Prospective study of vaginal dilator use adherence and efficacy following radiotherapy Journal Article

Authors: Law, E.; Kelvin, J. F.; Thom, B.; Riedel, E.; Tom, A.; Carter, J.; Alektiar, K. M.; Goodman, K. A.
Article Title: Prospective study of vaginal dilator use adherence and efficacy following radiotherapy
Abstract: Abstract Background and purpose 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. Material and methods Women with gastrointestinal (n = 63) and gynecologic (n = 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). Results 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 P <.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 P ≤.05). Conclusion 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. © 2015 Elsevier Ireland Ltd.
Keywords: adult; treatment outcome; aged; major clinical study; intensity modulated radiation therapy; fluorouracil; cancer radiotherapy; endometrium cancer; prospective study; quality of life; vagina disease; late effects; age; digestive system cancer; patient compliance; external beam radiotherapy; mitomycin; anus cancer; rectum cancer; sexual function; vagina bleeding; female genital tract cancer; pelvic radiotherapy; vaginal stenosis; vaginal discomfort; gastrointestinal cancers; human; female; priority journal; article; vaginal dilator
Journal Title: Radiotherapy and Oncology
Volume: 116
Issue: 1
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2015-07-01
Start Page: 149
End Page: 155
Language: English
DOI: 10.1016/j.radonc.2015.06.018
PROVIDER: scopus
PUBMED: 26164775
PMCID: PMC5028178
Notes: Export Date: 2 September 2015 -- Source: Scopus
Citation Impact
MSK Authors
  1. Kaled M Alektiar
    269 Alektiar
  2. Karyn A Goodman
    254 Goodman
  3. Jeanne Carter
    118 Carter
  4. Bridgette Helen Claire Thom
    56 Thom
  5. Joanne F Kelvin
    78 Kelvin
  6. Ashlyn Tom
    14 Tom
  7. Ethel Beeling P Law
    20 Law