Quality of life of patients with cervical cancer after radiotherapy and chemoradiotherapy

«Radiation and Risk», 2020, vol. 29, No. 1, pp.120-128

DOI: 10.21870/0131-3878-2020-29-1-120-128


Mkrtchyan L.S. – Lead. Researcher, C. Sc., Med. Contacts: 4 Korolyov str., Obninsk, Kaluga region, Russia, 249035. Tel.: +7 (484) 399-32-04; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Ivanov S.A. – Director, MD, Prof.
Kulieva G.Z.K. – Researcher
Zamulaeva I.A. – Head of Dep., D. Sc., Biol., Prof.
Krikunova L.I. – Head of Dep., MD, Prof. A. Tsyb MRRC

A. Tsyb MRRC, Obninsk


Radical courses of combined radiation and chemoradiation therapy cause the development of genitourinary syndrome of menopause (GSM) in patients with cervical cancer, that significantly affects their quality of life. In this connection there is a need to develop effective methods for managing perineovaginal atrophy. We drew our attention on health benefits of hyaluronic acid and on the results of the use of volume-forming gels based on the hyaluronic acid for treatment of complications in patients with gynecological cancer and induced menopause. That was the reason to study the usability of hyaluroinc acid based biomaterials for rehabilitation treatment of women underwent specialised treatment for cervical cancer. The study included 33 postmenopausal women with stage Ib2-III cervical cancer (average age was 52.0+/-9.0 years, average age of menopause onset was 43.9+/-1.2 years, average duration of menopause was 8.0+/-5.6 years). All patients underwent combined radiation (18.2%) or chemoradiation therapy (81.8%). After treatment no signs of the disease progression were found. All patients had vaginal atrophy of different severity (the average pH of the vaginal discharge was 6.5+/-0.7; the vaginal health index score was 6.9+/-2.8), this abnormality negatively affected the quality of sexual life (average score for the questionnaire PISQ-12 – 15.9+/-4.9; median – 16 (33.3%) out of 48 possible). For treatment of perineovaginal atrophic changes volume-forming fillers based on stabilized hyaluronic acid were injected using intravaginal (submucous) and perineal (subdermal) injection techniques. Re-examination carried out in 4 weeks after treatment demonstrated statistically significant pH value reduction (average value – 5.4+/-0.8), increased intravaginal health index score (average score – 16.5+/-2.5) (p<0.05) and no recurrent postmeno-pausal atrophic vaginitis symptoms. All of this positively affected sexual function (the average score for the PISQ-12 questionnaire was 11.9+/-4.9, p<0.05). Our results demonstrate effectiveness of the developed treatment of atrophic vaginitis in cervical cancer patients underwent radical courses of combined radiation and chemoradiation therapy.

Key words
cervical cancer, combined radiotherapy, chemoradiotherapy, quality of life, genitourinary syndrome of menopause, postmenopausal vaginitis, hyaluronic acid.


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