The objective of this retrospective analysis was to determine the incidence and extent of vaginal
mucositis (VM) in women with gynaecological
cancer undergoing external (chemo)
radiation therapy (CRT). A retrospective analysis was set up to collect data on the incidence and severity of VM in women treated with external pelvic RT for gynaecological
cancer at the Jessa Hospital, Hasselt and ZOL, Genk, BE between January 2017 and June 2018. At the start and end of their external (C)RT, they rated the frequency and intensity of five common symptoms of VM. Thirty-three patients treated with RT for gynaecological
cancer met the inclusion criteria. A non-negligible proportion of patients already experienced at least one VM symptom to any degree before the start of RT, a proportion that further increased towards the end of the RT (73%). At the end of RT, on average, about 25% of these patients reported moderate-to-severe symptoms (against about 7% before the (C)RT). These results suggest that VM is a rather frequent side effect in gynaecological
cancer patients that aggravates during treatment up to a moderate severity level. Although the small sample size, these data highlight the need for attention to VM.Impact StatementWhat is already known about this topic?
Radiotherapy plays an important role in the treatment of gynaecological
malignancies. A debilitating complication in patients undergoing pelvic
radiotherapy is vaginal
mucositis, an
inflammation of the vaginal mucosal lining. To date, the incidence of vaginal
mucositis is still not well documented.What this paper adds? A non-negligible proportion of patients already experienced at least one symptom related to vaginal
mucositis before the start of
radiotherapy. Most patients presented mild to moderate vaginal
mucositis symptoms at the end of external pelvic
radiotherapy. Burning sensation,
pruritus, and
pain were the most frequently documented
radiotherapy-induced complications.The implications of this paper: Vaginal
mucositis is an underrated side effect of pelvic
radiotherapy that needs to be tackled multidisciplinary by a team of nurses, radiotherapists, oncologists, and gynaecologists. The team should tackle the complication from the start of
radiotherapy by using the most appropriate measures. Due to a possible link between acute vaginal
mucositis and late vaginal toxicity, the team needs to follow-up patient's post-
radiotherapy to support patients in late complications and advise/encourage patients in performing vaginal dilatation to prevent vaginal
stenosis.