1
|
Forret A, Mares P, Delacroix C, Chevallier T, Potier H, Fatton B, Masia F, Ripart S, Letouzey V, de Tayrac R, Salerno J. [Photobiomodulation and vulvovaginal disorders after anticancer treatments]. Bull Cancer 2023; 110:883-892. [PMID: 37183056 DOI: 10.1016/j.bulcan.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 05/16/2023]
Abstract
Anticancer treatments induce vulvovaginal complications that alter the quality of life and sexuality of patients. New technologies, such as photobiomodulation, could address this problem, for which few effective therapeutic solutions exist. The objective of this study was to describe the characteristics of patients seeking treatment and to observe the effects of photobiomodulation. This is a prospective cohort of patients treated for cancer, in failure of first-line medical treatment, managed at the University Hospital of Nîmes. The history, symptoms and impact of the disorders on their quality of life were collected. At follow-up, improvement was assessed using the PGI-I and FSFI questionnaires. Twenty-eight patients were treated. They were all menopausal, half of them after anticancer treatments [chemotherapy (78%), radiotherapy (36%), hormone therapy (36%)]. The main symptom reported was vaginal dryness (72%). Seventy-one percent of patients (n=20) felt that their daily life was affected≥8/10. All patients had sexual dysfunction. Twenty-two patients received at least 6 sessions of photobiomodulation. Seventy-two percent (n=18) of patients felt better or much better after treatment (PGI-I≤2). The median improvement estimated by the patients was 65% (Q1=50%; Q3=72.5%). There was also a significant clinical improvement. No serious adverse events were reported. Due to the small number of patients in a heterogeneous population with no control group, we cannot extrapolate our results. However, the objective was to assess the status of these pathologies and the contribution of photobiomodulation in patients who have failed first-line treatment; and these results are encouraging.
Collapse
Affiliation(s)
- Amaury Forret
- CHU Amiens-Picardie, service de gynécologie-obstétrique, 1, rue du Professeur-Christian-Cabrol, 80000 Amiens, France.
| | - Pierre Mares
- CHU de Nîmes, service de gynécologie-obstétrique, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Charlotte Delacroix
- CHU de Nîmes, service de gynécologie-obstétrique, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Thierry Chevallier
- CHU de Nîmes, service BESPIM, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France; Université de Montpellier, Institut Desbrest d'épidémiologie et de santé publique, UMR 1302, UMR Inserm, Montpellier, France
| | - Hugo Potier
- CHU de Nîmes, service BESPIM, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France; Université de Montpellier, Institut Desbrest d'épidémiologie et de santé publique, UMR 1302, UMR Inserm, Montpellier, France
| | - Brigitte Fatton
- CHU de Nîmes, service de gynécologie-obstétrique, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Florent Masia
- CHU de Nîmes, service de gynécologie-obstétrique, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Sylvie Ripart
- CHU de Nîmes, service de gynécologie-obstétrique, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Vincent Letouzey
- CHU de Nîmes, service de gynécologie-obstétrique, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Renaud de Tayrac
- CHU de Nîmes, service de gynécologie-obstétrique, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France
| | - Jennifer Salerno
- CHU de Nîmes, service de gynécologie-obstétrique, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France; Service de chirurgie gynécologique, Clinique Beau-Soleil, 119, avenue de Lodeve, 34070 Montpellier, France
| |
Collapse
|
2
|
Bretas TLB, Issa MCA, Fialho SCAV, Villar EAG, Velarde LGC, Pérez-López FR. Vaginal collagen I and III changes after carbon dioxide laser application in postmenopausal women with the genitourinary syndrome: a pilot study. Climacteric 2021; 25:186-194. [PMID: 34291703 DOI: 10.1080/13697137.2021.1941850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the clinical response and collagen remodeling in the vaginal wall after three sessions of carbon dioxide (CO2) laser application. METHODS Fourteen postmenopausal women with vulvovaginal atrophy, aged 45-65 years and sexually active, were evaluated with clinical questionnaires, gynecological examinations and histological techniques before and after 20 weeks of treatment (ClinicalTrials.gov NCT03939078). Treatment consisted of 3-monthly sessions of the CO2 laser. Clinical questionnaires included the Vaginal Health Index, the Female Sexual Function Index and the International Consultation on Incontinence Questionnaires Short Form. Biopsies were taken from the lateral vaginal wall at week 0 (left wall) and week 20 (right wall). Tissue samples were stained with hematoxylin and eosin, Periodic Acid-Schiff, Picrosirius Red Stain and Orcein dyes. Immunohistochemical study was used to quantify collagens I and III in the samples. RESULTS The mean age was 54.4 ± 4.5 years, and the average time of amenorrhea was 7.6 ± 5.1 years. The Female Sexual Function Index and the Vaginal Health Index Score values increased while the International Consultation on Incontinence Questionnaire Short Form score decreased after the programmed treatment. There was no significant change in vaginal pH. Histological studies showed increases in the total and superficial epithelial cell layers, and type III collagen fibers (from 10.86 ± 7.66 to 16.87 ± 3.96, p < 0.05), and immunohistochemical studies confirmed the significant increase in collagen III. CONCLUSION Histological findings revealed epithelial atrophy reversal and collagen remodeling of the vaginal wall. Immunohistochemical analysis showed an increase in collagen type III fibers.
Collapse
Affiliation(s)
- T L B Bretas
- Department of Clinical Medicine, Federal Fluminense University Faculty of Medicine, Niteroi, Brazil
| | - M C A Issa
- Department of Clinical Medicine, Federal Fluminense University Faculty of Medicine, Niteroi, Brazil
| | - S C A V Fialho
- Maternal and Child Department, Federal Fluminense University Faculty of Medicine, Niteroi, Brazil
| | - E A G Villar
- Department of Pathology, Federal Fluminense University Faculty of Medicine, Niteroi, Brazil
| | - L G C Velarde
- Department of Statistics, Federal Fluminense University, Niteroi, Brazil
| | - F R Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
| |
Collapse
|