ESTRO 2025 - Abstract Book

S799

Clinical - Gynaecology

ESTRO 2025

Purpose/Objective: To evaluate the impact of radiotherapy on sexual health in women with gynecological cancers

Material/Methods: A comprehensive search of PubMed, Cochrane Library, CINAHL, Scopus, Embase, APA PsycInfo and Web of Science was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were searched for studies published from 2000 to August 2024 using MeSH terms and keywords related to "gynecological cancer and radiotherapy and sexual health." Inclusion criteria were all studies reporting on the impact of radiotherapy on sexual health in women with gynecological cancers including endometrial, cervical and vulvar cancers (excluding ovarian cancer) using validated patient-reported outcome (PRO) questionnaires. Comprehensive and systematic reviews were excluded. Data were extracted by two independent reviewers (LH, IV). Results: Of the 828 screened records, 47 studies met inclusion criteria. Most studies evaluated cervical cancer (n=24, 51%), followed by endometrial cancer (n=11, 23.5%) and a mix of gynecological cancers (n=12, 25.5%). The most common study designs included retrospective, cross-sectional and prospective longitudinal studies. A wide variety of patient reported quality-of-life (QOL) questionnaires were used, with the most common being EORTC QLQ-C30, EORTC QLQ-CX24 and Female Sexual Function Index. Increased sexual dysfunction, including dyspareunia, vaginal dryness and decreased sexual desire following radiotherapy was widely reported. Controversial results were reported regarding vaginal dilation +/- pelvic floor exercises; some studies showed reduction in dyspareunia and dryness while others showed no differences. The combination of surgery with radiotherapy +/- chemotherapy was associated with increased sexual dysfunction and dissatisfaction compared to surgery alone. For endometrial cancer patients, vaginal brachytherapy alone was associated with better global QOL compared to EBRT. Despite the large number of studies published, the data shows inconsistent findings and a wide variability in PRO measurement tools. Some studies compared their results to control groups and others to reference population. The main limitations of the studies are the retrospective design, small number of patients, lack of control group, lack of baseline sexual health assessment, low survey response rates and recall or selection bias. Conclusion: Overall, radiotherapy was associated with deterioration in sexual function mainly due to dyspareunia, vaginal dryness and lack of sexual desire. There is poor agreement between physician reported outcomes and patient reported outcomes highlighting the importance in proactively questioning patients about sexual health. These results underscore how sexual health in women is underreported in the literature and emphasize the growing need for proper tools to prospectively report and evaluate sexual health in women with gynecological cancers.

Keywords: Sexual health, radiotherapy, gynecological cancers

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Proffered Paper Chemoradiation and IGBT Alone or in combination with Protein Kinase inhibitor in Stage III Cervical cancer: Results for Phase III Randomized trial. Supriya Chopra 1 , Jayant S Goda 1 , Prachi Mittal 2 , Ankita Gupta 1 , Venkatesh Pai 1 , Sadhana Kannan 3 , Santosh Menon 4 , Kedar Deodhar 4 , Sheela Sawant 5 , Prafulla Thakkar 6 , Manjunath Nookala 7 , Vikram Gota 7 , Jaya Ghosh 8 , Prachi Sawant 2 , Sushmita Rath 9 , Seema Gulia 9 , Venkatesh Rangrajan 10 , Sneha Shah 10 , Palak Popat 11 , Sudeep Gupta 9 1 Radiation Oncology, ACTREC,Tata Memorial Centre, Navi Mumbai, India. 2 Radiation Oncology, Tata Memorial Hospital,Tata Memorial Centre, Mumbai, India. 3 Epidemiology and Clinical Trials Unit, ACTREC,Tata Memorial Centre, Navi Mumbai, India. 4 Pathology, Tata Memorial Hospital,Tata Memorial Centre, Mumbai, India. 5 Department of