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Efficacy of a nurse-led sexual rehabilitation intervention for women with gynaecological cancers receiving radiotherapy: results of a randomised trial.
Suvaal, Isabelle; Hummel, Susanna B; Mens, Jan-Willem M; Tuijnman-Raasveld, Charlotte C; Tsonaka, Roula; Velema, Laura A; Westerveld, Henrike; Cnossen, Jeltsje S; Snyers, An; Jürgenliemk-Schulz, Ina M; Lutgens, Ludy C H W; Beukema, Jannet C; Haverkort, Marie A D; Nowee, Marlies E; Nout, Remi A; de Kroon, Cor D; van den Hout, Wilbert B; Creutzberg, Carien L; van Doorn, Helena C; Ter Kuile, Moniek M.
Afiliación
  • Suvaal I; Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands.
  • Hummel SB; Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands.
  • Mens JM; Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Tuijnman-Raasveld CC; Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands.
  • Tsonaka R; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
  • Velema LA; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • Westerveld H; Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
  • Cnossen JS; Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands.
  • Snyers A; Department of Radiation Oncology, Radboudumc, Nijmegen, The Netherlands.
  • Jürgenliemk-Schulz IM; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Lutgens LCHW; Department of Radiation Oncology, Maastro, Maastricht, The Netherlands.
  • Beukema JC; Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands.
  • Haverkort MAD; Department of Radiation Oncology, Radiotherapiegroep, Arnhem, The Netherlands.
  • Nowee ME; Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
  • Nout RA; Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • de Kroon CD; Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands.
  • van den Hout WB; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
  • Creutzberg CL; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • van Doorn HC; Department of Gynaecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Ter Kuile MM; Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands. M.M.ter_Kuile@lumc.nl.
Br J Cancer ; 131(5): 808-819, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38961193
ABSTRACT

BACKGROUND:

The multicentre randomised SPARC trial evaluated the efficacy of a nurse-led sexual rehabilitation intervention on sexual functioning, distress, dilator use, and vaginal symptoms after radiotherapy for gynaecological cancers.

METHODS:

Eligible women were randomised to the rehabilitation intervention or care-as-usual. Four intervention sessions were scheduled over 12 months, with concurrent validated questionnaires and clinical assessments. Primary outcome was the Female Sexual Function Index (FSFI). A generalised-mixed-effects model compared groups over time.

RESULTS:

In total, 229 women were included (n = 112 intervention; n = 117 care-as-usual). No differences in FSFI total scores were found between groups at any timepoint (P = 0.37), with 12-month scores of 22.57 (intervention) versus 21.76 (care-as-usual). The intervention did not significantly improve dilator use, reduce sexual distress or vaginal symptoms compared to care-as-usual. At 12 months, both groups had minimal physician-reported vaginal stenosis; 70% of women were sexually active and reported no or mild vaginal symptoms. After radiotherapy and brachytherapy, 85% (intervention) versus 75% (care-as-usual) of participants reported dilation twice weekly.

DISCUSSION:

Sexual rehabilitation for women treated with combined (chemo)radiotherapy and brachytherapy improved before and during the SPARC trial, which likely contributed to comparable study groups. Best practice involves a sexual rehabilitation appointment 1 month post-radiotherapy, including patient information, with dilator guidance, preferably by a trained nurse, and follow-up during the first year after treatment. CLINICAL TRIAL REGISTRATION NCT03611517.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de los Genitales Femeninos Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Br J Cancer Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de los Genitales Femeninos Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Br J Cancer Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido