Dataset Information

Blue LED as a new treatment to vaginal stenosis due pelvic radiotherapy: Two case reports.

ABSTRACT:

Background

Currently, the advancement cancer treatment technology improves overall survival, however, adverse events are still a challenge for health professional. Genitourinary syndrome of menopause and vaginal stenosis are conditions that impact the quality of life of patients undergoing radiotherapy. We present two such cases in patients with previous cervical and endometrial cancer. These conditions were handled with an innovative method using an energy-based device with blue light emitting diode for concomitant vaginal and vulvar irradiation. Positive impact in clinical findings, cytologic changes, and referred symptoms were documented.

Case summary

One patient diagnosed with vaginal severe vaginal stenosis with previous cervix cancer treatment and other patient diagnosed with mild stenosis with severe dyspareunia and recent endometrium cancer treatment were considered for vulvovaginal treatment with weekly blue led device and closely evaluated with repeated validated questionnaires and cytological samples.

Conclusion

This innovative technique showed an improvement in all areas of the examiner's criteria, the cytological criteria, and most bothered symptoms.

SUBMITTER: Barros D

PROVIDER: S-EPMC8362505 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Publications

Blue LED as a new treatment to vaginal stenosis due pelvic radiotherapy: Two case reports.

Barros Daniela D Alvares Cecília C Alencar Teresa T Baqueiro Priscila P Marianno Augusto A Alves Rafael R Lenzi Juliana J Rezende Laura Ferreira LF Lordelo Patricia P

World journal of clinical cases 20210801 23

<h4>Background</h4>Currently, the advancement cancer treatment technology improves overall survival, however, adverse events are still a challenge for health professional. Genitourinary syndrome of menopause and vaginal stenosis are conditions that impact the quality of life of patients undergoing radiotherapy. We present two such cases in patients with previous cervical and endometrial cancer. These conditions were handled with an innovative method using an energy-based device with blue light e ...[more]

PMID: 34447833

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Project description:ObjectiveTo propose a consensus for prevention of vaginal stenosis in patients submitted to pelvic radiotherapy.MethodIn this methodological study, Delphi technique was applied for content validation on vaginal stenosis prevention. Data regarding content validation were collected from 32 specialists practicing in the oncology profession. The content validity index of items in the consensus was calculated based on the evaluations by the specialists.ResultsIn the first round, of the 38 items evaluated, 29 items reached a Content Validity Index (CVI-I) greater than 80%, and 9 items had a CVI lower than 80%. Of the items that did not obtain agreement, 2 items were excluded, and 7 were reformulated and included in the second round. In the second round, all 7 items obtained a CVI-I greater than 80%. The final instrument consisted of 29 items validated in the first round, plus 7 items reformulated and consolidated in the second round. The judges agreed that it is the responsibility of the health professionals to consult the patients undergoing radiation therapy in the area of sexuality to patients. The radiation oncologist should be the first professional to address this issue and the nurse oncologist in the follow-up consultation should pass the guidelines to the patients as comprehensively as possible. Patients should be informed about vaginal dilation, regardless of whether they are sexually active or have a partner. They should also be informed of when they can resume sexual activity. The procedure of vaginal dilation should be individualized. The prescribed vaginal dilators should be used with a lubricant for a duration of at least 5-10 minutes, 2-3 times a week, as per the need of each patient (sexual activity and/or clinical follow-up) for an indefinite time. Patients should seek medical help in case they experience pain, discomfort, or bleeding during dilation.ConclusionThe Brazilian version of the consensus for vaginal stenosis prevention in patients submitted to pelvic radiotherapy was validated with 36 items in 7 categories related to Responsibility; Target population; Rationale; Vaginal dilator; Content instructions; Information provision; and Patient support. In Brazil, the educational practices on vaginal dilation for patients submitted to radiotherapy partly revealed similar difficulties as identified in other studies as well as countries with reference to specific guidelines for the start and duration of vaginal dilation. The final consensus developed in this study could strengthen the guidelines for education of patients in Brazil and provide a future scope to establish a single and safe guideline.

Project description:BackgroundRadiotherapy is effective in the treatment of cancer but also causes damage to non-cancerous tissue. Pelvic radiotherapy may produce chronic and debilitating bowel symptoms, yet the underlying pathophysiology is still undefined. Most notably, although pelvic radiotherapy causes an acute intestinal inflammation there is no consensus on whether the late-phase pathophysiology contains an inflammatory component or not. To address this knowledge gap, we examined the potential presence of a chronic inflammation in mucosal biopsies from irradiated pelvic cancer survivors.MethodsWe biopsied 24 cancer survivors two to 20 years after pelvic radiotherapy, and four non-irradiated controls. Using tandem mass tag (TMT) mass spectrometry and mRNA sequencing (mRNA-seq), we charted proteomic and transcriptomic profiles of the mucosal tissue previously exposed to a high or a low/no dose of radiation. Changes in the immune cell populations were determined with flow cytometry. The integrity of the protective mucus layers were determined by permeability analysis and 16S rRNA bacterial detection.Findings942 proteins were differentially expressed in mucosa previously exposed to a high radiation dose compared to a low radiation dose. The data suggested a chronic low-grade inflammation with neutrophil activity, which was confirmed by mRNA-seq and flow cytometry and further supported by findings of a weakened mucus barrier with bacterial infiltration.InterpretationOur results challenge the idea that pelvic radiotherapy causes an acute intestinal inflammation that either heals or turns fibrotic without progression to chronic inflammation. This provides a rationale for exploring novel strategies to mitigate chronic bowel symptoms in pelvic cancer survivors.FundingThis study was supported by the King Gustav V Jubilee Clinic Cancer Foundation (CB), The Adlerbertska Research Foundation (CB), The Swedish Cancer Society (GS), The Swedish State under the ALF agreement (GS and CB), Mary von Sydow's foundation (MA and VP).

Dataset Information

Blue LED as a new treatment to vaginal stenosis due pelvic radiotherapy: Two case reports.

Background

Case summary

Conclusion

Publications

Blue LED as a new treatment to vaginal stenosis due pelvic radiotherapy: Two case reports.

Similar Datasets

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