Patient-reported sexual health outcomes of cervical cancer patients treated with definitive chemoradiation and MRI-guided brachytherapy

• Published in: Gynecologic oncology 2024-11, Vol.190, p.153-159
• Main Authors: Chuk, Elizabeth, Conway, Jessica L., Hanuschak, Jennifer, Han, Kathy, Milosevic, Michael, Lukovic, Jelena, Ferguson, Sarah E., Salman, Ailya, Santiago, Anna T., Rink, Alexandra, Croke, Jennifer
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anxiety - etiology; Brachytherapy - adverse effects; Brachytherapy - methods; Chemoradiotherapy - adverse effects; Cross-Sectional Studies; Depression - epidemiology; Depression - etiology; Female; Humans; Menopause; Middle Aged; Patient Reported Outcome Measures; Patient-reported-outcomes; Prospective Studies; Radiotherapy, Image-Guided - adverse effects; Radiotherapy, Image-Guided - methods; Sexual Dysfunction, Physiological - epidemiology; Sexual Dysfunction, Physiological - etiology; Sexual Health; Survivorship; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - psychology; Uterine Cervical Neoplasms - radiotherapy; Uterine Cervical Neoplasms - therapy
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2024.08.022

Sexual health is an important survivorship issue in cervical cancer. We assessed patient-reported sexual health outcomes and correlations with oncologist-assessed vaginal toxicity (VT). This was a prospective, cross-sectional study of stage IB-IVA cervical cancer patients treated with definitive chemoradiation, who completed a socio-demographic questionnaire and the following patient-reported-outcomes (PROs): Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Menopause Rating Scale (MRS), Hospital Anxiety and Depression Scale (HADS). VT was assessed using the CTCAE v4.0. Sociodemographic, clinical data, PROs and VT were summarized using descriptive statistics; correlations were evaluated using linear regression analyses. Between August 2018 and April 2022, 73 patients were analyzed. Median age was 49 (range 25–81), 57.5% had vaginal involvement at diagnosis and 76.9% were partnered. Sexual dysfunction (FSFI score ≤ 26), sexual distress (FSDS-R ≥ 11), severe menopausal symptoms (MRS ≥ 17), anxiety (HAD-Anxiety >7) and depression (HAS-Depression >7) were reported in 86.3%, 54.5%, 36.2%, 46.6% and 24.7%, respectively. Grade 2+ VT was reported in 27.4%. No significant associations were found between PROs and VT. On multivariable analysis, non-partnered status, use of hormone replacement therapy, and International Commission on Radiation Units and Measurements – rectovaginal dose (ICRU-RV) >65Gy were associated with worse sexual health (p