American Brachytherapy Society Working Group Report on cancer surveillance, sexual health, and pelvic toxicity management in gynecologic malignancies

Purpose: This guideline provides evidence-based recommendations for the follow-up of women after gynecologic radiation therapy, including brachytherapy. Methods and Materials: A panel of members from the American Brachytherapy Society (ABS) performed a review of available literature regarding evidence for the follow-up management of gynecologic radiation therapy patients. A summary of evidence and individual clinic expertise was used to formulate general guidelines for the follow-up management. Results: This report provides recommendations regarding the frequency of follow-up examination and imaging post-treatment. Here, we also provide recommendations regarding the management of pelvic floor dysfunction and sexual and vaginal health after radiation therapy, specifically brachytherapy. In addition, recommendations are provided regarding vaginal dilators, pelvic floor physical therapy, and estrogen therapy. Conclusion: This working group report provides recommendations for appropriate surveillance of gynecologic patients postradiation therapy, as well as guidance for management of potential pelvic and vaginal toxicities related to treatment. Individual expert opinions are provided on vaginal dilator recommendations.