Sexual dysfunction and quality of life in cervical and endometrial cancer patients before and after low-dose-rate brachytherapy: a cohort study.

Abstract

Background: Research on low-dose-rate (LDR) brachytherapy for gynecological cancer primarily examines treatment toxicity while overlooking aspects such as sexual desire, arousal, orgasm, satisfaction, and overall quality of life. We assessed sexual function and quality of life in patients with cervical and endometrial cancer before and after LDR brachytherapy, identifying factors related to sexual dysfunction and good quality of life 3-6 months after brachytherapy.

Materials and methods: We prospectively followed a cohort of patients with a histopathological diagnosis of cervical and endometrial cancer who were treated with LDR intracavitary brachytherapy (n = 139). The SyDSF-AP, FACT-G, PHQ-9, and PHQ-15 scales were collected using a self-administered questionnaire before and 3-6 months after treatment. The analysis included estimating incidence rates and conducting a binary multiple logistic regression.

Results: Sexual dysfunction was observed in 14.4% of individuals, with 30% already affected at baseline. Higher education was associated with a decreased likelihood of developing or maintaining sexual dysfunction (OR, 0.10; 95% CI, 0.01-0.97). Physical wellbeing improved after treatment, with scores increasing from 69.3 to 78.7 (p < 0.001; effect size = 0.34). The presence of moderate-to-severe somatic symptoms, major depression, and sexual dysfunction reduced the likelihood of starting or maintaining a good quality of life.

Conclusion: Over 10% of patients experienced sexual dysfunction, with physical wellbeing being the only area that showed improvement after treatment. Research in this area enhances awareness and understanding of how healthcare providers can better support sexual and health-related wellbeing.