TY - JOUR
T1 - Literature Review of Vaginal Stenosis and Dilator Use in Radiation Oncology
AU - Damast, Shari
AU - Jeffery, Diana D.
AU - Son, Christina H.
AU - Hasan, Yasmin
AU - Carter, Jeanne
AU - Lindau, Stacy Tessler
AU - Jhingran, Anuja
N1 - Publisher Copyright:
© 2019 American Society for Radiation Oncology
PY - 2019/11
Y1 - 2019/11
N2 - Purpose: Guidelines for the care of women undergoing pelvic radiation therapy (RT) recommend vaginal dilator therapy (VDT) to prevent radiation-induced vaginal stenosis (VS); however, no standard protocol exists. This review seeks to update our current state of knowledge concerning VS and VDT in radiation oncology. Methods and Materials: A comprehensive literature review (1972-2017) was conducted using search terms “vaginal stenosis,” “radiation,” and “vaginal dilator.” Information was organized by key concepts including VS definition, time course, pathophysiology, risk factors, and interventions. Results: VS is a well-described consequence of pelvic RT, with early manifestations and late changes evolving over several years. Strong risk factors for VS include RT dose and volume of vagina irradiated. Resultant vaginal changes can interfere with sexual function and correlational studies support the use of preventive VDT. The complexity of factors that drive noncompliance with VDT is well recognized. There are no prospective data to guide optimal duration of VDT, and the consistency with which radiation oncologists monitor VS and manage its consequences is unknown. Conclusions: This review provides information concerning VS definition, pathophysiology, and risk factors and identifies domains of VDT practice that are understudied. Prospective efforts to monitor and measure outcomes of patients who are prescribed VDT are needed to guide practice.
AB - Purpose: Guidelines for the care of women undergoing pelvic radiation therapy (RT) recommend vaginal dilator therapy (VDT) to prevent radiation-induced vaginal stenosis (VS); however, no standard protocol exists. This review seeks to update our current state of knowledge concerning VS and VDT in radiation oncology. Methods and Materials: A comprehensive literature review (1972-2017) was conducted using search terms “vaginal stenosis,” “radiation,” and “vaginal dilator.” Information was organized by key concepts including VS definition, time course, pathophysiology, risk factors, and interventions. Results: VS is a well-described consequence of pelvic RT, with early manifestations and late changes evolving over several years. Strong risk factors for VS include RT dose and volume of vagina irradiated. Resultant vaginal changes can interfere with sexual function and correlational studies support the use of preventive VDT. The complexity of factors that drive noncompliance with VDT is well recognized. There are no prospective data to guide optimal duration of VDT, and the consistency with which radiation oncologists monitor VS and manage its consequences is unknown. Conclusions: This review provides information concerning VS definition, pathophysiology, and risk factors and identifies domains of VDT practice that are understudied. Prospective efforts to monitor and measure outcomes of patients who are prescribed VDT are needed to guide practice.
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U2 - 10.1016/j.prro.2019.07.001
DO - 10.1016/j.prro.2019.07.001
M3 - Review article
C2 - 31302301
AN - SCOPUS:85071876081
SN - 1879-8500
VL - 9
SP - 479
EP - 491
JO - Practical radiation oncology
JF - Practical radiation oncology
IS - 6
ER -