Quality of life of patients with cervical and uterine cancer after radical treatment and rehabilitation options using hyaluronic acid-based volume-forming agents

Purpose of the study. To assess the quality of life in patients with cervical cancer (CC) and endometrial cancer (EC) after radical treatment and to evaluate the effectiveness of hyaluronic acid (HA)-based volumizing agents in correcting vulvovaginal atrophy (VVA).

Patients and methods. The study included 201 patients with stage I–III CC and stage I–II EC (FIGO, 2018) after surgical (Group 1, 33.3 %), combined (Group 2, 37.3 %), or concurrent radiotherapy/chemoradiotherapy (Group 3, 29.4 %). Corrective therapy consisted of intravaginal and perineal administration of HA-based formulations according to the authors’ technique. Dynamic evaluation included vaginal transudate pH, Vaginal Health Index (VHI), and sexual function (PISQ‑12).

Results. Following radical treatment, all patients demonstrated severe VVA, which was more pronounced in groups receiving radiotherapy either alone or as adjuvant treatment – vaginal pH 6.59 ± 0.6 and 6.43 ± 0.8, respectively, versus 6.05 ± 0.9 after surgery (p = 0.001 and p = 0.01). VHI was 7.7 ± 2.5 and 9.2 ± 3.7, respectively, compared with 11.1 ± 3.7 in the surgical group (p = 0.00001 and p = 0.02). After restorative therapy, improvements were noted as early as 1 month: in Group 1 – pH 5.2 ± 0.8 and VHI 17.3 ± 2.9; in Group 2 – pH 5.5 ± 0.6 and VHI 16.75 ± 3.0; in Group 3 – pH 5.4 ± 0.7 and VHI 16.7 ± 2.6 (all p < 0.00001, intergroup comparisons p > 0.05), with sustained effect over 12 months. Sexual function normalized: PISQ‑12 decreased from 15.9 ± 6.7 to 12.0 ± 5.0 and from 14.7 ± 6.0 to 12.0 ± 4.7 in Groups 1 and 3 at 1 month, while in Group 2 scores declined from 15.8 ± 4.9 to 9.5 ± 3.5 at later follow-ups (all p < 0.00001).

Conclusion. Patients with CC and EC after radical treatment develop vaginal mucosal atrophy, more pronounced after radiotherapy. This condition can be effectively corrected using HA-based formulations.

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