O impacto de diferentes terapias na atrofia vulvovaginal e na qualidade de vida em pacientes com câncer ginecológico: uma revisão sistemática

Abstract

Tumors of the female genital tract have a worldwide incidence of 17%, with cervical cancer being the most common. These tumors are capable of causing deleterious changes in vaginal health and also in personal life, with an impact on relationships, sex life and female identity. Vulvovaginal atrophy is one of the morphological alterations found in patients with gynecological cancers, both because of the biological compartment of the tumors themselves and because of the main treatments available to combat them, whether it be radiotherapy, chemotherapy or surgical excision of the organs. Thus, the aim of this study was to identify the treatments for vaginal atrophy, as well as the impact on the emotional and sexual health of women with gynecological cancers. To this end, this systematic review was conducted in accordance with the methodological guidelines proposed by the Principal Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases used to conduct the literature search were PubMed and Web of Science. A total of 886 articles were obtained in the first search. After eliminating duplicates and screening articles using the inclusion/exclusion criteria, 7 articles were obtained and analyzed graphically and descriptively. The largest number of articles were published between 2017 and 2020. Most of these studies were conducted in Italy. The interventions were tested on patients who had survived the following gynecological cancers: uterine, ovarian, vaginal and vulvar. In addition, five types of treatments were tracked and divided into: vaginal suppository, oral medication, surgical, CO2 laser therapy and vaginal dilator. Twenty-four outcomes (24) were assessed to measure vaginal health and 30 to assess general, sexual and emotional quality of life. In general, all the interventions were able to improve the vaginal health or at least the sexual health of the patients. Thus, although with limitations, all treatments represent potential for treating vulvovaginal atrophy in patients with gynecological cancers.