ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2019
Extended duration of dilator use beyond 1 year may reduce vaginal stenosis after intravaginal high-dose-rate brachytherapy.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Vaginal dilator therapy for pelvic cancer patients: a review.Gynecologic oncology reports · 2026Review
- The effectiveness of a 3-dimensional printed vaginal dilator in mitigating radiation-induced vaginal stenosis for patients with cervical cancer.Journal of gynecologic oncology · 2026Article
- High-Dose-Rate Brachytherapy for Vaginal Rhabdomyosarcoma (RMS): Lessons Learned at a Single Institution.International journal of radiation oncology, biology, physics · 2025Article
- Clinical practice guidelines: sexual dysfunction in gynecological cancer patients.Sexual medicine · 2025Review
- Vulvovaginal Atrophy Following Treatment for Oncogynecologic Pathologies: Etiology, Epidemiology, Diagnosis, and Treatment Options.Medicina (Kaunas, Lithuania) · 2024Review
- Impact of Vaginal Dilator Use and 68 Gy EQD2Journal of personalized medicine · 2024Article
- Review
- Pelvic Floor Therapy and Initial Interventions for Pelvic Floor Dysfunction in Gynecologic Malignancies.Current oncology reports · 2024Review
- Vaginal dilator use more than 9 months is a main prognostic factor for reducing G2‑late vaginal complications in 3D‑vaginal‑cuff brachytherapy (interventional radiotherapy)?Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023Article
- Patient reported improvement in sexual health outcomes following care in a sexual health clinic for women with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- Compliance and clinical efficacy of vaginal dilator after radiotherapy for cervical and endometrial malignancies.Ecancermedicalscience · 2023Article
- Preliminary results of a vaginal constraint for reducing G2 late vaginal complications after postoperative brachytherapy in endometrial cancer: a prospective analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2022Article
- Vaginal stenosis in women with cervical or endometrial cancer after pelvic radiotherapy: a cross-sectional study of vaginal measurements, risk for sexual dysfunction and quality of life.International urogynecology journal · 2022Article
- Assessment of an onco-sexology support and follow-up program in cervical or vaginal cancer patients undergoing brachytherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Pelvic Radiation Therapy Induced Vaginal Stenosis: A Review of Current Modalities and Recent Treatment Advances.Medicina (Kaunas, Lithuania) · 2021Review
- EQD2 Analyses of Vaginal Complications in Exclusive Brachytherapy for Postoperative Endometrial Carcinoma.Cancers · 2020Article
- The microbiome and gynaecological cancer development, prevention and therapy.Nature reviews. Urology · 2020Review
- Literature Review of Vaginal Stenosis and Dilator Use in Radiation Oncology.Practical radiation oncology · 2019Review
- Vaginal stenosis and dilator use after pelvic brachytherapy.Revista CuidarteArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVaginal dilators (VD) are recommended following vaginal or pelvic radiotherapy for patients with endometrial carcinoma (EC) to prevent vaginal stenosis (VS). The time course of VS is not fully understood and the optimal duration of VD use is unknown.
methodsWe reviewed 243 stage IA-II EC patients who received adjuvant brachytherapy (BT) at an academic tertiary referral center. Patients were instructed to use their VD three times per week for at least 1-year duration. The primary outcome was development of grade ≥ 1 VS using CTCAEv4 criteria during the follow-up period. The log-rank test and multivariable Cox proportional hazards modeling were used to evaluate the effect of VD use (noncompliance vs. standard compliance [up to 1 year] vs. extended compliance [over 1 year]) on VS.
resultsThe median follow-up was 15.2 months over the 5-year study period. At 15 months, the incidence of VS was 38.8% for noncompliant patients, 33.5% for those with standard compliance, and 21.4% for those with extended compliance (median time to grade ≥ 1 VS was 17.5 months, 26.7 months, and not yet reached for these groups, respectively). On multivariable Cox regression analysis, extended compliance remained a significant predictor of reduced VS risk when compared to both noncompliance (HR 0.38, 95% CI 0.18-0.80, p = 0.012) and standard compliance (HR 0.43, 95% CI 0.20-0.89, p = 0.023).
conclusionsThe risk of VS persists beyond 1 year after BT. Extended VD compliance beyond 1 year may mitigate this risk.
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