Gabriela C. Cantarelli , Ana M.H.M. Bianchi-Ferraro , Chayanne Dedonatto , Marcela F.R. Fernandes , Rafaela B. Vanzin , Rita C.M. Dardes , Angela F. Logullo , Joaquim S. de Almeida , Gil Facina , Zsuzsanna I.K. de Jármy-Di Bella , Marair G.F. Sartori , Marisa T. Patriarca , LARF-Study Group
{"title":"对接受辅助治疗的乳腺癌幸存者使用二氧化碳激光、射频和丙炔治疗绝经期泌尿生殖综合征后的阴道进行临床和组织形态学评估。","authors":"Gabriela C. Cantarelli , Ana M.H.M. Bianchi-Ferraro , Chayanne Dedonatto , Marcela F.R. Fernandes , Rafaela B. Vanzin , Rita C.M. Dardes , Angela F. Logullo , Joaquim S. de Almeida , Gil Facina , Zsuzsanna I.K. de Jármy-Di Bella , Marair G.F. Sartori , Marisa T. Patriarca , LARF-Study Group","doi":"10.1016/j.maturitas.2024.108155","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To perform clinical and histomorphometric evaluations of the vagina before and after treatment for genitourinary syndrome of menopause with CO<sub>2</sub> laser, fractional radiofrequency, and promestriene in breast cancer survivors using adjuvant endocrine therapy.</div></div><div><h3>Methods</h3><div>The study included women experiencing moderate to severe genitourinary syndrome of menopause. Following pre- and post-treatment protocols, participants graded their symptoms on a visual analog scale and underwent a gynecological examination to evaluate the Vaginal Health Index and obtain a vaginal biopsy. Subsequently, they were randomized to laser, radiofrequency, and promestriene groups. The energy groups underwent three consecutive monthly outpatient vulvovaginal treatments, while the control group received promestriene treatment for four months, followed by a post-treatment evaluation.</div></div><div><h3>Results</h3><div>Sixty-two women completed the study protocol (21 laser, 20 radiofrequency, and 21 promestriene). While histological differences (vaginal thickness [<em>p</em> = 0.002] and number of stromal papillae [<em>p</em> = 0.004]) were observed between the pretreatment samples of tamoxifen and anastrozole users, the symptoms did not differ between them. A decrease in symptom intensity (<em>p</em> < 0.05) and an improvement in the Vaginal Health Index (<em>p</em> < 0.001) were observed post-treatment, regardless of the type of adjuvant endocrine therapy used. Most pretreatment vaginal samples did not indicate histological atrophy, and no significant histological differences were observed after treatment. No clinical or histological damage was observed.</div></div><div><h3>Conclusion</h3><div>CO<sub>2</sub> laser and radiofrequency therapies could be considered alternative treatments for genitourinary syndrome of menopause in breast cancer survivors receiving adjuvant therapy. These treatments promoted significant improvements comparable to those delivered by promestriene, without histological or clinical tissue damage.</div><div>Trial Registration Number: <span><span>NCT04081805</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"191 ","pages":"Article 108155"},"PeriodicalIF":3.9000,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical and histomorphometric evaluation of the vagina following treatment with CO2 laser, radiofrequency, and promestriene for genitourinary syndrome of menopause in breast cancer survivors on adjuvant therapy\",\"authors\":\"Gabriela C. Cantarelli , Ana M.H.M. Bianchi-Ferraro , Chayanne Dedonatto , Marcela F.R. Fernandes , Rafaela B. Vanzin , Rita C.M. Dardes , Angela F. Logullo , Joaquim S. de Almeida , Gil Facina , Zsuzsanna I.K. de Jármy-Di Bella , Marair G.F. Sartori , Marisa T. Patriarca , LARF-Study Group\",\"doi\":\"10.1016/j.maturitas.2024.108155\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To perform clinical and histomorphometric evaluations of the vagina before and after treatment for genitourinary syndrome of menopause with CO<sub>2</sub> laser, fractional radiofrequency, and promestriene in breast cancer survivors using adjuvant endocrine therapy.</div></div><div><h3>Methods</h3><div>The study included women experiencing moderate to severe genitourinary syndrome of menopause. Following pre- and post-treatment protocols, participants graded their symptoms on a visual analog scale and underwent a gynecological examination to evaluate the Vaginal Health Index and obtain a vaginal biopsy. Subsequently, they were randomized to laser, radiofrequency, and promestriene groups. The energy groups underwent three consecutive monthly outpatient vulvovaginal treatments, while the control group received promestriene treatment for four months, followed by a post-treatment evaluation.</div></div><div><h3>Results</h3><div>Sixty-two women completed the study protocol (21 laser, 20 radiofrequency, and 21 promestriene). While histological differences (vaginal thickness [<em>p</em> = 0.002] and number of stromal papillae [<em>p</em> = 0.004]) were observed between the pretreatment samples of tamoxifen and anastrozole users, the symptoms did not differ between them. A decrease in symptom intensity (<em>p</em> < 0.05) and an improvement in the Vaginal Health Index (<em>p</em> < 0.001) were observed post-treatment, regardless of the type of adjuvant endocrine therapy used. Most pretreatment vaginal samples did not indicate histological atrophy, and no significant histological differences were observed after treatment. No clinical or histological damage was observed.</div></div><div><h3>Conclusion</h3><div>CO<sub>2</sub> laser and radiofrequency therapies could be considered alternative treatments for genitourinary syndrome of menopause in breast cancer survivors receiving adjuvant therapy. These treatments promoted significant improvements comparable to those delivered by promestriene, without histological or clinical tissue damage.</div><div>Trial Registration Number: <span><span>NCT04081805</span><svg><path></path></svg></span>.</div></div>\",\"PeriodicalId\":51120,\"journal\":{\"name\":\"Maturitas\",\"volume\":\"191 \",\"pages\":\"Article 108155\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-11-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Maturitas\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0378512224002500\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Maturitas","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0378512224002500","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Clinical and histomorphometric evaluation of the vagina following treatment with CO2 laser, radiofrequency, and promestriene for genitourinary syndrome of menopause in breast cancer survivors on adjuvant therapy
Purpose
To perform clinical and histomorphometric evaluations of the vagina before and after treatment for genitourinary syndrome of menopause with CO2 laser, fractional radiofrequency, and promestriene in breast cancer survivors using adjuvant endocrine therapy.
Methods
The study included women experiencing moderate to severe genitourinary syndrome of menopause. Following pre- and post-treatment protocols, participants graded their symptoms on a visual analog scale and underwent a gynecological examination to evaluate the Vaginal Health Index and obtain a vaginal biopsy. Subsequently, they were randomized to laser, radiofrequency, and promestriene groups. The energy groups underwent three consecutive monthly outpatient vulvovaginal treatments, while the control group received promestriene treatment for four months, followed by a post-treatment evaluation.
Results
Sixty-two women completed the study protocol (21 laser, 20 radiofrequency, and 21 promestriene). While histological differences (vaginal thickness [p = 0.002] and number of stromal papillae [p = 0.004]) were observed between the pretreatment samples of tamoxifen and anastrozole users, the symptoms did not differ between them. A decrease in symptom intensity (p < 0.05) and an improvement in the Vaginal Health Index (p < 0.001) were observed post-treatment, regardless of the type of adjuvant endocrine therapy used. Most pretreatment vaginal samples did not indicate histological atrophy, and no significant histological differences were observed after treatment. No clinical or histological damage was observed.
Conclusion
CO2 laser and radiofrequency therapies could be considered alternative treatments for genitourinary syndrome of menopause in breast cancer survivors receiving adjuvant therapy. These treatments promoted significant improvements comparable to those delivered by promestriene, without histological or clinical tissue damage.
期刊介绍：
Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care.
Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life
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