Evidence map›Paper›PMID 38550361›Full record

ArticleAdvances in radiation oncology2024

Long-Term Patient-Reported Dyspareunia After Definitive Chemoradiation for Anal Cancer: Using the Anterior Vaginal Wall as an Organ-at-Risk to Define an Actionable Dosimetric Goal.

Michael K Rooney, Joshua S Niedzielski, Ramon M Salazar, Angelica Arzola, Prajnan Das, Eugene J Koay, Albert Koong, Ethan B Ludmir, Bruce D Minsky, Sonal Noticewala and 3 more

Open access · goldAbstract read
In one paragraph

Article in Advances in radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
3.4field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Improving our understanding of the quality of life of patients with metastatic or recurrent/persistent anal cancer: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Pooled it
  3. Article
  4. Article
  5. Interstitial HDR brachytherapy for anal cancer-results and quality of life.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Michael K RooneyDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Joshua S NiedzielskiDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ramon M SalazarDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Angelica ArzolaDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Prajnan DasDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Eugene J KoayDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Albert KoongDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ethan B LudmirDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Bruce D MinskyDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Sonal NoticewalaDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Grace L SmithDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cullen TaniguchiDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Emma B HollidayDepartment of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
The University of Texas MD Anderson Cancer Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Chemoradiation therapy (CRT) is the standard treatment for squamous cell carcinoma of the anus (SCCA). This study aimed to investigate the relationship between vaginal dosimetry and long-term patient-reported dyspareunia after treatment. We further aimed to use the anterior vaginal wall (AVW) as an organ at risk to define an actionable dosimetric clinical goal to decrease the risk of patient-reported dyspareunia. Methods and Materials: Women with SCCA treated with intensity modulated radiation therapy-based CRT were surveyed at least 2 years after successfully completing therapy. A Female Sexual Function Index (FSFI) pain subscore ≤4 was used to define dyspareunia. Dosimetric parameters were calculated for both the full vaginal canal and AVW. Multivariable linear regression models were created to identify predictors of FSFI pain subscore using backward selection to identify final variables include in the models. An actionable dosimetric predictor for dyspareunia was established using the Youden index method for cutoff optimization. Results: Of 184 women who were contacted, 90 (49%) returned completed surveys. Of those who completed surveys, 51 (56.7%) reported being sexually active, and 47 had dosimetric data available for review. Of sexually active respondents, 32 (68%) had an FSFI pain subscore ≤4. Multiple regression models were generated using the full vaginal canal and AVW as organs at risk, and both models showed similar predictive relationships with volumetric dose parameters emerging as the best dosimetric predictors for dysparenuia. Age over 65 years was also associated with higher FSFI pain subscores (eg, less pain with intercourse) in both models. AVW V35 Gy < 60% was identified as the optimal cutoff to reduce the risk of patient-reported dyspareunia. Conclusions: Increased dose to the vaginal canal is significantly associated with worse patient-reported dyspareunia following CRT for SCCA. Minimizing dose to the AVW to V35 Gy < 60% may reduce the risk of this quality of life-limiting toxicity. Further prospective evaluation is needed to validate these findings.

Identifiers

PMID38550361
PMCPMC10966171
OpenAlexW4391487243

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.