Interventions Preventing Vaginitis, Vaginal Atrophy after Brachytherapy or Radiotherapy Due to Malignant Tumors of the Female Reproductive Organs—A Systematic Review

Adrianna Wierzbicka, Dorota Mańkowska-Wierzbicka, Stanisław Cieślewicz, Marta Stelmach-Mardas and Marcin Mardas
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Adrianna Wierzbicka: Department of Obesity Treatment, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Science, Szamarzewskiego 84 St, 60-569 Poznan, Poland
Dorota Mańkowska-Wierzbicka: Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki Hospital, Przybyszewskiego 49, 60-355 Poznań, Poland
Stanisław Cieślewicz: Department of Oncology, Poznan University of Medical Science, Szamarzewskiego 82/84 St, 60-569 Poznan, Poland
Marta Stelmach-Mardas: Department of Obesity Treatment, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Science, Szamarzewskiego 84 St, 60-569 Poznan, Poland
Marcin Mardas: Department of Oncology, Poznan University of Medical Science, Szamarzewskiego 82/84 St, 60-569 Poznan, Poland

IJERPH, 2021, vol. 18, issue 8, 1-12

Abstract: Background: Radiotherapy, as a method of treatment of cervical and uterine cancers, may induce severe late-onset vaginal side effects. Unfortunately, little evidence on the management of adverse effects has been presented. This study aimed to evaluate the available interventions which reduce symptoms of vaginitis and vaginal atrophy by improving dyspareunia, mucosal inflammation, vaginal pH and vaginal dryness in women who have undergone brachytherapy or radiotherapy due to uterine or cervical malignancies. Materials and methods: A comprehensive literature search was performed following PRISMA guidelines. The systematic search was conducted using electronic databases, namely Scopus, Web of Science and PubMed, between October and November 2020 to identify randomized controlled trials (RCT) and, prospective randomized studies (PRS). Results: The analyzed population consists of 376 patients with uterine or cervical cancer, treated with hyaluronic acid, vitamin A, vitamin E, alpha-tocopherol acetate and dienestrol. Intervention with HA along with vitamin A and vitamin E revealed advantage in endpoints such as reduced dyspareunia, vaginal mucosal inflammation, vaginal dryness, bleeding, fibrosis and cellular atypia. Administration of alpha-tocopherol acetate reduced vaginal mucosal inflammation and improved vaginal acanthosis, whereas dienestrol resulted in reduced dyspareunia, vaginal caliber and bleeding. Conclusions: Vaginal suppositories were found to be clinically effective at the management of late-onset vulvovaginal side effects after radiotherapy.

Keywords: women’s health; reproductive health; vagina; vaginal atrophy; radiotherapy; brachytherapy; endometrial cancer; cervical cancer; women’s mental health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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