, 2.4 (±1.3); arousal, 2.2 (±2.0); dryness, 2.1 (±2.1); and pain, 1.9 (±2.3). Compared to the index population in which the FSFI cut-score was validated (healthy women ages 18-74), all scores were low. Compared to published scores of a postmenopausal population, scores were not statistically different. Multivariate analysis isolated factors associated with lower FSFI scores, including having laparotomy as opposed to minimally invasive surgery (effect size, -7.1 points; 95% CI, -11.2 to -3.1; P<.001), lack of vaginal lubricant use (effect size, -4.4 points; 95% CI, -8.7 to -0.2, P=.040), and short time interval (<6 months) from hysterectomy to questionnaire completion (effect size, -4.6 points; 95% CI, -9.3-0.2; P=.059). Conclusions: The rate of SD, as defined by an FSFI score <26, was prevalent. The postmenopausal status of EC patients alone is a known risk factor for SD. Additional factors associated with poor sexual functioning following treatment for EC included receipt of laparotomy and lack of vaginal lubricant use. © 2012 Elsevier Inc.
Keywords: adult; aged; major clinical study; cancer adjuvant therapy; cancer patient; cancer radiotherapy; radiation dose; cancer staging; endometrial cancer; hysterectomy; endometrium cancer; laparotomy; pain; radiotherapy; prevalence; sexual satisfaction; vaginal dryness; cohort analysis; risk factors; patient monitoring; validation study; oncology; questionnaire; sexual dysfunction; radiation oncology; scoring system; brachytherapy; minimally invasive surgery; cross-sectional study; regression analysis; multi variate analysis; gynecology; sexual function; diseases; sexual behavior; surveys; high dose rate; effect size; standard deviation; orgasm; continuous variables; current levels; multivariate regression; short time intervals; time interval; intravaginal radiation therapy; sexual arousal
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 84
Issue: 2
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2012-10-01
Start Page: e187
End Page: e193
Language: English
DOI: 10.1016/j.ijrobp.2012.03.030
PROVIDER: scopus
PUBMED: 22572074
PMCID: PMC5538259
DOI/URL:
Notes: --- - "Export Date: 1 October 2012" - "CODEN: IOBPD" - "Source: Scopus"
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MSK Authors
  1. Sujata Patil
    428 Patil
  2. Elizabeth Jewell
    57 Jewell
  3. Richard R Barakat
    627 Barakat
  4. Kaled M Alektiar
    262 Alektiar
  5. Mario Leitao
    329 Leitao
  6. Ethan Martin Basch
    169 Basch
  7. Jeanne Carter
    114 Carter
  8. Shari Damast
    10 Damast
  9. Anne Austin Eaton
    122 Eaton
  10. Antonia Bennett
    18 Bennett